Hillingdon Hospital's AGM was actually fun!

................................................Hillingdon Hospital

AGMs are usually dry as dust – but not true for Hillingdon Hospital! Good food and fascinating speakers attracted a big turn-out from the public, with every seat taken.

Of course there was reference to the highlights of the year and rejoicing that the accounts showed a profit, but there were also two special presentations.

The first was about the new Emergency Assessment Centre, which allows GPs to send patients straight into the hospital, by-passing A&E. This is a 24 bed ward staffed by consultants and senior nurses, leading to rapid diagnosis and treatment, and shorter hospital stays. All this is good news for patients.

The second presentation was about the Rapid Recovery Programme for knee replacement operations. Hillingdon is one of only two hospitals in UK using a technique pioneered in the USA that uses epidural anaesthesia and a smaller incision, to facilitate swift recovery. Patients are on their feet within hours of surgery and only spend three days in hospital. One patient in the audience was highly enthusiastic about her two new knees!

Earlier in the day, at the Trust’s Board Meeting, the new cleaning and catering contract for Hillingdon and Mount Vernon Hospitals was awarded to Sodexho from 1st November. Staff will transfer to the new employer, a popular change as Sodexho offers improved employee benefits. It also offers a mammoth 1000 more cleaning hours per week at Hillingdon Hospital, plus food considered superior to the current provision, including a children’s menu not previously available. This is all welcome news. We should see big improvements ahead.
Joan

Health services across London

Finances
NHS hospitals in London are controlling their money better than last year, but seven are still facing problems of huge debts from previous years. Their first aim is to balance this year’s books, with the backlog taking a back seat. However they are not alone - 17 NHS hospitals across the country are described as “financially challenged”

Commissioning
All but two of the London Primary Care Trusts are working together to plan the health services their populations need. Hillingdon PCT is not part of that project, possibly because it has big historic debts. Instead Hillingdon PCT is acting as an NHS guinea-pig by forming links with the private sector to set up and monitor its health service contracts - BUPA is the successful bidder for this work.

Ara Darzi Report
Public consultation on Lord Ara Darzi’s proposals for models of health care across London runs from November to February. Further consultations will come later to consider particular local plans.
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Lord Darzi is now leading a national health services review. To bring London into line with that review, a review of London’s children’s services and mental health services is now taking place. Reports from both are due in December 2007.

18 week national target - maximum 18 weeks from GP referral to
hospital treatment
Some specialties find this target very challenging. Orthopaedics is the worst - only 25% of London orthopaedic patients are currently admitted within the target time. There are many problems to overcome. Complex pathways make it difficult to capture data. Patients may be referred to several hospitals, may face several diagnostic waits and possibly in-patient episodes too. It may be difficult even to identify a start date for the 18 weeks.

MRSA
This is staill a problem across London. It is mainly identified in hospitals but it poses public health and primary care problems too. The number of cases has dropped by almost half in the last year and the average rate in London hospitals is only 1.8 cases in each hospital per month, which gives little margin for variation

First NHS London Annual Report
This is available on request from Tel: 020 7932 3700. Lots of facts and figures are also available in the papers for NHS London’s September Board Meeting, allowing comparison of performance in NHS Hospital Trusts and Primary Care Trusts across the capital.

Joan

West Herts PCT update

Watford Hospital news
On Thursday, the West Herts PCT endorsed the proposals for a new Acute Assessment Unit at Watford General Hospital.

This will be an exciting development, ahead of the long-term plans to rebuild Watford Hospital completely. The main features are:
· Modular build, on three floors, with various specialist services including angioplasty
· Cost is expected to be £36.8 milllion
· The adjacent A&E will be refurbished and car parking improved.
· The AAU will be on the site of the present Post Graduate Centre – but a new PCG will be in place before the AAU construction starts
· The AAU will have 120 short-term beds, increasing Watford’s total beds from 419 to 545. Hemel Hospital will lose all its beds and St Albans City Hospital will gain two. Over all the Trust will lose 122 beds, but demand is expected to reduce as patients living north of Hemel are likely to go to Luton Hospital rather than Watford.
· The Trust hope to save lots of money through these changes and deliver a better service too – we will watch closely.


Finances
· Some patients are going to Harefield Hospital and Hillingdon Hospital rather than to Watford, partly because Watford is finding it difficult to meet the Government’s 18 week target – which measures time from GP referral to start of treatment.
· The PCT is confident it will achieve year-end financial balance.


Performance reports
· Audiology: The backlog at West Herts Hositals Trust will be met by the end of October. Additional capacity has been secured from the independent sector.
· Cancer: Excellent performance continues
· MRSA: There has been around 30% improvement in MRSA from the same period last year.
· Clostridium difficile: Visiting teams at both West Herts Hospitals and East & North Herts Hospitals focused on the need to improve rapid isolation of patients, ward and theatre cleaning, hand hygiene and antibiotic prescribing.


Cancer Services Review
· In response to a question at the AGM, which followed the main meeting, we were told that a national statement on cancer services is expected before Xmas and that the Herts cancer review will be delayed to incorporate the national guidelines.
· It was noted that the Community Voice petition to save cancer services at Mount Vernon had already beaten its 70,000 target, with many signatures from Herts residents. The public wants the review to give re-assurance that cancer services will stay long-term at Mount Vernon Cancer Centre.


Joan

Hillingdon PCT seeks private sector help!

In comparison with its London neighbours Hillingdon PCT spends 11% more of its total spend on hospital services, particularly at Hillingdon Hospital. It can check obvious coding errors in its bills but lacks the expertise to challenge inappropriate procedures and charges – and local clinicians are reluctant to challenge each other because they need to work together.

The PCT therefore explored buying help from the private sector, but only one bid met its needs and that cost too much. It then looked at getting better staff and doing the job itself, but at best that would be a risky business and would take many months to set up. So it considered a hybrid model, increasing its own staff to improve low level monitoring and employing private sector expertise for more complex challenges.

The draft proposal put to the Main Board this week covers three years’ private sector support tied to increased staffing in the PCT to cover less complex work. The Board decided to let its Chief Executive and a couple of its Non-Executive Directors sort out final details. If all goes to plan, the PCT hopes to save £4.9 million over three years and to strengthen its own expertise during that time.

The Board papers did not give the private sector contractor’s name. However a few days ago the Health Service Journal and The Financial Times published articles about the proposals, leaking BUPA as the proposed contractor.

Joan

Petition "Save Mount Vernon Cancer Services" reaches its target!

Yes! We have beaten our target of 70,000 signatures! In fact we already have 72,500 and now our sights are set on achieving 75,000 or more.

It is not too late to add to this splendid total. Next weekend there will be collections at Michael Sobell House, at Waitrose in Ruislip and possibly elsewhere. Let me know if you can help with the Waitrose collection on Saturday, organised by Ruislip Residents Association, as we still need more collectors. Also tell me if you want to run your own collection - but don't delay as time is running out.

We shall go on collecting until the day we present the petition, but that is still to be finalised. Please make sure no petition forms are tucked away in odd corners - we want every signature to reach the final count.

Joan
Tel: 01895 636095

Hillingdon Hospital car parking

Some good news at last for frustrated car drivers!

Hillingdon Borough Council is changing 28-30 car park spaces in the road out side Hillingdon hospital from residents’ parking to public pay and display.

40 additional car parking spaces are also to be made available within the hospital grounds. Work will be completed between August and October.

Joan

Hillingdon and Mount Vernon Hospitals are seeking Foundation Trust status

This is a chance for ordinary people to have a greater say in their local hospitals. So make sure you apply!

Foundation Trust status would give the Trust greater freedom to control its own affairs, but it would still be within the NHS. To become a Foundation Trust it needs around 2,000 local people to become Members of the Trust, who will receive information about the Trust’s plans, will be able to attend meetings with the Governors and Directors, and will elect the Trust’s Governors. ‘Phone 0800 8766 953 for an application form.

More details on our entry for 31st August.

Joan

Mount Vernon Cancer Centre Director speaks to The Community Voice

Peter Ostler, Director Mount Vernon Cancer Centre, was guest speaker at the September meeting of The Community Voice. His enthusiasm was infectious and everyone thoroughly enjoyed his update on Cancer Centre issues.

He spoke of all the exciting developments at the Cancer Centre – the five new linear accelerators, with four already in use and the last one coming into operation in a few weeks’ time, plus wonderful new office and planning facilities.

The Cancer Centre has always worked closely with the Paul Strickland Scanner Centre, but now it has its own MRI scanner, dedicated to radiotherapy planning.

The brachytherapy suite, gifted by two most generous donors, has brought revolutionary new treatment for prostate and other cancers, and cryotherapy can be used for prostate cancers that have not responded to other treatments.

Some things still need to be done. The ward block needs to be rebuilt. IT needs to be strengthened, with improved IT links to other hospitals. The most immediate project is expansion of the chemotherapy suite, which will assist research plans.

The decision not to build a new hospital at Hatfield means that the Cancer Centre is safe at Mount Vernon for the next few years, but its long-term future remains uncertain.

It is still managed by East & North Herts NHS Trust, many miles away in Stevenage, but Hillingdon Hospital now provides anaesthetic cover, as well as being the Cancer Centre’s landlord. Mount Vernon already provides cancer services to a network of other hospitals. Early discussions are exploring the possibility of linking it with another cancer centre, such as the Royal Marsden or University College London.

Despite national shortages, the Cancer Centre has a full complement of radiographers and other critical staff. Physics staff were particularly praised for commissioning the new linear accelerators in record time.

Newspapers recently reported that the UK’s cancer survival rates compare unfavourably with outcomes for its European neighbours. The speaker urged caution in accepting this research. Meaningful comparison needs statistics covering the same time period, with common collection methods. He noted that UK survival rates are constantly improving and that cancer treatment is now subject to national protocols, with little variation across the country – but he stressed that more work is needed to improve early diagnosis.

Note: The Community Voice petition to “Save Cancer Services at Mount Vernon Hospital” now has over 65,000 signatures and is still growing! This shows the strength of local support for this much loved cancer centre.

Joan

West Herts Hospitals - Watford / St Albans / Hemel Hempstead

There was a Board Meeting in public this week. These were the highlights:

1. Finances
The Trust has achieved a small surplus for the second month running – a remarkable turn around after years of spiralling debt. However, whether the target of £5m surplus can be achieved over the while year is still in doubt. Tight control over staff costs is seen as the key thing to watch.


2. Major infections
These are still over target, with 15 MRSA bacteraemias in the first four months of the year. There is now a root cause analysis of every case of MRSA, allied to a staff training programme.

Clostridium difficile cases dropped from 50 in June to 36 in July. Antibiotic prescribing is being closely controlled and peroxide nebulisers are being used to disinfect isolation rooms. Isolation of patients is seen as a key factor to reduce infection.


3. Staffing issues
The Trust had a staff of 3,322 employees in July, down by 160 since last November. Use of agency staff has reduced too, down now to around 2%.

Chief Executive, David Law , reported that staff concerns about A&E staffing levels had been addressed by further discussions with unions and staff. Staff numbers in A&E now match levels in similar hospitals.


4. Targets
Only audiology patients now wait more than 13 weeks for diagnostic tests, but extra staff should clear the backlog by October. However, cancelled operations are still above target and complaints handling is recognised as needing big improvements.

Cancer services are meeting all target times. Gordon Ramsey, Medical Director, suggested that better survival rates in Europe are due to earlier diagnosis and centralisation of cancer services.


5. Scoring on surveys
All three sites were rated acceptable or above for food, cleanliness and privacy/dignity. St Albans City Hospital was rated good for all three factors. Introduction of “Steamplicity” food was warmly welcomed by patients at Watford Hospital and extending this system to St Albans Hospital is under consideration, but set-up costs are expensive.


6. Elective surgery
Work at St. Albans City Hospital is nearing completion. Patients from across Herts. will undergo elective surgery at that hospital from next month.



Joan

Harrow PCT Board meeting 4 September 2007

Harrow PCT Board Meeting, 4 September 2007

(only main points of interest, not a complete record)

The agenda was huge, about 3 centimetres thick, but mercifully more than half of the items were ‘Information Only’, without discussion. So the chairman was able to drive the meeting through the other items in just over 90 minutes. There were 5 members of the public in attendance

‘Healthcare for London’ and the ‘North West London Strategy’ were probably the most important items. The first of these was largely administrative, to set up the joint committee of London PCTs to set up the consultations discussions to deal with the Darzi report. So, this was setting up the terms of reference and the rules of procedure for this joint committee. It is proposed to include some of the PCTs from just outside London, as frequently some of their patients use London services (just as we make us of West Herts). The NWL Strategy document was produced by the ‘Clinical Reference Group’, a body consisting largely of senior medical staff of the hospitals. They have 9 ‘commissioning intentions’
Unscheduled care
Long term conditions
Paediatrics
Obstetrics
Standardising Clinical Practice
Primary care
Cancer Services
Senior Level Commissioning
Acute Care
It was noted by the public that there was no mention of Mental Health and that Cancer Services did not actually appear in the document either. There were several comparisons of how activities in NW London compared with national figures for these, with indications of what could be achieved if local practice could achieve national average figures – forgetting that if NWL figures were to be at the same level as the current national averages then the national figures would be lower. It seems me that the medics do not understand arithmetic.
There was a long paper on ‘Commissioning Strategy’, with concerns about health inequalities across Harrow, ignoring that some of these are due to the ethnic background (and hence the genetic make-up) of the community.
In answer to a question about the current measles outbreak, we were told that there were about 10 cases in NW London, 2 of them in Harrow, but that figures for North and North East London are very much higher (over 100).

Paul Samet
5 March 2007