Comments please!

Having checked our ‘Visitors Statistics: communityvoicehealth.org.uk’ I find that we average “170 Hits a day”. This is great news; some one out there in cyberspace is watching what we do!!

Hits for August were 4,075, September 4,902, October 5,284 and this month, November, 4,809. Since December 2006 there have been 51,545 hits. Our record was in March 2007 with an average of 260 hits a day with a total for that month of 8,083 hits.

Why are we having so many hits? Could they be web surfers or people who are really interested in finding out what The Community Voice is doing. Maybe, like me, people have Community Voice as their “Home Page” which would register as a hit even if I moved straight on to another site, I doubt it.

Further investigation reveals that we are getting hits from many countries. 45% from the USA, 35% from the UK, 7% from Spain and the remaining from other countries around the globe. People found us by using search engines such as Google, Yahoo, Ask and their own servers search engine. They looked for various subjects or items we covered such as, PCT meeting, Ara Darzi on health care for London, Mountwood Surgery, Minor Injuries unit, Mount Vernon Hospital, Cancer etc., all subjects we have covered in our meetings and on the website.

One thing that is sadly missing is “comments from our visitors”. None of the items we have covered have comments. It is simple to do, just click on the ‘comments’ at the foot of the item, fill your comment in the box, choose an identity, you do not need to sign up, then just publish your comment.

Thank you

Donald

Health Service Journal Awards 2007

Health Service Journal Awards 2007

The Health Service Journal is a weekly publication, widely read by NHS personnel. Each year HSJ Awards are presented for excellence within the NHS, in a wide range of categories. This year there were over 1000 entrants. We have no idea how many came from our area but two local Trusts were finalists, which is an honour in itself as competition is fierce. The three levels of category success are “Winner”, “Highly Commended” and “Finalist”.

Central & North West London Foundation Trust was a finalist in two categories - “Mental Health Innovation” and “Patient-Centred Care” – both related to a project that helps service users to take an active part in managing their own conditions.

Royal Brompton & Harefield Trust was a “Good Corporate Citizenship” finalist - it buys fresh local food, which is healthier for patients and provides local employment too.

Two other NW London hospitals achieved awards. Imperial College London and St Mary’s Trust were highly commended for “Patient Safety” and Hammersmith Hospitals Trust was a finalist in “Improving Patient Access”.

Congratulations to all these Trusts! We rejoice in their success.

Joan

NHS East of England's November Board Meeting

This SHA covers a huge area - from the Wash, down the coast to Essex and right across the country to the Mount Vernon Cancer Centre in Northwood. Its Board meets in Cambridge, which is a long way for us to go, but last week we managed a “first” by being represented in the public gallery, to hear its proceedings.

There was nothing about the Mount Vernon Cancer Centre and little about Watford Hospital or SW Herts services, except to note the poor Health Care Commission ratings of the Hertfordshire Primary Care Trusts and particularly the West Herts Hospitals Trust, with the subsequent resignation of that Trust’s Chief Executive, David Law. (As noted in our previous entry).

We heard about Lord Ara Darzi’s review “Our NHS Our Future”, which applies across the country except for London. The SHA is required to set up 8 Clinical Pathway Groups - Maternity and New Born / Children / Staying Healthy / Planned Care / Acute Care / Long Term conditions / Mental Health / End of Life Care. These Groups must report on a national timetable with draft clinical pathway reports by mid December and final reports by mid January. The SHA has to report its vision for the future by February.

As in London, MRSA and clostridium difficile are causing concerns. Policies for reducing infection are similar too, featuring: Hygiene issues / Isolation and cohort nursing / Appropriate antibiotic prescribing / Deep cleaning / Care of lines and catheters / Screening proposals / Policies for care in the community – with support from PCT and SHA intensive support teams.

The best news was that this year the region expects to deliver a surplus “for the first time in living memory” (words quoted from the Chairman’s Report). All its PCTs expect to be in financial balance by March 2008

At the end there was a slot for public questions and we asked for information on when the Hertfordshire Cancer Services Review is expected to take place, noting that the 76,000 signatures in our petition show that local people want cancer services to stay at Mount Vernon. Later we received a phone call to update us – it seems the Cancer Review is still some way off, possibly being launched in April or May 2008.

Joan

Update on Hertfordshire's Acute Services Review

A major event was held on Monday to update over 100 community representatives on the responses submitted to public consultation on the Herts. Acute Services Review, which ran from June to October 2007.

Over 6000 questionnaires were returned, also 300 letters/emails and 330 ‘phone calls. The NHS held 19 public meetings and provided speakers at over 160 community events. 1400 NHS staff attended internal events.

Some topics were raised many times: Travel and access to services / Emergency care / Preference for local services / Maternity services / Urgent care centres / Capacity of PCTs to take on new roles / Population growth / Exclusion of cancer services from the consultation.

Specific West Herts issues were: Children’s services / Birthing Unit at Hemel Hempstead / Infection control / Accessibility / Traffic problems around Watford General Hospital / Exclusion of Hemel Hempstead as an option for acute care.

All responses were analysed. Relatively few people responded from Watford and St Albans areas but responses were high from Hertford, Hitchin and Welwyn.

More people wanted the major hospital in East Herts. to be the QEII Hospital in Welwyn, rather than the Lister Hospital in Stevenage - but many more people responded from the Welwyn area. Unsurprisingly, most people wanted services to be near home.

Most people agreed that elective surgery should be provided at St Albans rather than at Hemel Hempstead.

There were seven workshops during the event, so participants had a chance to air their views on many aspects of the consultation. Common concerns from all the workshops were a) The need to communicate well, so that the public knows what is available and how to get help and b) The need for good transport facilities, so that patients, visitors and staff can access available health services.

Feedback on the public consultation and this event will go to the East of England Strategic Health Authority and the two Hertfordshire Primary Care Trusts. Decisions are expected at a special meeting to be held in public in mid December 2007 - possibly 19th December. When the date is confirmed, the final consultation report will be published on www.enherts-pct.nhs.uk/consultation

Joan

Is there now a ray of hope for West Herts Hospitals?

...................................Watford General Hospital

All has been doom and gloom for this NHS Trust for years. Last month, because of its bad national ratings, its Chief Executive resigned (see our 26th October web entry). Now suddenly things are looking up, too late to help David Law, too late probably to make much difference to the Trust’s ratings next year, but none-the-less a turn for the better.

The Trust’s finances start to look under control, with a small surplus reported this month and good evidence that it will achieve its target of £5m surplus by the end of the financial year.

An experienced interim Chief Executive has been seconded from the top of the NHS, Jan Filochowski.

The St Albans Elective Centre is now open, providing capacity for more surgery, more potential to earn money and ability to meet waiting time targets without sending patients to costly private sector competitors, as was previously necessary.

Infection control is also improving, helped by receipt of a £315,000 grant. Infection wards have opened at Hemel and Watford Hospitals. New cases of infection are isolated within three hours. Zero tolerance of hand hygiene breaches is now the rule – staff who err twice will be fired! All patients are to be screened for MRSA before admission. Antibiotic prescribing is severely restricted, to reduce cases of clostridium difficile. Surely infection rates will drop soon?

As a further morale boost, the recent Healthcare Commission visit went well. All issues raised during the Commission’s August visit had been addressed and ward cleanliness was praised.

Other snippets from this week’s Board Meeting also gave encouragement. Weekly patient satisfaction surveys have been introduced. The League of Friends now provides an emergency pack for patients arriving in hospital without soap etc. Sponsorship has enabled production of a bedside folder, to provide in-patient information. Around £1m is to be spent on essential improvements to staff accommodation.

There does at last seem room for optimism. We will watch the future closely, with our fingers crossed!

Joan

A good start to December ....

So, when do we meet again? Our next meeting is on Thursday 6th December at 7.45pm in the Post Graduate Centre at Mount Vernon Hospital.

It should be a good meeting. Our guest speaker is David Houlihan-Burne, Consultant Surgeon at The Hillingon Hospital. He is to speak on his own specialty, under the heading of "Good news for new knees!". At his own hospital's AGM he had the audience totally under his spell, so we hope he engenders similar magic for our December meeting.



To celebrate the festive season, we will be keeping business to a minimum to allow time for us to enjoy mince pies, seasonal drinks and time to socialise together. Altogether we hope this sets off December to a flying start.



Joan

Mental health services - the Cinderella of the NHS?

At our November meeting, last week, our guest speaker was Claire Murdoch, Chief Executive of Central & North West London Foundation Trust, speaking about mental health services.

One of our own members called mental health services the Cinderella of the NHS, but the enthusiasm of Claire Murdoch almost blinded her audience to the real stigma and discrimination that surrounds the service her Trust provides.

No service could have a better advocate. She is relatively young and eye catching. Above all she oozes a vigorous approach to the world that she leads and she says she loves her job.

She told us that one in four people will suffer mental illness at some time in life. Many prison inmates are suffering from mental illness. Mental health maladies can strike at any time from the cradle to the grave. But episodes of mental illness can be overcome and patients with long-term conditions can be helped to live fuller lives despite their illness.

Mental health patients find real difficulty in obtaining employment, so many are homeless and friendless. The old system provided safety and asylum, often in beautiful surroundings, so its passing is mourned by some - but many people were locked up for life simply for becoming pregnant outside marriage or for minor misdemeanours in youth. There are big improvements today.

She believes that good control of finances is the key to providing high quality services. She should know, as her Trust has an annual income of £200m, employs 3,500 staff on more than 100 sites, and yet manages to achieve a Healthcare Commission rating of “Excellent” for quality of its services and “Good” for its management of resources.

Her Trust provides mental health services in Kensington, Chelsea, Westminster, Brent, Harrow and Hillingdon and for substance misuse also for Ealing, Hounslow and Hammersmith – for these services it is the biggest provider of services in the UK and probably in Europe too.

Her Trust has Foundation status but it needs more members – she left us piles of application forms. Membership brings no obligations but permits members to receive newsletters about the Trusts activities and allows members to vote for and to stand as Governors of the Trust. Get in touch with the Trust, or with us, if you want details on how to become a member.

In answer to questions we learned that the Trust seldom receives offers of help from volunteers, but such offers are most welcome. If they can get volunteers to help them the Trust will set up Sunday cafes so that in-patients and their visitors can have somewhere to go on quiet Sunday afternoons. Is anyone inspired to offer to help?

We took our speaker to task on the issue of her Board holding its meetings in private – of which we strongly disapprove – but she assured us this is under review. We hope she may be influenced by all that we said to her on this issue.

She was a delightful and informative speaker and we look forward to her coming again at a later date. Mental health services are lucky to have her!

Joan

Hillingdon is a guinea pig for the NHS

Hillingdon Primary Care Trust’s huge financial deficit – over £50million – has led it to being singled out to pilot the Department of Health’s new ideas for using the private healthcare sector to help control how NHS money is spent.

Primary care trusts “commission” NHS services – a catch-all term to cover planning what services are needed, setting up contracts to provide those services and paying for the services that are actually provided.

The DoH has picked 14 private sector companies to appear on a list, which it hopes will be used by primary care trusts to help them in their commissioning role. This list is part of the recently launched Framework for procuring External Support for Commissioners, usually shortened to FESC.

Hillingdon PCT is the first to try out this new idea. It has agreed to employ BUPA to help assess local healthcare needs and to manage and analyse its hospital contracts. The PCT will pay BUPA £350,000 a year for three years and it hopes that over that time BUPA will help it to save £11m.

The DoH has been closely involved in all the preliminary planning, so it was a great shock that when it came to signing the BUPA contract the DoH suddenly demanded nine weeks to scrutinise the contract before saying “Yes” or “No”.

The PCT was aghast - its only hope of meeting its crucial DoH target to break even financially in the year ending March 2008 depends on immediate savings. A delay of nine weeks would be akin to suicide! So last Wednesday the PCT Board agreed to sign a three month interim contract with BUPA costing £100,000 so that work can start on Monday.

The whole NHS will watch the outcome of this project. The long-term aim is for the PCT both to save money and to learn how to manage its affairs. The PCT hopes it will then be able to cope on its own, without BUPA – but I wonder whether BUPA has other ideas?

Joan