April Board Meeting in public of East & North Herts Hospitals

Board members were asked why they had not applied sooner for Foundation status? The short answer was that they had to sort out financial problems first. Also, what would happen if they failed? They did not think that likely.

Next month there will be a paper on the new Board structure – they will view themselves as a product-led organization.

There is a new Stroke Service at QEII Hospital in Welwyn, covering the whole of the Trust’s area. There will be an analysis in 3 months to assess its impact on A & E and the CCU. It has not yet been given press publicity as it has only been running for 3 weeks and they want to be sure there no problems - but the ambulance service is taking patients there already.

It costs the Trust £1.5m per year to repay a Dept. of Health loan. The Trust would prefer to pay it off quickly but this is not allowed.

An additional CT scanner is being installed which is needed to meet the 18 weeks waiting time and will also screen out inappropriate referrals to cardiology. The Chairman asked (as Devil’s Advocate) if one, why not two? The answer, surprisingly, was not principally money, but space.

There was quite a bit of talk about Mount Vernon – there is no doubt the Board is proud of its achievements there. The Cancer Centre generates a significant contribution to the Trust’s “profit” but it has an “underspend”, partly due to difficulty in recruiting technical and scientific staff. However, a large amount of surplus money is to be invested in Mount Vernon.

The Trust conducted a Health & Well Being Survey and of the staff who responded, 35% said they had experienced violence or aggression during the last year.

Jean Dixon

Hillingdon PCT achieves success - at last!

Finance: For the first time in five years this PCT has broken even! It was warned that it will have tough time in 2008-09 to keep up the good work – but even so, this is a triumph.

Targets: It also met other end-of-year national targets, in which it is jointly responsible with Hillingdon Hospital. The target for treating patients within 4 hours of arrival in A&E was reached and the targets for treating patients within 18 weeks of referral from GPs.

However the MRSA target was too tough, even though total cases in the year dropped from 37 to 31. The target required the hospital to reduce its originally low rate to a point where it would have been one of the best nine in the country! It is appealing that this target was unfair.

Polyclinics: Yiewsley is the PCT’s area of greatest need and the PCT is considering options. Local GPs are willing to co-operate so it has potential for a polyclinic of some kind. However in other areas GPs have serious reservations about polyclinics, fearing loss of local surgeries and take-over of polyclinics by private companies. Patients have reservations too – they like GP surgeries to be close to home.

New Renal Unit in Hayes: This Grange Road Unit will be open 7am to midnight, 6 days per week, providing more than 100 slots for local patients – a wonderful new facility!

Patient Choice: Patients can select secondary care at any hospital listed for “Choose and Book”. If hospitals cannot meet 18 weeks targets they should not be listed – but some possibly are. If a patient is likely to wait over 18 weeks it is the PCT’s job to find somewhere else – but the patient can choose to wait. The PCT is then exonerated from its duty. (This is different from what the Board was told last month!)

Joan

Hillingdon Hospital's Rebuilding Plans

The Hospital’s Chief Executive, David McVittie, addressed Hillingdon PCT at its April Board Meeting.

He stated that the condition of the Hillingdon Hospital estate is a threat to the Trust’s future, so it would like to start rebuilding the hospital immediately. However, it is deterred by Monitor’s opposition to it doing this before it becomes a foundation trust.

The Trust proposes a phased programme starting with demolition of the buildings around the annexe corridor in 2008-09 and over the next two years, followed by replacement of the Tower Block and podium.

The number of beds is still under debate. The minimum plan would be to keep the best of its old buildings, with 150 old style beds, plus 200 new single bed rooms, at a cost of £150m.

The Trust will provide elective surgery, particularly orthopaedics at the Mount Vernon Treatment Centre, which is due to open in January 2009. It plans to develop bi-lateral knee replacement, spinal and sports injury services and to bid for providing primary care musculo-skeletal services for the PCT .

It is also committed to maternity services and it expects the number of deliveries to exceed 4,500 by 2011-12.

Joan

Andrew Lansley MP, Shadow Minister for Health,

Andrew Lansley MP, accompanied by Nick Hurd MP, had a top brass reception at the Mount Vernon Cancer Centre today. E&N Herts Trust manages the Cancer Centre so its Chairman, Richard Breazley, was there, together with his Chief Executive, Nick Carver, plus Peter Ostler, the Cancer Centre Director, and Susan D’Arcy, Radiotherapy Manager – and me. Having explained that Nick Hurd had invited me, everyone was very gracious about me being there.

When the two MPs arrived, introductions were made, and we all set off on a full tour of the Cancer Centre. In walking from section to section a number of informal exchanges ensued, which were informative and interesting.
In addition I was accorded the privilege of a few minutes with Andrew Lansley ahead of his private meeting with the Chairman and Chief Executive. I thanked him for coming, expressed the concerns and commitment of local people to retention of cancer services on the site, and made clear that The Community Voice welcomes support from all political directions, despite our own non-party political stance. As Shadow Minister for Health, Andrew Lansley could be a very powerful ally.

This was an unusual opportunity to exchange views with influential people and I have emailed my thanks to Nick Hurd for making it possible.

Joan

Maggie's Cancer Home opens near Charing Cross Hospital

To play the Video, Click the arrow. Turn up your sound.

A new concept in the care of newly diagnosed cancer patients opened near Charing Cross Hospital. On the BBC News.

Donald

West Herts Hospitals start to crow!

Success is sweet. If ever a Hospital Trust had a right to crow – this is it! From an abysmal start early in 2007-08 the Trust has pulled itself up by its boot-straps to come out of the mire.

For the first time anyone can remember it ends the year with a financial surplus - only £2.5m, peanuts in NHS terms, and of that only £0.8m likely to be recurrent, but none the less a fantastic achievement.

As for national targets, once as remote as pie in the sky, in A&E the current rate for seeing patients within four hours is above the 98% requirement and the whole year average misses target by only 0.3% - amazing! The 18 week target between GP referral and treatment has been met for out-patient treatment - 90% success today versus 60% earlier in the year. For in-patient treatment, earlier in the year the Trust stood at only 30%, but by end of March it was achieving the milestone target of 85%!

Targets for infections were breached long ago – but huge efforts have resulted in the Trust now being within monthly target for MRSA and clostridium difficile cases are reducing every month. A stringent hand hygiene policy has resulted in a written warning for a senior doctor – offend again and he will be out! - and three junior doctors have been warned too.

Last year the Trust had the damning distinction of being worst in the country for Annual Healthcare Commission Ratings with “Weak” for both “Quality of Service” and “Use of Resources” - but not again this year. Today it is confident of “Fair” for both, with even a possibility of a “Good”!!

The Chief Executive, Jan Filochowski, is guest speaker at our meeting next Thursday, 1st May, at 7.45pm in the PGC Mount Vernon Hospital. Come along and hear what he has to say. He is a mild-mannered man – but something tells me that on this occasion he might even be heard to crow!

Joan

Showcase of Hillingdon Primary Care Providers' Services

It was called a showcase and it was a splendid affair, showing the breadth of work and the dedication Hillingdon Primary Care Services give to their patients.

Today’s event at Barnhill Community Centre provided many exhibits, many chances to talk to front-line staff and a rare opportunity to hear Christine Beasley, Chief Nurse for England, speak about today’s NHS.

NHS staff were there in great numbers but, sadly, there were only a few members of the public and apparently no one from the press. Yet again NHS communication seems to have been ineffective.

So, what did we see? Here are a just a few of the services represented - falls / tissue viability (pressure sores and leg ulcers) / wheelchairs / community dentists / physiotherapy / incontinence / childrens’ care / palliative care / speech and language therapy / community nursery nurses – and many more.

Christine Beasley spoke about the move towards more care in the community and the need for this to be personalised, effective and safe. Commissioning and provision of services are two sides of the same coin, but historically the NHS has done too little to prepare commissioners for their demanding role.

Health varies greatly across the country. Infant mortality in the worst areas in England is as bad as the worst in Europe, but in other areas is low. In some fields we lead the world. The way to improve services is for commissioners to involve local clinicians in identifying how to move from where they are to the best quartile within the NHS, then to match the best in the NHS and then to become world leaders – an inspiring vision!

By way of light relief, but with a serious message, Clare Rand, Senior Physiotherapist, persuaded the audience to engage in pelvic floor exercises. She suggested that we do these exercises when the traffic lights turn red! - an entertaining interlude, before an excellent buffet lunch.

Thank you Hillingdon PCT Provider Services for showing us your wares.

Joan Davis and Donald Edwards

Official opening of the new Radiotherapy Centre at Mount Vernon

Monday 7th April 2008 was a very special day in the history of Mount Vernon, the day when the National Cancer Director, Professor Mike Richards, came to perform the opening ceremony in the presence of a largely NHS audience – but we were there too, represented by James Kincaid, Vice Chairman, and Donald Edwards, our Publicity Officer, who was glued to his camera throughout the event.


All the top brass from East & North Herts Hospitals NHS Trust were there, taking pride that they currently run the Mount Vernon Cancer Centre. Their Chairman, Richard Beazley, expressed much regret at the collapse of the proposal to move the Cancer Centre to Hatfield – in contrast of course to our own delight at that collapse! However we rejoice with him in the excellent new facilities at Mount Vernon. Later this year we hope that the Herts. Cancer Review will confirm that those facilities are secure on their present site, at least for the next few years.


Dr. Peter Ostler, Clinical Director at the Cancer Centre, spoke about the amazing new technology which makes the radiotherapy bunkers removable, originally to allow them to be moved to Hatfield. This installation comprised five bunkers, complete with linear accelerators already in place - a world first achievement.


Professor Mike Richards, the Cancer Czar, noted that this important radiotherapy centre is one of the largest in the country, with many clinicians, radiotherapists, physicists and 140 nurses on its staff. The recent face-lift cost £22 million. When pressed on future plans, he indicated that satellite working might be set up from the Cancer Centre, to make local services available to more people.

He noted that in cancer survival rates the UK lags behind its European neighbours, which he attributed mainly to late diagnosis. Earlier identification is the key factor, needing more patient awareness, more primary care and more radiotherapy services. Staff shortages were a bottle-neck a few years ago, but rapid progress since 2000 has produced around 40% more radiotherapists and clinical oncologists. Better data collection is also vital, so that comparisons between hospitals can become possible. Also, we spend more on in-patient cancer care than other countries, so in future we will be exploring how to treat more patients through ambulatory care.


It was a very happy occasions and smiles were abundant – as Donald’s wonderful pictures and DVD show. I was very sorry that I could not be there myself.

Joan & Donald

News from Royal Brompton & Harefield Hospitals

James Kincaid sent us this news after the Board meeting on 26th March

1. “Master Planning Exercise”
Although not yet at formal planning stage, exploratory work is ongoing to examine ways to bring both the Chelsea and Harefield sites fully up to 21st century standard and simultaneously to maximise the use and value of the total estate.

Presentations were made to show the possibilities on both sites.

a) At Chelsea: The Brompton Hospital consists of a number of separate buildings spread over an area of SW3 between Fulham Road and King’s Road. The proposition being examined is to centre redevelopment on the Sydney Street building, linking it to another adjacent site via an intervening new build, all funded largely from the sale of the remaining properties. Much detail has still to be worked through, but the Board agreed planning should continue on the basis outlined.

b) At Harefield: This presentation gave a vision for the future or, in the presenting consultant’s less than elegant phrase, a “scoping exercise”. The complexities involved are considerable. The site lies wholly within the Green Belt, albeit identified as a “Major Developed Site”, with the restrictions that implies. The southern part of the site, including the main hospital complex, is in the Harefield Village Conservation Area, while an area in the north-west is designated a “Nature Conservation Site of Local Importance”. There are also four Grade II listed buildings on site (all in poor condition).

The consultants considered that the present hospital footprint was more than sufficient to allow for full modernisation and some future expansion, perhaps with a little permitted “infill”. As this represented little more than a third of the total acreage, they postulated a variety of developments for the remainder, from a residential care home to mixed-range private housing. The “vision” provoked much scepticism, mainly from the public, and it was decided that Trust executives would revisit the exercise with the consultants.

2. Heart Science Centre (HSC)
As if plans to revamp Harefield were not already complicated enough, a simmering dispute with the Magdi Yacoub Institute (MYI) seems to be coming to a head.

In 2001, the Trust signed a Heads of Agreement agreeing to the sale of the Phase I Unit of the HSC to MYI (then known as Harefield Research Foundation), on the strength of which MYI bought land and developed Phase II. The collapse of the Paddington project caused further negotiations on the sale of Phase I to be put on hold and the proposed Master Plan has subsequently placed serious doubt on the advisability of selling at all, as HSC is centrally located within the hospital complex.

MYI is threatening legal action if the sale does not go ahead soon and Trust senior management was deputed to hold further talks urgently to see whether any way short of legal action can be found to resolve the matter.

3. Current Performance

The Trust originally budgetted for a £6m. surplus in 2007/8. Early months’ results caused the SHA to insist on a revision to £2.4m. By the end of the year RBH was back on track for £6m., but the SHA refused to allow a further revision. Management is therefore now engaged in attempting to accrue forward purchases in order to remain within this “political” budget !

James Kincaid.

Vice Chairman

May Meeting of The Community Voice

Our May meeting will be on Thursday 1st May, as usual starting at 7.45pm in the Post Graduate Centre, Mount Vernon Hospital.

Our guest speaker will be Jan Filochowski, Chief Executive Officer of West Herts NHS Hospitals Trust. He will update us on news from his Trust, particularly on developments at Watford General Hospital which is apparently, at last, making spectacular progress after many years of difficulty.

This part of the meeting will be followed by brief general business and then by our Annual General Meeting, when we will look back over the past year and look ahead to the future. Guests are welcome, so we hope for a good audience despite the clash with some local elections and with the election of a new Mayor for London.

Joan

Community Voice meeting 3 April 2008

Our guest speaker was Fiona Wise, the CEO of North West London Hospitals Trust, who told us about developments and plans, particularly at Northwick Park. To set the scene she gave us some facts and figures: the trust has 3 hospitals, Northwick Park, St Mark’s (on the NPH site) and Central Middlesex, which has recently been largely rebuilt. The trust is one of the busiest in London, with an annual budget is around £300 million, employing 4200 staff. Last year, nearly 5000 babies were born there, it treated around 180,000 patients (enough to fill Wembley Stadium more than twice), some 18,000 tests are done daily. Current targets and status include
· reducing infections – coming down but not yet on target;
· ’18 week’ from referral to consultation, tests and starting treatment, on target;
· 4 hour A & E – not meeting 98% target - but have more than 7% above expected numbers;
· Finance – problems;
· Improving experience, staff satisfaction, public engagement – making improvements;
· Emergency preparedness – working hard, major incidents (e.g. how do you cope in a flu epidemic if staff are ill?).
Major changes are planned for London, there is a ‘London review’, a ‘NW London review’ and a local review. Among the intended developments are specialist stroke services. She was hoping to improve the demand management, better use of electronic communication, A&E and urgent care (there is a new centre for this at NPH), more intensive use of CMH.

In a lively question and answer session, Fiona was asked whether she expected to reduce the number of beds – answer ‘No’, could anything be done to improve internal communications – she hopes to do this, it’s been a long term problem at NPH, inter-consultant referrals seemed to be a problem – yes, but that’s because the PCT insists on being involved although in emergencies it’s always done, this is a national problem,
could NHS financial procedures be improved – if only!

On this occasion we had a ‘double bill’, with Sarah Brierley from E & N Herts, giving us a brief presentation on the trust’s plans for applying for ‘Foundation Trust’ status. There had been a very badly advertised – and therefore poorly attended – meeting and this was an attempt to repair the damage. One of the interesting points that came out was that this trust is planning to continue to hold meetings in public.


Paul and Donald
5 April 2008

Meeting with Mount Vernon's General Manager

Three of our Executive Members met with Karen Blackbond today. It was a pleasure to hear that construction of the Treatment Centre is on schedule and it will open in January 2009, complete with 4 operating theatres, 14 day case beds, 12 short stay beds, 24 in-patient beds and 2 High Dependency Units. It will be linked to the completely refurbished Princess Christian Unit, making one light and airy new building.

The Treatment Centre will take most planned surgery from Hillingdon Hospital and hopes to make a name for itself as an orthopaedic centre of excellence. It will also have a wide range of outpatient clinics, possibly over an extended working day.

We discussed concerns over parking provision and were reassured by hearing that at least 88 more parking spaces will be provided, close to the Treatment Centre, on level ground.

Our concerns about exit and entry of more cars from Rickmansworth Road were noted and solutions will be explored. We also raised the long-standing problem of the junction between the road from Harefield and the Rickmansworth Road, opposite the Green Man on the Hertfordshire side of the county border, which will be made worse by increased traffic. We were promised that these problems will be reviewed – also that options for improved patient transport from the south of Hillingdon are being explored.

All this was very positive, topped off by hearing that the whole site is being considered for landscaping. Although not under the control of Hillingdon Hospital, the Mount Vernon Cancer Centre is also thriving, with the Cancer Czar, Professor Mike Richards, coming on Monday next week, 7th April, to open its newly extended radiotherapy centre, which is still the largest in the country south of Manchester!

Mount Vernon has had some tough years, but at last it is emerging from the shadows, with a bright future ahead. We are lucky to have it on our door-step.

Joan