Peter Latham, Chair of Willesden Patient Participation Group and Member of the Steering Group of Brent Patient Voice, has given permission to Nan Tewari for this extract from his November 2015 Newletter to be published on Wembley Matters as a Guest Blog. It gives an interesting, and at times worrying, insight into current developments in local health provision.
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The national NHS news remains
worrying. Today we have news of junior doctors voting on a strike.
A new OECD report says that Britain now comes low in the international league
tables for most categories of national healthcare. Male expectation of
life at birth comes 14th out of 34, and 24th for
women. Cancer 5 year survival rates are 21 out of 23 nations for cervical
cancer, and 20 out of 23 for both breast and bowel cancer. For surviving
a heart attack we come 20th out of 32 nations, and for surviving a
stroke 19th out of 31 nations. For unnecessary hospital admissions
for asthma or lung disease due to poor care at home we are ranked 22 out of 34
nations. The OECD estimate that to bring the NHS up to just OECD
average performance would require an extra 26,500 doctors and 47,700 extra
nurses at a cost of an extra £5 billion per year. Britain currently
spends £2,100 per person on healthcare, slightly below the OECD average.
Another report this week suggests that one quarter of all cancer diagnoses are
made only when the patient goes to A&E already having symptoms so that
their average survival time is poor.
At our local Brent level there
continues to be much paper activity at Brent CCG but not very much to report
about actual changes put in place.
At the Brent CCG Governing Body
meeting on 4 November 2015 the Deputy Chair Doctor Sarah Basham announced that
the Brent CCG Chief Financial Officer Jonathan Wise is leaving. She did
not give any reason and did not announce a replacement. This is
unfortunate at a time when Brent CCG have moved from an annual financial
surplus to Mr Wise’s report of an underlying financial deficit of about £1.3
million as at September 2015. The CCG has filed a financial recovery plan
as required by NHS England by 31 October 2015. This needs to be set in
the context of an annual budget of about £375 million.
Brent Community Cardiology Service
& other Brent Planned Care projects.
The new Brent Community
Cardiology Service provided by Royal Free London NHS Foundation Trust that
started in March 2015 at the Willesden and Wembley Centres for Health and Care
is improving on many of its early problems. There are now clinics at both
centres each weekday. More specialist cardiologists have been appointed
although not all have started yet. There was a gap in the contract
specification with no provision for diastolic heart failure. The CCG has
now decided to issue a contract variation to cover this when the projected
volume of patients and their needs have been clarified.
I have been appointed as a
patient representative on the monthly contract review group for this
service. The main continuing concern for patient safety is on the 14 day
contract maximum waiting time for urgent cases from GP referral to first
offered appointment. Mr Robin Sharp Interim Chair of Brent Patient Voice
has waived doctor/patient confidentiality in the public interest to reveal that
when referred by his GP for atrial fibrillation in June 2015 his first offered
appointment was with a 62 day wait. No explanation has been given. At the
monthly meeting on 4 November with an agenda item for waiting times as at 30
October no figures were published for current waiting times. It was said
by Brent CCG that the figures will only be published after they have been
verified. So patients have no confirmation that all or any patients assessed as
urgent are being offered a first appointment within 14 days. I requested
the figures ‘subject to verification’ but this was refused. Brent Patient
Voice will now report this problem to Healthwatch Brent with a view to
notification to the Care Quality Commission.
At the Brent CCG Annual General
Meetings on 2 September and re-run on 14 October in answers to my questions the
chair Doctor Etheldreda Kong confirmed that the 2012 ‘Planned Care’ business
case for transferring about 13 specialist adult out-patient services out of
hospital in 5 ‘Waves’ into new community clinics under the slogan ‘Better Care
Closer to Home’ has been discontinued after the introduction of just the Wave 1
new ophthalmology service provided by the commercial provider BMI (who run the
commercial Clementine Churchill Hospital at Sudbury Hill), and the new Brent
Community Cardiology Service provided by the Royal Free whose problems are
reported above.
This project has been currently replaced by much less
ambitious schemes e.g. just for physiotherapy instead of the major Wave 2 new
integrated multi-disciplinary, musculo-skeletal (MSK) service project for which
the procurement was discontinued in March 2015 following which Brent CCG
estimated £713,000 had been spent on it.
Brent CCG A&E Advertising
Campaign: “A&E is for life-threatening emergencies only”.
This advertisement has cropped
up at bus stops in the borough etc and also carried the Brent Council
logo. Brent Patient Voice has complained that it is false and misleading
and made a complaint to the Advertising Standards Authority. BPV has
given examples of non life-threatening emergencies that justify admission to
hospital through A&E e.g. a penetrating eye injury. Brent CCG has
not challenged this and it is notable now that the wording on the Brent CCG
website headline slide show has now been altered to say ‘A&E is for
emergencies only’.
Brent CCG Whole Systems
Integrated Care (WSIC) Project with Brent Council
This imposing sounding project
has run into difficulties from lack of funding. It proposes an integrated
care plan just for elderly people with one or more long term conditions such as
heart failure or asthma. Part of the aim is to reduce the need and cost for
unplanned hospital admissions. A WSIC pilot in part of the borough was
planned to make sure the systems would work. This pilot has now been
abandoned for lack of funds. The current proposal is to start the scheme
across the whole borough in April 2016 without this pilot testing.
Brent CCG Commissioning Intentions
2016/17.
At the Governing Body meeting on
4 November the ‘final’ draft Commissioning Intentions (local health services
purchasing plan) 2016/17 was approved. The plans can be found on the
Brent CCG website and include feedback from the patient involvement and
consultation events including the Health Partners Forum on 7 October
2015. I have been unable to discover the closing date for the online
patient survey.
