This page will contain local overview information, such as reports on local NHS services from Hillingdon’s External Scrutiny Committee; this Committee is set up by Hillingdon Borough Council and all its members are Hillingdon Councillors.
The page will also contain information about neighbouring NHS services, including Northwick Park Hospital and Watford General Hospital, which are sometimes used by Hillingdon residents.
RAFT's Open Day on 16th May, for invited guests only as its premises are small, heard about its fascinating current research. Its aim is always to meet the needs of patients - to help skin to heal, to avoid scarring problems, to assist use and function of artificial limbs, and to combat the deadly effects of ultra violet light in causing skin cancer. It works closely with the NHS and most of Britain's plastic surgeons have passed through its doors as trainees. Click here to learn more from RAFT's website.
This meeting of the Committee focused on a performance review of local NHS Trusts. Subsequent to abolition of the previous Annual Health Checks, local authorities are now encouraged to send evidence to the Care Quality Commission (CQC) about local adult social care, as well as health and mental health services, on an ad hoc basis.
In view of the breadth of the remit, a large number of eminent speakers were present, representing all local providers of NHS services. Witnesses were present from the Care Quality Commission, The Hillingdon Hospitals NHS FT, The Royal Brompton & Harefield NHS FT, Central & North West London NHS FT (which now provides Hillingdon’s community health services as well as mental health services), together with NHS Hillingdon (the main commissioner of local NHS services), the London Ambulance Service, and the Local Dental Committee.
Since The Community Voice, of which we are a member, monitors developments in all the above organisations, there were no great surprises in the reports that were presented. However, some items of interest were confirmed.
Keith Bullen. on behalf of NHS Hillingdon, reported that this Primary Care Trust is still trying to absorb / offset a financial shortfall of £19m for 2010 –2011.
Claire Murdoch, Chief Executive CNWL, noted that her trust employs over 5,000 staff of whom 1095 are Hillingdon based. Her trust is concerned about delayed discharges from inpatient care in Hillingdon, due to difficulties in making appropriate arrangements for care in the community when patients leave in-patient care.
Councillors asked searching questions. At the end questions were also invited from people in the public gallery. The most interesting concerned the importance of carers to the NHS, which was not touched on by any of the reports – an enhanced perception of the importance of carers is needed throughout the NHS.
Executive and Non- Executive members form teams to visit wards and departments in the Trust’s hospitals.· Before each Board Meeting one of these pairs makes informal visits and then reports are given to the Board as the first item on the agenda.· This has proved very valuable as staff are happy to raise issues and discuss local problems – a two-way communication strategy that benefits everyone
The Trust is either meeting all its targets or is within a whisper of doing so.· It expects to end the financial year with a small surplus, possibly a little less than planned, but in a world when many NHS bodies are struggling it is doing very well.· The DoH has accepted for consideration its application for foundation trust status – an important milestone in the process.· It is a real pleasure to see the Trust thriving
MARK EASTON NOTED NHS ADVANCES
Mark Easton, Chief Executive Officer NHS Harrow, reviewed recent years in which the NHS budget rose from £34.7 billion in 1998 to £102.3 bn this year, providing 26% more nurses, 12% more midwives and 58% more doctors – a total now of 1.4 million staff. Waiting times are much shorter, there are more effective drugs, and better organisation in key areas. He used stroke services as an example. Concentrating services in eight London hospitals was contentious, but London now has one of the best stroke services in the world, which is expected to save 500 lives per year.
THEN CAME THE CRUNCH
Looking ahead, the country’s massive deficit of £109 bn forces everything to be cut back. The NHS is less hit than some sectors, but tough decisions lie ahead. The number of North West London managers is being cut by two-thirds, with eight management teams merging into three, but that alone is not enough. People will have to be cared for in more efficient ways and old methods that are not based on evidence must be scrapped.
SO WE FACE CHANGES
PCTs are to be abolished by 2013 with a major transfer of power and responsibility to groups of GPs who will be responsible for the whole budget. Their hard decisions must relate to their community’s needs, rather than the needs of individuals, like the PCTs that they will replace. They will need management teams to help them.
Every NHS hospital trust has to be a Foundation Trust by 2014, or face merger or takeover by another provider - from the NHS, private or voluntary sector. Monitor, the NHS economic regulator, will promote competition. Undoubtedly the private sector will grow.
AND HARROW HAS PROBLEMS
NHS Harrow, with a budget of over £340 million is facing a year-end deficit of £16m. Over the last three years its income has grown by 15% but expenditure has grown by 27%. Hospital spend has increased by 40% - at Great Ormand Street and Chelsea & Westminster hospitals by over 100%! Private spend has increased from almost nil to over £3m. All this despite better access to primary care services, including three walk-in centres – so investing in community services has not reduced expenditure on acute services as planned. This cannot continue – books must be made to balance. Some changes are already underway but other difficult decisions lie ahead.
BUT OPTIMISM PREVAILS
He ended on an optimistic note. He believes the founding principles of the NHS will endure and that in Harrow there are both strong GP leaders and an engaged local community to make that happen.
FOUNDATION TRUST APPLICATION:
Still no decision from the Department of Health about when the Trust can hope to become a foundation trust.NEW BLOOD TESTING SYSTEM:
NEWS ON PRESSURE ULCERS:
Staff have introduce a cardboard clock system placed at the bedside of vulnerable patients, which shows when they next need to be moved. Simple but effective!2010 OUT-PATIENT AND MATERNITY SURVEYS:
The Trust was greatly encouraged! It moved from being in the worst four in the country in the 2009 Out-Patient Survey to “substantially average” in 2010, a dramatic improvement – and it was better than the national average for 67 of the 73 questions in that survey. There was also significant improvement in the Maternity Survey, where it was better than the national average for 66 of the 76 questions.
The Trust has received an award for its patients’ experience in the “Going for Gold” campaign and it is short-listed for the Health Service Journal award for patient safety in relation to surgery.
FINANCES:These are sound too, with a predicted surplus of £7.5 million for the year ending in March 2011.
The White Paper on Health was this meeting’s focus. Nine stakeholders were invited to attend. Robert Creighton and Peter McKenna LAS gave apologies, but the following gave evidence:
Dr Ellis Friedman, Joint Director of Public Health / Dr Tony Grewal, Medical Director of Londonwide / Adam Crosby, Operations Manager London Ambulance Service Hillingdon / Kevin Byrne Head of Policy LB Hillingdon / Linda Sanders, Director Adult Social Care & Housing LBH / Keith Bullen, chief Operating Officer NHS Hillingdon / Maria O’Brien, Managing Director Hillingdon Community Health
The following points emerged:
GP Consortia: Nationally 52 GP consortia have signed up as pathfinders to manage their local budgets and commission patient services. Eight London pathfinders have already been approved.
PROPOSED MERGER OF NORTH WEST LONDON NHS HOSPITALS TRUST WITH EALING NHS TRUST:
Northwick Park Hospital is in Brent - but is so close to the Harrow border that it serves Harrow too - which has no acute hospital within its own area.
NORTH WEST LONDON HOSPITALS NHS TRUST
Northwick Park Hospital is one of the two hospitals forming the North West London NHS Hospitals Trust – the other hospital is the Central Middlesex Hospital. This Trust has serious financial problems, which will stop it becoming a foundation trust.
EALING HOSPITAL NHS TRUST
Ealing NHS Trust also has problems because it is too small to stand alone as a foundation trust.
WILL THEY MERGE?
These two trusts are now exploring a merger, hoping that they will be able to achieve foundation trust status by working together. At recent Board meetings, both Trust Boards agreed to develop the strategic outline case for the proposed merger.