Monday, July 31, 2017

Mental Health

Mental health is often a Cinderella service which has been neglected by governments of all political colours.

So I am pleased to learn of the announcement by Jeremy Hunt that 21,000 more mental health nurses will be recruited and that £1.3 billion will be spent to treat an extra one million people by 2021.

Thursday, July 27, 2017

Quote of the Year

"Anyone who thinks the West Cumberland Hospital doesn't have a future, or that we are closing it, can think again."

Stephen Eames, Chief Executive of Cumbria Partnership NHS Foundation Trust, on the news that  between £35 million and £50 million of new government money is to be invested in improving facilities and services at West Cumberland Hospital, as quoted in today's Whitehaven News.

Monday, July 24, 2017

Cumbria Health Scrutiny meeting 24th July 2017

Cumbria's Health Scrutiny committee - a joint committee run by Cumbria County Council but which also contains one councillor from each of the six districts in the county - met this morning at County Hall in Kendal.

There was an interesting discussion about the minutes of the call-in meetings on 22nd March.

I asked for the work programme for the committee for the forthcoming year to look at the lessons which could be learned from that scrutiny process and this was taken on board.

It was also noted that the committee will be reviewing what actually happens to the service as a result of the decisions the NHS success regime took.

There was also a very interesting presentation to the committee from the NHS care commissioning bodies. Among the issues noted was the challenge of recruiting staff and it was noted that the huge investment which has just been agreed in our local health services - £65 million pounds announced last week -is something we must shout about as it demonstrates that the government and the NHS are committed to the future of local health services in Cumbria.

Thursday, July 20, 2017

£65 million for Health in Cumbria and up to £50 million for WCH.

More than £65 million has been awarded to support the development of health services in West, North and East Cumbria.

This will include between £30 million and £50 million to be made available for West Cumberland Hospital. (WCH)

The work at WCH will include a new diagnostics suite, housing cardiology, breast screening, a vascular lab, and a new mortuary. It is expected that the work will be completed by Spring 2018.

Trudy Harrison MP has welcomed this "fantastic news" which will mean faster diagnostic turnaround for conditions including cancer, shorter waiting times, and better patient care.

More comments on the WCH announcement from the News and Star here

The announcement of £65 million for health services in West, North and East Cumbria was made yesterday morning by Health Secretary Jeremy Hunt and NHS England chief executive Simon Stevens at the Kings Fund, and includes significant investment in:    
  • Cancer care including a new radiotherapy machine,     
  • £30 to £50 million for the next phase of development at WCH      
  • The establishment of Integrated Care Communities (ICCs) which will mean more co-ordinated health and care services delivered locally.
Stephen Eames, chief executive at North Cumbria University Hospitals NHS Trust, said that

“This is fantastic news for patients in Cumbria. This significant investment in our local cancer services – in partnership with the excellent specialist services at Newcastle hospitals – means we can provide more modern cancer treatment, from state of the art facilities, which will benefit people living across north Cumbria.

“We are keen to get on with the next phase of development at the West Cumberland Hospital and this will enable us to push on with those necessary changes

“But perhaps most importantly this shows real confidence in our health and care system and we are delighted that this sends a signal to those who may choose to come and work here that things are improving.”

The funding will released over the next three years:

CANCER

    
There will be between £30-50 million to improve access to chemotherapy and radiotherapy by establishing a new cancer centre, complete with new equipment at Cumberland Infirmary in Carlisle. It will enable the links with specialist services at Newcastle hospitals to be further strengthened.  The investment should help 95 per cent of Cumbria patients with suspected cancer receive a diagnosis within four weeks and, by improving access, both 1 year and 5 year cancer survival rates are set to increase. This includes a new radiotherapy LINAC machine which will help to make the service sustainable.

WEST CUMBERLAND HOSPITAL
WCH will receive between £30-50 million to refurbish and redevelop parts of the hospital estate to bring it up to date, improving the experience of both patients and staff.

INTEGRATED CARE COMMUNITIES
Up to £5 million will be spent supporting the development of Integrated Care Communities – local hubs that bring together GPs, social care, community services, mental health services and specialist hospital consultants to support people closer to where they live.

Health Secretary Jeremy Hunt said: “This funding will support strong local plans to help the NHS modernise and transform care for patients.

“A measure of success of these transformation partnerships is that people can see and feel improvements being made in their local area – there are already excellent examples of this across the country and this money will allow them to go further and faster.”

NHS England chief executive Simon Stevens said: “Today we’re firing the starting gun on the first wave of major service upgrades and care redesign which will benefit people living in counties, towns and cities across England.”

The announcement from NHS England can be found at:

 https://www.england.nhs.uk/2017/07/patients-to-benefit-from-325-million-investment-in-nhs-transformation-projects/

Monday, July 17, 2017

Thanks to our NHS staff as the service is praised in an independent report.

An independent report has ranked Britain's NHS as the best health service of those in eleven leading countries.

This is of course down to the hard work and dedication of Britain's doctors, nurses, dentists, midwives and all the other people who work in our NHS.

Thank you to all those who give exceptional care to patients and whose work makes the NHS possible.

Saturday, July 15, 2017

Health Scrutiny - looking back to 22nd March and forward to 24th July

I have today received the agenda papers for the forthcoming Cumbria Health Scrutiny meeting on 24th July which are available on the CCC website here.

This meeting will receive the draft minutes of the now notorious meetings on 22nd March for which the actual scrutiny meeting minutes are available here and the record of the "dispute resolution" meeting with the NHS "Success Regime" which took place during the recess is available here.

There is a protocol for attempting to resolve disagreements between the Health Scrutiny Committee and the NHS organisations which the committee is supposed to scrutinise before you get to the stage where the committee "calls in" decisions and refers them to the Secretary of State.

That in itself is a good thing but if the advice which was given to the 22nd March committee is correct, one aspect of that protocol was a disaster waiting to happen in terms of public confidence in the consultation and scrutiny process - and the disaster happened on 22nd March.

I can see the logic in encouraging the Scrutiny Committee and the NHS Trust to discuss the issues and concerns after a "call in" vote to allow for the possibility of some honourable compromise before the reference to the minister goes ahead.

Apparently the protocol provides the possibility of an immediate discussion with the Trust during a recess immediately after the vote, and for the committee to then reconvene and be asked to vote again the same day on whether to proceed with the previous decision.

Now even if you manage to avoid any confusion over whether the meeting is finished and don't end up with a decision reversed after some councillors have gone home - which was part of the problem on 22nd March - there is a serious problem with this process.

Whether you agree with the initial decision or not, the original vote to refer a decision to the Secretary of State would not be taken lightly, and would almost certainly involve a lengthy debate, as it did on 22nd March.

Is it really a good idea to try to resolve all the concerns that caused to a vote to refer a matter to the minister, and then reverse the decision that same evening?

If the times given in the draft minutes of the two meetings are correct - and I am asking for these times to be checked as I have difficulty believing them - then seven hours elapsed between the start of the Health Scrutiny meeting at 10.30am, and that of the "dispute resolution" meeting at 5.30pm.

That seven hour period included three ten minute adjournments after motions were proposed to refer items back and there was also a lunch break, but it is fair to argue that most of this period was . spent formally or informally discussing the Success Regime decisions. During this time there were votes in principle to refer three of the Success Regime proposals to Jeremy Hunt.

The draft minutes of the "dispute resolution" meeting between two members of the scrutiny committee and the success regime say that it started at 5.30pm and finished at 6.10pm.

The minutes of the final session of the reconvened Health Scrutiny meeting cover about two and a half pages of A4 typescript, which describe some additional assurances given by the Success Regime and the details of three votes, one each about whether to proceed with the previous decisions. Two of these votes reversed the previous decisions. The minutes state that this meeting finished at 6.20pm - ten minutes after the time given for the close of the "dispute resolution" meeting.  

So if these minutes are correct the maximum time available to present various assurances to those members of the committee who had not gone home, and hold three votes, reversing two major decisions, was ten minutes.

I do not accept that it is sound governance to have a protocol which allows a committee to spend seven hours debating the NHS Trust's proposals, immediately followed by a forty minute discussion with the Trust, after which there is a ten minute meeting of the committee which reverses two of the three proposals.

Even if it turns out that the minutes are wrong or that I have misunderstood them and that a bit longer was spent on the two later meetings, I would still argue that this protocol needs to be changed or clarified. It is not reasonable to spend an entire working day of detailed debate about the concerns raised by thousands of residents, patients and staff with the NHS Trust's proposals and then claim to be confident that due consideration has been given to the arguments presented when votes to challenge those proposals are reversed in two short meetings the same evening.

The change around of votes was

Maternity - initial decision ten votes to one to call in.
Subsequent vote - six to one to proceed with this decision, which was therefore upheld.

Children's services - initial decision eight votes to three to call in.
Subsequent vote - five to two against proceeding with this decision, which was therefore reversed.

Community hospitals - initial decision ten votes to nil to call in with one abstention.
Subsequent vote - four to three against proceeding with this decision which was therefore reversed by one vote.


We have to learn from this. The thousands of people who took part in the consultation need to know that their concerns have been properly considered - and this process could have been perfectly designed to destroy trust that this had taken place.

Agenda for forthcoming Cumbria Health Scruting meeting on 24th July 2017

The next meeting of the Cumbria Health Scrutiny committee will be held at County Hall in Kendal at 10.30am on the morning of Monday 24th July to consider the following agenda:
 
1.
 
Election of Vice-Chair  To appoint a Vice-Chair, who shall be a District Councillor representative, appointed by the District Council representatives serving on the Committee. 
 
2.
 
To receive any Apologies for absence. 
3.
 
To note the Membership and Terms of Reference of the Committee.
 
4.
Disclosures of Interest
5.
 
To consider whether the press and public should be excluded from the meeting during consideration of any item on the agenda. 
6.
 
To confirm the minutes of the meetings held on 28 February and the Special meeting held on 22 March 2017  
 
7.
 
To agree the membership of the Health Scrutiny Variation Sub-Committee
8.
 
Looking Forward - The Health and Care System in Cumbria
To receive a joint presentation by the Corporate Director – Health, Care and Community Services, Chief Operating Officer, North Cumbria NHS Clinical Commissioning Group and Chief Operating Officer, Morecambe Bay NHS Clinical Commissioning Group on the Vision and Priorities for Health and Care in Cumbria. 
 
9.
 
To consider a report by the Strategic Policy and Scrutiny Adviser  
10.
 
To note that the next meeting will be held on Monday 9 October 2017 at 10.30 am at Cumbria House, Carlisle
 
The full agenda and supporting documents are available here.

Monday, July 10, 2017

Next phase of WCH deveopment gets under way

Excellent news for residents of West Cumbria as the next phase of improvement at West Cumberland Hospital (WCH) in Whitehaven gets going.

The second phase begins with work on an area to house a new Diagnostics Suite (Cardiology, Breast Screening, and Vascular Laboratory) and Mortuary beginning this month (July 2017).

Following the £90m investment by North Cumbria University Hospitals NHS Trust in ‘Phase 1’ which saw the new hospital building open in October 2015, this next phase known as ‘Phase 1b’ represents a further investment of £8.9m. The Phase 1b scheme will prepare for the demolition of parts of the old hospital and for the subsequent ‘Phase 2’ of the hospital redevelopment.
    
The new Diagnostics Suite will be in a fully refurbished part of the old hospital building, providing patients and staff with the same quality of care environment that patients in the new hospital are already experiencing. The work is set to be complete by Spring 2018 and as part of this work; two of the main lifts in the old hospital will also be fully refurbished.

In addition, as part of the ‘Phase 1B’ programme, a new multi faith/secular area and Bereavement Suite has already opened in a more central location as a space where people can come for peaceful, reflective time.

The Henderson Chemotherapy Suite is also set to move to an interim location within the hospital where there will be a lot more space and a better environment including a therapies room, additional accessible toilet facilities and improved privacy and dignity for patients and their relatives. When the Trust signs off ‘Phase 2’ of the redevelopment, the Henderson Chemotherapy Suite will form part of that phase to create a purpose built chemotherapy facility.

As well as work on clinical services, new support services accommodation and offices are being created in order to start preparing some areas of the old hospital building for demolition in 2018. This will involve the demolition of unused parts of the old hospital and in turn, it will allow the Trust to create a new main entrance during Phase 2, with the new building visible from Homewood Road.

    
Stephen Eames, chief executive at North Cumbria University Hospitals NHS Trust, said:
 
“I am delighted to publicly confirm the next phase of the redevelopment. We have had very positive feedback about the new hospital from both staff and patients since it opened in October 2015 and we now want to ensure there is a clear timeline for the remainder of the works to be completed.
 
“As well as the work taking place this summer which will provide many benefits to staff and patients, we very much look forward to the planned demolition of parts of the old building in order to showcase the fantastic new building.
 
“The next step is to refresh the outline business case (OBC) for ‘Phase 2’ and finalise ‘Phase 3’ plans of the redevelopment which will allow us to look as a health and care system at ensuring we make the best possible use of the space we have including considering academic functions with our partners at the University of Central Lancashire (UCLan).

More details on the Trust Website at

http://www.ncuh.nhs.uk/news/2017/July/next-phase-of-wch-redevelopment-underway.aspx