Tuesday, April 02, 2019

New home for Cardiology and Vascular services at West Cumberland Hospital;

North Cumbria NHS has announced that Redevelopment work continues at West Cumberland Hospital in Whitehaven as Cardiology and Vascular services move into their new home at the heart of the hospital.

The departments are now in the centre of the hospital, in one area, making it easier for patients to access services and in a much improved environment.

You can find the departments off the main corridor, next to the restaurant and towards Coronary Care and Intensive Care. The facilities are all brand new and have been designed specifically for the specialist departments, allowing dedicated rooms to be used rather than shared facilities of the previous area.

There is an additional consulting room, a dedicated pacemaker room and a treadmill room. The move also allows patients to have scans and then be seen by a consultant in one place.

North Cumbria University Hospitals NHS Trust (NCUH) is nearing the completion of ‘Phase 1b’ of the redevelopment with the Breast Screening service also due to move into its new home in the coming weeks. This follows Phase 1 of the redevelopment which was completed in October 2015 with the opening of the new £90m hospital.

Alan Jennison, senior chief cardiac physiologist at NCUH, said:

“The new facilities are absolutely brilliant, all of the staff are thrilled. We are much closer to the heart of the hospital and it means much improved access for our patients. It’s much brighter and roomier than before, it’s a wonderful place to work.

 “The building has also been designed to be ‘future proof’ meaning we will be able to accommodate future improvements as the service develops, which is brilliant news for the people of west Cumbria.”

Patient Graham Robinson of Crosby, Maryport said:

“I’ve been coming to the hospital since 2006 and have been in the old and new departments, the improvements are fantastic. Everything is better, the rooms, waiting areas, access, parking, it’s much brighter and what the hospital needed. The staff here are all pleasant and I wouldn’t want to go anywhere else.”

Outline business cases are currently in development for further phases of the redevelopment work at West Cumberland Hospital including the demolition of the old hospital buildings and plans to provide more accommodation and academic facilities in partnership with the University of Central Lancashire (UCLAN).

Thursday, March 14, 2019

Full press release on Maternity Services at WCH

I published a quote from Stephen Eames earlier today about maternity services at West Cumberland Hospital (WCH).

As the 12 month review comes to an end the NHS has been making very positive noises about the future of consultant-led maternity at WCH.

I think the whole press release from North Cumbria Health and Care is worth quoting. It reads as follows.

"Maternity 12 Month Review Period To End Amid Positive Progress

The 12 month review of maternity services at West Cumberland Hospital in Whitehaven will end this month.

There has been positive progress over the year, and there will now be a period of review before NHS North Cumbria Clinical Commissioning Group’s (CCG) Governing Body makes any decision about the long term future of services.

Consultant-led maternity services and the development of ‘alongside midwife-led care’ will continue to operate and there will be no changes in the coming months simply because the 12 month period has ended. There will be a review and a report to support a decision early in the summer.

There has been some improvement in recruitment to maternity services as well as the recent appointment of paediatric consultants; this was an area that was making the sustainability of services challenging. 

Maternity and Paediatrics services were also rated as good in a recent Care Quality Commission (CQC) report, and the most recent CQC national survey of patient experience, where women were asked about their experiences during labour and birth and the quality of antenatal and postnatal support, rated the Trust as good, or as better, than the national average.

Work with the community and Third Sector through co-production has become established and some areas are making a real difference.

Stephen Eames, who is the leader of the North Cumbria Health and Care System and chief executive of North Cumbria University Hospitals NHS Trust, said:

“There has certainly been positive progress over the last 18 months. The CQC report published in November was very positive about the services and about how women feel about their care, and we are making some real progress in recruitment. We are also working very productively with the community to support maternity and paediatric services. It hasn’t been easy to establish a new way of working in co-production but we are making real strides in some areas.”

Since the Healthcare For The Future consultation in Autumn 2016 there has been considerable work to established alongside midwife-led care at both West Cumberland Hospital in Whitehaven and the Cumberland Infirmary in Carlisle. In particular there has been the involvement of local new mums through the Maternity Voices Partnership.

There has been collaborative work to develop audits of the new service and on areas of service improvement, including establishing Short Stay Paediatric Assessment Units at both hospitals, which are proving popular with patients and their families as well as staff as it allows children and young people to be seen and reviewed more quickly. 

There has also been the development of co-production work with the community and staff. 

The Venerable Richard Pratt, Archdeacon of West Cumberland chairs the Working Together Steering Group. He said:

“The conversation has changed dramatically over the last 18 months, and while there has been more progress in some areas than others, the value of working together collaboratively is really paying off. There is still a long way to go and we are working to review of this type of ‘working together’, looking at how effective we have been, and how we can improve co-production in future.”

The CCG Governing Body agreed a 12 month review of progress around the longterm sustainability of consultant-led services as part of its decision making process in March 2017. This involves a group of independent clinical experts – the Independent Review Group (IRG) chaired by Bill Kirkup.

The 12 month time-limited review period started on April 1 2018 and will end on 31 March 2019. The process of reviewing data will continue for some time after this.

It is expected that the IRG will complete its review of data collected to the end of March and make recommendations in May or June. It will then be considered by the CCG Governing Body meeting in public in early summer.

Jon Rush, the chair of NHS North Cumbria CCG, said:

“We were very clear when we said we wanted to really test the sustainability of consultant-led maternity services over a longer period, and now that the 12 month period is coming to an end we look forward to receiving recommendations from the Independent Review Group about the progress that has been made. We will then reach a decision about the future of those services and we anticipate this being in the early summer.

“We know a lot of people have worked very hard to make progress, including community groups in west Cumbria such as the Voices group, who have got involved in co-production, and we are grateful for all the hard work that has taken place.”

We will continue to update our community on progress and the final decision will be clearly signposted ahead of that decision being made. Until then services will continue as they are.

 Notes to Editors

• Find out more about North Cumbria Health and Care System (our Integrated Care System (ICS)) on our ICS website. We are one of 14 ICS at the leading edge of integrated services in England.

• Has maternity been saved? Decisions about areas consulted on during the Healthcare For The Future Consultation were made on March 8 2017. The Maternity decision was to allow for a 12 month period of testing the progress in sustainability of consultant-led services. The 12 month period comes to an end on March 31 2019 and there will then be a period of review by the Independent Review Group (IRG) made up of expert clinicians and chaired by Bill Kirkup. It will make recommendations to NHS North Cumbria Clinical Commissioning Group’s Governing Body which will be considered at a meeting in public early in the summer.

• The North Cumbria Health and Care System is made up of health and care commissioners and providers – Cumbria Partnership NHS Foundation Trust, NHS England, NHS North Cumbria Clinical Commissioning Group, North Cumbria University Hospitals Trust, NHS Improvement, North West Ambulance Service, primary care – working in partnership with Cumbria County Council and third sector organisations. 

• More information from Julie Clayton, head of communications and engagement at NHS North Cumbria Clinical Commissioning Group on 01768 245490"

Quote from Stephen Eames on maternity services at WCH

“There has certainly been positive progress over the last 18 months. The CQC report published in November was very positive about the services and about how women feel about their care, and we are making some real progress in recruitment. 

We are also working very productively with the community to support maternity and paediatric services. It hasn’t been easy to establish a new way of working in co-production but we are making real strides in some areas.” 

Stephen Eames, leader of the North Cumbria Health and Care System and chief executive of North Cumbria University Hospitals NHS Trust, quoted in a press release by North Cumbria NHS Health and Care, about the conclusion of the 12 month review into consultant-led maternity at West Cumberland Hospital.

This and other recent statements from Stephen Eames have been widely interpreted as strong hints that the review is likely to confirm that consultant-maternity at West Cumberland Hospital is sustainable and will continue.

Tuesday, March 05, 2019

Cervical Screening Saves LIves

Last week, as I reported here, a report to Cumbria health scrutiny committee described how health outcomes vary enormously between different parts of Cumbria.

Or in plain English, if you get cancer and you live in Copeland you are more likely to die soon from it than you would be if you lived in Eden. 

There are also significant variations between health outcomes in different parts of Copeland.

There are various reasons for these differences, some of which related to lifestyle, and some to health service issues that the local NHS is seeking to address.

But two of those reasons are

1) Residents of the areas with better outcomes for cancer patients tend to go to their doctor sooner, e.g. at an earlier stage of the disease when there is more chance of successful treatment, and

2) Residents of the areas where more people survive cancer are more likely to accept invitations to be screened for cancer.

This is the Cumbrian context relevant to today's announcement by Public Health England, unveiling a new 'Cervical Screening Saves Lives' campaign, part of the government's Long Term Plan which provides an extra £20.5 billion for the NHS.

Key facts: 
  • Public Health England has launched the major new national campaign ‘Cervical Screening Saves Lives’, to increase the number of women attending their cervical screening across England. 
  • The campaign will encourage women to respond to their cervical screening invitation letter, and if they missed their last screening, to book an appointment at their GP practice. 
  • Around 2,600 women are diagnosed with cervical cancer in England each year, and around 690 women die from the disease, which is two deaths every day. 
  • It is estimated that if everyone attended screening regularly, 83 per cent of cervical cancer cases could be prevented. 
  • Regular screening, which only takes a few minutes, can help stop cervical cancer before it starts, as the test identifies potentially harmful cells before they become cancerous, and ensures women get the right treatment as soon as possible. 

Why this matters

  • If more people take up cancer screening - cervical screening or many other types of screening - it will save some of those people from dying well before they need to.
  • For example, if every woman took part in the cervical cancer screening programme, more than 2,250 women a year would be spared from suffering this form of cancer and 570 families a year would no longer suffer the premature loss of a mother, wife, sister or daughter, often years before they needed to die.
  • It will also not just prolong lives but mean a higher quality of life by reducing the impact of cancer.

Sunday, March 03, 2019

Cumbria NHS trusts to merge

One of the reports presented at last week's meeting of Cumbria Health Scrutiny Committee was a progress review on the merger of the two main trusts providing NHS care in North, West and East Cumbria.

The former organisations which are merging are

which provides secondary care in the northern two-thirds of the county running West Cumberland Hospital (WCH) and the Cumberland Infirmary at Carlisle (CIC), and

which is much less easily describe din a sentence but provides more than 60 community and mental health services over an area which currently covers the whole of Cumbria.

I personally think the advantages of the package which this merger comes with outweigh the disadvantages  -it makes for a simpler, less "balkanised" structure in which the resources of the NHS in the Northern two-thirds of the county can more effectively be concentrated on the issues which most need attention - but there are important questions to be asked and some of them were asked on Tuesday.

The most obvious issue is that the existing trusts do not cover identical areas and there is work to be done to make sure that the new arrangements are as satisfactory in the Barrow and South Lakes area of the county as they are in the North.

There are some concerns in this area and they were raised and discussed at the meeting.

This is taking place in the context that more partnership working with neighbouring trusts to provide Mental health services will be taking place and the North and South of Cumbria will be looking in different directions. This will need to be subject to careful scrutiny when more detailed proposals come forward,

The  report "This is us" which went to the committee can be found here.

The question of a name for the merged organisation has yet to be settled: if you have any constructive suggestions I gather the Trusts would be delighted to hear them!

Thursday, February 28, 2019

Cancer Care in West, North and East Cumbria

The Cumbria Health Scrutiny meeting on Tuesday 26th Februry received a very important report and presentation on cancer care in the Northern part of the county (including West and East Cumbria.)

You can read the report here.

The report included

1) Details of the current issues around health outcomes for those who suffer from cancer in the northern two-thirds of Cumbria

2) Information on the alarming levels of health inequalities - people in parts of the county have much better chances of surviving cancer for longer and with less devastating consequences.

3) A large part of this is due to issues of lifestyle and also to how quickly people go to their doctor when they have a problem - one of the causes of differential outcomes is that people in the areas with better survival rates tend to present at an earlier stage of the onset of the disease when there is more chance of doing something about it. Similarly, some is due to higher take-up of screening programmes.

4) The report discussed some of the measures being taken to improve take-up of cancer screening. It cannot be stressed too strongly, if you are offered a cancer test, it may save your life to take it up.

5) The report also discussed the new cancer centre at Carlisle. This very welcome new facility is not being provided at the expense of cancer services in the West of the county and we discussed at the meeting how cancer services in the West are being improved too.

Wednesday, February 20, 2019


It was announced today that a new joint unit, NHSX, will be created to bring the benefits of modern technology to every patient and clinician.

It will combine the best talent from government, the NHS and industry. NHSX will aim to create the most advanced health and care service in the world to diagnose diseases earlier, free up staff time and empower patients to take greater control of their own healthcare.

Currently, much NHS technology relies on systems designed for a pre-internet age.
  • Patients are not getting the care they need because their data does not follow them round the system. 
  • Change has been slow because responsibility for digital, data and tech has been split across multiple agencies, teams and organisations. 
  • NHSX will change this by bringing together all the levers of policy, implementation and change for the first time. 

NHSX will work with the NHS and the wider digital economy to build world-class digital services.

These will improve care for patients and enable medical research. The organisation will use experts in technology, digital, data and cyber security to deliver on the Health Secretary’s tech vision and the Long Term Plan for the NHS.

NHSX’s responsibilities will include: 
  • setting national policy and developing best practice for NHS technology, digital and data - including data-sharing and transparency setting standards – developing, agreeing and mandating clear standards for the use of technology in the NHS 
  • ensuring that NHS systems can talk to each other across the health and care system helping to improve clinical care by delivering agile, user-focused projects 
  • supporting the use of new technologies by the NHS, both by working with industry and via its own prototyping and development capability 
  • ensuring that common technologies and services, including the NHS App, are designed so that trusts and surgeries don’t have to reinvent the wheel each time 
  • making sure that all source code is open by default so that anyone who wants to write code for the NHS can see what we need 
  • reforming procurement – helping the NHS buy the right technology through the application of technology standards, streamlined spend controls and new procurement frameworks that support our standards 
  • setting national strategy and mandating cyber security standards, so that NHS and social care systems have security designed in from the start 
  • championing and developing digital training, skills and culture so our staff are digital-ready delivering an efficient process for technology spend, domain name management and website security 

The CEO of NHSX will have strategic responsibility for setting the national direction on technology across organisations. The CEO will be accountable to the Health Secretary and chief executives of NHS England and NHS Improvement.

NHSX will work closely with the Government Digital Service and other central government functions to learn from their experiences and ensure there is continued alignment with the Digital, Data and Technology profession across government.

Health Secretary Matt Hancock said:

"Modern technology has an incredible potential to change people’s lives for the better and revolutionise the care they receive.

Because I care about patients getting the best treatment, I care about the NHS getting the best technology. But everyone knows how hard it’s been to get the NHS to adopt the best in digital.

We’ve set out a clear tech vision for the NHS, which underpins our NHS Long Term Plan. Now we’re bringing together the tech leadership into NHSX, which will be responsible for harnessing the true potential of technology to transform care, save lives, free up clinicians’ time and empower patients to take greater control of their own health. 

NHSX will combine some of the best minds from among the NHS, leading innovators, and government into one unit to set national policy, remove red tape and create a culture of innovation to allow the best innovations to flourish. This is just the beginning of the tech revolution, building on our Long Term Plan to create a predictive, preventative and unrivalled NHS."

Tuesday, February 19, 2019

February meeting of the Cumbria Health Scrutiny Committee

The February meeting of the health scrutiny committee responsible for democratic scrutiny and challenge of the NHS in the county of Cumbria will take place at County Hall in Kendal from 10.30 am on Tuesday 26th February 2019.

The meeting will be open to the public. The agenda and reports for the meeting are available in the County Council website here.

I am more that a little surprised at the way the agenda for the meeting has panned out. These meetings approximately alternate between Carlisle and Kendal. Mostly they contain a mix of North Cumbria and South Cumbria/Morecombe Bay items.

This time, except for the boilerplate agenda items like declarations of interest, committee briefing report, data of next meeting, every single major item on the agenda is wholly or almost entirely about North Cumbria. 

To be precise, there are five major items on the agenda, of which four are entirely about the NHS in North Cumbria with no relevance to the Barrow and South lakes area at all, and the fifth is mostly about North Cumbria with some potential knock on effects in the south of the county. 

And it's one of the meetings held in Kendal.

Almost certainly too late to change the venue now without causing disruption which is more trouble than it's worth, but I will be suggesting that next time we have an agenda which is this heavily weighted towards one side of the county we make that meeting one of the ones held in that part of the county.