Dr Susan LaBrooy is the unpretentious Medical Director of Hillingdon Hospital - who knows how to captivate an audience.
She covered a huge amount of material. She explained that single room accomodation in hospitals is often contentious, but only until people know all the facts. Most opponents fear isolation but are reassured when they hear that nurses will work differently, each based with their own patients, not at a central desk. Nurse contact time with patients will increase. Friends and family can visit freely too and can even stay overnight in the patient's room. Rooms have en suite WCs and showers. Medication is held in the room with the patient, reducing the risk of errors. Patients get a good night's rest with less noise and infection risk is greatly reduced.
In both the private sector and the USA, single room accommodation is the norm, but in the NHS this is new. Kidderminster Hospital has 100% single room wards but that hospital provides only elective procedures. The current NHS requiremnt is that all new hospitals must have at least 50% single rooms. Hillingdon is expected to be the NHS pioneer with its proposal to build its new hospital with all single rooms for both elective and emergency care.
Because it is at the cutting edge of new design, the NHS has agreed to fund a pilot ward in Hillingdon Hospital ahead of the final plans for its rebuild. This pilot will have three wings, each with a different single room design. This will allow both staff and patients to sample the options and to comment on what is good or bad. Research on outcomes will then be used to guide plans for both Hillingdon and other hospitals in the NHS. If the patients do not like it we are assured it will not be built!
We also learned that the demand for hospital beds is constantly reducing and wards are gradually being closed, so Hillingdon Hospital will be much smaller when it is rebuilt. Improved surgical techniques, such as key-hole surgery, are less invasive so patients recover more quickly and stay less time. Most surgery is now day-surgery, not requiring over-night beds. Conditions formerly addressed by surgery can now be treated with the improved drugs available. The need for beds in Hillingdon Hospital will reduce still further next year, when the Mount Vernon Treatment Centre opens.
Mount Vernon is increasingly taking over elective surgery from Hillingdon Hospital, which avoids competition with emergency surgery, so fewer operations are cancelled. Hillingdon Hospital's long links with Mount Vernon Cancer Centre are being strengthened too. From this month it will take over all responsibility for anaesthetic cover for the Cancer Centre from East & North Herts Hosital. This makes sense because that hospital is miles away in Stevenage.
The vision for Mount Vernon's future includes new buildings replacing old, with the world-class Cancer Centre at the heart of a thriving health village offering a wide range of services. Linkages to other cancer centres could support Mount Vernon’s work.
Let's hope that vision is fulfilled and that the Cancer Centre is not whisked away to distant places - sign our petition to make clear that you want it to stay in its present home!
Next our speaker turned to wider issues for the 21st Century,
starting by noting that Hammersmith Hospital, St Mary’s Hospital and Imperial College are forming an Academic Health Science Centre, to make London equal to other world-class leaders.
Patient care will radically change. High technology diagnosis, early interventions, better drugs and minimally invasive treatments are constantly improving care. Cancer will increasingly become a chronic disease. Information technology will transform treatment. Already X-rays are digital and can be displayed on computer screens – so no more missing X-rays! Already Hillingdon has its own MRI scanner, greatly benefitting its new strokes service. Stem cell research promises major changes. Lastly, patients will increasingly be in charge of their own pathway, with swift access to advice when needed, rather than being monitored through routine hospital appointments.
Of course new hospitals must be cost-effective, which early Private Finance Initiative schemes were not. Good value must be achieved when spending public money. Also Primary Care services must provide cover for early discharges from hospital - but in Hillingdon the current number of beds is only a few more than is planned for the new hospital, so problems should be minimal.
Taking so much change on board is challenging, but the prospect is exciting too. We came away from the meeting encouraged and inspired. Now we must be patient, while it all falls into place. In the mean-time - sign our petition!
Joan
. .Professor Yi Mien Koh
