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Health

Audience spell-bound by speaker!, November 08
At its meeting on 6^th November Jan Filochowski, Chief Executive of West Herts Hospitals Trust, held full sway over members of The Community Voice, including delegates from Ruislip Residents.  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

Hillingdon Hospital’s pilot ward is on show! October 2008

Hillingdon Hospital’s Board heard several items of good news at its meeting on 29^th October. 

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 24 hour 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:

Research will also test and compare room designs for:

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.

Hillingdon Primary Care Trust is in the news! October 2008

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.

A blue plaque for Alexander Fleming at Harefield Hospital, October 2008
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 many years from 1939. 

The plaque was unveiled by the Mayor of Hillingdon, Councillor Brian Crowe, on Monday 29^th September, in the presence of dignitaries from both Hillingdon Borough Council and the Royal Brompton & Harefield 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.

Two very different AGMs on consecutive days, September 2008

Hillingdon PCT’s AGM 23^rd 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.

Mount Vernon Cancer Centre – good news confirmed! September 2008
A month ago we saw that the tide was turning for the Mount Vernon Cancer Centre and this splendid news was confirmed on September 4^th.  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 4^th November.  The discussion document is available on-line at www.enherts-pct.nhs.uk/mvcc - or telephone 01707 369701.  We hope many members will respond to this consultation, so that the public voice is loud and clear.  We want the Cancer Centre to stay at Mount Vernon!

For a time ambulances were based at Winston Churchill Hall Ruislip, 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. 

Enquiries by The Community Voice, of which Ruislip Residents is a member, 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 a letter has been sent 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!

Hillingdon – out of the wood!  Or is it? June 2008
Last year Hillingdon PCT broke even for the first time in five years – a fantastic achievement!  However its backlog of debt is over £42 million – which the NHS says it must pay back.  £7.7 million is the amount it is supposed to find in the current year – a crippling burden.  Is that fair? 

The NHS is not democratic, so there was no way Hillingdon people could have stopped the debt arising.  Punishing the PCT is pointless – all the old Board have long since gone.  Punishing patients, children, old people who simply happen to live in the Borough is equally unjust. 

At the NHS London Board meeting this week, The Community Voice, of which Ruislip Residents is a member, made an impassioned plea for special help for Hillingdon.  If that plea falls on deaf ears Hillingdon will continue to have some of the worst accommodation in the NHS, since without money there can be no building of a new health centre in Yiewsley, nor replacement of The Hillingdon Hospital.  The 1940s temporary wards in that hospital are at last being pulled down – but that is only a first step.  A great deal needs to be done and with a huge NHS surplus in 2007-08 there is money in the bank to do it – it just needs a little creative accounting to set the money free.  We are watching and waiting!

Basic facts from NHS London June 2008

Board meetings last two or more hours.  Our report here must shrink to about two minutes.  Here goes!

Priorities for the year:  The SHA has six priorities for 2008-09.

1.  Consultation on delivering Healthcare for London
a.      PCTs or groups of PCTs will develop proposals for local services e.g. polyclinics.  PCTs will be asked to plan delivery of the total HfL programme by producing a five year Commissioning Strategy Plan.
b.      There will be pan-London consultation on major trauma and stroke pathways.
c.      Maternity pathways could require local or sector consultation.

2.  Commissioning
a.      The Department of Health has developed a programme called World Class Commissioning which outlines a set of competencies for PCTs.
b.      Pan London skills are being developed / also sector co-operation.
c.      All London PCTs will be expected to submit commissioning plans to NHS London by November.  They will then be assessed against performance on health outcomes

3.  Performance
Key targets are:
a.      A&E:  London achieved 97.3% of the four hour wait standard for 2007-08, just below 98% target.
b.      18 week waits from GP referral to treatment:  True now for 82% of inpatients - target 85% next December / and true now for 93% of outpatients - above 90% target for December
c.      Healthcare acquired infections – MRSA has dropped by 52% over three years and clostridium difficile rates fell 15% last year
d.      Modern matrons: target was to double the number by May 2008 - London rose from 436 to 906

4.  Trust transformation
To stabilise Acute and Mental Health Trust performance across London

5.      Public health initiatives
Priority is to combat smoking and obesity, the main causes of strokes and heart attacks

 6.      Improving internal effectiveness
To deliver future programme of work

All this will take money, so it is important that the London surplus for 2007-08 was £280million – 2% of its total resources.  Compare this with its 2005-06 deficit of £174 million.  Astonishing!

Herts Review of Mount Vernon Cancer Centre, June 2008

For people who love the Mount Vernon Cancer Centre, the new Herts PCTs Commissioning Review appears as yet another hurdle to face.  However it is heartening that Hillingdon PCT, at its June meeting, reaffirmed its support for cancer services at Mount Vernon. 

Its Chief Executive, Yi Mien Koh, recalled that in June 2006, when facing the possibility of services being moved from Mount Vernon to Hatfield (a threat now abandoned), the PCT Board had agreed. 
a) Proposed increase (to alternative cancer centres) in journey times and additional cost to individuals are unacceptable.
b) The preferred option is for safe and affordable supported ambulatory cancer services to be available at an accessible local site to Hillingdon
c) On the assumption that cancer services are to be withdrawn from the Mount Vernon site when Hatfield opens, the PCT will request that The Hillingdon Hospital considers the inclusion of ambulatory cancer services in its redevelopment plans”.   

She went on to state:
“I would like to take this opportunity to reaffirm Hillingdon PCT’s position taken previously, which I have conveyed to the two North West London PCT Chief Executives on the review steering group.”

And then she added:
“I have also expressed to David McVittie HPCT support for The Hillingdon Hospital to bid to take over Mount Vernon Cancer Centre from East & North Herts NHS Trust.” 

There was no dissent around the table – Hillingdon PCT Board shares our views!

Hillingdon Hospital rebuilding plans, May 2008

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

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

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

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

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

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

Andrew Lansley MP, Shadow Minister for Health, visited Mount Vernon Cancer Centre on 29^th April 2008

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

When the two MPs arrived, introductions were made, and we all set off on a full tour of the Cancer Centre.  In walking from section to section a number of informal exchanges ensued, which were informative and interesting.

In addition I was accorded the privilege of a few minutes with Andrew Lansley ahead of his private meeting with the Chairman and Chief Executive.  I thanked him for coming, expressed the concerns and commitment of local people to retention of cancer services on the site, and made clear that The Community Voice and its members, including Ruislip Residents Association, welcome support from all political directions, even though many of them are non-party-political organisations.  As Shadow Minister for Health, Andrew Lansley could be a very powerful ally.

Official opening of the new Radiotherapy Centre at Mount Vernon, April 2008

Monday 7^th April 2008 was a very special day in the history of Mount Vernon, the day when the National Cancer Director, Professor Mike Richards, came to perform the opening ceremony in the presence of a largely NHS audience, but our own member, Donald Edwards, was there too, busy taking pictures including a video. 

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

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

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

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

It was a very happy occasions and smiles were abundant,  I was very sorry that I could not be there myself.

All the Board Meetings come together! April 2008

This week has seen a bevy of Board Meetings in public, seven in two days!  I have attended four of them – West Herts PCT, Hillingdon PCT, NHS London and Hillingdon Hospital.   

Some themes are common to them all.  They are all challenged by national targets particularly the target to treat in-patients within 18 weeks of referral by GPs and the target for A&E departments to treat 98% of patients within four hours – hospitals are challenged as service providers, but PCTs are also held responsible as purchasers of services, and strategic health authorities are responsible for their whole patch. 

They are all concerned with money.  However, none of the NHS bodies in our catchment area are causing major concern this year.  Hillingdon PCT has made a mammoth effort and has achieved break even, but still carries forward £42m of historic debt.  NHS London expects to carry forward a combined total of £300m surplus from its patch this year, but it has plans to make good use of it all in the months ahead.

Infections are another common concern.  Huge input of both money and effort has been made to combat these threats.  The MRS bacteraemia plan for London is 70 cases or less per month, achieved in 6 of the last 10 months reported.  Clostridium difficile cases are now 14% lower than last year in London - and West Herts PCT reports that it now has one of the lowest rates of this infection in the country.

Every PCT in the country has to make plans for a new health centre or polyclinic in the year ahead, offering an 8am to 8pm walk-in service seven days a week.  West Herts PCT has already announced that it expects its new health centre to be in Hemel Hempstead.  Hillingdon PCT is considering Yiewsley as its most likely site.

Another common theme for PCT’s is the current requirement that they split off their “provider” services from their “commissioning” services, operating clinics and district nurses, health visitors etc at “arms length”.  They are all busy setting up their new arrangements.  Separating the purchasing of services from provision of services is intended to avoid conflicts of interest, promote better services, and eventually to allow new providers to tender for service contracts.

Lastly, how and when hospitals will achieve foundation trust status is a common concern.  Central and North West London Foundation Trust achieved success in 2007 (it provides mental health services to most of NW London area).  Royal Brompton and Harefield’s application ground to an unexpected halt because of uncertainties over new ways of funding research.  The Hillingdon Hospital is expected to get FT status next February, Royal National Orthopaedic Hospital in May 2009 and North West London Hospitals in December 2009, when possibly West Herts Hospitals will too.

In all directions NHS staff are busy with end of year summaries, whole year targets and milestones.  March 31^st is the dead-line for this year’s statistics.  April brings a clean sheet, to start a new financial year.

What’s new in Hillingdon PCT? - March 2008
Hillingdon PCT’s use of BUPA to check its hospital bills is being watched throughout the NHS.  The three-year contract, first of its kind in the country, was signed on 31st January.  Hospitals code each episode of care they provide.  High coding leads to high bills.  BUPA’s first task is to check and challenge invoices received by the PCT where coding could be too high - a task the private sector no doubt perfected long ago.  Maybe the NHS will learn a few new tricks!

Our local hospitals are all in a frenzy to meet their “18 week” target by end of year, on 31^st March.  This target covers time from GP referral until treatment actually starts.  Treating enough patients before that dead-line is speeding up hospital activity and of course causing lots of bills.  Net result is that Hillingdon PCT – and no doubt other PCTs too – suddenly find their careful financial predictions start to look silly.  Hillingdon PCT still hopes to break even at year-end – but is no longer as confident as once it was.

Hillingdon’s new Referral and Management Centre is up and running, with 461 referrals in its first two weeks.  The aim is to treat patients near home rather than sending them to hospital.  The PCT thinks this is great - cheaper than hospital care.  What do patients think?  I hope they are being asked!

Breast-feeding is in the news.  It is said to promote long-term health benefits, including preventing obesity.  However, Hillingdon’s breast-feeding rate is the worst in London.  So, local young mums can expect to be pressured to feed their babies as nature intended.  Problem is that some of them can’t and some don’t want to do this.  How far should they be pressured?  Should Hillingdon Hospital and PCT be penalised?  It is noteworthy that these questions were not asked in the PCT Board meeting!

Star studded panel of speakers on: “Lord Ara Darzi’s proposals for Healthcare for London” - February 2008

The main item of the Community Voice meeting on 7^th February was a forum on Lord Ara Darzi's proposals, which are currently the subject of public consultation.

The panel of guest speakers was truly exceptional:

Don Neam, Communications Director, Healthcare for London, from NHS London

Professor Yi Mien Koh, Chief Executive of Hillingdon Primary Care Trust

Dr Sarah Crowther, Chief Executive of Harrow Primary Care Trust

Gareth Jones, Director of Strategic Planning, West Herts Primary Care Trust

Don Neame introduced the proposals and noted that copies of the consultation document, and a short summary version, are available from FREEPHONE 0808 238 5430.  Responses must be received by 7th March 2008.

The main proposals are:

1.      Very specialised services concentrated in only a few hospitals across London e.g. major stroke services, trauma services, major children's services, 24 hour A&E services.

2.      More services in the community, closer to home, some in polyclinics.

3.      More services at home e.g. end of life care, more home births

4.      Polyclinics serving up to 50,000 people, either in central buildings or as networks of smaller health centres and surgeries, staffed by GPs, providing a wide range of shared diagnostic and other services, open extended hours.

5. Local general hospitals providing hospital services for the majority of conditions, with emergency surgery provided separately from elective surgery.

After the introduction, Gareth Jones gave a brief update on the outcome of the recent Herts public consultation on health services, noting that Herts is in some ways already implementing the Ara Darzi proposals – concentrating major hospital services at Watford General and Lister hospitals, with elective surgery only at St Albans and Lister hospitals, and eight Urgent Care Centres spread across the County. 

All the guest speakers contributed to the subsequent discussion and answered audience questions. These ranged widely, from concern about the future of the Northwood & Pinner Community Hospital site, concern about the much needed health centre in Yiewsley, and the impact of the various Ara Darzi proposals on local residents.  Several questioners emphasised the importance of maximising the advantage of the adjacencey of Harefield Hospital and the Mount Vernon Cancer Centre Centre, both of which serve a wide population.

Time ran out too fast. The flow of questions and comments could have gone on for ever!

After the speakers had left, other local issues were raised.  The excellent progress of Hillingdon Primary Care Trust towards financial stability was noted – it expects to break even this year, which is a huge accomplishment, although it will still carry forward over £42m of historic debt. 

The £1m Mount Vernon Cancer Centre Appeal was noted too.  This appeal is to aid research and to redesign the Chemotherapy Suite.  Donation can be made on-line at:

www.cancertreatment.org.uk

There was also an appeal for members of the public to support Hillingdon Hospitals bid for Foundation Trust status, by applying to be a member – this carries no obligations, but would provide occasional updates, by post, on hospital news.  Tel:  0800 8766 953 to apply.

 Hillingdon PCT News January 2008

Some people think NHS Board meetings are very dull – but this one certainly was not! 

Two new facilities are being launched, the Referral and Management Centre (RMC) and the Clinical Assessment and Treatment Service (CATS).  These will keep people out of hospital and provide services nearer to home.  Both are good news for patients.

Good news too about finances.  At last the PCT predicts breaking even at end of year in March, which brings in train permission from NHS London for more money to be spent on patient care - £1.5m to meet the national target for hospital treatment to start within 18 weeks of GP referral; £500k to support patients discharged from hospital; also money for clamydia screening and extension of GP opening hours.  All these will benefit patients.

Most importantly we learned that the former policy of selling off PCT land and buildings to raise cash is now dead.  Current policy is to retain and use all properties for health or social care purposes.  This reversal is partly due to public outcry about the earlier threats to sell PCT clinics – proving that public outrage can have impact!

Public concern about bed sores at Northwood & Pinner Community Unit, in Mount Vernon Hospital, also had impact, leading to a review published this week.  This shows that only one of the 16 pressure sores arose within the Unit - all the rest went in with the patient.  However the review uncovered the deplorable fact that in twelve months to April 2007, Hillingdon residents suffered a total of 50 pressure sores arising from stays in various hospitals!  The PCT is now pressing the hospitals to take better care.  

Also the Board showed it has a heart.  It refused to extend the two year moratorium on provision of electrically powered indoor/outdoor wheelchairs.  These are needed only by very incapacitated people who cannot leave their homes without a special wheelchair.  There is no legal obligation, so Brent, Ealing, Harrow and Herts PCTs have already withdrawn from provision.  Much to its credit Hillingdon PCT is exploring further how it might be able to help – no promises, but at least it is trying.

Policy on “Healthcare for London” is currently under public consultation.  All 31 London PCTs are holding roadshows.  Harrow’s was held last Saturday and was very interesting - Hillingdon’s is on Saturday 2^nd February, 1pm – 7pm, in the Middlesex Suite, Civic Centre Uxbridge.  Go along to learn more about polyclinics, specialist centres and possible changes in other hospitals.

Lastly, Hillingdon PCT has several staff changes - Hilary Pickles is retiring, Barbara Wood and Terry Kelly have new jobs.  All these will be missed.  A new post is to be created from 1^st April - Director of Patient and Public Involvement.

As a footnote, Hillingdon PCT ’s response to the Third Runway proposal at Heathrow is to oppose further expansion of the airport specifically on health grounds.  An interesting background paper was presented to the Board giving details.

Who could call that a dull meeting??

Hillingdon Hospital News – January 2008

Presentation to the Board on “Healthcare for London” proposals – Hillingdon PCT Chief Executive, Yi Mien Koh, aided by her Chairman, Mike Robinson, told members of the hospital Board about the Ara Darzi proposals to centralise major trauma, major stroke and major children’s services  into just a few hospitals, and to transfer many hospital services into the community.  Unsurprisingly, some of her audience felt threatened by these proposals and were very critical.  This item took a big chunk out of the meeting, so other items were cut short.

Heathrow’s January Crash - the near-disaster at Heathrow earlier in the month led to 18 minor casualties, a mercifully light outcome, but it showed that the hospital is ready for anything, so congratulations are due for all the forward planning and staff preparedness.

Infection Control –  targets for the year for cases of MRS and clostridium difficile were breached long ago.  The best to hope for now is improvement month on month, which happened in December, so progress is being made.  Also, external agencies have been complimentary about the measures the Trust has introduced.  A new start in April will be very welcome.

Hillingdon Hospital rebuild - demolition of Tudor and Willows buildings is starting now, to be followed by construction of the exciting “Pilot Ward”, due for completion by August 2008.  This will be used by the Department of Health and the Trust to test out the use of single bedroom wards.  If patients and staff like the pilot, this research will influence the design of the new Hillingdon Hospital and other hospitals across the NHS.

The new Mount Vernon Treatment Centre – building is on schedule and due for completion in December 2008.  The existing Princess Christian building is being redesigned internally.  Some staff are being moved out temporarily during this work.  When everything is finished, everyone will rejoice! 

Money – despite an unexpectedly high seasonal deficit in December the Trust remains, much to its credit, on target to end the year in surplus. 

Foundation Trust bid - the Trust is still a lot short of the number of members it needs to show that the public backs its application for Foundation Trust status.  Get application forms from Tel: 0800 8766 953 – or from Joan, (see top of web page for details), who has several thousands!!  Give them to family, friends, neighbours and other contacts – try taking them to the work place, the golf club, or wherever you can.

Save Cancer Services at Mount Vernon Petition Delivered to Whitehall, December 2007

77,781 Petition signatures reached Whitehall!

Many members of Ruislip Residents Association were active contributors to the Community Voice petition to “Save Cancer Services at Mount Vernon Hospital” which earlier this month was presented to Ben Bradshaw, Minister of Health, with a final total of 77, 781 signatures.  Surprisingly, he had summoned a reception party of three relevant Chief Executive Officers – David McVittie, CEO Hillingdon Hospital Trust; Nick Carver, CEO East & North Herts Hospitals Trust,  Anne Walker, CEO West Herts and East & North Herts Primary Care Trust.

The delegation included three MPs,giving cross party political support - Nick Hurd MP (Ruislip / Northwood), Gareth Thomas MP (West Harrow) and John McDonnell MP (Hayes and Harlington).  John Randall MP (Uxbridge) supported the cause but could not be present.  Four Community Voice members completed the team, one from Harrow, one from Watford and two from Hillingdon – those representing Hillingdon are both RRA members, Joan Davis and Donald Edwards.

They petition was presented amidst many photographic flashings – including some from the Harrow and Hillingdon Times, which sent photographers to Whitehall to record the event.

This was followed by frank and open discussion with the whole gathering.  The delegation stressed three things:

1. Local people right around Mount Vernon want the Cancer Centre to stay on that site – providing local cancer services.
2. It is absurd for the Cancer Centre to be run from Stevenage – 30 miles away.  Local people want it to be run locally, logically by Hillingdon Hospital, which already provides anaesthetic services and is its landlord. 
3. Collaboration between the Cancer Centre and the Marsden Hospital is welcomed locally – the Cancer Centre suffers from isolation and prestigious friends in the NHS would be an asset.

The Minister gave assurances that there are no current plans to move the Mount Vernon Cancer Centre. The forthcoming Herts. Cancer Services Review will consider cancer services strategically, including the future role of the MV Cancer Centre and local views will be taken into account.

Now we must await proposals in the Herts. Review, expected early 2008, and hope that the petition and representations will influence what is proposed. When ordinary people pull together, they can have impact on what actually happens!

 Joan Davis

Hillingdon is a guinea pig for the NHS, November 2007

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

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

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

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

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

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

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

Snippets of news from the Community Voice October meeting

Roger Sale, long-standing friend of the Community Voice, has retired as Director of the Paul Strickland Scanner Centre at Mount Vernon.  He will be sadly missed.  Margaret Sullivan, his successor, takes up the reins at an exciting time.  The Scanner Centre is about to install an advanced CT scanner and early next year it is getting an additional PET / CT scanner – all achieved with public donations.

Paradigm Housing has awarded £1000 to Community Voice!  This will pay out-of-pocket expenses to Hillingdon residents who travel on our business and allow Hillingdon residents who cannot travel by public transport to come to our meetings.  So volunteers can help us without digging deep into their own pockets.  No excuse now for not volunteering! 

Central North West London Foundation Trust wants feedback on the mental health services it provides in Harrow and Hillingdon – both good and bad reports are welcome.  Martin Plummer represents us to the Trust on these issues.  ‘Phone him on 0208 573 1790 to give him feedback in strict confidence, which he will pass on to the Trust.

Royal Brompton and Harefield Hospital has a vacancy for a Non- Executive Director.    We have the relevant application form.

The Community Voice petition to “Save Cancer Services at Mount Vernon Hospital” has over 75,000 signatures and is still growing!  Time is running out, so get stray petition forms back without delay.

We responded to the West Herts public consultation on its acute health services.  Now we await the expected review of Herts cancer services and hope our huge petition will make it abundantly clear that local people want the Cancer Centre to stay exactly where it is - at Mount Vernon!

Harrow Council is being taken to Judicial Review about its withdrawal of support for care services .  We will watch this with great interest.  From the patient’s point of view health care and social care are equally important in providing a good quality of life.  Other Councils will be watching closely too, so this review will have impact way beyond Harrow.

Our October speakers were David McVittie, CEO Hillingdon Hospital and Davina Baptiste.  As always, David McVittie was a fascinating speaker – he updated us on building plans at both Hillingdon and Mount Vernon Hospitals and talked about Foundation Trust plans.  Davina Baptiste outlined the national bowel cancer screening programme.  More details about all these issues are available on request.

Next Community Voice meeting is on Thursday 1^st November - 7.45pm in the PGC Centre, Mount Vernon.  Claire Murdoch, CEO, Central North West London Foundation Trust will speak on mental health issues.

Ruislip Residents collect petition signatures! September 2007

A few weeks ago the Community Voice challenged its members to spend a day at their own local supermarkets collecting signatures for the “Save Mount Vernon Cancer Services”.

Ruislip Residents Association responded by collecting signatures at Waitrose in Ruislip last Saturday, collecting a total of 929 signatures!  This brings the full count to over 74,000 – a splendid number, which is still growing.

The public’s tremendous support for this petition should send a firm message to the NHS - leave cancer services at Mount Vernon!   We hope the cancer review, expected in a few months’ time, will show that the NHS does listen when the public voice is loud and clear.

Thanks are due to all those who contributed to our very successful collection.

Hillingdon PCT seeks private sector help! September 2007

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

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

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

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

“Save Mount Vernon Cancer Centre” petition, update September 2007

Stop Press!

Waitrose in Ruislip has agreed that we can collect signatures for the “Save Mount Vernon Cancer Centre” petition next Saturday, 22^nd September.

We hope to collect signatures from 9am to 5pm but we need lots of volunteers to help do this.  Give Joan Davis a call on Tel: 01895 636095 if you have an hour or two to spare.  There will never be less than two people collecting and at least one of the team at any time will be able to answer questions from members of the public – so anyone can volunteer.

The petition broke its initial target of 70,000 signatures last weekend!  Now our target is 75,000!  If we all pull together this can be achieved.

Increased numbers will convey an even stronger message that local people want to keep their cancer services at Mount Vernon.  There are no short-term risks, so current patients are safe, but we want these services long-term to meet the needs of future patients.  Remember, one in three of us will get cancer one day! 

Mount Vernon Cancer Centre Director speaks to The Community Voice, September 2007

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

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

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

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

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

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

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

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

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

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

Ruislip Residents is holding a special event to collect signatures at Waitrose, Ruislip, on Saturday 22^nd September – it has permission from the store to do this, but it needs people to do the collecting.  Please ‘phone Joan on 01895 636095 if you can spare a couple of hours between 9am and 5pm on that day.

Hillingdon Hospital - will it get its rebuild?

Hillingdon Hospital is well ahead with its plans to rebuild with 100% single rooms, but moving its plans forward needs support from NHS London. That is now uncertain because the report from Professor (now Lord) Ara Darzi on London's health services proposes a new strategic model with fewer acute hospitals and much work transferred to primary care.

So Hillingdon Hospital has first to establish where it will come in the new scheme of things, before it can even guess what premises it will need - which is very disappointing for staff who have laboured hard to complete plans based on the older model of care.

Perhaps all will be well and this hospital will continue to have an A&E day and night, with lots of emergency work to justify the new building as planned - or even find itself promoted to being a centre of excellence for stroke care or other specialties, which would need to be reflected in its premises design.

However, it could be demoted to just day-time A&E cover, with far fewer beds, or even turn into a general hospital with no A&E at all.

All this uncertainty is hard on staff and all they or anyone else can do is wait and see. Whether there are threats for the new Mount Vernon Treatment Centre or the Mount Vernon Cancer Centre are other conundrums. Of course we must welcome the new Academic Health Science Centre proposed for Hammersmith Hospital, St Mary's Hospital and Imperial College - and some local residents will benefit from their no doubt excellent services, but most of us will hope to have our medical services nearer to home. Maybe polyclinics are the answer, with around 45 GPs serving 50,000 people. Perhaps the old Northwood & Pinner Community Hospital will have a new lease of life in that disguise. One thing is certain, "All change!" is still in vogue in the NHS.
 

Interesting snippets about health in Hillingdon, July 2007

Hillingdon PCT's recent Board meeting publicised facts and figures about the health of local people. Here are some interesting nuggets of information:

1. Hillingdon PCT is among the top 5% of PCTs commissioning most NHS continuing health care. This is much to the credit of Hillingdon PCT but, sadly, most long-term patients have to dig deep into their savings to provide what is euphemistically called social care, which is not paid for by the NHS.

2. The gap in the life expectancy between the fifth of wards with the highest and lowest life expectancy in Hillingdon is 4.8 years – the main driver for male inequality is cardiovascular disease (CVD).

3. The school height and weight survey showed that schools with high levels of pupils from ethnic minority backgrounds also had higher levels of obesity among pupils.

4. There was an increase in births to mothers from ethnic minority backgrounds of 42% between 2001 and 2005.

5. Diabetes is above national average, explained by the local ageing south Asian population.

6. TB rates are high, like some other areas of London.

7. Based on these demographic trends Hillingdon’s Local Area Agreement focuses on:

Links

www.supportmountvernon.com Support Mount Vernon Cancer Centre Website  

Community Voice Website www.communityvoicehealth.org.uk

If you have any views on the above or want to help please contact Joan Davis see Feedback

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