December 2016 Health Update

National and Regional Issues

1. National online survey for dementia patients diagnosed in last two years and their carers: This notes experiences of diagnosis, support and awareness.  It is open until 31^st January 2017.
2. London Child and Adolescent Mental Health Services: This service currently has higher waiting times than planned despite increased investment.  This affects achievement of 18 week referral to treatment target for these young patients.
3. Apprenticeships: The Government’s Apprenticeship Reform Programme aims to achieve 3 million apprenticeships by 2020.  The Apprenticeship Levy operates from April 2017.  Employers, both public and private, with pay bills over £3m per year, will pay 0.5% of each month’s pay bill plus 10% from the Government, from which the employer can fund  training costs from registered providers.  The Hillingdon Hospitals Trust has already started 40 apprenticeships and is planning more – health care assistant support workers, a chef, and business and administration workers.
4. Harrow and Hillingdon Mental Health Services: Services in these London Boroughs remain chronically less successful than other areas served by Central & North West London FT.  Under achievements against targets over at least the last four months are attributed to various factors including patients not engaging with the service, staff sickness, staff shortages and poor data quality.

Royal Brompton & Harefield FT

1. Congenital Heart Disease (CHD) Proposals: Following an exchange of correspondence with NHS England and on the advice of Counsel the Trust decided not to launch a Judicial Review on these proposals and it intends to work collaboratively with NHSE throughout the consultation process, but it has written to NHSE notifying it of the Trust’s concerns with its proposals.
2. Recruitment of Harefield Consultants: In line with increasing activity across the Transplant and Mechanical Support service of Harefield Hospital, the Trust is recruiting for two Consultant Transplant and Cardiac Surgeons – one is a new post, the other is a replacement.  It is also recruiting for a Consultant Thoracic Surgeon at Harefield, which is a replacement post.

The Hillingdon Hospitals NHS FT

1. Joint pathology service with Imperial College Healthcare Trust + Chelsea & Westminster FT: Hub (Charing Cross Hospital) and spoke model, began in September, with only urgent tests locally.
2. New outpatient pharmacy: This will greatly reduce waiting times for patients.
3. Blue light ambulances at Hillingdon Hospital: Blue light ambulance concerns have been reviewed as part of an extensive review of pressures on the Urgent and Emergency Care Services at this hospital. A sustained and continuing rise in the volume of high-priority ambulances was considered largely appropriate by both LAS and THH clinicians.
4. Staffing levels: Average fill rates were over ninety percent against planned levels. The need for additional staffing at night, to maintain patient safety and comfort, remained a feature across both sites. Pagget Ward has continued to be used as additional capacity for inpatients in addition to functioning as a day care unit. Compared to last October there was a net increase of 180 whole time equivalent staff, primarily spread across the clinical divisions.

Hillingdon Clinical Commissioning Group

1. Moves towards greater CCG autonomy: All eight NW London CCGs are now applying for fully delegated Primary Care Commissioning, to provide greater autonomy from NHS England from 1^st April 2017, a year ahead of other CCGs. Potential conflicts of interest are recognised as a risk of full delegation but NHS England has produced extensive guidance which prescribes establishment of a Primary Care Commissioning Committee chaired by a lay member and with lay and executive majority to mitigate this issue.
2. Integrated performance: Key performance challenges include London Ambulance Service response times, A&E four hour waits, referral to treatment 52 week waiters, cancer treatment waiters, MRSA, Child & Adolescent Mental Health Services (CAMHS), Musculoskeletal  Community Physiotherapy services  and NHS 111 call back times.
3. Identification of patients with atrial fibrillation: The Board’s application for funding for a pharmacist to identify these patients in GP lists has been successful – so that these patients can be prescribed improved medication to reduce their risk of suffering a stroke. The project is expected to come into operation early in the New Year.*