The Community Voice

June meeting of the Community Voice

2009-05-11T00:06:00.004+01:00

Our June meeting will be at 7.45pm on Thursday 4th June in the

Post Graduate Centre Mount Vernon Hospital.

Our guest speaker will be Barbara Gill, Project Director Mount Vernon Cancer Services Development Project, speaking on “Making progress on cancer services” – the way ahead for the Mount Vernon Cancer Centre

Visitors are welcome as guests

A whirlwind of change in community health services!

2009-05-11T00:01:00.007+01:00

Maria O’Brien was guest speaker at the Community Voice May meeting.

She covered so much ground that we felt a whirlwind had hit us! Her enthusiasm and dedication to patient services was transparent and exciting. Summarising is an impossible task.

Traditionally PCTs have commissioned services – which means planning and purchasing – and they have also provided community health services. NHS national policy now obliges PCTs to separate theses two roles. The former PCT provider services are now called Hillingdon Community Health which, from 1st April 2009, has been designated as an autonomous provider by NHS London. Maria O’Brien is its Managing Director.

However, Hillingdon Community Health is still responsible to the PCT Board although it is now an independent organisation with its own £30.5 million budget from Hillingdon PCT. It employs 550 staff to provide 32 different health services in patients’ homes and 19 clinics.

Its Adult Services include district and specialist nursing, podiatry, specialist dentistry, community matrons, various therapies, infection control, wheelchairs, rapid response teams, safeguarding adults service. It is responsible for two GP practices in the south of Hillingdon and also for the 22 bed in-patient facility at Mount Vernon in the Northwood and Pinner Community Unit.

Its Children’s & Young People Services include health visiting, child development, community paediatricians and nursing, various therapies, school nursing, safeguarding children, looking after children and also family planning and sexual health.

Various options are open to this new organisation. It could remain as it is or become a Community Foundation Trust. It could integrate with an acute NHS Trust or a Foundation Trust, or the Local Authority. It could become a Social Enterprise, outside the NHS, or merge with another PCT Provider. It could even become a private enterprise.

In 2009-10 it aims to focus on expanding and improving clinical services for local users, but it will also consult with staff, patients and the public, the local authority, hospital, and GPs before making recommendations about its future framework in Autumn 2009.

Within the next two months it hopes to achieve a wait of no more than two weeks for physiotherapy. It also plans to develop a “home” intravenous antibiotic service, expansion of the Rapid Response Service, a new wound care service, more community matrons to support patients with long term conditions and expansion of other services including diabetes, rehabilitation, immunisation and children’s services.

Hillingdon PCT has been very supportive, more so than many PCTs, with investment in community services and an extra 110 front-line posts in Hillingdon.
Questions came thick and fast. All were answered. It was a highly informative and interesting experience for the audience.

Many thanks to Maria O’Brien!

Joan

North West London Hospitals, April 2009

2009-05-05T20:40:00.003+01:00

Principal items only. Altogether a very satisfactory report of what has been happening.

1. CEO report A variety of interesting items reported here. The trust has received full registration by the (new) Care Quality Commission (CQC), which came into being on 1 April. Like many other hospitals NWLH has a shortage of midwives. In London there are 400 vacancies for midwives but there are only 200 being trained. Trouble ahead!

2. Annual Performance This was very good in many areas. The A&E target of 98% patients being treated within 4 hours was reached, for the whole year, in spite of an increase in the number of patients being treated. The MRSA target of 28 cases was met – ‘target’ is the wrong word, it’s actually a permitted maximum. Regarding C.Diff there was a 40% improvement over the last year’s figures. The ‘18 week’ target of 90% (for referral of a patient for tests, diagnosis and treatment) was met comfortably, with 98% and this earned an efficiency bonus of £700K.

3. Swine flu The Trust is well prepared, one of the ‘London referrals’ had been to NPH. Staff in infection units are being advised to have vaccinations. Alert precautions will remain in force for a long (unspecified) time.

4. Cervical screening There is a 14 day target for screening. Numbers have recently increased greatly, referred to as the ‘Jade Goody’ effect.

5. Mid-Staffordshire check list Trusts have been asked to compare their performance against the recent report of multiple failures at the Mid-Staffordshire Trust. Our trust has a clean bill of health in this comparison.

6. Finance With some heroic work on non-recurrent items, the trust finished the financial year with a positive balance of about £170K. An adverse balance is expected for next year.

Paul

What's new in April in Hillingdon Hospital?

2009-05-03T10:58:00.004+01:00

Resignation of the Chairman

The Chairman, Tony Valentine, has announced his resignation, effective on the 1st July.

Accident and Emergency Department activity

Demand has recently escalated with an extra 35 to 40 patients per day in A&E, mostly between 8pm and midnight. So Hillingdon Hospital failed to meet the national target of treating all A&E patients within four hours of arrival. In April its rate dropped to 96.4%, bottom for London and in the lowest quartile nationally. So, the Trust has been summoned to discuss its action plan with NHS London. Additional staff are being introduced on evening shifts.

Finance
2008-09 was very challenging, with the combined pressures of achieving the 18 week target, very high energy and utility price rises, and a large increase in agency staff use. Never-the-less, the Trust delivered its best performance on national and local targets and ended the year with efficiency savings of £4.7m. The highest earning departments were Obstetrics and Trauma / Orthopaedics, followed by Accident & Emergency.

Flu Pandemic
In a recent audit of preparations for a possible ‘flu pandemic the hospital scored an assessment of 98%. This was a national audit, in which the London average was a score of 82%, so The Hillingdon Hospital was considered well prepared

MRSA Screening
It is hoped that all elective patients will be screened for MRSA by the end of April or early May. All inpatients after two weeks are now re-screened every 14 days to assist in the identification of high-risk patients.

Pressure ulcers
A successful pressure ulcer awareness week was launched in March to raise awareness among both staff and the public.

Joan Davis

A walk-in GP centre is coming to Hayes!

2009-04-21T12:40:00.004+01:00

Hillingdon PCT has announced that from autumn 2009 there will be a walk-in medical service in the town centre of Hayes. This free NHS service will be open 8am - 8 pm with a GP available 365 days of the year.

This service will be provided by Bondcare Medical Services Ltd, an independent provider of healthcare services across the UK.

Joan

NHS Harrow, 14 April 2009

2009-04-19T21:19:00.003+01:00

NHS Harrow is the new working name of Harrow PCT. Apparently several PCTs have adopted this style, as it is clearer to the public what the function of the organisation actually is.

This report covers main items of the recent Board meeting, held on 14 April

1. Performance All seems quite satisfactory. The (98% in less than) 4 hour A&E target (at Northwick Park, of course) has been achieved for the whole year, in fact NPH is the only London hospital that has gone from ‘red’ to ‘green’ within a single year. Regarding immunization there are variations in the GP records and the PCT’s own counting.

2. Finance and Budgets The overall closing balance will be very near the target of a surplus of £1.7 M, there may be some changes because the Pharmacy contract has been changed nationally. No major changes are expected for the coming year.

3. Sustainable Health Care This was presented by the Director of Public Health. It is concerned with saving carbon in the borough, everyone agrees it’s a good thing to do but no one knows what the costs will be. One suggestion that met with general approval was the suggestion that people should write shorter reports.

4. Primary Medical Services in East Harrow This was about the provision of new services, to replace a Health Centre that was closed about 2 years ago and some GP practices that have closed. Three alternative proposals were presented, each involving the Community Health Centre in Belmont, supported by a 2 GP led Health Centres. A local consultation is to be held shortly.

Paul

Voluntary Services in Hillingdon & Mount Vernon

2009-04-18T17:09:00.003+01:00

Voluntary Services for both Hillingdon and Mount Vernon Hospitals have proved to be invaluable. There are the volunteer drivers who transport patients to and from the hospitals in their own car; others work in the charity shops raising money for the hospitals. In the past the Comforts Fund has provided funding for many projects and equipment in both hospitals. Another aspect of their work is escorting patients to and from reception to the correct clinic, doctor or ward. They certainly are an asset.

YOUR HOSPITAL NEEDS YOU - BECOME A VOLUNTEER

New Watford and Three Rivers Health and Social Care Group

2009-04-11T23:40:00.006+01:00

On 7^th April, in Watford Town Hall, a new health and social care group was launched by Hertfordshire Local Involvement Network. That LINk covers a very wide area and it is therefore setting up a number of sub-groups, of which this one, covering Watford and Three Rivers, is among the first.

The event was a great success. Over forty people attended, including representatives from Herts. County Council, Watford Council, Three Rivers Council, West Herts PCT, West Herts Hospitals NHS Trust and various voluntary organisations. Donald Edwards, our Publicity Officer, and I represented The Community Voice but it was good to see a number of other members present too.

As our two organisations share much common ground, we were allowed to display Community Voice publicity boards, to show our own range of interests. I was also invited to speak briefly to welcome the new organisation on behalf of our members. Increasing public awareness and input into local health and social care services will benefit us all. We look forward to working closely with the new group and are confident that this will be to our mutual advantage.

Joan

Next Meeting, on Thursday 7th May 2009

2009-04-10T09:26:00.007+01:00

At this meeting, Maria O’Brien, Interim Managing Director of Provider Services, Hillingdon PCT, will be our guest speaker, speaking on: “The whirlwind of change - in local NHS services”.
As always we will meet at 7.45pm in the Post Graduate Centre at Mount Vernon Hospital. Visitors are welcome.

Do you know about all the changes that are taking place? If not, come and find out!

Joan

Our April Meeting

2009-04-10T09:21:00.007+01:00

David McVittie is always a popular guest speaker. He has charm and is frank. As Hillingdon Hospital’s Chief Executive, his news is up to date and correct. So, he enchants his audience – and our April meeting was a great success.

Firstly, his Board intends to rebuild Hillingdon Hospital on its present site. It looked at all options and this was the best. In an ideal world the RAF site at Uxbridge might be first choice, but in practice it is not a front runner.

No London acute hospital has been successful so far in achieving foundation trust status in under three years, so his Trust is not alone in its disappointment that its application is on hold. It remains confident of ultimate success. It already has over 5,500 Foundation Trust members and has recently held elections for Governors.

He spoke about the current trauma and stroke public consultation. His hospital receives less than one major trauma case per week, so it cannot not match the criteria for a major trauma centre, but the proposals will allow it to continue, as now, to deal with the majority of local trauma cases.

However, his hospital already provides a hyper-acute-stroke service for most of the day, so it is disappointed by the consultation proposals, which would send all local stroke patients to Northwick Park Hospital for the first 72 hours of a stroke attack. His hospital would then become a local stroke unit, dealing only with transient ischaemic attacks and rehabilitation.

His Trust’s vision for Mount Vernon is unchanged. The new car park outside the Mount Vernon Treatment Centre will open in June. Various old buildings must be demolished. New cancer wards are needed, also new staff accommodation and new wards for elderly care. A joint venture with the private Bishopswood Hospital could lead to shared accommodation for endoscopy services.

The Trust is proud of its two new facilities. Bevan Ward in Hillingon Hospital provides en-suite single rooms. The Mount Vernon Treatment Centre provides top class elective care.

The Trust has also done well in meeting national targets, in achieving a small financial surplus, in the outcome of staff surveys, in its thriving Patients in Partnership programme and in introducing its consultant-led Emergency Admissions Unit which is open 24 hours a day, seven days a week.

The speaker stayed late to answer questions and to hear audience comments. As always our meeting provided an opportunity for members to relate directly to the speaker - interchanging views and information, to mutual advantage, we hope.

Joan

Hillingdon Round-Up late March 2009

2009-03-28T09:03:00.002Z

Hillingdon Hospital’s Foundation Trust application
This application is now on hold. The fact that the Trust has not met its MRSA target is a factor, but not insurmountable as the numbers are actually low. The valuation of the Trust’s estate appears to be the main stumbling block.

The Hospital Trust’s Finance
A surplus is still forecast for the end of year despite a very difficult month in February.

Hillingdon PCT’s Finance and Performance
The PCT is forecasting breakeven for 2008/09, meeting its statutory duty for the second year since 2002 – this achieved despite in-year repayment of £9m for its historic debt (leaving £35m debt to carry forward into 09/10).

On performance of national priorities and targets, Hillingdon is in the top half of London PCTs, which is very encouraging.

However there are problems between the PCT and Hillingdon Hospital over signing 2009/10 contracts – the due date was missed due to differences about coding and local prices for non-tariff services. NHS London has asked both parties to resolve their differences locally.

PCT’s Commissioning Strategy
Preliminary results from the World Class Commissioning process showed Hillingdon PCT’s scores to be mid-table for London, with it named as an exemplar by NHS London for information based decision-making. This accolade is very sweet in view of the PCT’s chequered history.

NHS London is working with all 31 PCTs to implement sector commissioning arrangements. The North West London Commissioning Partnership, an acute services commissioning vehicle covering 8 PCTs - Brent, Ealing, Hammersmith & Fulham, Harrow, Hillingdon, Hounslow, and Kensington and Chelsea, and Westminster - expects to go live on 1st July 2009.

Third Runway at Heathrow
In response to the PCT’s letter, the Permanent Secretary of the Department of Transport has confirmed that a formal health impact assessment will need to be conducted as part of any planning application by BAA, if further development were to be supported by the government. He reiterated the government’s firm commitment that Heathrow will not be extended until the air quality and noise limits have already been met.

PCT’s Premises
The PCT’s Public Health and Joint Commissioning teams moved to the Civic Centre on 16th March, signifying the PCT’s intention to work jointly with London Borough of Hillingdon.

Provider Services
By end of March the PCT’s Provider arm expects to be accredited as an Autonomous Provider Organisation (APO) ready to start operating independently, although still a sub-committee of the PCT operating with delegated powers. Its key priorities for investment in 2009/10 are: safeguarding children and adults, health visiting, speech therapy, community dentistry and TB.

Joan

The Mount Vernon Cancer Centre is safe!

2009-03-28T08:41:00.005Z

Success, at long last! The 2002 Varley Review recommendations have been overturned – so, no more talk about moving the Cancer Centre away from Mount Vernon.

Instead all efforts will be directed towards making Mount Vernon the hub of a system with satellite services further north, in Hertfordshire or Bedfordshire, to provide routine radiotherapy for those who currently have very long journeys.

The current Review’s Interim Report is being launched on Monday 30th March, at a stakeholders’ conference, but the document is already in the public domain. The main issue now is to ensure that services remain first rate in both Mount Vernon and any satellites. No one wants second-class services, even if they are close to home.

This success is a triumph for local people. The two Community Voice petitions – each with over 70,000 signatures - were a lot of hard work, but the outcome is very sweet. When ordinary people pull together, they can make things happen!

Joan

West Herts Hospital Trust better and better!

2009-03-25T07:23:00.002Z

On 19th March, again it was all good news for the Board of this Trust.

The move of all acute services from Hemel Hempstead Hospital to Watford General Hospital was concluded without a hitch. This is a triumph as the move is acknowledged to be the biggest such project in today’s NHS. The Chief Executive, Jan Filochowski, had insisted that the original date be put back, to allow step by step transfer, and the outcome fully justified his caution, as all went well. Both staff and patients like the new Acute Admissions Unit (AAU) at Watford and the Urgent Care Centre at Hemel is thriving too, with over 350 patients per week.

Disclosures about Stafford Foundation Trust have made all hospitals edgy, but this Trust has below national average mortality rates in all departments, so it has no concerns of that kind.
Furthermore, it is meeting all those elusive NHS targets. Its infection control is first rate, well within target for MRSA cases and a national star for reduction of clostridium difficile cases. Performance on 18 weeks waiting list targets is above national targets. It continues to exceed all three national cancer targets. Bed pressures have eased slightly. Delayed transfers of care have reduced in number in recent weeks.

The Trust's Healthcare Commission Quality of Care rating is now balanced between “good” and “fair” depending on it achieving 98% for the A&E target over the whole year (it reached 100% on the previous day!). This target was not in doubt until the February snow storms caused unusual pressures and caused a temporary fall below target.

Add to all this that the Trust has a small financial surplus this year and expects to clear its historic debt next year. All good news.

But what about the patient experience? Are patients happy too? Survey results indicate that there is an improvement in patient satisfaction. So, what more can anyone want? I guess there are cracks somewhere and some patients fall down them – but the general picture is still amazing, unusual and good.

Joan

Hillingdon Hospital update from David McVittie on Thursday 2nd April

2009-03-14T00:34:00.003Z

Everyone knows that The Hillingdon Hospital is long past its “sell-by date”, with dilapidated buildings too old to repair. So where should the hospital be rebuilt? The Board of The Hillingdon Hospital has well developed plans to rebuild on the present site but some people, led by John Randall MP, call for the rebuild to be on the old RAF site in Uxbridge.

Why does The Hillingdon Hospital Board reject that proposal? Has the current recession changed the options? Come to our 2nd April meeting, at 7.45pm in the Post Graduate Centre Mount Vernon, to have an update from David McVittie, Chief Executive of The Hillingdon Hospital.

He may touch on other issues too so come with your questions ready. Why does the Healthcare for London consultation propose to stop Hillingdon Hospital from providing 24 hour care for stroke victims, despite it offering an excellent service? Should we be fighting to keep what we’ve already got? How is the Trust’s foundation trust application faring? These and other questions may feature in our meeting. Visitors are welcome, as always.

Joan

Good News for Cardiac Patients!

2009-03-11T01:54:00.004Z

Dr Nigel Stephens charmed his audience at our March meeting, talking about the Cardiology Department at Northwick Park Hospital, which he has led for 13 whirlwind years of change.

He noted that before 1961 there were no visual pictures to assist cardiologists, so little could be done to help patients. However, in the USA between 1959-61, there were major advances with the development of angiograms, open-heart surgery and heart-lung machines. By 1976 balloons were being introduced into arteries and ten of the early patients are still alive today. By 1988 the first coronary stent was introduced, a flexible tube supporting the artery and this technique is still in use today.

The last five years have seen even more advances, with more emphasis on speedy treatment and primary angioplasty now the favoured method of combating heart attacks. As a result there is now only a 5% chance of dying during a heart attack compared with a 20% chance only a few years ago.

At Northwick Park, angioplasty was introduced in 2002 in an exclusively consultant service. It has had outcomes second to none, with a total of over 2000 patients treated.

Heart failure used to be a cinderella discipline but cardiac resynchronisation can now transform life for some patients and 50 cases have received that treatment at Northwick Park.
However there is no open-heart surgery or heart transplants at that hospital.

Over the last five years national waiting–time targets have led to many improvements. In 2004 16 people waited 18 weeks for treatment – in contrast today 230 people are waiting barely six weeks - and the wait for angiograms is only three weeks.

Surprisingly, although many people go to A&E departments with chest pain, only five in a 100 cases are due to serious conditions - and today, new A&E technology can identify which of these are heart attack cases needing urgent treatment.

Dr Stephens talk was entitled “Good news for cardiac patients”. We came away convinced that this was an apt title.

Joan

Good and Bad News from Hillingdon Hospital

2009-03-11T01:18:00.003Z

Firstly the good news
Both Mount Vernon Treatment centre and Bevan Ward are open and much appreciated by both staff and patients.

It is encouraging that there have been no cases of infection in Bevan Ward – single rooms and isolation remain the most powerful tools against infection.

The Treatment Centre is receiving out-patients as well as elective surgery patients, but the operating theatres are not yet being used to full capacity.

Now for the bad news
There were three cases of MRSA in January and two more in February making a total in year of 16 cases, four above target. Everyone was clearly devastated.

27 pages of the Board papers and most of the Board Meeting discussion were devoted to MRSA. Every case is documented and analysed in detail. All elective surgery patients are now pre-tested for this infection. Hand hygiene is closely monitored. Pressure sores are vigorously avoided. It is difficult to know what more could be done.

And no news on the Foundation Trust application
At the time of the Board meeting hopes were high that there would be an announcement within hours – but these hopes were dashed by silence. Until such an announcement is made no one can be sure of the outcome.

Joan Davis

Hillingdon Primary Care Trust News

2009-03-11T01:14:00.003Z

The February PCT Board meeting was jam-packed with facts, so here are a few snippets of special interest to patients:

The Hillingdon Referral Medical Centre The RMC currently processes over 80% of GP referrals to hospital consultant services. Patient satisfaction surveys for dermatology patients are currently underway – so these patients can say what they think of the service.

Physiotherapy Services Additional investment is being provided to reduce waiting times. No one in Hillingdon should then wait more than two weeks to see a physiotherapist. Weekend services are to be developed and the “physio-direct” telephone service.

Early intervention for psychosis The PCT has failed its target of treating 38 new patients in the year. However the new consultant started in post on 1st January 2009 so the PCT hopes to do better in future.

GP surgeries extended hours Good news for patients - over 55% of surgeries now offer extended hours – so fewer patients now need to go to A&E in hospitals.

Patient Choice From 1st April 2009 patients will have right to choose where they have treatment when referred for their first outpatient appointment, but this choice is at Hospital Trust level, not site level – so, if you choose The Hillingdon Hospital, you could find your treatment is provided only at Mount Vernon Hospital, since both these hospitals are part of the same Hospital Trust. Patients can choose any hospital in England that provides the required service and meets the NHS standards, including independent and private hospitals that appear on the Choose and Book list.

Podiatry Service This service is supporting the Hillingdon Age Concern’s Toenail Cutting Service by providing training and support when problems arise – good news, particularly for older people.

The Rapid Response ~Service This service, started in September 2006, to look after patients for a short time in their own homes, has now extended its hours to 8.30am to midnight, for 365 days per year.

Health Visitors The national shortage is being tackled locally by supporting staff to undergo part-time training – so the PCT is trying to grow its own Health Visitors!

Parkinson Disease Specialist Nurses A bid for funding two part-time specialist nurses is underway and appointments are expected early in 2009.

Joan

Harrow PCT Board, 3 March 2009

2009-03-04T12:26:00.003Z

Interesting highlights only.

1. Rebranding As from 2 April the PCT is to be known as ‘NHS Harrow’. It is believed this will be more meaningful to the public than ‘Harrow PCT’. On legal documents, however, it will still be ‘Harrow PCT’, as that is the officially registered name.

2. Operating Plan for 2009/10 A huge item, of some 140 pages, but discussion took no longer than 10 minutes. It is the detailed plan covering just about everything the PCT expects to do during the next year, spelled out in excruciating detail.

3. Emergency Planning Annual Report How to cope with emergencies that can be foreseen, such as a potential influenza pandemic..

4. The ‘World Class Commissioning’ Panel Report In spite of the rather fatuous name, this is the report of a panel of NHS experts, aided by some with healthcare experience abroad, on how well Harrow PCT does its work. According to the panel, not as well as the ‘self assessment’ that went alongside. But they recognised that the PCT had a bad period in the past and has come out of that, with a largely new team that shows promise.

5. Transfer of Commissioning Responsibility for Social Care Needs from PCT to Harrow Council This considered the transfer of people with learning disabilities from the PCT (i.e. NHS) to the local Council (i.e. local government financing). The number of people involved is not very large, the sum involved is under £4 M, but the problems involved are very major. Very few other councils have shown any willingness to accept the financial responsibility as this will be in competition with all other local authority funding instead of being safely sheltered within NHS funding. It will be interesting to see how Harrow and NHS Harrow cope with this.

Paul

North West London Hospitals trust Board, 25 February 2009

2009-03-04T12:19:00.003Z

1. The fire and the power failure. The fire at NPH on 11 February started with the generators in the basement, causing a lot of smoke to rise through the main ward block. Nobody was injured, about 170 patients had to be moved, no one suffered more than ‘some discomfort’. A culture of regular fire drills helped, with staff knowing what to do. Problems included moving patients connected to various items of (electrical) equipment. A & E was out of action for a few hours. Some patients were moved to other hospitals. One of the consequences of the fire is that there is a temporary reduction in the number of beds available but it is hoped this will be only for a short time.
A few days earlier there had been a power failure, soon after midnight on one of the coldest nights. The power supply in Sudbury failed, affecting about 900 homes and the hospital. The emergency supply kicked in immediately apart from one unit, which had to be started manually. The whole incident took about 4 hours to resolve.

2. Finance. There has been a lot of newspaper publicity about the reduction of next year’s budget by about £32 M and naturally this was an important item. The expectation is that the in-year financial outcome will be a ‘break even’ situation. As the stated intention is to make these savings without affecting the quality of the service there is much interest in how this can be done but nothing was said about this.

3. Performance All quite satisfactory. The number of MRSA and C. Difficile cases is well down on the (not to be exceeded) targets. The trust gets some bad ratings from the Healthcare Commission surveys but the reason is interesting. Patients are given questionnaires, to be returned by them to the Commission. It seems that the proportion of NWLH patients who submit such questionnaires is lower than the HC would like – and the trust gets a bad grading because of this. This seems unfair to me. There is more: the questionnaires are only in English yet the NWLH Trust clientele is roughly 50% non-English and the questionnaires are many pages long.

Paul

Our next meeting

2009-02-16T21:46:00.004Z

We next meet on Thursday 5th March, as usual in the Post Graduate Centre, Mount Vernon Hospital, at 7.45pm.

There is plenty of parking in the nearby main car park. Doors open at 7.30pm.

Our guest speaker will be Dr Nigel Stephens, Consultant Cardiologist at North West London Hospitals NHS Trust, speaking on: "Good news for cardiac patients".

We are always pleased to welcome visitors, as our guests.

Joan

North West London Hospitals Trust Board, 28 Jan 2009

2009-01-29T21:26:00.004Z

Highlights of the meeting

1. Maternity figures are lower than expected It seems that people register with the hospital but then do not come for the birth. One theory is that several of these expectant mothers are East Europeans who are returning home because of the economic situation.

2. Infection Prevention and Control The number of MRSA cases is below the target, at 22 instead of 24 so far (32 for the whole year). In fact there have been no new cases since November. C.Diff cases are also well below the expected numbers.

3. Overall Performance The numbers of patients arriving at A & E has reached record levels. Cold weather and staff sickness contribute to the difficulties. Actually, this is a general London problem, even if not national. The healthcare Commission’s survey of A & E departments has found that there are major differences in responses between national figures and London figures, reason not readily explainable. The trust performs quite well when compared with other London trusts, not so well on a national comparison.

Paul

Winter takes its toll at Hillingdon Hospital in January 2009

2009-01-28T21:38:00.003Z

A very cold December combined with outbreaks of flu put The Hillingdon Hospital Trust under intense pressure. In January the Trust continues to have 30 additional beds open, to meet demand, as well as keeping more beds empty than is usual.

Winter vomiting virus is now imposing additional pressures. Some wards are already infected and are closed to new patients. The virus is more easily caught than the common cold and to curtail the risk of it being brought into the hospital, friends and relatives of patients are asked to make only essential visits.

Infections
The Trust had two MRSA cases in January making a total of 13 so far in year, breaching the whole year target of 12 cases maximum. The Board learned that three of the patients identified with MRSA had no symptoms, so it is possible that contamination of samples could have occurred. It was also noted that in January last year that there were 28 cases of MRSA in year, so there has been dramatic improvement despite failing the target. (Note too that every Trust has a target based on its own past performance, and that Hillingdon Hospital’s target is lower than many similar hospitals.

FinancesDecember’s financial performance was better than the same month last year and so the Trust’s financial position is as planned for this point in the year.
Joan Davis

Cancer Waiting Time Targets

2009-01-28T21:35:00.002Z

The following targets were introduced between 2002 and 2005:
Two Week Wait Rule:
If a GP suspects cancer, the patient must be seen by a consultant within two weeks

31 Day target:
A cancer patient must receive first treatment within 31 days of “decision to treat”

62 day target:
A patient referred by a GP must receive first treatment within 62 days of GP referral.

Targets from January 2009 are:
Consultant upgrades (62 day pathway)
If a consultant makes a cancer referral, treatment must start with 62 days.

Screening Referrals (62 day pathway)
Similarly if screening leads to a cancer referral, treatment must start with 62 days.

Subsequent treatments:
Patients with a recurrence of cancer or needing subsequent cancer surgery or chemotherapy, should be treated with 31 days of being fit enough to have the treatment.

From 1st January 2010
All referrals to a symptomatic breast service, regardless of suspicion of cancer, must be seen within two weeks

From 1st January 2011
Patients with a recurrence of cancer or needing subsequent radiotherapy or other cancer treatment, must be treated within 31 days of being fit enough to have the treatment.

There are also new rules about how 31 days and 62 days are counted. The clock cannot now be stopped for patients to consider options or go on holiday, so reported compliance is expected to fall.

Joan

Hiilingdon PCT can see light at the end of the debt tunnel

2009-01-28T10:07:00.002Z

Last month it was proposed that London’s 31 PCTs should all pull together to resolve London’s historic debts. The Department of Health offered a sweetener of £100m, so the deal has now been agreed, throwing a life-line to Hillingdon PCT which is still burdened with huge debts.

Providing Hillingdon PCT breaks even financially up to March 2011, including debt repayments of over £8m in each of those years, then its remaining £19m debt will be met by the other London PCTs. In the meantime Hillingdon PCT can borrow from the other PCTs to enable it to provide essential local investment. This is all fantastic news.

Less good news is that Hillingdon PCT and The Hillingdon Hospital are facing some difficulties in resolving coding problems that govern how much the PCT pays for the hospital’s services. Pending resolution, Hillingdon PCT is withholding payment above the level of its commissioning agreement. It is hoped that mutual understanding will be reached, but the hospital could seek resolution via arbitration.

The Urgent Care Centre at Hillingdon Hospital is breaking even for the PCT, but the hospital’s A&E Department is losing income in consequence. In contrast, the PCT’s Audit Committee found that the Referral Management Centre (designed to keep people out of hospital and provide services closer to home) shows no evidence of value for money, nor of improving the patient experience and it has had a negative impact on the relationships with The Hillingdon Hospital and GPs - but it has been successful in providing services more locally for 70-80% of GP referrals. This sounds like win some, lose some

Targets and ratings continue to absorb much time and energy. Sub zero temperatures in December plus a local flu outbreak caused The Hillingdon Hospital to breach its A&E target to treat all patients within four hours of arrival. It also had two MRSA cases that month, one above target, but this target demands reduction of previous performance, which started from a low number. So, despite breaching its target for this time of year, this hospital continues to have relatively good MRSA infection control compared with similar hospitals.

The PCT’s Healthcare for London event in the Chimes, Uxbridge, last November, showed that the public has little awareness of what the PCT actually does. The PCT’s new strategy aims to improve public awareness and participation in its affairs and it is inviting both Hillingdon Local Involvement Network, LINk, and other lay representatives to join a number of its committees.

Joan

West Herts Hospitals under winter pressure

2009-01-22T22:31:00.007Z

The Board of the NHS Trust heard both good and less good news at its first meeting in public in 2009.

Good news is that it is keeping MRSA numbers low with only 11 cases so far this year. It is also meeting national targets to treat patients within 18 weeks of referral by their GP. Its £1m surplus so far this year is further good news, although this is a smaller surplus than forecast, so it was greeted with muted approval.

However there were some bad things too, including seasonal pressures on beds impacting on A&E performance in December, which therefore failed to treat 98% of patients within four hours of arrival.

Worse from the patients perspective, was an admission that for some aspects of mandatory staff training there is currently a compliance of only 40% - this appeared to shock some members of the Board and certainly shocked the public who heard the report.

Also there was an admission that some wards are operating with less that their agreed complement of staff, because recruitment of additional staff has not been sufficiently successful. Bank and agency staff have been used, but they are costly, and that expense has undermined the Trust’s financial planning.

After a number of Board meetings with only good news, this meeting was less self-congratulatory than other recent meetings. However this Trust’s remarkable recovery from dismal failure must not be forgotten. It has accomplished near miracles and it is that success which makes this Trust well on its way towards achieving foundation trust status, which at one time was unthinkable.

Joan

Harrow PCT 20 January 2009

2009-01-21T20:46:00.007Z

Highlights, not a complete report.

The annual OFSTED assessment of services for children and young adults in Harrow was quite satisfactory: on the 7 areas considered Harrow achieved 2 grade 4 and 5 grade 3.

Performance Report The A&E 4 hour target is causing some worries, with a great increase in attenders recently, staff sickness problems have caused some difficulties. Some of these are seasonal problems but all the London PCTs have seen them. Childhood immunisations are below the intended trajectory, again a London problem with figures below national averages.

There is a new pharmacy contract and £1 M has been set aside to deal with it.

Medium Term Financial Strategy This has now been agreed by all 31 London PCTs. The cooperation of the London PCTs has clearly impressed the DoH, which has provided an additional £100 M for London, so that the levy on PCTs can be reduced from 1.3% to 0.8%. For Harrow this means a reduction of £1.2 M.

Sex and Our City Another joint report from the PCTs, giving information on sexual health needs assessment and available services. Expenditure varies widely across the boroughs but it is also clear that spending more does not necessarily provide better services. Much further work has to be done.

Registration with the Care Quality Commission The CQC is the new body that replaces the Healthcare Commission in April. All providers have to register and declare that they meet criteria of service provision. The item that requires some rapid action is training on policies and protocols for the prevention and control of hospital acquired infections. All relevant staff must have received appropriate training within the last 12 months, Harrow has to give such training to some of its staff. Non-provision of training could mean that registration is refused and the PCT would not be able to operate.

Paul Samet
21 January 2009

Hillingdon PCT at Christmas 2008

2008-12-28T18:37:00.002Z

1. Finance
Good news is that the PCT has been granted an additional £1.31m capital allocation, to be spent by the end of March 2009 on its backlog of estate needs and critical IT needs! The Trust still predicts breakeven at year end – its top priority – but it will be hard-pushed to achieve this as it is currently £5.1m overspent against budget.

2. Medium Term Financial Strategy for London (MTFS) This strategy aims to clear legacy debts of London’s PCTs and hospital trusts and to ensure implementation of Healthcare for London across the capital. A new Challenged Trust Board will ensure stringent controls and governance arrangements are in place for those trusts that are enabled to clear historic debts. If Hillingdon PCT maintains breakeven for the next two years, its outstanding debt at the end of 2010/11 will be paid off with funds provided by other London PCTs. (More details are given in the report from Harrow PCT’s December meeting). In the meantime Hillingdon PCT may be able to borrow from nearby PCTs to invest in Healthcare for London initiatives. From the perspective of Hillingdon residents, this is a major step forward, which - if the PCT can continue to balance its books - will eventually wipe out £19m of historic debt!

3. Operating framework 2009-10 / financial allocations
Hillingdon PCT is a loser under a new weighted capitation formula, which favours areas with a higher proportion of older people. Hillingdon is deemed 6.4% over-capitation, so the PCT will have reduced increases each year until it reaches its new target allocation. In the next two years it will receive the minimum growth of 10.6%, in contrast to the average of 11%, with some PCTs having considerably larger increases.

4. London Clinical and Business Support Agency (LCBSA)
This new agency, known as the “Hub”, brings together pan-London services, supports PCT commissioners and shares risks across the capital. It is expected to improve the health of Londoners and minimise costs. It will be responsible for delivery of Healthcare for London planning and The Thames Cancer Registry. Hillingdon PCT is a net gainer in the system and it is handing over its BUPA contract to the HUB.

5. London Specialised Commissioning Group (SCG) This Group, based in Croydon PCT, will operate as a single team, with five Divisional Directors. It will cover many specialised services eg Burns, HIV, AIDS, cystic fibrosis, cleft lip and palate.

6. Consultation on acute stroke and major trauma services
All 31 London PCTs are working together on these services and both East & North Herts PCT and West Herts PCT have shown interest in joining them too.

Three London trusts can meet the criteria for designation as major trauma centres by 2010 – Barts and The London / Kings College Hospital / St Georges Healthcare. Provision for some areas of north and west London are still being explored.

Twelve bids met the requirements for a hyperacute stroke unit, including Northwick Park Hospital. Hillingdon Hospital only met the criteria for being a stroke unit, but both these hospitals met the criteria for Transient Ischaemic Attack (TIA) services.

It had been intended that public consultation would start in January, but this may be delayed.

Joan Davis

West Herts Hospitals Trust - on track for foundation trust status!

2008-12-28T18:16:00.003Z

It seems that miracles can happen in the NHS.

In 2006-07, for the second year running, this Trust had Healthcare Commission ratings of “Weak” for both quality of services and use of resources, one of only four trusts in the country with such an abysmal record. Last year it achieved “Fair” for both ratings - and now it is well on the way to two “Good” ratings for the current year. Astonishing!

Two years ago it was a non-starter for financial trust status and faced being taken over or broken up – now it is on track to meet the Department of Health Applications Committee in May 2009, followed by Board to Board monitoring by Monitor in the summer.

It has responded to public consultation about its proposed foundation trust membership, and has both extended its consultation to February 2009 and replaced its “Out of Area Patient (& their Carers)” category with a new public constituency “Out of West Hertfordshire Area”, which will be welcomed by residents of Harrow and Hillingdon. Its membership is at 1800 and this is expected to grow when a Membership Manager takes up post in the New Year.

What has the Trust done to achieve such progress?

· It has conquered infections – no MRSA for the last two months and well within target for the year, and amongst the best in the country for its dramatic reduction in cases of clostridium difficile.

· It has achieved, or is on the way to achieving, all the national performance targets and it is a country leader with nearly 99% of its A&E patients being treated within four hours.

· As for finances, at month 8 in the year the Trust has a surplus of £1.2m and continues to forecast a £4.4m surplus by March 2009, although overspending on bank and agency staff could jeopardise that plan so - to combat the risk - if managers fail to deliver within budget, then their delegated authority will be taken away!

The Trust’s positive approach extends to an unannounced Healthcare Commission inspection in October. First hand feedback was encouraging, but with the report still awaited, the Trust has already put into place an action plan to meet criticisms the report might contain - boxes to be stored off the floors / regular cleaning of store rooms / cleaning schedules to be standardised / sellotape not to be used on posters / English tests to be undertaken by all Medirest staff prior to recruitment. The last of these points will be music to the ears of many patients and staff – although many will ask why this fundamental requirement was not standard practice anyway!

Joan Davis

The Hillingdon Hospital Trust - progress December 2008

2008-12-28T18:10:00.005Z

Progress has been steady, but without dramatic news.

Foundation Trust progress
Having gained Department of Health approval to advance toward foundation trust status, the Trust is now under scrutiny by Monitor. The process for election of public and staff Governors is underway with the election for the Council of Governors in February in readiness for authorisation as a Foundation Trust, hopefully in March 2009.

Surveys of equipment and estate
Matrons have audited the Trust’s mattresses, with 180 being replaced in early December.

The Trust’s property has been comprehensively surveyed, with a report of over 1500 pages. The buildings survey was undertaken by an external company, which reports a backlog of high/significant maintenance of over £22m, with a total backlog approaching £50m - excluding C Block at Mount Vernon, which was already awaiting demolition.

Maintenance designated high/significant risk means something that can have an effect on the delivery of core healthcare services e.g. the out-patients department roof at Hillingdon Hospital needs major repair work, for which tenders have been prepared. £30m has been allocated over the next four years to reduce this high/significant risk to £2.8m and the total backlog to £17.6m.

Safeguarding children
Following the court verdict on the Baby P case, all local authorities including Hillingdon Borough, together with their partners such as the Trust, have been taking stock of the effectiveness of local practices to safeguard children. Everyone hopes that nothing similar could fall through the safety net here.

Patients’ experiences
The Trust takes seriously the views of patients. 154 in-patient survey responses in October were, as usual, carefully analysed and league tables compiled, by ward, for each survey question. Survey results are used to improve performance and to encourage increased response levels from patients. Similar surveys are being piloted for out-patients and maternity patients. A Patient Experience Steering Group is being set up to receive and monitor survey results.

Infections
The Trust was disappointed to have two MRSA cases in November but it hopes to stay within its full year target of 12 cases maximum. However, a new Department of Health target to include screening of all day cases - approximately an additional 1000 patients per month - will be very challenging, as the Trust currently screens only 22% of these cases.

Finances Revenue was lower than expected in November and operating expenses relatively high, but the year-end forecast surplus remains unchanged. Agency and locum use exerted cost pressures, also energy and utility costs.

Joan Davis

NWL Hospitals Trust Board, 17 Dec 2008

2008-12-18T07:56:00.004Z

A rather brief meeting of just over 1 hour, well out of normal sequence (as the Board usually meets on the last Wednesday of a month the ‘proper’ date would have been 31 December – avoided for fairly obvious reasons).

Healthcare Commission and the Care Quality Commission
The HC is being abolished, to be replaced by the CQC, a new regulator of health services. All NHS trusts that provide health services will have to register with the CQC. Applications for registration must be made on-line between 12 January and 6 February 2009. It seems that at this time not all the regulations are known in detail.

NHS London Medium Term Financial Strategy
This is the same item already reported on in the meeting of Harrow PCT last week. Viewed from the hospitals it is not necessarily the good thing that the PCTs think it is. The fear is that the hospitals will get a bad deal from the PCTs.

Performance
Some interesting points here. Attendance at A&E is up quite considerably, about 8% compared to last year, with the reasons unknown. Last Monday 795 patients attended A&E, about 200 more than the previous ‘record’, more than 100 of these requiring admission to hospital. This caused a big problem with the provision of beds. Incidentally, many of the London trusts have high A&E attendance on Mondays, but no one knows why this should be so.

For the first time the Trust is ahead of its MRSA target.

There is a diarrhoea problem apparently, principally among elderly patients. The medical opinion is that as many of the elderly are admitted with respiratory problems they are given antibiotics, which have unwanted side-effects. So, take care which antibiotics are used!

Paul

Harrow PCT Board Meeting, 9 December 2008

2008-12-15T19:31:00.005Z

Apart from the usual business there were three highly interesting matters, involving major cooperation between PCTs. Brief accounts of these follow.

Proposals for a Medium Term Financial Strategy for London
NHS London now has a surplus of about £300 million but the local situation varies greatly. It is expected that by 2011 the historic debt will stand at £373 million for hospitals and one PCT (Hillingdon) will still have a debt of £19 million. A steering group of CEOs has developed an approach as an alternative to the top slicing approach used by the SHA, to tackle residual debts.

Basically, the proposal is that over the next 2 years PCTs are to invest from existing resources in a collaborative fund to help clear the debts of financially challenged Hospital Trusts and Hillingdon PCT. Five financially challenged PCTs (Bexley, Enfield, Hillingdon, Hounslow and Kingston) would not be required to invest in this fund until their debts are cleared. A Challenged Trust Board (CTB) of PCT and NHS London Directors would assist the local PCT in ensuring that a Hospital Trust receiving such funds was using them appropriately. In the case of Hillingdon PCT, which itself would be a beneficiary, it could expect to be monitored by this body.

London Clinical & Business Support Agency (Business Case)
A huge item, of about 140 pages! The aim is to provide a common agency for the supply of certain services and cooperative help. Very laudable, spelled out in great detail, in terms of legal contracts. If it all works as intended, PCTs will be able to give better services at reduced cost.

Provider Alliance with Ealing
Harrow and Ealing intend to form a joint agency for providing certain services (not exactly specified at this time). Again, the hope is that there will be improvements at lower costs.

James and Paul

Video No.16, Professor Gordon Rustin, Director of Medical Oncology, Mount Vernon Hospital

2008-12-13T13:56:00.007Z

Gordon Rustin qualified from the Middlesex Hospital, London in 1971. He was appointed Senior Lecturer in Medical Oncology at the Charing Cross Hospital in 1984, but moved full-time to Mount Vernon Hospital to become Director of Medical Oncology in 1995. He was awarded an Honorary Professorship by UCL in 2001 and visiting Professorship by University of Hertfordshire in 2006. He has published widely on management of gynaecological cancers and germ cell tumours’, the use of tumour markers, especially CA 125, and on phase I, II and III trials. His definitions using CA 125 to define response and progression of ovarian carcinoma are internationally known as the “Rustin criteria”.
Since 1990 he has been able to translate laboratory work on vascular targeting into the clinic. As chief investigator of the phase I trials of DMXAA, CA4P and OXI4503 he has developed a unique experience of running trials of vascular disruptive agents (VDAs). He has led the world in introducing functional imaging into determining the activity of VDAs. Because of his large referral practice, he is also able to contribute patients to many other trials. For 5 years until 2008 he was chairman of the ovarian cancer sub group of the NCRI gynaecological clinical studies group.
Part One

Part Two

Watch this spot!

2008-12-10T23:02:00.008Z

The spot to watch is found by tapping "Early Day Motion" into Google (or similar search engine) and looking for Early Day Motion 128.
This EDM has been tabled by John McDonnel MP, as a result of our long-running fight to get foundation trusts to hold board meetings in public - as all other NHS hospitals, local councils and parliament itself are legally obliged to do. The wording is:

That this House notes with concern that NHS foundation trusts are not required in law to meet in public, with the result that decisions that have a significant and direct impact on the provision of health services to local communities can be made by a board of directors meeting in secret; considers that this practice flies in the face of the principles of openness and transparency in health policy making; and welcomes the campaign by The Community Voice to draw attention to this issue and to call for a change in the current legislation to require NHS foundation trusts to meet in public.

We are bursting with pride at this reference to ourselves in such an august setting and by logging onto the site there is all the excitement of watching the number of signatures grow - today this EDM has 16 supporting signatures. How many will it have tomorrow? Make sure your MP is amongst those listed! Of course EDMs do not directly change the law but they are a stepping stone in that direction, so we are very grateful to John McDonnel MP for giving our campaign such a wonderful boost!

Joan

After the Christmas festivities ...

2008-12-10T22:50:00.003Z

In January, our usual first Thursday in the month meeting date falls on New Year's Day - so we shall NOT be meeting! However, our mailing will go out in mid-January as usual, our Executive will continue to deal with any pressing issues, and this web-site will be updated to keep members in touch with any developing news.

February will bring us up to date with the latest idea in the health field - polyclinics. Harrow is one of the five polyclinic pilot sites in London, so we are delighted that Dr Sarah Crowther, Chief Executive Harrow Primary Care Trust, is coming to our meeting on Thursday 5th February to tell us all about it. We will meet as usual at 7.45pm in the Postgraduate Centre at Mount Vernon. We welcome visitors, so do feel free to come to this meeting to hear our interesting speaker.

Joan

Paul Strickland Scanner Centre Update

2008-12-10T22:30:00.003Z

December brought us a home-grown treat at Mount Vernon. We meet in the Post Graduate Centre, just round the corner from the Scanner Centre. We heard from its Chief Executive, Margaret Sullivan, about its state of the art scanners - altogether five of them - 2 PET/CT, one 64 slice CT scanner and two MRI scanners, all replaced regularly to keep the centre always up to date. It also has a cyclotron on site, producing short-life isotopes , that allow the Centre to maximise the number of patients scanned and to undertake valuable research.

Its scanners have a huge range of potential uses, from identifying cancers to diagnosing a tear in a knee cartilage. They can be involved in diagnosis and treatment.

The success of the Scanner Centre is evidenced by its involvement in drug trials and other research, the grants it obtains, its many publications and its strong links with academia and industry. We are lucky to have it at Mount Vernon as a resource for local people - but the fact that it exists is also a tribute to the efforts of local people as it is a charity and ever grateful for the support it receives from fundraising by its many local friends and grateful patients.

After her talk, Margaret Sullivan joined members in welcoming in the festive season with traditional mincepies and seasonal drinks.

A happy Christmas and New Year to all members of The Community Voice and its many friends!

Joan

Video 16.- Dr. Edwin G.A. Aird BSc MSc PhD FIPEM MRCR (Hon)

2008-12-09T12:17:00.006Z

Medical Physics is the application of physics to medicine. Its origins are from the use of physics to determine the radiation dose to radiotherapy patients at the turn of the century (20th!!). Physicists now work in many different branches of medicine. However, at Mount Vernon, they are mainly involved in the use of radiation in imaging and radiotherapy. Physicists have a very long training period before they can operate as registered workers within the NHS. Following a degree in physics there are typically at least 4-5 further years of training before registration.

After qualification, Physicists can be found working in the following areas at MVCC (radiotherapy section):

Machine (linear accelerator) quality assurance and dosimetry;

Patient treatment planning using complex computer planning to design individual dose plans for each patient treated on the linear accelerators. This now includes the latest planning techniques that use Intendity Modulated radiotherapy (IMRT) together with Image Guided Radiotherapy (IGRT).

Patient dosimetry: verifying that the planned dose is being deliveredcorrectly, including the use of in-vivo dosimetry and portal imaging.

Teaching and Training of all staff involved with Radiotherapy: Physicists; Radiographers; Clinical Oncologists.

Dr. Edwin Aird's distinguished medical history, to the present day, started when he:-

Trained at Newcastle University (Physics BSc; MSc and PhD) and Newcastle General Hospital. He worked at Newcastle General in Medical Physics; Radiation Physics and Radiotherapy Physics 1967-1985.

Head of Radiotherapy Physics, Barts 1985-1988;

He was appointed Head of Medical Physics, Mount Vernon Hospital 1988-

He is also involved with running National Centre for QA in Radiotherapy Clinical Trials for UK; and Chair of Group for QA in Clinical Trials for EORTC (European Organisation for Research and Treatment of Cancer) 2006-

Part One

PartTwo

The Community Voice visited Bevan Ward

2008-12-07T18:39:00.003Z

On Friday, we were privileged to be guided around Hillingdon Hospital's Bevan Ward by Marie Batey, Director of the Patient Experience & Nursing. Everyone already knew a lot about this 24-bed ward, each bed in its own room with its own en suite facilities. This "Blog" has several reports about it, as well as a short film, but seeing is believing and everyone could still hardly believe their eyes! Some people suggested that patients won't want to go home!

No one wants to be ill, but if illness comes it is a great blessing to have comfortable surroundings. The first patients will move in from Fleming Ward in mid-January, allowing that ward to be refurbished. Their responses to all the new facilities will be carefully monitored, so that the patient's perspective can be incoporated into the underlying research. Ultimately, patients all over the country will benefit from the outcome of this wonderful project.

Video No. 15- Parts 1 & 2 - Consultant Surgeon, David Houlihan Burne on Knees.

2008-12-05T17:56:00.005Z

Mr David Houlihan-Burne is a Consultant orthopaedic surgeon at The Hillingdon and Mount Vernon Hospitals NHS Trust, specialising in knee and sports injury surgery. He qualified at St Marys Hospital Medical School in 1995 before embarking on a career in surgery. His orthopaedic training took place in various London teaching hospitals. He then undertook a knee and sports injury fellowship in Bristol where he gained further experience in knee reconstructive surgery. His research interests include innovate working practices to improve patient satisfaction and reduce lengths of hospital stay as well as advances in ligament reconstruction and knee cartilage preservation surgery. Mr Houlihan-Burne leads the Rapid Recovery Programme at Hillingdon Hospital which has shown dramatic increases in patient satisfaction and reduction in inpatient length of stay.

PART ONE

Minister praises Harefield Hospital for cutting-edge patient services

2008-11-29T13:09:00.004Z

PRESS RELEASE
Friday 21st November 2008

Ann Keen, Parliamentary Under Secretary for Health Services, today visited Harefield Hospital where she learnt more about its leading primary angioplasty service for heart attacks and its artificial heart programme.

Ms Keen spent an hour at the hospital meeting staff and patients who had recently benefited from care at Harefield. Praising the hospital, she said, “It is a privilege and an absolute pleasure to be here. Thank you for everything you’re doing – it’s fantastic.”

Ms Keen - a former nurse whose responsibilities include cardiac and cancer services, patient safety and chronic long-term conditions – was greeted by the Trust’s chief executive, Bob Bell, and chairman, Lord Newton of Braintree. She then toured the catheter labs where director of the Trust’s heart division and consultant cardiologist, Dr Charles Ilsley, gave her a detailed overview of Harefield’s leading primary angioplasty service for heart attacks. Dr Miles Dalby, consultant cardiologist, explained how the heart attack centre has the fastest door to treatment time in the country at just 23 minutes. Dr Dalby also described the importance of Harefield’s location - optimally placed in terms of geography to care for patients brought in directly by ambulance services from a wide surrounding area.

Meeting the Minister, heart attack patient Nicolas Farr, a farmer living close to Baldock in Hertfordshire, said of the primary angioplasty service, “If there wasn’t this treatment here at Harefield I probably wouldn’t be here. It’s absolutely extraordinary how quickly it’s done.” Fiona Hughes, a relative of Nicholas’ who is a former nurse, said, “I can’t fault the care here – it is inspiring to see such good nursing.” Nicholas’ wife, Trish Farr, also an ex-nurse, added, “Everywhere is so clean. It literally sparkles.”

Ms Keen then went on to the transplant unit where Dr Emma Birks, consultant cardiologist, gave her an overview of Harefield’s pioneering artificial heart programme – the largest of its type in the UK. A number of patients were introduced to the Minister including those currently living with artificial hearts. James Jackson spoke to Ann Keen about his cutting-edge treatment at Harefield.
James had been critically ill in his late teens and was given an artificial heart to allow his own heart to naturally recover. He then had his artificial device removed.

Earlier in the day, the Prime Minister Gordon Brown and Ann Keen visited the Magdi Yacoub Institute based at the Heart Science Centre on Harefield Hospital grounds. The Prime Minister unveiled a statue in tribute to the work of Professor Sir Magdi Yacoub, who he said was regarded as a hero around the world. The Prime Minister also took the opportunity to describe Royal Brompton & Harefield NHS Trust as “a magnificent Trust which is doing so much good work in so many different areas.”

Heart patient, James Jackson, who was also present at the unveiling, commented, “I was very nervous when meeting the Prime Minister but I was really impressed by how interested he was in my condition and how positive he was about Harefield.”

Royal Brompton & Harefield NHS Trust- Press Release

2008-11-29T12:37:00.003Z

Wednesday 26th November 2008

High risk profile of patients identified in transplant review

The report of the external review of recent outcomes in the heart transplant service at Harefield Hospital finds today that the overall high risk-profile of patients was an important contributing factor. The findings of both the external review of case-notes and the Trust’s internal review were consistent with the UK Cardiothoracic Transplant Audit (UKCTA) statistical analysis, which showed that heart transplant recipients at Harefield had a higher risk-profile in 2008 compared with previous years and UK centres as a whole.

Risk adjustment using the (UKCTA) risk model reduced the difference between the observed and expected number of deaths within 30 days at Harefield and at other UK centres in 2008. The centre effect estimate for Harefield reduced by more than 50 per cent with risk adjustment and the UKCTA analysis found that: “The number of cases was low (15) and Harefield was not identified as significantly divergent.” An estimate of 90-day mortality incorporating all patients transplanted in 2008 up to 31 August is awaited.

The report concluded: “The number of operations reviewed is small as heart transplantation in the UK is a low volume procedure, with only around 288 transplants carried out nationally over the 32 months of the review. As a consequence differences and changes in mortality, which may appear large, are not necessarily identified as significant from a statistical perspective.”

Commenting on the report’s findings, Professor Timothy Evans, medical director of Royal Brompton & Harefield NHS Trust, said: “We welcome the findings of this report and will continue to implement an action plan based upon its recommendations.”

For a copy of the report, visit:
http://www.rbht.nhs.uk/media/press-releases/transplantreview/ and open the PDF file at the foot of the page.

With kind permission - Royal Brompton & Harefield NHS Trust

North West London Hospitals Trust 26 Nov 08

2008-11-28T21:39:00.004Z

A fairly brisk meeting. The new chairman expects all Board membrs to have read agenda papers and so manages in 2 hours what used to take about 3. Good for him.

The ‘Dr Foster’ report has singled out the trust as the most improved DGH in the country (details already circulated on the CV blog, from the press release). General pleasure at this, showing that good work can be done in elderly buildings, by trusts that the Healthcare Commission does not rate highly.

The Joint Clinical Investigation Report to Brent PCT, Harrow PCT and NWLH Trust was about the infection control procedures of the two PCTs and the hospital. A very detailed report, with several recommendations for improvement. The hospital comes out of all this very much better than the PCTs.

There is a slight improvement in the financial position, the expected deficit is now rather less than was reported a month ago. But the real problem is that Brent and Harrow send more patients than agreed in the SLA. This leads to ‘overperformance’ (who thought up that word?) and so several departments exceed their planned budgets. This has to be reported, because the Board is required to know which departments are overspending. As the hospital cannot turn away patients who arrive at its doors this really only tells one what medical conditions these patients have on arrival.

Performance The cumulative A&E rate is now 98.4%. Recently, on one day over 650 patients came to A&E, whereas the usual attendance is about 550. The reason for this sudden increase is not known. The biggest problem actually turned out to be the handling of discharge notes, rather than dealing with the patients.

Response to MVH Consultation The Trust has responded that they would support ‘Cancer Centre with satellites’, and add that they would like to be a satellite. The response letter also questions why ‘Option A’ (moving the cancer centre) has been dismissed, reckoning that close liaison with a DGH would be advantageous. But they recognise the financial problem involved.

Paul
28 November 2008

Video No. 14 Judy Valverde, Manager, Postgraduate Centre

2008-11-28T19:31:00.004Z

Judy Valverde is the manager of the Postgraduate Medical Centre at Mount Vernon Hospital. This is the venue for the Community Voice meetings at 7.45pm on the first Thursday of the month.

Exciting times at Hillingdon Hospital

2008-11-28T08:30:00.003Z

How often do hospitals trusts have two things to boast about together? That is the happy position of Hillingdon Hospital. Bevan Ward, its pilot ward with 24 beds in single rooms with en-suite facilities is due to open early in January (scroll down to watch the video)– and a few weeks later it will be opening its new Treatment Centre at Mount Vernon Hospital. Here are a few facts:
The Treatment Centre handover is due on 19th January 2009. First patients will come on 3rd February. There will be a formal opening later, probably in March, possibly with a royal personage to open it.

The main entrance will contain two specially commissioned stained-glass art panels.

Completion of the nearby car park is not expected until several weeks after the opening, but some disabled spaces will be ready.

At first the Treatment Centre will have two operating theatre sessions daily, but extension of services is already being considered. It will have four operating theatres, 24 in-patient beds, and 14 day-case beds.

90% of elective care and orthopaedic care will transfer from Hillingdon Hospital to Mount Vernon – but patients who particularly want to be treated at Hillingdon will still have that option.

Around 500 staff have been consulted about the changes involved. Agreement has been reached with nurses, clinicians, theatre and therapy staff; and a pharmacist is being seconded to the Treatment Centre. Consultant timetables have also been agreed.

There will be changes at Hillingdon Hospital too. Day case beds there will be reduced from 19 to 14 and Jersey Ward will be closed. This will free-up 20 theatre sessions, the equivalent of closing two operating theatres. One ward from the annex corridor will be moved into the tower block.

Altogether an exciting time!

Joan

Hillingdon PCT's battle with debt

2008-11-28T08:28:00.002Z

Hillingdon Primary Care Trust continues to battle with financial problems. Its November Board papers show that at month 7 in the year it has an overspend of £4.5m. This is mainly due to unexpectedly high cost of hospital services. But an underlying cause is its £42 million historic debt. The PCT is still expected to break even in the year, despite repaying £7.7 million of the debt, plus £0.9 million for interest.

The Community Voice has made clear to NHS London that this burden is crippling local health services. We contend that the debt should be wiped out – the NHS is not democratic, local people had no control over the debt arising, so why should they suffer for years while it is repaid?

All the top staff in post when the debt arose have gone. The new NHS staff did a wonderful job last year in breaking even. Why should they be stressed by a debt they did not cause?

As an example of how this hurts local people, the Yiewsley Health Centre is one of the most neglected in the country, but there is no money to replace it. Latest news is that NHS London has set up a PCTs Group to resolve legacy debts. We hope that Hillingdon’s desperate need for help receives positive support.

Joan

Round-up from West Herts Primary Care Trust

2008-11-28T08:24:00.004Z

Estates strategy
51% of the PCT’s estate is over 33 years old. Some is barely fit for purpose and there is a backlog of maintenance. Last year 9% of recorded accidents were due to such failures, but all maintenance recognised as a safety risk is treated as a priority .

Surplus premises are often developed for other NHS services, but sometimes they are sold. It was noted that this is a bad time to sell, as prices are at bottom of the market.

Finances
NHS debts across Hertfordshire in 2006/07 totalled £84m. By the end of 2007/08 all these deficits were cleared. What a terrific achievement! The two PCTs can now start to invest in improving services, but must still take care. Future requirements are hard to predict and there are many uncertainties. For example, recent NICE guidance will oblige PCTs to pay for costly drugs, which they did not expect.

Mount Vernon Cancer Services Review
The PCT Board expects an interim report in January. It is encouraging that the West Herts. Professional Executive Committee, representing local clinicians, supports Mount Vernon Cancer Centre remaining on its current site, as the hub of a system with one or more satellites.
Update on Hemel Hempstead / Watford General Hospitals
There is much change afoot here. The Hemel Hempstead beds are no longer linked to Watford General Hospital, instead they are used for primary care provided by the PCT. In time they will be moved to a new hospital - a January workshop is to consider where best to build it.

A new Urgent Care Centre opened in Hemel Hempstead in October 2008, as first step towards closing the A&E there. Transport services are being strengthened, to support centralisation of health services at Watford General. The new Acute Admissions Unit at Watford will open in March 2009.

Change is in the air!

Joan

Good news from North West London Hospitals

2008-11-27T21:43:00.004Z

Here are press releases by North West London Hospitals Trust about two very interesting news items.

LOCAL HOSPITALS ‘MOST IMPROVED’ SAYS DR FOSTER HOSPITAL GUIDE 2008
The North West London Hospitals NHS Trust is one of the ‘most improved Trusts’ in the country for reductions in death rates, according to Dr Foster’s Hospital Guide published this week.
Improvements in care at the Trust have led to it being singled out by Dr Foster for making reductions in its mortality rate of around 30%, over three years.
The Trust’s Director of Nursing, Elizabeth Robb, said: “Our mortality rates were already below the national average but the sustained improvements we have made in 2007/08 puts us amongst the top acute trusts in the country for last year.”
Tom Moloney, Chief Executive of Dr Foster Intelligence, said: “We’re pleased to highlight in this year’s Hospital Guide that North West London Hospitals NHS Trust continues to reduce its mortality rate and is one of the most improved in the country. Clearly this is good news for patients and families and testament to the continued hard work of all hospital staff.”
The improvement is the result of an initiative at the Trust to introduce checklists across eight key areas such as stroke, diarrhoea and vomiting, heart failure and MRSA. The checklists set out for staff the top five things they can do that are known to improve care and save lives.
The idea was developed from the Saving 100,000 Lives campaign. Started in the United States in 2004 by the Institute for Healthcare Improvement, this aimed to reduce hospitals’ deaths by 100,000 in two years by hospitals following best practice.
“We adapted this and set a target of saving 110 lives and decided to pilot checklists for eight key areas” said Elizabeth Robb. “The good news is that before we started this project our mortality rates were already below the national average. At the end of the year our mortality rate dropped from 84 to 71 (100 represents the national average expected mortality rate). If you equate this to actual lives saved it is 285.”

STATE-OF-THE-ART THEATRE CUTS RECOVERY TIME FOR PATIENTS IN HALF
A new £500,000 state-of-the-art laparoscopy theatre at St Mark’s Hospital in Harrow, opened today by TV presenter Lynn Faulds Wood, founder of Lynn’s Bowel Cancer Campaign, and TV broadcaster John Stapleton, offers not only less invasive surgery but also faster recovery times for patients.
St Mark’s is one of only a few hospitals in London to use laparoscopic or “keyhole” surgery for advanced complex procedures such as removal of the bowel. In laparoscopic surgery, cameras are inserted into the body so the surgeon can watch what he or she is doing on a monitor. Only a small cut needs to be made – this considerably improves the outcome for patients, with a reduced risk of infection and shorter hospital stays.
The new theatre, one of only a few in the country, combines the latest high-tech equipment and high definition imaging, allowing surgeons to carry out complex surgery while making only small incisions. Equipment in the theatre is suspended from the ceiling by mechanical arms so that lighting and camera angles can be controlled by computers at the simple touch of a button.
Robin Kennedy, Consultant Surgeon at St Mark’s said:
“As one of only 16 hospitals to become a national training centre for laparoscopic colorectal surgery we will be using this theatre to train surgeons of the future. The new system also creates high definition images which are essential for the teaching we do both in the UK and worldwide.
“This theatre is purpose built for the keyhole surgery techniques we now use to remove the bowel. Combined with our enhanced recovery programme we are able to reduce the time in hospital after major bowel surgery. In the past people used to have to stay 10 or more days and take at least two to four months to recover fully. Now they stay four days and look fully recovered after two to four weeks.”
The theatre will treat 1,000 patients a year.

Note of explanation about “Dr Foster”
Dr Foster, the publisher of the annual Hospital Guide, provides independent information on health services in the UK. It is now the market-leading provider of research, analysis and communication products to NHS organisations.

Paul

Video tour of The Bevan Ward - Pilot project for single rooms

2008-11-12T21:23:00.005Z

The exciting news is that Bevan Ward, now on show to staff and with invitations in the local press for members of the public to see it too. This pilot ward has 24 beds, in three wings each colour coded, green, blue and lilac. Each wing with eight rooms of different design to the other two. The purpose of this pilot is to research the benefits for patients of having single bedrooms with en-suite facilities. Research will compare current and pilot ward facilities, to find out what effects the new facilities have on patient outcomes.
This video tour we hope will give you a good idea of what you can expect.
Internal fitting-out is still in progress so excuse any extraneous noise, when complete it will provide a quiet and peaceful experience.

Donald

December Meeting of The Community Voice

2008-11-10T12:58:00.005Z

Our next meeting is on Thursday 4th December. As usual this will be at the Post Graduate Centre Mount Vernon Hospital at 7.45pm. We are looking forward to hearing about developments at the Paul Strickland Scanner Centre as its Chief Executive, Margaret Sullivan, is to be our guest speaker.

Business will be kept to a minimum at this meeting, to allow time for us to socialise afterwards with mince pies and

seasonal drinks for eveyone attending.

How the year has flown - it is almost time to say "Happy Christmas!"

Joan

Audience spell-bound by speaker

2008-11-10T12:43:00.002Z

Jan Filochowski, Chief Executive of West Herts Hospitals Trust, held full sway over members of The Community Voice at our November meeting. He spoke for over an hour, answered questions as they arose, and his audience would have kept him there till midnight if the Chairman had not intervened.

Such a basket of good news is rare in NHS circles. A year ago his Trust was failing, with high rates of infections, long waiting lists, targets not met, heavily in debt with plans for rebuild of its hospital on hold and no hope of achieving financial trust status. Today all that is changed. Now it is amongst the best in the country for several targets and there is a surplus in the bank. Plans for rebuilding the hospital are moving positively ahead and consultation on becoming a foundation trust is already under way. Wow!

All this was backed from the audience with a recommendation that Watford General A&E is now wonderful – quick, efficient and kind. What a turn-around!

To apply for membership of the foundation trust telephone 08444 776321

Joan

The Bevan Ward in Pictures

2008-11-07T19:44:00.007Z

The Bevan ward has 24 beds, in three wings, each with a different colour scheme, lime green (?), blue and lilac. In each colour scheme there are four rooms on each side of the corridor. Each colour scheme has its own individual design. The purpose of this scheme is to research the benefits for patients of having single bedrooms with en-suite facilities. The building is portable and the life on this site is expected to be 5 years. Experience gained will be used in the design of the new hospital. More information in a previous entry, Thursday 30th October 2008

Donald

Secure drugs lockers in the drugs store.

Secure drugs store and dispensing room.

Patients social meeting area.

Lilac rooms shower & Toilet suite

Blue rooms shower & toilet suite

Green rooms shower and toilet suite

Lilac rooms

Blue rooms

Green rooms

Lilac corridor

Blue corridor

Green corridors

Design layout of the Bevan Ward

Artist's impression of Bevan Ward alongside Hillingdon Hospital.

Hillingdon Hospital NHS Trust – New Staff Uniforms

2008-11-02T22:38:00.005Z

The process for devising the new uniform choices has been extremely thorough.
The Trust needed to consider multiple facets such as the control and prevention of infection, combined with the welfare and safety of the patients and staff. In doing this, a number of open staff consultations took place where views were shared with representatives from all groups of Nursing, Midwifery and Allied Health Professionals. In addition, advice was sought on the equality related aspects of the of the uniform i.e. age, gender, religious and cultural requirements including specific individual needs where relevant.

The agreed choice of style, colour and fabric is as follows:

Styles
1. Tailored style tunic top with collar and scrub type trousers with a drawstring waist.
2. Tailored Scrub top (without collar) and scrub type trousers with a drawstring waist.
3. Dress in the same fabric as above.
4. Clip on/off sleeves can be provided.
5. Staff can order a mix of these ranges if desired.

Colours
▪ Matrons – Purple tunic/ scrub top and black scrub trousers
▪ Sisters – Navy tunic/ scrub top and navy scrub trousers
▪ Staff Nurse – Royal blue tunic/ scrub top and royal blue trousers
▪ HCA – Petrol blue tunic/ scrub top and petrol blue trousers
▪ Site Practitioners – Grey tunic/scrub top and black trousers

Fabric
Toray Antimicrobial

Footwear
It has been agreed that ‘Crocs’ may be worn but only in black and meeting Health and Safety standards i.e. no holes and only those Crocs with supporting straps over the heel.

With thanks to Cathy Moran, Deputy Nurse Director

North West London Hospitals Trust Board, 29 October

2008-11-01T17:08:00.006Z

Trauma Centres and Stroke Centres Following the ‘Darzi proposals’ there is currently a process of planning for the trauma and stroke centres that were proposed.
The trust is not bidding to become a major trauma centre but is supporting the bid by Imperial Healthcare Trust to become one. The services of the trust’s Maxillo Facial Trauma services would be available to Imperial and there could be rehabilitation services, using the Regional Rehabilitation Unit at Northwick Park would be a help for that. The hope is that Northwich Park Hospital could be designated as a (simple) ‘trauma centre’.
The trust is bidding for NPH to become a designated Hyper Acute Stroke Unit (HASU), supported by ‘stroke units’ at NPH and CMH and a TIA clinic at NPH. A HASU would receive all stroke patients in its area for the first 72 hours of their care, with subsequent transfer to the Stroke Units. The initial transfer into a HASU is intended to take place within 30 minutes of an ambulance arriving to pick up the patient. It is believed that Northwick Park is well placed geographically to deal with stroke patients in the North West area. The intended 30 minute transfer would not be achievable if the HASU were further into London.
In the discussion it was pointed out that the NHS tariff for such units is well below the expected cost of running them. These bids assume that appropriate finance will be made available, otherwise all bids are off. The hope was expressed that all bidders should take the same stance on finance.

Healthcare Commission Annual Health Check This refers to the year 2007-8. The trust was rated ‘Fair’ for service and ‘Weak’ for use of resources. The resources assessment is due to not meeting the financial targets. Regarding service, the trust met most of the targets but had poor results in the patient surveys. The overall scoring system seems to be curious, the HCC uses 59 indicators but reports on only 10 of these, and the rules appear to change without warning.

Healthcare for All, with special attention to People with Learning Difficulties This followed from a national review, which highlighted the difficulties that people with learning difficulties experience in accessing proper services. Healthcare professionals are often unaware of such problems. Among the recommendations is the appointment of a ‘Learning Disability Champion’ and proper training of staff.

Quarterly Matrons’ Report The Cardiology matron reported that at CMH the ward’s toilets were male and female but in the corresponding ward at NPH there was only a mixed gender toilet. Instant decision by chairman: put a second toilet there immediately!
The matron reporting on the Lister Unit pointed out that the place was badly maintained, no redecoration had been done for some 10 years. Second instant decision by chairman: do something before Christmas!

Finance and Performance The trust has a new finance director, Kishamer Sidhu. The year to date deficit is £5.6M, some £2.4M worse than the budget. The numbers of patients seen by the trust is well above the 'Service Level Agreementss' expectations and there is no indication that Harrow and Brent PCTs are willing to increase their payments. The chairman stressed the need to have credible plans in place quickly to improve the position.
Regarding performance, the situation is quite good. The A&E 4 hour target of 98% has been easily met, it is now 98.6%. (Returning only 97.6% last year was one of the reasons for the ‘Fair’ rating; having many more patients than expected is not regarded as an excuse for failing to meet a target.)

Paul Samet

Hillingdon Hospitals pilot ward is on show!

2008-10-30T00:55:00.004Z

Today Hillingdon Hospital’s Board heard several items of good news.

Firstly good news about recently published Healthcare Commission Ratings – it maintained its Good” rating for use of resources and improved its quality of service rating from “Fair” to “Good”, which was very pleasing.

Secondly it heard that it already has 4214 public members for its foundation trust – but it wants more, so it will continue recruiting. With only one MRSA case in September, it is currently on target for control of that infection and it is ahead of target for finances, which of course is all good news too.

However, the really exciting news was about Bevan Ward, now on show to staff and with invitations in the local press for members of the public to see it too. This pilot ward has 24 beds, in three wings each with eight rooms of different designs. The purpose of this pilot is to research the benefits for patients of having single bedrooms with en-suite facilities. Research will compare current and pilot ward facilities, to find out what effects the new facilities have on patient outcomes, including:

Reduction in healthcare associated infections
Sleep quality
Staff workload and walking distances
Patient satisfaction
Noise levels

Research will also test and compare room designs for:

Patient visibility if the door is closed
Distance from bed to bathroom
Space for visitors
Use of handrails to aid patient safety
Use of hoist for moving and handling patients

Staff are very excited about the ward and they praise the high quality of the facilities, which had not been expected in a prefabricated temporary building. They are confident that patients will be enthusiastic too. First patients will be using the ward before Christmas, after staff training is completed.

Joan

Hillingdon Primary Care Trust is in the news!

2008-10-29T00:15:00.005Z

Hillingdon PCT’s October Board Meeting brought a lot of interesting news.

1. Healthcare Commission Annual Health Check
The PCT improved from “weak” to “fair” on use of resources and stayed “fair” for quality of services – a step in the right direction!

2. Finance
The PCT still expects to breakeven in March, despite overspending £2.9m in the first six months of the year. This will take all its contingency funds plus additional savings – repaying its historic debt is a big burden and is still keeping it poor.

3. GP led health centres
All London PCTs have to open a new health centre this year. Hillingdon’s plans to replace Yiewsley Health Centre with extended services did not meet NHS London requirements, because the services could not be provided competitively. So the PCT had to think again. Instead, tenders are now being considered to provide new services in Hayes, mainly for patients of the Elers Road practice. This project will strain the PCT’s finances in 2009-10, but replacing the Yiewsley Health Centre remains the PCT’s priority.

4. Strategy for GP health services
All London PCT also have to plan how to implement Lord Darzi’s proposals for GP services to be provided in polyclinics – services can be provided within one building or from a number of locations through co-operation between a group of GP practices. Public consultation on Hillingdon’s plans will take place from November 2008 to January 2009.

Hillingdon’s strategy is to organise GP practices into eight groups, within three polyclinic areas based in:
i) Hayes Town Centre - to serve Hayes and Harlington, with some services at The Warren practice
ii) Uxbridge Town Centre - to serve Uxbridge and West Drayton, with some services in Yiewsley.
iii) Ruislip Manor - to serve Ruislip and Northwood, with some services in Northwood.

5. Engaging with patients, the public and service providers.
The PCT will be in the Chimes, Uxbridge, on November 3rd to gather views about health services from the public. It is also holding a conference on 14th November to explore how it can work with all its partners in social care, primary and secondary health care and the voluntary sector.

6. Current services
The PCT is meeting some national targets, including currently no MRSA cases, but it is below target on:
1. Choose and book
2. Early psychosis intervention
3. Chlamydia screening
4. Immunisations and vaccinations
5. Number of patients seen by dentists
6. Workforce sickness
7. Workforce appraisals

News on pressure ulcers is good - no cases in this quarter or last in Northwood and Pinner Community Unit at Mount Vernon, and with cases in nursing homes down from ten cases to six.

There were early problems with referrals lost between the new Referral Medical Centre and Hillingdon Hospital, but these problems are being overcome. Many patients are now being treated swiftly in the community instead of waiting for hospital appointments.

Joan

Deputy Superintendent Radiographer - Alan McNair - X-Ray Dept.

2008-10-26T20:14:00.003Z

The X-Ray Department is located in the Minor Injuries Unit in the Princess Christian building. Most types of x-rays are undertaken as are ultrasonic examinations. There is very little waiting time for x-rays, once called in, the whole process takes a few minutes.

Our meetings

2008-10-26T07:45:00.006Z

Our last meeting, in early October, was packed with news - from the sorry plight of Northwick Park Hospital, (part of NW London Hospitals Trust which was recently deemed amongst the ten most challenged trusts in the country), to the dramatic improvement in Watford General Hospital, (part of West Herts Hospitals Trust which now dares to seek foundation trust status).

We also had the pleasure of hearing Buzz Coster update us about the Lynda Jackson Macmillan Centre at Mount Vernon, a local jewel in its support services for cancer patients.Our next meeting is on Thursday 6th November, at 7.45pm in the Post Graduate Centre at Mount Vernon, when our guest speaker will be Jan Filochowski, Chief Executive of West Herts Hospitals NHS Trust, who will bring us up to date on all that is happening at Watford General Hospital. That hospital is in Hertfordshire, but its importance extends over a wide area - I personally have much to thank it for, although I live in Hillingdon. Visitors are welcome to this and all our meetings. There is a big car park nearby and parking is usually free.

Joan

The Community Voice visits the Houses of Parliament

2008-10-24T19:19:00.003+01:00

Nick Hurd MP kindly organised our visit to the Houses of Parliament today. We were in two parties of twenty people, escorted by highly trained tour guides whose knowledge was extensive.

The whole event was fascinating, from the new arrangements for receiving and screening visitors - fortunately it was dry and we did not have long to wait, but some visitors must arrive very wet as the queuing area is open to the sky! - right through to the end of our hour and a half tour.

We saw both the House of Lords and the House of Commons and were treated to a huge amount of history, anecdote and detailed information. It made a big impression on us all. As so often happens, it was the little things that will probably stay with us longest. I shall always remember this happy occasion whenever anyone says "Toe the line!" or "Its in the bag!" And next time I see the Queen wearing her crown I shall remember that it is actually very heavy - in weight, as well as history.

It was a great pleasure to be there and I am sure we would all highly recommend taking this tour if the opportunity arises, but potential visitors should be warned that once underway no one is allowed to sit down. Fortunately, there is now a visitors cafe, which many of us were pleased to visit as soon as the tour was over!

West Herts Hospitals Trust gets better and better!

2008-10-24T19:05:00.007+01:00

At this week’s Board Meeting the Trust was justifiably proud of its remarkable progress.

Last year the Healthcare Commission Trust rated the Trust “Weak” on both quality of service and use of resources but in recently published results for 2007-2008 it has been rated “Fair” on both counts – a tremendous achievement. However, the Chief Executive, Jan Filochowski, stressed that this only reflects progress up to the end of March and even more progress has been made since then. So the Trust hopes to do even better this year for quality of service but, sadly, it cannot improve it use of resources rating until its historic debt is cleared, which will not be until 2009-10.

However, improvements in current services are highly encouraging, with the Chief Executive suggesting that this year’s over all performance lies between reasonable and good. Many improvements were reported.

The Trust is now meeting and exceeding national standards for treating A&E patients within four hours.

For infection control, its has achieved the best improvement in the country, with a 98% reduction in clostridium difficile cases and no MRSA cases last month or this month. This achievement led to congratulations from Hertfordshire Primary Care Trust, NHS East of England, and even local newspapers – which do not often offer praise.

The Trust is also now close to achieving the 18 weeks targets, for the time between patients being referred by GPs and treatment actually starting.

Far fewer operations are now being cancelled and the Trust is now achieving the national target standard, although it is too late for it to reach that standard for the whole year. This improvement is despite St Albans City Hospital undertaking 50 more operations this year than last year, so it is considerable progress.

All this was good, but there was one area causing disappointment and concern. The recently published national patient survey showed that at the time of the survey (many months ago) patients were not happy with the service provided. The Trust is now making this issue a priority.

Joan Davis

The unveiling of a Blue Plaque to Aledxander Fleming at Harefield Hospital

2008-10-17T17:07:00.004+01:00

The unveiling of a blue plaque at Harefield Hospital on September 29th, to honour Alexander Fleming, is the second in a series of plaques being erected around The Borough of Hillingdon to honour famous people who lived or worked in the borough. The first being William Wilberforce.

The unveiling was attended by Professor Sir Magdi Yacoub, the renowned heart transplant surgeon and a group of invited guests. Lord Newton, Chairman of the Royal Brompton and Harefield NHS Trust introduced Cllr. Brian Crowe, the Mayor of Hillingdon who performed the unveiling ceremony.

Sorry for the unavoidable delay in posting this video.

Video No. 12 - Wendy Riddle, Chief Biomedical Scientist in Histopathology at MVH

2008-10-16T12:32:00.004+01:00

Histopathology was previously known as Morbid Anatomy which may conjure up gruesome images rather like the painting by Dutch artist Pieter van Miereveld ‘The Anatomy Lesson of Dr Willem van der Meer’.
So what is it all about?

Histopathology is the branch of pathology which deals with the tissue diagnosis of disease. A tissue diagnosis can be made on the basis of biopsy material taken from the patient on the ward or clinic or in the operating theatre, or from autopsy material.

The laboratory is staffed by a team of Histopathologists (medical doctors who have specialised in histopathology) and Biomedical Scientists who work together to prepare samples for examination and to establish a diagnosis.

The diagnostic information provided by the Histopathologist will enable the clinician to determine the best course of treatment and /or any further surgery that is required for the patient.

Joan Interviews Nick Hunt, Royal Brompton & Harefield NHS Trust

2008-10-13T18:33:00.005+01:00

After the unveiling of the blue plaque to Arthur Fleming at Harefield Hospital on 29th September, Nick Hunt , Director of Services, Royal Brompton and Harefield NHS Trust, responded to some questions from Joan Davis, Chairman of The Community Voice.

Donald

Video No. 11 - Michael Bishop, The 'Bio-Engineer'

2008-10-11T18:08:00.006+01:00

Physics and bio-engineering are little known but essential components of the cancer centre. The highly skilled workforce both service and check the complicated equipment to ensure that the correct amount of radiation is delivered to the area to be treated. It also creates bespoke items to meet individual patient need, such as supports to immobilise limbs or heads during radiation therapy.When new equipment is delivered the physics staff can spend between 2 and 3 months taking measurements to ensure the characteristics of the machine are known. These checks are repeated throughout the machines life as part of a rolling program of quality assurance.

News from Royal Brompton & Harefield NHS Trust

2008-10-11T12:06:00.007+01:00

Heart transplantation programme at Harefield Hospital to undergo review.

Royal Brompton & Harefield NHS Trust will be working with the National Specialised Commissioning Team (NSC Team) and the Healthcare Commission over the next month on a review of Harefield Hospital’s heart transplantation programme.

As part of the Trust’s routine monitoring and audit of its transplant operations, data is collected on post-operative survival including 30-day survival rates. Over the summer months of 2008, the Trust noted a small increase in mortality rates within 30 days of heart transplant surgery and, specifically, that the small number of deaths had occurred consecutively.

As a result, the Trust commenced an internal review at the hospital, developed an action plan and alerted the NSC Team. The NSC Team subsequently liaised with the Department of Health and the Healthcare Commission and all parties agreed that an external review should take place.

The review will be carried out by an independent heart transplant surgeon and a transplant cardiologist, agreed by the Trust, the NSC Team and the Healthcare Commission. If suitable donor organs become available during the course of the review, the transplant team will consult with the external reviewers before undertaking any heart transplantations. All other services, including the Ventricular Assist Device (VAD) and lung transplantation programmes, will continue as normal.

The review will comprise a case note review, a review of the actions taken so far and those planned by the Trust, and is due to be completed by the end of October 2008.

Professor Timothy Evans, Medical Director at Royal Brompton & Harefield NHS Trust, said, “We welcome the opportunity to work with the National Specialised Commissioning Team and our independent reviewers over the coming month. Heart transplantation is an incredibly complex field of medicine and a high-risk procedure. We are keen to be informed by the conclusions of the review and we will work hard to implement any recommendations which might emerge.”

(This is a press release from Harefield Hospital, which we have permission to copy here)

Cllr. Ray Puddifoot on Hillingdons Blue Plaque initiative

2008-10-02T10:33:00.004+01:00

Chairman Joan Davis interviews the Leader of Hillingdon Borough Council, Cllr Raymond Puddifoot, on the blue plaque scheme. The initiative involves Blue Plaques being put up in the borough to mark notable resident of the borough.
Donald

A blue plaque for Alexander Fleming at Harefield Hospital

2008-10-01T12:12:00.007+01:00

A Hillingdon Council initiative has honoured Alexander Fleming with the erection of a blue plaque at the entrance to Harefield Hospital, where he worked for a number of years from 1939.

The plaque was unveiled by the Mayor of Hillingdon, Councillor Brian Crowe, on Monday 29th September, in the presence of dignitaries from both Hillingdon Borough Council and the Royal Brompton & Harefield NHS Trust. The Mayor paid tribute to Alexander Fleming’s pioneering work in the development of penicillin, which brought such profound and lasting impact to the fight against infections.

Donald Edwards, Publicity Office of The Community Voice, was well prepared with both video and still cameras to capture the event. He also seized the opportunity to record interviews with some of the people who were present, adding another dimension to this very special occasion. We were most grateful to all those who allowed him to do this.

West Herts Hospitals seeks to become a foundation trust!

2008-10-01T07:14:00.005+01:00

The astonishing turn-around of West Herts Hospitals Trust over the last year has been frequently noted on this site. At yesterday's AGM we heard again about its meteoric rise from being one of the worst NHS trusts in the country to it becoming a leader in several fields.

This amazing progress has culminated in the Trust daring to seek foundation trust status - at one time an inconceivable development! East of England SHA backs this application and public consultation started on 22nd September. To obtain the consultation booklet telephone 0844 776 321 or visit the Trust's website.

The Trust needs to demonstrate public support for its application and it aims to recuit 5,000 members. Applying for membership will show personal support and help the Trust towards its aim, so we hope that many of our own members will choose to do so.

Joan

No. 10 Video. Karen Blackbond, General Manager, MVH

2008-09-28T21:41:00.003+01:00

Hillingdon PCT's September Update

2008-09-28T19:06:00.003+01:00

Areas where PCT is not meeting targets:
a. Choose and book – DoH reported level in July was 33% - Referral Management Centre is achieving 46% of all routine admissions. (Target 90% - but note HPCT is in top half of London PCTs)
b. Cancer - 62 days to start of treatment – 93% in June v target 100% (5 breaches since April)
c. Chlamydia screening a national priority – 1.5% in June v month target 4%
d. Immunisations and vaccinations a national priority
e. Workforce sickness – 5.6% in June v target 3.5%
f. Workforce appraisals – 26 in June v target 74
g. Contract management
h. Smoking cessation – 285 quitters in June v month target 386

Finance
a. Month 5 spend is £2.1m above budget - acute activity continues to rise, increasing by 7% this year.
b. Recent increase in pharmacy fees will cause a part year £1m cost – no extra cash yet from SHA.
c. Continuing care costs continue to rise as more people are becoming eligible.
d. Full year forecast is still to break even by using all reserves.

Cervical Screening
Hillingdon PCT’s five year target is to screen 80% of women aged 25 – 64 years, which would be expected to reduce deaths by about 95%. In 2007-08 Hillingdon achieved 74.42% (a drop from previous year). Only 13 of 49 GP practices in Hillingdon achieve 80% target. Two new managers are being recruited.

Balanced scorecard / patient satisfaction for GP services
The balanced scorecard reports on a range of factors to indicate overall perfomance and allow comparisons. Data for Quarter 3 in 2007-08 was presented alongside data for Quarter 1 2008-09.

Considering this data in a positive light:
a. 48 out of 49 GP practices, 25% are in the top group for management of diabetes and chronic heart disease (for which payments are made to GPs depending on their performance).
b. Using the green /amber / red system only 2 practices are in the red band for access to GP services versus 4 practices last year.
c. Three practices are in the red band for clinical cost effectiveness of prescribing versus 6 last year.
d. Two GP premises have moved out of the red band this year.

However close examination of the data published shows that
a. Only 3 out of 49 GP practices were green across all the good services indicators – and one of those is a practice serving patients with a high deprivation score, from premises rated red, which clearly shows that good service can be achieved where there is sufficient determination by the GP practice.
b. Conversely, 46 out of 49 practices still need to improve, despite an action plan introduced last year.

Also data from the Department of Health patient survey over five measures of access to GP practices, carried out earlier this year by the Ipsos Mori survey of 11,894 people, shows data for every practice by name and indicates that 20 out of 49 practices were below average in all areas identified. Also that:
a. For % of patients satisfied with telephone access, the Hillingdon average was just above the London average and just below the national average - but 13 practices were below all those averages.
b. For ability to get an appointment within 48 hours, Hillingdon was below national but above London averages – but 26 out of 49 practices were below all those averages.
c. For ability to book three or more days in advance the Hillingdon average was better than both national and London averages – but 18 practices were below all those averages
d. For ability to book with a specific GP, Hillingdon was just above the national average and above the London average – but 15 practices were below all those averages.
e. For satisfaction with opening hours, both Hillingdon and London were below the national average, but 28 practices were below all those averages.

The above outcomes are despite the PCT initiating an action plan in September 2007 to work with the 10 practices then having the least level of patient satisfaction.

In-depth work with up to 20 practices is now being undertaken to support improvement in the level of satisfaction over the five measures, including follow up with five of the practices identified for specific action last year.

Joan

Hillingdon's External Scrutiny Committee

2008-09-28T14:30:00.004+01:00

This Committee's September meeting co-incided with Hillingdon Hospital's AGM. This was unfortunate as the scrutiny agenda included both Hillingdon LINk and the Mount Vernon Cancer Centre consultation. However, both meetings were in Hillingdon Civic Centre so I attended the first part of this meeting, before going on to the hospital's AGM.

HAP gave a presentation on its administrative support to Hillingdon LINk, which I heard, but I was unable to stay to hear the Scrutiny Committee’s questioning.

I happened to see the Chairman later and learned that the Committee demanded an update from HAP in six months’ time and, most importantly, had agreed its excellent draft response to the Mount Vernon Cancer Centre consultation, taking precisely the same line as agreed by Community Voice at its September meeting - confirming support for the Cancer Centre to stay at Mount Vernon and for the Review Group to look at the possibility of the Cancer Centre having satellites on other hospital sites, with the proviso that finance, staffing and support issues are resolved so that ALL cancer services are first rate for patients.

Joan

West Herts news

2008-09-28T14:13:00.005+01:00

West Herts news comes from the September meeting of the Primary Care Trust Board

Hemel Hempstead changes
a. Management of Hemel’s intermediate care beds passed to West Herts PCT from 1st September.
b. An Urgent Care Centre will open at Hemel on 1st October.
c. Local outpatient and diagnostic services will stay at Hemel, together with a rehabilitation stroke unit.
d. The PCT proposes a new General Hospital in Hemel, but the site is not yet determined.
e. Negotiations for a NHS Surgi-Centre at Hemel are ongoing, planned to open in Autumn 2010.
f. There is delay in transferring acute services from Hemel to Watford due to construction problems.

Changes to services at Watford General Hospital
a. The Acute Admissions Ward has been handed to the Trust, for phased occupation from February.
b. Phase 1 of Children’s Emergency Department is now in use - it is well received by staff / patients.
c. A revised stroke pathway is to be introduced in October.

Mount Vernon Cancer Centre Commissioning Review
Public consultation is underway and ends on 4th November, with three options:
a. Move the Cancer Centre to a District General Hospital – the Review Group recommends rejection of this.
b. Develop cancer services on the Mount Vernon site.
c. Make Mount Vernon Cancer Centre a hub, with satellite cancer services on other Herts sites.

NHS dentistry access in Hertfordshire
a. The number of patients treated in the previous 24 months is down by 13.4%.
b. As a result of a new NHS contract in April 2006, four dentists decided to treat only private patients.
c. Hertfordshire is quite well served by NHS dentists and a large number can take more patients.
d. Standards for access to NHS dentists are proposed for Hertfordshire patients:
Urban routine treatment within 3miles and 15 minutes travel time,
Rural routine treatment within 12 miles and 30 minutes travel time,
Urban emergency treatment for those in pain, within 10 miles and 24 hours,
Rural emergency treatment for those in pain, within 12 miles and 24 hours.

New contracts for NHS services in South Oxhey and The Mount, Prison
The Archway Surgery has agreed a three year contract to serve both these groups of patients.

Finances
a. The PCT is required to break even in the current year with an under-spend of £1m.
b. Its current under-spend is £1.57m excluding contingency and earmarked reserves and uncommitted funds – it could end the year with £5.2m surplus, so it is considering how best to use at least £0.5m.
c. Proposals for investment include improving its cardiac and cancer re-hab. services / strengthening stroke prevention and services / increasing partnership funding e.g. Age Concern / Carers in Herts.

Targets
a. Data variability at Watford General is causing concern for the 18 weeks target for admitted patients.
b. The main risk for Provider Services is community paediatrics – data completeness is a problem due to the way the national formula calculates the target.
c. The ambulance services are in danger of not meeting targets.
d. Both East & North Herts Trust and West Herts Trust met their clostridium difficile annual targets.
e. Neither Trust met its MRSA target – E&N 33 cases v target 22 and West Herts 37 cases v target 18.

Hertfordshire staffing issues
a. Additional staff are being recruited to improve access to Psychological Therapies.
b. Workforce sickness is low at 4.77%, which is below national average for PCT staff.
c. Staff non-attendance at training sessions is to be penalised at £50 if not cancelled in advance.

Hertfordshire LINk
The launch is to be on 20th November. Shaw Trust has been appointed as host organisation.

GP Patient Survey in West Herts - results 2007-08
a. There has been a small decline in patient satisfaction levels for telephone access/ 48 hour access / ability to see a specific GP.
b. The PCT is writing to the Senior Partner of every underperfoming GP practice.

Joan

Items of news from Hillingdon Hospital

2008-09-28T13:47:00.003+01:00

At its September meeting the Trust Board was updated on several interesting items including:

1. New consultant appointments
The Trust has attracted strong candidates in virtually every specialty of its recruitment programme. This year it has already appointed new consultants in ophthalmology, obstetrics and gynaecology, paediatrics, neurology and orthopaedics plus two consultant appointments in anaesthetics which have still to be confirmed.

2. Hillingdon Hospital’s Pilot Ward with single room accommodation
The prefabricated building was delivered early in September. Its build quality and space layouts are very good, matching traditional or permanent build quality. Excitement about the research potential of this pilot ward extends far outside Hillingdon Hospital to the wider NHS, the health construction industry and the political world. “Open events” are to be held for staff, public and external professional groups over 2 weeks from end of October.

3. Referral Management Centre
Problems with the RMC are causing delays resulting in some patients not receiving appointments within the schedule for their pathway. This leads to a risk of missing diagnostic and treatment targets. Daily reports are now exchanged.

4. PCT/Hospital relationship
Whilst there are still a number of challenges, there is real effort on both sides towards real practical progress in this relationship. Both parties now recognise the need for a shared vision for the future health economy.

5. Finance Low income was expected in August, but has been worse than expected. The biggest swing was in the medicine division where income dropped sharply whilst costs rose. Efficiency savings improved over the same period, so the Trust is only £41k behind its target, but this masks the fact that surgery and women’s and children’s divisions are significantly behind with their savings plans. Agency, bank and medical locum costs have risen significantly.

6. SHA visit
The Trust’s A&E target to treat 98% of patients within four hours is on track over the current year, but its performance was inconsistent in August - so London SHA set up a visit by an inspector who is regarded as an expert in this field. Overall she was impressed at the transformation she thought had taken place since her last visit some three years ago. She was particularly complimentary about the Trust’s emergency admission process and discharge planning. However, she had suggestions about organising work and managing patient flows which are now being introduced.

Joan

NHS London Board Meeting, September 2008

2008-09-27T12:30:00.004+01:00

Here are some highlights from the meeting

A: Organisational Issues

Change of Chairman:
George Greener left in August. Interim Chairman is Mike Bell. Sir Richard Sykes starts in December 2008.

NHS London’s 2008-09 priorities are: Delivering healthcare for London / Strengthening commissioning / Performance regime and targets / Trust transformation / Healthy London / Internal effectiveness

NHS London’s key targets are:
A&E target, to treat all patients within 4 hours (now much better than last year)
18 week targets from GP referral to start of treatment (95% target for non-admitted patients is already achieved / 86% is now achieved for admitted patients, but target for December 2008 is 90%)

MRSA and clostridium difficile (currently good progress towards both targets)
Financial control (a surplus of £320m is planned for London in 2008-09; six trusts are currently overspending and six are spending too little)

Other measures of success:
Five networked polyclinics should be operational by March 2009 including Alexandra Avenue Clinic, South Harrow

A successful public consultation is expected on pan-London proposals for trauma and stroke care.

Achievement of targets is expected for A&E patients/ MRSA / clostridium difficile / replacement of mixed sex wards / targets for start of treatment within 18 weeks of referral by a GP

Outer NW London Group:
This Group comprises Brent, Ealing, Harrow and Hillingdon PCTs. It has been set up to provide shared community healthcare services via a single NHS organisation independent of the PCTs.

London Clinical and Business Support Agency:
This was set up in July 2008 to act as a hub providing support services to all London PCTs.

B: Problems in Harrow and Hillingdon

Hillingdon Hospital:
The Trust has provided less access to genito-urinary services than expected and has had breaches in the target for cancer patients to start treatment within 62 days

In August it had problems in treating A&E patients within its four hours target (but it has remained within its year to date target)

It missed its challenging MRSA target for July (but is now on trajectory with 5 cases to date).

It missed its clostridium difficile target (72 to end of July v target 56)

Hillingdon PCT:
At month 4, £1.5m below its target of £1.4m surplus

Below London average on GP practices offering extended hours (19th out of 27 PCTs providing data).

Below London average on chlamydia screening (24th out 31 PCTs)

North West London Hospitals Trust:
At month 4 it had a deficit of £2.68m - £0.9m more than planned.

It has not been achieving its MRSA target.

It just missed its clostridium difficile target (78 cases to end of July v target 76)

Royal Brompton & Harefield Hospital Trust:
Is not meeting national 18 weeks targets for either admitted or non-admitted patients.

Joan

North West London Hospitals Board 24 September

2008-09-26T20:50:00.005+01:00

I was unable to attend the meeting, but here are some interesting points picked up from the agenda.

1. Chief Executive's report

Maternity review. The report on three deaths during 2007/8 was published in mid-September. The review panel found these incidents were not the result of deficiencies in care bit highlighted some areas for improvements.

Mount Vernon Cancer Centre. This was a an almost straight copy of the press release but omitted the statement that option (a) [moving to another hospital site] was not being discussed by the review group. I wrote to Fiona Wise before the meeting, pointing this out and mentioning that I would certainly have raised it if I had been at the meeting.

2. Harrow Elderly Care Wards Report This refers to incidents that occurred while the wards were run by the PCT, i.e. before April 2008. There has been an inquiry into the potentially inappropriate use of restraints on elderly patients in Fletcher Ward. The problems had arisen at times when the ward was somewhat understaffed and several of the staff members were not properly trained. The PCT had been aware that there were potential difficulties but had been unable to do anything about them. [This item has been the subject of a lengthy article in the Harrow Times.]

All other items seem to have been fairly routine.

Paul

Two very different AGMs on consecutive days

2008-09-26T19:27:00.003+01:00

Hillingdon PCT’s AGM 23rd September 2008
This was in the afternoon, low key and all over in 15 minutes, before the routine Board Meeting. Just a few members of the public were present. It launched the Annual Report 2007-2008 highlighting the PCT’s main activities, accomplishments and areas for improvement. Copies are available by telephone: 01895 452047

However the Board had much cause for rejoicing. The PCT had achieved financial break-even for the first time in many years, had met all its financial duties and all national performance targets except for MRSA, where it was only marginally below its very challenging target. This was true success and very sweet.

The Hillingdon Hospital’s AGM
This AGM on the following day reported an equally successful year. However, in contrast to the PCT’s AGM, this was an evening event in the comparative splendour of Hillingdon Council Chamber. There were displays and refreshments before the meeting, followed by reports and presentations to a packed audience, which filled the Chamber. The Chairman, Tony Valentine, was clearly delighted with the large audience, mainly members of the proposed foundation trust. He noted the strong local support for the Trust indicated by that evening’s attendance and also by the large number of volunteers who work in the two hospitals and by the success of the Patients in Partnership initiative, which is thriving.

After highlights of the year from the Chief Executive Officer, David McVittie, including progress towards the Mount Vernon Treatment Centre which will open in January, the very successful Annual Accounts were present by the Finance Director, Paul Wratton. Then there were presentations on infection control, with senior nursing staff resplendent in their new dress uniforms. This was followed by news about Bevan Ward, the pilot ward for testing three types of single-bed rooms, which will open next month – this project is a step towards final plans for rebuilding The Hillingdon Hospital. Lastly there was a detailed update on progress towards foundation trust status, which may be achieved as early as next February.

The Trust’s Annual Report was launched too. Obtain a copy of the report, or apply for foundation trust membership, or find out more about becoming a Governor by telephoning 01895 238282.

Joan Davis

Our October Meeting

2008-09-14T12:36:00.003+01:00

As usual we will be meeting on the first Thursday in the month, on 2nd October, in the Post Graduate Centre at Mount Vernon Hospital.

Come and hear our guest speaker, Buzz Coster, talking about the wonderful work in the Lynda Jackson Macmillan Centre at Mount Vernon. Visitors will be very welcome.

Joan

Mount Vernon's Cancer Research

2008-09-14T11:18:00.002+01:00

Our September guest speaker, Dr Paul Nathan, Medical Oncologist at Mount Vernon Cancer Centre, set off our autumn programme to a memorable start. We could have listened to him for hours, so picking out highlights is almost impossible.

He told us that research is essential in a top cancer centre but it is very expensive, time consuming and, on average, achieves success in only 10% of trials. Pharmaceutical companies will only co-operate with centres that have a good reputation.

However, research has wide benefits. Entering a trial offers patients fresh hope, usually when all other hope has been exhausted, and they generally do better than other patients. Research enables the cancer centre to attract high quality staff, which benefits the local community because all cancer patients are treated by a highly qualified team. Nationally there is a shortage of skilled staff, but Mount Vernon Cancer Centre is generally successful in attracting and retaining the staff it needs.

Advanced cancer cannot usually be cured, so improvements depend on research. After early tests on animals, small numbers of people are tested to identify safe drug dosages and any major risks, before final trials with large groups of volunteers. The major funder is Cancer Research UK, but Mount Vernon needs an academic partner to have access to those funds, so it is exploring links with either University College London or the Royal Marsden Hospital, which is very exciting.

Mount Vernon’s cancer research is led by Professor Gordon Rustin, Professor Peter Hoskin and the speaker himself, who specialises in kidney cancer and melanoma research. Of around 6,500 new cases of kidney cancer annually in the UK, most patients live only about ten months after diagnosis. Chemotherapy is not a cure but Interferon helps about 10%. Mount Vernon is one of the few centres trialing Sunitinib, which delays progression of the cancer for about 70% of patients – of 35 patients in one trial, 8 patients are alive and well three years after the trial started, a huge advance. This drug is available in some countries but not yet in UK, which has led to protests from patients.

The National Institute of Health and Clinical Excellence (NICE) was set up for cost effectiveness and to tackle postcode prescribing. It is unique in the world but other countries are interested in it as a model. NICE assesses all drugs on their increase in Quality Adjusted Life Years (QALYs). Such assessments take a long time - Sunitinib has been licensed for use for three years, but NICE has not yet finished appraisal, a devastatingly long delay for patients with an expectation of living only 10 months. Sadly, cancer drugs are expensive and on average offer only a 14 month increase in life. This is poor compared with treatments for other conditions, which is why NICE may not endorse these drugs.

Radiotherapy is in new buildings at Mount Vernon but a new chemotherapy suite is badly needed there. The Cancer Treatment and Research Trust Appeal has raised almost all the sum needed but is still £200,00 short so a last hard push is needed for success. (To find out more and how to donate see the website www.cancertreatment.org.uk or telephone: 07758 739185 - some audience members indicated that they would take this appeal to meetings of their own organisations).

Joan (with apologies for late publication due to personal pressures)

Mount Vernon Cancer Centre - good news confirmed!

2008-09-14T11:12:00.001+01:00

Last month we said the tide was turning for the Mount Vernon Cancer Centre. On the day of our September meeting this splendid news was confirmed. However, the BBC’s mid-day television news was ambivalent, leading some listeners to think the Cancer Centre was under threat, when exactly the opposite was true!

The Review’s Publicity Officer was onto the BBC double-quick, and the next TV report made clear that the current proposal is to reject the Varley 2002 recommendation to move the Cancer Centre out of Mount Vernon. Major changes since 2002 suggest that instead of closing the Cancer Centre its services should be expanded, possibly by making Mount Vernon the hub of a system with satellite services in other hospitals.

However, in order to reject the Varley recommendations, all stakeholders must first be consulted, so public consultation is underway until 4th November. The discussion document is available on-line at www.enherts-pct.nhs.uk/mvcc - or telephone 01707 369701. The Community Voice urges all members to respond to this consultation, so that the public voice is loud and clear. We want the Cancer Centre to stay at Mount Vernon!

Joan - with apologies for late publication due to personal pressures

Brief update on Hillingdon Hospital

2008-09-02T00:12:00.005+01:00

Just a few notes about today's Board meeting:

1. Future Board Meetings
At its last meeting the Chairman announced that when the Trust becomes a foundation trust it will hold Board meetings in public, but this was not minuted. I was allowed to raise this omission before the Minutes were agreed, so I hope the Minutes of this meeting will confirm the decision. We have waged a long campaign for Foundation Trusts to hold Board Meetings in public so it is wonderful news that Hillingdon Hospital has agreed - we want to see it in print, to be sure it is true!

2. Hillingdon Hospital’s Pilot Ward with single rooms for all patients
It was agreed to call this ward Bevan Ward, in honour of Aneurin Bevan - a very apt choice in the diamond jubilee year of the NHS that he set up..

3. Delay in referrals from Hillingdon’s new Referral Medical Centre (RMC)
The RMC assesses whether to refer patients to acute or community services. Referrals to Hillingdon Hospital are arriving 7 days after referral, which both the hospital and Hillingdon PCT agree is unacceptable. The hospital considers that referrals should arrive within 48 hours, so that treatment can start as soon as possible. This issue is being carefully monitored.

4. New CT scanner and new endoscopes
Recent recommendations for stroke patients to receive a CT scan within an hour of arrival at A&E has led to 15% increase in demand fro CT scans since last year. So Hillingdon Hospital is proposing to spend £640 k on a new CT scanner and the business case was approved by the Board. This will reduce the hospital’s need to use the Paul Strickland Scanner Centre, but the Board received assurances that this will not destabilise the Scanner Centre.

The endoscopy unit currently uses very old equipment, past its accepted useful life, and the Trust therefore proposes its replacement at a cost of £207k.

All this is good news for patients.

5. Releasing Time to Care
Pilot projects have shown that changes in ways of working can allow nurses more direct contact time with patients. The Trust expects to introduce this project to all wards, starting with a launch on 29th September involving three wards – Katherine, Jersey and Pinewood. The project is based around modules which are expected to take a year to complete. Outcomes from pilot sites found that the amount of direct contact with patients rose from 25% to 46%, with great benefits for both staff and patients.

6.Death of Michael Rosen, Non-Executive Director
After adjournment of the Board Meeting last Friday, the entire Board attended Michael Rosen’s funeral. A discreet card of condolence was available at today's meeting, which I was pleased to sign on behalf of members of The Community Voice.

Joan Davis

North West London Hospitals Trust Board 27 August 08

2008-08-30T22:17:00.003+01:00

Performance In the past the Trust found it very difficult to meet the national target of ‘98% of A&E patients treated within 4 hours’. In April there was major reorganisation of how A&E operates and since then the 4 hour target is being met consistently, recently the figure was well over 99%. As a result the trust is now 75th in a national league table of A&E performance, whereas it was 144th in March.

Infection control is also improving. MRSA figures are slightly above target, but one is dealing with small numbers anyway, 15 so far this year instead of 11, so a single case alters that percentages significantly. C.Diff is well below target, but there are doubts about what the target actually is! The numbers are going down all the time, elsewhere they seem to be rising.

Utilisation of Operating Theatres and Cancelled Operations It seems that the trust’s utilisation of its operating theatres is a little under 70%, against a national target of 80%. The Medical Director pointed out that the utilisation could easily be increased by being slower at one’s work and, secondly, the trust does more operations than some other local hospitals with a much higher theatre utilisation So, there is more to it than a single figure as an indication of what happens in practice. And similarly with cancelled operations. It is not always administrative incompetence but there may be good medical reasons, such as the patient’s condition on the day is not as it had been expected to be when the operation was scheduled, that cause an operation to be cancelled. Both of these items showed that having a medical opinion is often a useful counter to an administrator’s views of what should be done.

‘The Productive Ward’ There was an interesting presentation on a scheme initiated by 4 trusts and now being spread to others, of how some reorganisation, including standardised layouts for stores and common procedures, can result in a big increase in the time that nurses spend with patients. In the pilot schemes there was an increase from 25% to around 50%. The trust is intending to introduce these new methods of working in the coming months.

Paul

August News from West Herts Hospitals Trust

2008-08-22T11:02:00.003+01:00

1. General progress
The turn-around of the Trust is being maintained. It is now meeting national targets for treatment within 18 weeks of referral by a GP, also the target for patients to receive treatment within 4 hours of arriving at A & E. Infections are low and reducing steadily. Additional work is increasing income and providing a small financial surplus. Cancelled operations are fewer. Delayed transfers have been reduced by opening an intermediate care ward at Hemel Hempstead. All this is a huge achievement.

2. Application for Foundation Trust status
The East of England SHA is now satisfied that the Trust can move towards being a foundation trust, possibly achieved in December 2009.

Public consultation on the Trust’s proposals will run from 23rd September until 16th December 2008. The Chief Executive, Jan Filochowski, has offered to come to a Community Voice meeting to explain the proposals to our members.

3. Watford Hospital
The Outline Business Case for the new hospital is now being prepared.

The last issue of the Health Service Journal, 14 August 2008, featured this £200m private finance initiative health campus, which is expected to take account of environmental issues – rainwater will be piped off the hospital roof to water the football pitch and there are hopes of cutting energy consumption by 27%.

4. Staffing issues.
Attention now focuses on recruitment, to reduce reliance on agency staff, which is expensive and less satisfactory than permanent staff.

From April to June the Trust recruited 90 new members of staff, compared with 27 for the same period last year. 14 additional midwives are due to start work soon.

The Trust is starting to replace junior doctors with experienced nurse practitioners at night. This improves quality of care, because issues arising at night generally require nurse intervention, and it also leads to financial savings.

Joan

News on the Mount Vernon Cancer Centre Review

2008-08-08T16:36:00.003+01:00

A “User Involvement Group” has been set up to feed the views of patients and the public into this Review. I am privileged to be a member. Other members come from across the wide area served by the Mount Vernon Cancer Centre.

We met for the first time on 7th August. There was a lot of support for the Cancer Centre. Several members have been patients there.

The first task of this Review is to reconsider the 2002 Varley Report, which recommended moving the Cancer Centre off the Mount Vernon site, a recommendation that still stands although so much has changed since then. A report is expected in November 2008 to address this issue.

Assuming that the Varley recommendation is rejected, the main task will then be whether radiotherapy should be provided at Mount Vernon alone or at Mount Vernon plus one or more satellites in Hertfordshire. Numerous factors must be considered including clinical factors, demographics, workforce and transport issues as well as plans in neighbouring areas. The Review’s final report is not expected until late in 2009 but there may be an interim report in Spring 2009.

This first meeting boded well - an encouraging start to a long process. The Community Voice has championed the Mount Vernon Cancer Centre through many dark days but, at long last, a strong ray of light is appearing on the horizon.

Joan

No. 9 Video. - Nuclear Medicine

2008-08-07T18:45:00.005+01:00

The Nuclear Medicine department is hidden away at the end of the main building on the lower ground floor, with the Endiscope Unit on the first floor.

Nuclear medicine allows radioactive markers to be administered to the patients and then tracked as they pass around the body, thus identifying abnormalities in the patient.Planning radiotherapy requires very specialised skills, pin-pointing exactly where radiation will be administered and ensuring that the patient is in precisely the same position each time they are treated .
Nuclear Medicine uses the application of radioactive materials to aid the diagnosis and for treatment of patients. Different radioactive isotope/chemical combinations are used depending on the part of the body under investigation or being treated. These decay naturally, emitting gamma (g) and beta (b) radiation.
Depending on the examination required, tests can just involve a series of simple blood tests, a collection of urine samples or being scanned. But all examinations involve the administration of a radioactive material either as a small injection or in a capsule form.All the scans are performed on a dedicated Gamma camera, which detects the radioactivity within the body and creates a computer image of the area of interest. The scans produced are usually viewed in conjunction with images from other modalities, such as, MRI, CT, Ultrasound and X-rays. These other imaging techniques demonstrate anatomy (what the skeleton or organ looks like), whereas the nuclear medicine scans demonstrate the physiology or metabolic activity (i.e. how the organ is working).As well as diagnostic tests the department also uses different radioactive isotopes for different kinds of therapeutic effects, the therapies vary from treating a hyperactive thyroid to alleviating bone pain for bone metastases.The nuclear medicine department at Mount Vernon Hospital consists of a multidisciplinary specialised team that includes 3 senior radiographers, 1 technologist, 4 physicists and 2 administrative staff.

London congestion charge, is your treatment costing you?

2008-08-07T12:40:00.003+01:00

Are you or a relative travelling into central London for NHS cancer treatment? Did you know that you could be entitled to a refund of the £8 Congestion Charge you may have paid? We are carrying out a survey to assess how well the congestion charge reimbursement scheme is working. If you pay the congestion charge to get to your treatment in London, please fill in our survey and tell us about it. Visit: www.macmillan.org.uk/campaigns and fill in the survey online, or contact rhaughton@macmillan.org.uk or on 020 7840 2036 for a copy. We know that people living with cancer face all kinds of unexpected extra expenses such as for travel, prescriptions and child care. So Macmillan Cancer Support successfully campaigned in 2004 to have the Congestion Charge reimbursement scheme put in place. We now want to hear cancer patients views on and experiences of it.

Please contact the above, NOT Community Voice.

Donald
Publicity

North West London Hospitals Trust Board Meeting 30th July 2008

2008-08-04T22:52:00.001+01:00

A successful bid
The trust has made a successful bid, subject to ministerial approval, to establish a clinical and laboratory service in the south of England for the diagnosis of patients with atypical and complex Ehlers-Danlos syndrome (this is a group of heritable disorders of connective tissue). A second such centre is being established in Sheffield, to cater for the north of England.

Midwife-led Birthing Centre
The Brent BC transferred successfully to NPH on 1st July. In its first 19 days there were 35 deliveries. This rate matches c.670 births p.a., whereas the unit in Brent had about 300 deliveries p.a. As one of he aims of the move was to increase the use of this service these initial indications suggest that the move was the right thing to do.

Performance
The trust now regularly meets the 98% target for A&E, exceeding it quite comfortably. Recently, on one of the hottest days of the year, they had the largest number ever of patients attending A&E, many with respiratory symptoms. Even so, they coped within the target. Well done!.

Finance
Finance is always a problem in the NHS, sometimes for odd reasons. It’s not that the money doesn’t exist, just that it’s in the wrong place. For instance, the trust has been given approval to appoint a number of junior doctors but the funding for their salaries has been delayed. Many parts of the NHS delay paying bills, so that their cash flow problems are eased, but this tactic leaves somebody else with a cash flow problem. This way of working was described as ‘problem transference’.

Paul

Mount Vernon’s new £1.43 million chemotherapy trial centre one step closer

2008-07-24T17:54:00.002+01:00

New unit, once approved finally, will provide state-of-the-art environment for cancer patients involved in chemotherapy trials

Northwood, UK – 23 July 2008 – A new £1.43 million chemotherapy research trial facility – which is being supported by the Cancer Treatment and Research Trust (CTRT) – is one step closer to being built at the Mount Vernon Cancer Centre. This follows consideration of a business case at a recent meeting of the Trustee of the East and North Hertfordshire NHS Trust Charitable Fund (known more commonly as enhance herts), which has been leading the fundraising efforts on this important project, through its CTRT Appeal.

In order to meet the needs of increasing numbers of patients and updated regulatory requirements for conducting clinical trials, the cancer centre’s current facilities need to be overhauled completely. The proposal is for the existing facility to be renovated and expanded so that patients undergoing chemotherapy trials, as well as those receiving standard treatments, will be cared for in state-of-the-art surroundings.

The chief executive of the East and North Hertfordshire NHS Trust, Nick Carver, welcomed the announcement: “The decision by the Trustee of enhance herts to approve the business case in principle, subject to all outstanding issues being resolved by its next meeting in September 2008, enables us to keep momentum going on this important project for the Mount Vernon Cancer Centre’s continued development. This means that we can carry on with the design work that is underway already and seek tenders to build the new facility – which we are aiming to open during mid-2009, subject to final approval being received.

2/Mount Vernon’s new £1.43 million chemotherapy trial centre one step closer

“This important project is just the latest in a series of major investments in the Mount Vernon Cancer Centre that have been managed by the Trust. In September 2006, a new £2.25 million brachytherapy unit – which provides specialist radiotherapy for diseases such as prostate cancer – was opened to patients. Just six months later in March 2007, the £21.82 million New Radiotherapy Wing began treating its first patients.

“Assuming there is no delay in the building of the new chemotherapy trials facility, £25.5 million of combined NHS and charitable investment will have been pumped in to Mount Vernon since the Trust took over the running of the cancer centre in April 2005. This has helped us not just to improve the range and quality of care provided to patients, but importantly also the environment in which they are treated. While there is more to be done still, many of the centre’s facilities have been transformed.”

Professor Gordon Rustin, who is a director of medical oncology at the Mount Vernon Cancer Centre and has been at the heart of plans to develop its chemotherapy trial facilities, said: “I am very pleased that the new unit is a step closer to being built. I and my colleagues – with the welcome support of the Cancer Treatment and Research Trust in particular – have been working hard to deliver this vital project.

“With our fundraising efforts continuing, we are confident that all the money needed to deliver the new unit will be raised. The real heroes of the CTRT Appeal are the cancer patients who formed the appeal committee, as well as the thousands of former patients who have made donations – both big and small.”

The proposed new chemotherapy trials facility at Mount Vernon will include:
· an area, comprising 16 treatment chairs and two beds, for treating up to six patients taking part in clinical trials and a maximum of 12 receiving standard chemotherapy;
· three consulting rooms for the examination of patients, undertaking clinical procedures, follow-up appointments and private discussions with patients and/or their families or carers;

3/Mount Vernon’s new £1.43 million chemotherapy trial centre one step closer

· one counselling room for consultations that may involve breaking distressing news to patients;
· two prep areas for laying up trolleys for phlebotomy and chemotherapy administration, as well as checking drugs;
· more space for research nurses who are monitoring patients taking part in clinical trials;
· better facilities for research data and sample processing.
· enlargement of the waiting room area to accommodate the increasing numbers of patients using the facility, along with their relatives and/or carers – including views of, and access to, landscaped gardens;

To date, after costs, £1.11 million has been raised through a combination of funds received and pledged, with an additional £300,000 underwritten funding available should it be needed. The current timelines see final business case approval being received in September 2008, subject to all outstanding issues being resolved to the satisfaction of the Trustee of enhance herts. The tendering process, which will commence shortly, should result in a contractor being appointed in October 2008, with construction starting the following month. If this timetable is delivered, then this would see the unit opening to patients from April 2009.

Three Board Meetings in two days - quick highlights

2008-07-24T13:22:00.003+01:00

Reading about three Board Meetings could be a marathon - so this just gives highlights. Watford PCT and Hillingdon PCT met on Tuesday, with Hillingdon Hospital Trust following, on Wednesday

Firstly common factors:
1. All these Boards watch finances like hawks - all have marginally overspent in the first quarter of the year, but still expect to break even in March 2009.
2. All are concerned about meeting infection targets, but all are reporting fewer cases, which is good news for patients.
3. None are meeting “Choose and Book” targets, but more patients are gradually having hospital appointments booked electronically, in GP surgeries.
4. New health centres are on the way - at Hemel Hempstead, Welwyn Garden City and Yiewsley – with building contracts hopefully in place by the end of 2008.
5. All have plans to tackle reductions in smoking and childhood obesity, and to increase rates of immunisation, screening and breast feeding.

Special Hillingdon items include:
1. Despite being in the top hospitals nationally for MRSA cases compared with number of beds, Hillingdon Hospital thinks its MRSA target is unfair. It started with few cases, but its target gets smaller each year and is now down to just 12 cases. Other same size hospitals have targets twice as big! “Failing” causes bad publicity and shakes patient confidence – remember this if it is unlucky and gets 13 cases!
2. Big news is that Hillingdon Hospital hopes to become a Foundation Trust in March 2009 and it has promised to continue holding Board Meetings in public! The Community Voice has long campaigned for this, as many FTs hold all Board Meetings in private.
3. The Mount Vernon Treatment Centre expects a grand opening in January 2009, with access aided by a new car park and a new road replacing the old “C” Block. But, who will open it - the Queen opened the Princess Christian building - so will she come again?
4. Also good news, Hillingdon Hospital’s pilot ward with single rooms will be completed in August and the public will be able to see it at an Open Day in September.

Watford issues include:
1. A new Urgent Care Centre is due to open at Hemel Hempstead in October 2008.
2. It was expected that by then inpatients would be received by the new Acute Admissions Unit at Watford Hospital – but the latter project has slipped to March 2009, leading to double running costs. The Primary Care Trust has set aside £2m to cover all such costs
3. The rate of GP referrals to West Herts. Hospital Trust is causing concern, up by 11.5% in first two months of 2008-09 compared with last year Causes are being explored, including patients being sent back to GPs (instead of consultant to consultant referrals), and possibly re-admissions following too early discharge from hospital.
4. Herts. County Council will get £361K per year for the next three years, to fund its Local Involvement Network (LINk). It must appoint a host organisation to provide administrative and other support to the LINk and it hopes to do so by September.

Joan

Topping Out - Mount Vernon Hospital Treatment Centre

2008-07-18T22:31:00.003+01:00

The "Topping Out" ceremony for the new Treatment Centre took place on Thursday 17th July 2008. Like the "Turf Cutting" ceremony which took place on 10th January 2007 where there was no turf to cut, likewise at the Topping Out, there was nothing to top! Still we visited the site and were shown round the ground and first floors. After a photo shoot we returned to the Managers meeting room. David McVittie CEO gave a brief outline on the project. See Video.

Construction of the Treatment Centre is on schedule. Hand-over is promised for the 5th December 2008 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.David McVitie CEO reassured us that at least 88 more parking spaces will be provided, close to the Treatment Centre, on level ground.
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, located in Hillingdon Borough.

No. 8 Video- The Post Room

2008-07-16T22:55:00.004+01:00

The Post Room may be considered the hub of the 'Snail Mail' for Mount Vernon Hospital. In charge of this important department is Elmer Gorospe. Known to many as Alma! Elmer does everything from collecting the mail from the postman to sorting the incoming and outgoing mail, franking outgoing mail and placing in the correct sack, tray or pigeonhole. Mail for Hillingdon Hospital is sent by 'internal mail' which is delivered via the shuttle bus. I was surprised to learn that Elmer is also a 'porter', she has to take the sacks of mail on a trolley to where the post van waits.
Donald
Publicity

The tide is turning for the Mount Vernon Cancer Centre!

2008-07-16T07:32:00.002+01:00

After fifty or so years of threat of closure, the tide is on the turn at last.

Nick Carver, Chief Executive of East & North Herts Hospital NHS Trust, which manages the Mount Vernon Cancer Centre, tonight assured Hillingdon’s External Services Scrutiny Committee that the Cancer Centre will stay at Mount Vernon. In his opinion its future there is safer than at any time in the last twenty years or more.

Why this wonderful news? Firstly, because investment over the last couple of years has transformed the site. Secondly, because the Cancer Czar, Mike Richards, came recently to the site and pronounced “We need Mount Vernon!” Thirdly, although Nick Carver did not quote this, recent guidance from the National Radiotherapy Advisory Group (NRAG) suggests that the UK needs to double its radiotherapy capacity – so it is not the time to spend a fortune on moving what is already up and running well.

Instead, conforming to latest guidance, the talk now is about making the Mount Vernon Cancer Centre the hub of a system, with one or more spokes on distant sites. Major diagnostic and treatment facilities could be concentrated at Mount Vernon, but with routine treatment provided also at satellite centres. That could make everyone happy!

Of course the current Commissioning Review must consider all options for the Cancer Centre, including moving it off site, as recommended by the 2002 Varley Review. Remember that recommendation still stands and will continue to do so unless and until it is considered again - and overturned.

Not quite time to uncork the champagne – but definitely the time to buy the bottles!

And, as icing on the proverbial cake, East & North Herts Trust has graciously reconsidered its constituencies for its Foundation Trust bid, so Mount Vernon will no longer be lumped with South Cambridgeshire and East Hertfordshire.

It was definitely a meeting I shall not forget.

Joan (15.7.2008)

Still no ambulance station in Ruislip

2008-07-16T06:40:00.003+01:00

What a saga! Back in 1994 the ambulances were homeless, sited in the road in Midcroft, off Ruislip High Street, waiting for calls with no facilities at all for the crews. There were petitions and counter petitions about building an ambulance station in the Pavilion in Kings College Road. That Battle was won by the opposition.

For a time ambulances were based at Winston Churchill Hall Ruislip, with crews waiting for calls in unsatisfactory upstairs accommodation. Then on to a temporary home at Mount Vernon Hospital. Now, still temporarily, they use the old Northwood & Pinner Community Hospital in Northwood Hills – it is warm and dry there, with basic facilities for the crews, but too far north to be ideal.

By 2006 an ambulance station site was identified behind shops in Pembroke Road, near the Ruislip Manor traffic lights but now, two years later, there is still no sign of building activity.

Our enquiries indicate that Transport for London, head leaseholder of the site, is blocking progress, despite planning permission for an ambulance station being agreed with Hillingdon Council. So we have written to the Deputy Mayor of London, Richard Barnes, to ask for his help to resolve this long-standing problem.

The only good news is that current ambulance response times are satisfactory, despite the lack of a purpose-built ambulances station. This is a credit to the crews of course, but they deserve a permanent, purpose-built home. We shall continue to press for this. Their fourteen years wait is already far too long!

Joan

No.7 Video- Paul Strickland Scanner Centre

2008-07-10T16:54:00.004+01:00

The Paul Strickland Scanner Centre remains at the forefront of world-class scanner technology with the latest CT scanner, 2 MRI scanners and a second PET/CT scanner just installed. The Centre continues to support the vital diagnosis, treatment and research into cancer conducted by our colleagues in the Cancer Centre. In the past many patients have travelled long distances to use the Scanner Centre’s services, especially for PET/CT. This has decreased as more PET/CT facilities have become available around the country.

The Paul Strickland Scanner Centre, is totally privately funded. It relies on donations and fund-raising events

Act quick to combat a stroke!

2008-07-10T12:34:00.005+01:00

The above poster is available from Community Voice on request by email.

We often hear how important it is to recognise a stroke - check that the patient can:

S - Smile normally

T - Talk normally eg answer a simple question

R - Raise their arms normally

( and stick out their tongue straight and walk normally)

If a stroke is possible and any of these responses are abnormal, ring 999. Speed is important because 15% of stroke victims can recover completely - but only if diagnosis and treatment are rapid.

Here is a quote from the Chief Executive's Report to East & North Herts Trust on 25th June 2008:

"QEII thrombolysed the first stroke patient in East & North Hertfordshire on the evening of 17th June. A 55 year old patient with a dense right sided paralysis which came on at 4.20pm was in casualty within 30 minutes. Dr D O'K was called at 5.13pm, the patient was assessed and given a CT scan, and thrombolysis started at 5.50pm. This was a remarkable turnaround time of less than 40 minutes from call to treatment. By 7pm all the patient's weakness had resolved. The patient was quoted as saying"it's amazing".

Joan - with thanks to Jean Dixon for attending the meeting

Next meeting of The Community Voice

2008-07-09T20:31:00.003+01:00

We do not meet in August and there is no mailing in July.

Our next mailing will be in mid-August. Our next general meeting is at 7.45pm on Thursday 4th September at the Post Graduate Centre Mount Vernon Hospital, when our guest speaker, Dr Paul Nathan, will update us on current research in the Mount Vernon Cancer Centre.

If anything of great note occurs in the meantime, we will report it here on our blog.

Have a good holiday!

Joan

Our July meeting focused on carers - their rights and their needs

2008-07-09T20:00:00.004+01:00

Our July meeting, last before our summer break, examined an important topic from many angles. We had three guest speakers to lead the forum, bringing views about carers from Harrow, Hillingdon and South West Herts, with input from three professional perspectives - Social Services, an organisation dedicated to carers, and a general organisation supporting older people. After each guest speaker had spoken for ten minutes, questions and comments were open to the audience.

Jill Akroyd, Development Manager, Herts Social Services, was invited to focus on the basic rights of carers, as defined nationally, plus any general problems that arise from the legislation. She told us about the new Revised National Carers Strategy , launched last month, which offers improved support for carers backed by £255m of funding.

Jonathan Sanders leads an older carers project for Hillingdon Carers, a voluntary organisation. He was invited to focus on how his organisation supports carers – and the key problems carers face. He noted the key role of GPs in alerting carers to their rights - but sadly only about a third of GPs are fully supportive.

Ann Hurley, Information and Advice Service Manager, Age Concern Harrow, was invited to outline the supplementary services her voluntary organisation provides for carers and the most frequently asked questions they receive from carers - which in her experience are about power of attorney and benefits entitlement.

Robust discussion followed and there was great concern that so few people are aware of Attendance Allowance, a non-means-tested benefit for patients who need help with basic personal care such as eating, washing, toileting. One member stated that she cared for her husband for nine years before anyone mentioned that he was entitled to help worth £67 per week!

Members were so incensed at the lack of posters and publicity about AA that they asked the Executive to explore launching a campaign to address this problem. Watch this space to hear what we actually do!

Joan

Chairman

No. 6 Video - The Estates Department. We Fix it

2008-07-09T16:05:00.003+01:00

The Estates Department are located round the side of the dental practice behind the Post Graduate Centre. It is a much smaller site than they originally had some years ago when I inspected plant in MVH.
As usually happens, they are not given much thought till something breaks down or falls apart, then they are called upon, like the emergency services, when can you come and sort out our problem.
Donald
Publicity

No.5 Video - The Volunteer Drivers of Mount Vernon

2008-07-05T12:23:00.003+01:00

Many patient attending the Hospital for treatment, have no viable means of public transport from home to hospital and back and taxi costs are prohibitive. This is where the Volunteer Drivers come to the fore. Without them many old or handicapped patients would experience great difficulty and expense getting to hospital.
Donald
Publicity

No.4 Video - The Comfort Fund Volunteers of Mount Vernon

2008-07-05T11:10:00.003+01:00

Volunteers are another group of 'The Unseen People of Mount Vernon'. Not only are they unseen but, as the word volunteers indicates, they are also unpaid. They give up their own time to help others and raise money for the hospital Comfort Fund, which goes back into helping the patients. You will note from comments in the video, this is a very satisfying use of your spare time. Why not think of joining up.

'Your Hospital Needs YOU'
Donald
Publicity

North West London Hospitals Trust Board 25 June 2008

2008-07-02T16:11:00.004+01:00

There was an interesting variety of issues raised at this meeting.

First, the good news. The (national) A & E target of dealing with at least 98% of patients within 4 hours is now being met regularly. Last year the trust averaged just under the target. Now the target is being met regularly, in one recent week the Trust achieved 98.81%. This is largely due to some reorganisation and better monitoring of what happens. MRSA is slightly up on target, 10 cases instead of 6, C.Diff is much better than target, 41 instead of an expected 57.

Next, some of the problem areas. We had the report of the Annual Inpatient Survey, for the period October – December 2007. This is the (national) Healthcare Commission’s report. At this trust 850 patients were asked to complete the survey forms but only about 350 (42%) did so, compared to a national response rate of 56%. On the whole the responses for NWLH were not very good, in the 20% worst performing trusts in 44 out of the 62 questions. Actually, most of the London hospitals did badly, especially the outer London ones. Among the best performing ones nationally were those who deal only with planned treatments, i.e. Royal Marsden. Figures for CMH were generally better than those for NPH. But one has to be careful in interpreting the figures, as several of the questions were subjective (e.g. ‘Did you find the food excellent, good, bad?). And some people don’t give correct answers: there are some matters where the survey answers contradict independent figures the hospital has its own figures, for instance on bed usage.

The quality of record keeping came up on other matters, too. First, resulting from the merger of Northwick Park and Central Middlesex, there are duplicate records, as the two hospitals had separate systems. Some people have been patients at both hospitals and the result is that records exist at both sites for the same patient. Combining these is proving difficult. But there is more, some patients give their names in different forms, even at the same hospital, again resulting in separate records. And people may also make mistakes in recording what they are told. It’s a big problem for the trust, in preparation for unified NHS records for the new national system. Steps are now being taken, by appointing additional staff and installing more equipment. There is also a problem of ‘cashing up’ outpatient records, because information is being missed especially in busy clinics. This has potential financial consequences.

Paul (once again, the only member of the public in attendance!)

No.3 Video - PATHOLOGY

2008-07-01T10:53:00.003+01:00

Pathology, everyone has their own name for the nurses that take our blood samples. As I was on my way in I met a couple of patients with the tell tale cottonwool on the arm, 'just seen the Vampires' , the other had just come from Transylvania. I call John, The Count till I eventually asked someone the correct name. The Phlebotomist. Now we all know.
Donald
Publicity Officer

No. 2 Video - Security at Mount Vernon Hospital

2008-06-27T16:13:00.005+01:00

In these days, where the news seems to always have stories of violence, even hospitals, which one would think were havens of peace and quiet, are not exempt. Notices about abusive language and violence to the staff are alien to most people who cannot understand anyone behaving this way to people who are trying to help them.
Dr. Ashish Rawal PhD., is a security guard, usually on night shift, till he completes his studies before, hopefully, joining Michael Sobel House as a complementary medicine therapist.
Donald
Publicity