September 2017 Health Update

National Issues

1. Review of health systems: A US think tank, the Commonwealth Fund, has compared health services in 11 countries including the US, Canada, Australia France and Germany, ranking the NHS top overall, praising its safety, affordability and efficiency – although it was less effective in preventing early death and in its cancer outcomes. This NHS success repeats its success three years ago and is despite the current NHS financial squeeze and lengthening waiting times.

Regional Issues

1. GP prescriptions: The eight NW London boroughs need to save nearly £135m this year, so they are considering the following prescription options:
   (i) Asking patients to buy items that can be bought cheaply without prescription;
   (ii) Asking GPs not to prescribe those items routinely;
   (iii) Obliging patients to re-order prescriptions if needed, to avoid pharmacists doing so automatically.
2. Threat to Royal Brompton: Ruislip Residents has protested loudly about the NHS England plans to transfer Royal Brompton’s Congenital Heart Disease services to alternative hospitals, because Royal Brompton fails its new rule requiring paediatric services to be based on the same site as CHD services. At Royal Brompton these services are provided by neighbouring Chelsea and Westminster Hospital. There have never been any problems relating to these arrangements, all clinical targets are met and both commissioners and regulators acknowledge that there are no concerns about the quality of Royal Brompton’s congenital heart disease services, which remain among the best performing in the country. NHS England also admits this requirement has no basis in evidence and is opposed by many doctors. No Trust in the country meets all the new requirements! If implemented, loss of CHD services would break-up the Brompton research teams, seriously threaten the Trust financially (including Harefield Hospital) through redundancy costs and loss of income, and other Trust services would be impossible without currently shared facilities.

Hillingdon Clinical Commissioning Group (CCG)

1. Shaping a Healthier Future: This is the NW London CCGs’ plan to improve local health services. The next step is to seek approvals from the Department of Health and HM Treasury to access the £500m of capital investment required to deliver this programme. In parallel, a number of outline business cases are being developed for (i) community hubs and (ii) the development of models of care in the community to support changed ways of working in local hospitals.
2. Northwood & Pinner Community Hospital: NHS Property Services sees this site as a key opportunity for early delivery of a new health facility and residential development, subject to the necessary consents and approvals. Planning consultants are already appointed.
3. Care Homes: Hillingdon‘s care homes, and home care market, face difficulties in recruiting and retaining staff, leading to delayed transfers of care from hospitals. To help stabilise the market the Council is requiring providers to pay their staff a minimum rate of £9.75 per hour, the London living wage.

The Hillingdon Hospitals NHS FT (THH)

1. Car parking charges: In September a new system in the Trust’s pay on exit car parks will have automatic number plate recognition, fewer barriers, and payment machines that give change and accept credit and debit cards as well as cash. It is hoped to extend this system to other car parks later but disabled drivers will pay £1 per visit and staff will pay an extra 10p per day.
2. Frequency of Board Meetings: After the July meeting. Board Meetings will take place every two months, instead of the previous monthly cycle – so there are no meetings ahead in August, October or December.

Mount Vernon Cancer Centre

1. Cyberknife: This provides very accurate radiotherapy for cancer patients, and is particularly useful for brain treatments. A most generous donor made Mount Vernon the first NHS hospital in the country to have this equipment, so Mount Vernon clinicians taught others how to use it when it became more widely available. However, recently, NHS England decided to pay for only 17 centres to use cyberknife to treat brain metastases and it invited all centres to apply for this funding. Unfortunately the Mount Vernon application by East & North Herts NHS Trust was submitted unsigned and it was therefore disqualified from consideration – requests to simply sign the application later were refused. So, local patients unlucky enough to have cancer with brain secondaries cannot have local treatment – they have to travel to other sites, and face all the problems which that implies – long journeys, unfamiliar surroundings, repeated tests, staff they do not know and trust. The Community Voice, of which Ruislip Residents is a member, is protesting loudly:
   (i) On behalf of patients;
   (ii) Because not using this donated equipment to the full could deter other potential donors from making similar gifts to the NHS and
   (iii) The Mount Vernon Cancer Centre loses a third of its income from this equipment.*