North West London Hospitals Trust Board, 28 May 2008

Some highlights from this meeting. As so often before, I was the only member of the public present.

The report on the recent Maternity deaths should be available to the Board at the end of June. The panel has 2 local members and 5 external experts with Anne Groves, one of the Harrow PCT non-execs, as chairman.

The performance report was very encouraging. The 98% '4 hour target' for A & E is being met, quite comfortably. This is partly due to comments made by Alan Bedford Consulting in March on some of the procedures in use and probably also the operation of the new Urgent Care Centre.

One area of concern is 'delayed discharges', which are at a much higher rate than intended. It seems that this due largely to Brent PCT being unable to handle some of their patients in time.

Infection rates for MRSA and C. diff are coming down, although they are still slightly above target levels.

One very interesting news item is the overall mortality rate at the trust is much lower than would be expected or the number of patients and case-mix the trust has.

Paul

60 firefighters attend evacuation drill at Harefield Hospital

The following account from, Joanna Parish, Head of Media Relations

Royal Brompton & Harefield NHS Trust.

Harefield Hospital tested its readiness for dealing with a major emergency in a large scale simulation on 20 May. Staff from the hospital were joined by colleagues from the London Fire Brigade, the Metropolitan Police, Hillingdon Hospital, Primary Care Trust and Borough Council, the Health Protection Agency, London SHA and other agencies to test readiness for a fire in the hospital.

The simulation represented the largest multi-agency exercise at Harefield in two decades, and one of the largest in London for some years. It was timed to take place after £3 million worth of improvements had been made to the hospital’s infrastructure. All NHS Trusts are expected to carry out similar exercises every three years.

Soon after midday the fire alarm was sounded and volunteer staff acting in the role of patients were evacuated from wards and moved to safe areas in the hospital. In total 30 ‘patients’ were moved to safety in the mock evacuation. A total of 13 fire appliances and 60 firefighters arrived at the scene. The exercise was structured so that staff were informed of fresh events in real time, simulating the effects of unexpected developments in a real emergency.

Commenting on the exercise, Patrick Mitchell, director of operations at Royal Brompton & Harefield NHS Trust, said: “Carrying out such a large multi-agency exercise was a major undertaking and required a great deal of planning and co-ordination. The conclusion from all those involved was that it was an extremely worthwhile project, not just for the Trust but for all our partners. We will be sharing the learning from the event with a much wider audience within the NHS and beyond.”

John Doherty, spokesperson for the London Fire Brigade added, “The exercise was an enormous success from the London Fire Brigade’s perspective. It enabled us to put into practice our command and control procedures for major incidents and of course reinforce our links with the Trust’s management team. The most important outcome from the exercise was that all agencies involved worked together to achieve a successful outcome, that of ensuring the safety and well-being of all ‘patients’”.

To view the video click 'play >' , bottom left and wait for it to start. Switch on your speakers.

Donald Edwards

Open Day at Harefield Hospital's Theatres 20th May

Harefield Hospital, The Royal Brompton and Harefield Trust opened its cardiothoracic theatres to the public from 10am to about 4pm. It was a very informative event and I, for one. learnt a lot from the visit. After the introduction in the 'quiet and soothing area', designed to give patients who are on their way to the theatre a calming experience with a virtual, interactive display of a scene by a lake. This led on to various display stands. The organ donations stand where you could put your name on the Organ Donor Register to donate your whole body or just parts of it to save the life of several people. On to the National Blood Service stand where you could 'Save a Life' by enlisting to become donor. Just give an armful like Tony Hancock ! You could learn how to avoid feeling faint after giving blood, how your blood is tested for various infections before it is used.

We moved on to the display of various instruments used during a heart operation and on to the hand washing station where you could wash your hands and check under the scanner to see if your hands were germ free. A most interesting display was the dissection of a pig's heart, very similar to a human heart. We saw various artificial heart valves and how they were fitted.

It was then on to the theatre, there were demonstrations on a by-pass operation and maintaining blood circulation to the body, 'Harvesting' a vein from the leg, I had been told they just made a slit at each end of the leg, snipped the vein and pulled it out, never gave it further thought. As an engineer I should have realised that like a main pipeline, there are many connections and junctions that had to be cut and sealed first. Never take anything for a fact if told you by a layperson.

I shall be making a DVD of my visit and hope to make short videos of various displays for the website.
Donald Edwards

Update from Hillingdon Primary Care Trust's May Board Meeting

Healthcare for London consultation

Lord Darzi’s national review set the pattern for changes to NHS services:
· Must always be of benefit to patients
· Must be clinically driven and based on evidence
· Must be locally led to meet local needs
· The public to be involved in developing proposals
· Existing services to be retained until new services are in place

Hillingdon PCT Board agreed that this is an opportunity to get investment into primary care, but there was concern about the cost of double running when old services are kept in place until new services are introduced. Also, the historic Hillingdon PCT deficit needs to be resolved before the PCT can invest in primary care and a working partnership must be developed with GPs. A report on Hillingdon PCT’s plans is expected in the autumn


The Herts PCTs Commissioning Review of Mount Vernon Cancer Services

NW London PCTs are represented by Chelsea & Westminster PCT and Harrow PCT. This is contentious. Hillingdon patients are major users of the Cancer Centre’s services and the Cancer Centre is on Hillingdon land. The 2007 Community Voice petition with over 77,000 signatures showed how much local people value the Cancer Centre. Why is Hillingdon PCT not represented on the Review??


Hillingdon Hospital’s rebuilding plans

The PCT has confirmed to Hillingdon Hospital that it supports plans for redevelopment of the Hillingdon Hospital site with 200 beds at a cost of £150m, subject to no increase in elective care provision.


Yiewsley Health Centre

The PCT is pushing ahead with plans to rebuild on the existing site. It says that planning permission is not likely to be a problem. When pressed on parking potential it was suggested that this might be provided below the building. None of this is finalised yet. What happens to services during rebuilding? Questions must be asked.

Joan

Hertfordshire policy on people who do not keep NHS appointments without due cause

Papers presented to the West Herts. PCT Board show a new policy for patients who waste NHS time by not attending appointments. In future, patients who do not attend for consultation or treatment without notification will be removed from the waiting list, and they will they not be given another appointment unless there are clear clinical indications following review of their case notes. Both patient and GP will be informed by letter.

Patients who cancel appointments twice will be discharged back to their GP if it is clinically appropriate to do so. In such cases both the patient and the GP will be informed by letter.

So, beware - make sure you turn up for appointments or give apologies and good reasons in advance. The NHS is getting tough!

Joan

Commissioning Review of the Mount Vernon Cancer Centre

This review is being set up by the two Hertfordshire Primary Care Trusts. It aims to clarify the role of the Mount Vernon Cancer Centre now that plans to move it to Hatfield have been abandoned.

A pan-PCT Steering Group has been set up to lead this review. North West London is represented by Chelsea & Westminster PCT and Harrow PCT. A user/ patients/ group is being set up to assist the Review. It appears very surprising that Hillingdon PCT has not been invited to send a representative, despite having the Cancer Centre geographically in its patch, sending large numbers of patients to it, and being the Cancer Centre's landlord - and not forgetting the 77,780 signature petition that the Community Voice presented to Ben Bradhaw, Minister of Health only a few months ago, which clearly showed the strength of local public support for this much loved NHS facility. Questions are being asked at Board Meetings on these issues.

A step nearer a new health campus in Watford!

On 15th May, Watford Borough Council's Development Control Committee gave the go ahead to the proposals for the £1bn Watford Health Campus. It voted to grant the necessary permissions subject only to suitable 106 agreements - that is agreements for sums the developers will pay the Council for its related expenses such as school places, traffic lights etc.


The site covers 26.5 hectares and will include:

• major new hospital buildings for Watford General Hospital


• the redeveloped football stadium


• a hotel with conference facilities


• space for new businesses


• hundreds of new houses


• a new road giving improved access.

All good news indeed!



Joan

INTERNAL TRANSPORT BUS TIMETABLE -MVH

Good new for all those who need to go to Hillingdon Hospital or The Royal Free Hospital from Mount Vernon Hospital, the bus is now able to carry Staff, Patients and their visitors. The problem with the insurance that stopped this service has now been rectified.

Well done.

Donald

Update on Watford Hospital Rebuilding Plans

In addition to all his other good news, our May guest speaker, Jan Filochowski, CEO West Herts NHS Trust, updated us on Watford Hospital developments.
A state of the art unit is due to open at Watford General in November 2008. This will transform emergency services, by providing better treatments with shorter stays and improved outcomes.
Looking further ahead, by 2015 a completely new hospital will be built on the site, as part of the Watford Campus. The new hospital will face the river and will have improved car parking facilities alongside the Football Stadium. Our speaker regards the building plans as broadly affordable, so they really can happen.
The Campus will probably include a hotel and attractive housing. A relief road at the bottom of the site is planned for 2010 and this will transform access to the hospital. There is also a 50% chance that the Metropolitan Line will be extended to Watford Junction, with an intermediate stop at the Watford Campus.

Good news in abundance – we just cross our fingers!

Joan

The Community Voice May Meeting

Jan Filochowski, Chief Executive of West Herts Hospitals - which includes Watford General Hospital – came as our guest speaker. To use the oft quoted comment on Caesar as a summary of his impact “He came, he saw, he conquered”!

Our previous report – half a dozen entries previous to this one - noted the astonishing achievements of his six months’ reign. From being an NHS trust deeply in trouble, West Herts Trust is now able to crow about its successes.

Our speaker was asked how he had achieved this transformation. He responded by praising NHS staff, highly educated and dedicated to their work. His approach was to identify problems and empower staff to solve them, giving support when needed. His method was to give responsibility to appropriate staff and then hold them to account for delivery. It worked - like magic!

His original commitment was to stay in post for six months, now ended. He has agreed to stay for a second six months, to finish the job for which he was appointed. Then he will go – and enjoy more time with his family. There is little doubt that this remarkable man will be much missed when he goes.

Our guest speaker next month, at 7.45pm on Thursday 5th June in the Post Graduate Centre Mount Vernon, will be Dr Martin Rhodes, Medical Director Harrow Primary Care Trust, speaking about “Ethical decision making in primary care”. We all know that difficult choices are a fact of NHS life. This will be our chance to hear how such decisions are made – and why one patient receives treatment that another is refused.

Joan