Thursday, December 14, 2017

Initial Feedback from Cumbria Health Scrutiny Committee 14th December 2017

The Health Scrutiny Committee met today in Carlisle to consider a very major list of important items affecting healthcare in Cumbria. There was a pre-meeting scheduled for 9.30am and the meeting itself ran from about 10.30am to about 4pm with a 45 minute break for lunch.

I'm not going to attempt to post a full record of the meeting this evening though I will try to put up some more details over the next few days but here are two or three particularly important points from the meeting.

1) Health Service provision for Deaf patients

There were presentations to the committee from Healthwatch Cumbria, the Cumbria Deaf Association, and a number of Deaf service users about the experiences of patients with hearing loss who needed to use NHS services in Cumbria.

Some of the stories we heard about the challenges faced by Deaf patients in Cumbria in communicating their needs and understanding what they were being told were extremely moving and raised a lot of important issues.

The Chief Operating Officer of the NHS Clinical Commissioning Group, arriving a few minutes early for his own session with the committee, caught the tail end of those presentation and I was pleased that he volunteered an interest in learning about the rest of the issues the Deaf service users had raised before we had the chance to make the suggestion ourselves. The points raised will indeed be passed on, both to the CCG and to the Trusts. 

The CCG representatives were there to take the committee through a "Healthcare for the Future" update.

One particularly important point which was made, following the "Call-In" of maternity services at West Cumberland Hospital and the  Independent Reconfiguration Panel (IRP) decision not to pursue a "full review" is that the policy of the NHS in Cumbria and the recommendation of the IRP is still to provide Consultant-led Maternity services at WCH and make it work.

The IRP agreed that the suggested twelve month timeframe which had been suggested to test the sustainability of retaining consultant-led maternity was, quote,

"potentially unrealistic and unhelpful if taken literally as  the deadline for a final decision. The intention must be to do everything possible to implement Option 1 and make it work."

I was not on the council or the committee at the time of the call-in but that is precisely the reason I would have voted for the call-in if I had been.

The CCG confirmed again today that they are indeed committed to making consultant-led maternity work, have made a lot of progress towards doing so, and also that they have not started the 12 month review of the sustainability of the service mentioned in the original decision. They will put forward a paper in February 2018 on what action it is proposed to take about any review, and will not start the clock on any review before that.

It was stressed that the CCG are not saying they will necessarily start a review in February, the CCG was saying that they will not start one before that.  As of today their policy is indeed to do everything possible to maintain Consultant-led maternity service at West Cumberland Hospital and make it work.

Thursday, December 07, 2017

Cumbria Health Scrutiny meeting

Cumbria Health Scrutiny Committee will be meeting on 14th December. There is a heavy and important agenda, for which details can be found at

http://councilportal.cumbria.gov.uk/ieListDocuments.aspx?CId=152&MId=10105

Tuesday, December 05, 2017

Local NHS starts new recruitment campaign

I am very pleased to see that the NHS trusts in Cumbria have started a new and more vigorous recruitment campaign, working with staff and local communities in a drive to attract health professionals to the area.
Two NHS Trusts, North Cumbria University Hospitals NHS Trust (NCUH) and Cumbria Partnership NHS Foundation Trust (CPFT), are working together with local people to raise the profile of Cumbria and the career opportunities our area can offer.
Last month the Trusts asked the public to support them by sharing photos that show what they love about living and working in Cumbria. They received over 100 entries which will now be used to promote the area to health professionals – such as doctors and nurses.
Stephen Eames, chief executive at NCUH and CPFT, commented: “The response from the public has been fantastic. We know that our staff and local communities are passionate about our NHS and the place they call home, and that’s really come across. The range of photos we have received will help us show just how much we have to offer.”
The photos will be used as part of a new recruitment campaign for the two Trusts. The rural nature of many services in Cumbria provides unique opportunities in terms of development and learning for health professionals. Innovative ways of covering medical roles have been recognised nationally and provide training opportunities unique to the area for experienced clinicians. Advanced nursing roles have also been developed to address gaps in areas such as dementia care.

Amanda Dunkley of the North Cumbria Hospitals Trust explained: “Our new campaign looks different to anything we’ve done before and will help us stand out to job seekers. It describes the kind of people we’re looking for in a bold and fun way. We’re looking for innovators, experts, adventures, thrill seekers, explorers, team players… the list goes on. We want to show that we have something for everyone.


“We’ve had to think outside of the box to address our recruitment challenges and that has really paid off. We now have some very innovative roles that aren’t available elsewhere in the country. The development opportunities that we can offer health professionals make Cumbria a really strong choice.”

Many changes in health and care services in Cumbria mean there is a greater focus on partnership working and doing things differently to improve patient care. Linda Bennetts, associate director of nursing for mental health at CPFT, said:

“It’s a really exciting time to join us and make a difference. We’re working with the wider health and care system to provide more seamless patient care through Integrated Care Communities or ICCs. As part of this we’ll soon be recruiting to a number of health and care posts that will focus on preventing ill health, empowering people to take care of their wellbeing and keeping people out of hospital.”


The latest recruitment activity builds on work that is already underway. A recent recruitment video showcasing Cumbria has attracted interest and a nursing careers fair in November resulted in 25 job offers to nurses in the area.
All NHS jobs in Cumbria are advertised on www.jobs.nhs.uk

Friday, November 24, 2017

WCH Maternity call-in result

The Independnt Reconfiguration Panel which considered the call-in on maternity services at West Cumberland Hospital has confirmed the Success Regime/CCG decision which means that a consultant-led service will continue to be provided for at least another year but its continuation beyond that is dependent on recruitment and retention issues being resolved.

As someone who is convinced that consultant-led maternity needs to be maintained at WCH and that the recruitment issues can and will be solved I am pleased that this will continue for now but disappointed that the question mark has been left, partiocularly as 12 months seems to me an unreasonably short period for the trial.

But I believe that this challenge must, can and will be met.

Stephen Childs,  Chief Executive at NHS North Cumbria Clinical Commissioning Group said:

"We are very grateful to the Independent Reconfiguration Panel for the careful consideration they have given this issue. We have always been very clear that we are wholly committed to delivering Option 1 – which includes consultant-led maternity services at the West Cumberland Hospital, if they are safe and sustainable. This review endorses the work we are doing to secure that.

We understand there may be some disappointment in the community with this decision, but we would absolutely urge everyone who cares about their community to work with us to make services at West Cumberland Hospital a sustainable success.

Our commitment to co-produce future services is already bringing together members of the community, NHS and care staff, as well as health and social care leaders. By working together positively we believe we can meet the many challenges ahead, the greatest of which remains the recruitment of medical and nursing professionals.

We heard very clearly through the consultation that the NHS does not have all the answers, and we are convinced that the only way to secure these services in west Cumbria for the future is by working positively and constructively together.”

Stephen Eames, Chief Executive at North Cumbria University Hospitals NHS Trust added:

"I would like to thank the Independent Reconfiguration Panel for their scrutiny of this very difficult decision. Our prime concern remains with the safety of our services for women and children across west, north & east Cumbria and we are absolutely committed to protecting patient safety and the quality of our services.

The IRP recognises the work we have been doing to-date in order to sustain consultant-led services at West Cumberland Hospital as well as acknowledging the challenges we are facing.

I understand that members of staff and our community may feel disappointed today but I would like to reiterate our commitment to both delivering Option 1 and to the future of West Cumberland Hospital. We are continuing to focus on recruiting more permanent medical and nursing staff to the Trust with a range of initiatives being undertaken. 

We also recently shared exciting plans for the further redevelopment of the hospital and I would like us all to work together to secure a very positive future for health and care services in West Cumbria.”
There will be, and should be, some strong opinions expressed about this at the next meeting of the Cumbria Health Scrutiny Committee in December. I welcome the statements by the local NHS to continue to provide consultant-led maternity services at WCH if they are safe and sustainable and we need to work with them to make sure that those serviecs are safe and sustainable and seen to be so.

Thursday, November 02, 2017

£46 million new look for West Cumberland Hospital

Plans showing how West Cumberland Hospital will look after another £46 million of investment have been unveiled this week.

Earlier this year, the Department of Health announced that north, west and east Cumbria was in line for up to £100m of investment, including completion of the WCH refurbishment & rebuild project, and a new cancer centre at Carlisle.

Cumbria's NHS organisations have since been working on detailed business cases, which will determine exactly how much money is released..

Designs and information about the current plans for the West Cumberland Hospital scheme have now been released and can be seen in today's Whitehaven News and on the Times and Star website here. It is estimated that this scheme will involve £46 million of further new investment in West Cumberland hospital above and beyond the extensive building programme which opened in 2015.

Cumbria NHS leaders say the completed hospital will be the first of its kind nationally, becoming an "exemplar" for the wider NHS.

The next stage of investment in WCH, Phase two of the overall scheme, estimated to cost £33m, will include renal, chemotherapy, therapies, pre-assessment, consultant-led maternity (obstetrics), gynaecology, a midwife-led maternity unit and office space.

Phase three will create a new build academic campus, in partnership with the University of Central Lancashire (UCLAN), at an estimated costof  £13m.

West Cumbrian GP John Howarth, who is joint deputy chief executive of North Cumbria University Hospitals NHS Trust and the Cumbria Partnership NHS Foundation Trust, said that after  years of community concern about the future of the hospital, which was in special measures and undergoing a major review of services, things are now changing for the better.

Dr Howarth added that the investment shows national confidence in the West Cumberland Hospital and that the newly-revamped hospital will be a real asset to the area, while the addition of the medical school will help solve long-standing recruitment problems for the long term.

“It’s really exciting. The important message is that we have two new phases of investment coming to the West Cumberland Hospital."

“We (north, west and east Cumbria) have got more than a quarter of all the national capital available to the NHS," he said.

“That shows a real transformation in national confidence. We have a rapidly evolving health system, which has given the confidence to significantly invest in us."

Once approved, it is expected that work will start on phases two and three late next year, to be complete by 2020. These two  phases will run alongside each other.

Dr Howarth stressed that it is not just about the physical buildings, but part of a unique wider plan.

“We are looking at how we make the West Cumberland Hospital the hub of an integrated care system, for Copeland and Allerdale, connecting the acute hospital with all of its services with primary care and community services," he said.

Dr Howarth added that the NHS in Cumbria is leading the way nationally on what he calls “population health”.

“What we have to begin to do is go beyond just delivering services, to have an ambition of improving overall health of the population.

“We therefore want to design a hospital that goes beyond delivering services, but contributes to the wider health and wellbeing of the communities it serves," he explained.

He stressed that Cumbria's NHS trusts are still committed to bed-based care where appropriate, with phase two providing top of the range facilities for patients who need acute care.

Dr Howarth, who is also a professor of primary care at Uclan medical school, believes that the new teaching facilities will also make a major contribution to tackling recruitment and retention problems, where possible recruiting students from Cumbrian schools who want to train and stay to practice in the area.

"I'm really optimistic. These courses are very attractive to students. One of the historic weaknesses we have had, particularly in west Cumbria, is that we have not had our own medical students,"

he said.

“Having our own campus in Whitehaven, for me as a doctor, is game-changing. It will take some years to really have an impact but in the medium to long term it will change our ability to train and retain our own doctors. For me, as a local doctor who has worked all my career here, it’s the most exciting development of that time."

Dr Howarth said overall he feels very positive about the future of the West Cumberland Hospital.

"My first job in the NHS was at the West Cumberland Hospital, in 1983, so this is fantastic to see," he said.

"I think we are going to end up with one of the best facilities in the country, here in west Cumbria.

"Our ambitions for the West Cumberland Hospital are unique. We want to go further than other places have gone.

"There will obviously be bigger hospitals in the country, but as a hospital within a fully integrated health and care system - nobody else has done that. West Cumbria is going to be a national exemplar."

Copeland MP Trudy Harrison, added: “The new development plans for West Cumberland Hospital which includes a health village and education facility is exciting news and a positive step in the right direction to implementing a fully integrated health and care system.”

Monday, October 09, 2017

Working Together group meeting, 12th October 2017

The Working Together group which brings together NHS leaders and staff and patient interests to talk about how we can improve the service is holding its next meeting this Thursday (12th October) at Lakes College from 6pm to 8pm and it is open to the public.

Details of the meeting with links to the agenda and to the notes of the previous meeting can be found on the relevant Cumbria NHS website page at

http://www.northcumbriaccg.nhs.uk/get-involved/engagement/co-production-and-the-working-together-group.aspx

Cumbria Health Scrutiny meeting 9th October 2017

I attended the Cumbria Health Scrutiny committee meeting today.

The full agenda and papers for the meeting can be found here.

We have not yet heard the outcome of Jeremy Hunt's reference of the committee's call-in of maternity services to the Independent Reconfiguration Panel (IRP.) I know Trudy Harrison MP is among those pressing for a resolution of this.

But there was a clear and, in my opinion helpful, response from the North Cumbria NHS Clinical Commissioning Group when members of the committee - quite reasonably - requested assurances that work by the local NHS will not prejudice or be biased against the option which local people support, to maintain consultant-led maternity services at both Carlisle and at West Cumberland Hospital.

Peter Rooney, who is the Chief Operating Officer of NHS North Cumbria CCG (the statutory body with responsibility for deciding what services will be provided in North, West and East Cumbria) said very clearly that the aim of the CCG is to maintain a consultant-led maternity unit at West Cumberland Hospital in safe and sustainable manner.

It is of course right that bodies like the Health Scrutiny Committee and Healthwatch should challenge the CCG and the Cumbria NHS on how they are meeting aims like that, and I am neither criticising those who ask questions on the subject or suggesting that we should be complacent. On the contrary for people to state frequently how much we need and depend on these services is helpful.

Nevertheless, it is also important to recognise when positive responses are given and I thought the answers given today were useful and positive.

Clearly when the IRP recommendation and Jeremy Hunt's response are published we will have to look at them very carefully but the key task is to work with the local NHS to ensure we get the best service for patients.

There was a lot of positive material presented today about "working together" (known in the current jargon as "co-production.") Unfortunately a lot of it was couched in the sort of jargon, littered with acronyms and works like "novation" which is not well presented for most of the public to understand. This is something we need to work on.

So here is a bit of plain English - the Working Together group which brings together NHS leaders and staff and patient interests to talk about how we can improve the service is holding its next meeting this Thursday (12th October) at Lakes College from 6pm to 8pm and it is open to the public

Wednesday, September 20, 2017

Maternity at WCH referred to Independent Panel

Following the "call in" at the Cumbria Health Scrutiny committee, Secretary of State Jeremy Hunt has referred the "success regime" proposals for maternity services at West Cumberland Hospital (WCH) to the Independent Reconfiguration Panel (IRP) asking them to conduct an initial review and report back to him by 4th October on whether a full review is needed.

The progress of the call-in had been discussed when "lead members" of the Cumbria Health Scrutiny committee (including myself) met the Clinical Commissioning Group last week.

At that stage the formal reference to the IRP had not been officially announced but the CCG did give us an assurance, which we were allowed to repeat in public, that they have not started the clock on the 12 month assessment period referred to in the decision, that they will not do so until the call-in process has officially concluded, and that if that 12 month assessment happens after the review it will not be started without a public announcement to that effect.

This week Jeremy Hunt has written to Cllr Claire Driver, chair of the Cumbria Health Scrutiny Committee, with an update on the progress of the call-in..

He said in the letter: "I am today writing to the Independent Reconfiguration Panel (IRP) asking them to undertake an initial assessment of your referral.
 
"Should the IRP advise me that a full review is necessary, you will have your chance to present your case to them in full.

"I have asked the panel to report to me no later than Wednesday, October 4."

While the community and the NHS await news of the decision, so-called "co-production" meetings - set up as a platform for the community and health chiefs to collaborate on  how to improve and protect services, have been taking place.

Stephen Eames, chief executive of North Cumbria University Hospitals NHS Trust, which runs both WCH and the Cumberland Infirmary in Carlisle, had been expecting news on the referral.

However he stressed that the trust have already made good progress on recruitment at WCH, particularly in paediatrics. This is a key area for consultant-led maternity services, as a paediatrician is needed on site in order to retain the Special Care Baby Unit - vital in dealing with babies born prematurely or with complications.

"We are almost up to full complement in paediatrics," said Mr Eames.

See News and Star article at

http://www.newsandstar.co.uk/news/Jeremy-Hunt-orders-maternity-review-4829e4b1-c0b3-448c-a585-b9e3bb6c34f9-ds