Support West Cumbria Hospital Services

West Cumberland Hospital business case looks set for approval

2011-12-31T11:06:00.000-08:00

It looks like the business case for the £90 rebuild and refurbishment for West Cumberland Hospital is finally likely to be agreed within the next few weeks.

The West Cumberland News and Star reports that

"Major progress could be made within weeks on the £90 million plan to rebuild Whitehaven’s West Cumberland Hospital.

The full business case for the landmark redevelopment of the infirmary is currently being considered by regional health chiefs."

The paper says that local NHS bosses are hopeful that the case will be approved at a Strategic Health Authority board meeting in January.

Their report continues:

"Progress at the West Cumberland Hospital is detailed in the latest newsletter on the development.

"It states that following months of work between its operators – the North Cumbria University Hospitals NHS Trust – and NHS Cumbria on a clinical strategy for the area, chiefs are “hopeful” that their business case will be approved.

That support is expected following a board meeting of the SHA in January.

Once that approval is in place, the scheme – one of the UK’s largest publicly-funded healthcare projects – will go to the Department of Health and Treasury for the final go-ahead.

"Plans for the West Cumberland involve partial demolition of the hospital, refurbishment of existing buildings, a new build and additional car parking.

Hospital management say another development milestone has been reached with detailed scale plans for every room of the new hospital being considered.

Clinicians and other department chiefs are now checking the intricate details for each room.

The signing off of these drawings will confirm taht every detail has been accounted for, including the number of sockets, light switches and beds needed.

"Elsewhere in west Cumbria, the SHA still has plans for the £11m rebuild bid for Cockermouth hospital and a new £4.1m health centre in Cleator Moor on its table.

In Cockermouth, the development replaces the Isel Road hospital, which is more than 100 years old.

It will also mean an end to the temporary accommodation on land next to the hospital, which houses two of the town’s GP practices after they lost their premises in the 2009 floods.

The new facility, which will create 55 jobs, will combine a nine-bed hospital, GP surgeries and a dentists.

"In Cleator Moor, the £4.1m health centre will be built between the Howgill Centre and the boxing club.

It will replace existing GP surgeries – Wath Brow and Wyndham Street."

See www.buildingyourhospital.ncuh.nhs.uk for updates on West Cumberland Hospital.

Lansley: I am strongly committed to WCH

2011-12-07T15:05:00.000-08:00

Health secretary Andrew Lansley confirmed while visiting Cumbria last week that he remains "strongly committed" to supporting West Cumberland Hospital.

The Secretary of State was in Cumbria to open a new wing at the Eden Valley hospice near Carlisle.

He made his comments to Penrith and the Borders MP Rory Stewart, who had arranged for him to meet a senior local consultant and GP to hear their concerns about services in Cumbria during his visit.

Rory Stewart asked Mr Lansley to consider writing off the debts of the North Cumbria hospitals trust. The minister said that he might be willing to consider this provided the trusts can come up with a strong plan for the future.

I am pleased by the confirmation that the government remains committed to our hospital, but it remains imperative that we keep up the pressure on the trusts and the government to ensure it is understood that we need a comprehensive range of health services in both West Cumbria and Carlisle.

John Bannister attacks Palliative Care "Shambles"

2011-11-19T03:38:00.000-08:00

The Reverend John Bannister, rector of Whitehaven and leading light of the "Save Our Services" campaign to protect hospital services has expressed his concern at the management of Palliative Care at West Cumberland Hospital.

The palliative care unit at the hospital has closed and health bosses say there is an area set aside in the new hospital building in the Copeland Unit (a ward of community beds managed by GPs) to provide up to six palliative care single rooms.

But in the interim period, patients who require hospital treatment as part of their palliative care are either being admitted to beds in the Copeland Unit or elsewhere in the hospital.

Revd. Bannister told the Whitehaven News that

“Palliative care is a specialist and complex system of care that should only be provided in an appropriate environment and not in the mix of a busy general ward where, with the best intentions, nurses don’t have the skill or time to give appropriate palliative care.”

“The mishandling of this service has resulted in a loss of what was a strong skill-base of trained palliative care nurses who now feel de-skilled and demoralised. I believe that it has also compromised the care needed by several patients, both causing additional distress and anxiety to them and their families in the final days of life.”

“The way in which we care for the dying is, in every way, a measure of our humanity. I am ashamed that in this situation West Cumberland Hospital has failed to live up to these standards.”

“In addition to compromising care for such a vulnerable group of patients I am also concerned that the firm agreement between the Trust and stakeholders that no clinical services would be moved off site without consultation has been disregarded.”

It is understood that palliative care support is now based in Workington with teams “in-reaching” into a hospital setting.

Mike Walker, the North Cumbria University Hospital Trust medical director, said that:

“Beds are available at the West Cumberland Hospital for palliative care patients who require hospital support. Their needs are identified by the clinical teams and palliative care patients are found the most appropriate bed in the hospital to meet their ongoing care.

“The Trust has been working very closely with GP commissioners to further develop palliative care services that meet the needs of patients in West Cumbria. The Trust will be holding further discussions in early December with the commissioning GPs and the West Cumberland Hospital Overview Scrutiny Task group.”

Dr David Rogers, lead GP for Copeland, said that:

“The local NHS has been working to improve palliative care services at the West Cumberland Hospital by integrating them with the Copeland Unit which also delivers rehabilitation, diagnostic tests and other support for inpatients.

“This is being taken forward by the hospitals trust and the partnership trust, which is now responsible for the Copeland Unit.

“Until this change has been completed, the hospitals trust has given reassurance that palliative care patients who require inpatient treatment will continue to receive this at the West Cumberland Hospital in the most appropriate setting for their needs.

“The overall change is part of a series of measures which will make sure specialist hospital care is there for people who need it, while at the same time extending this out into the community for those who want to end their days at home surrounded by their loved ones and the things they love.”

Hat tip to the Whitehaven News which was the source for most of the information in this article.

Time to honour West Cumberland Hospital bed promises

2011-06-17T01:00:00.000-07:00

When the "Closer To Home" review of hospital and health services in Cumbria took place, pressure from local medical staff, patients and residents secured a slight increase in the number of beds retained at West Cumberland Hospital - an a promise that the number of beds against usage would be kept under review and increased if it was shown to be inadequate.

It's time to have a very serious look at the number of beds currently available against what is needed.

One of the front page headlines in yesterday's Whitehaven News read

"Hospital's bed shortage leaves patients waiting in ambulances."

The article begins

"A shortage of available beds at West Cumberland Hospital has led to some emergency patients having to termporarily wait outside in ambulances.

"And on one occasion nine patients were said to have to sleep overnight in the A&E department because there were no spare beds on the wards.

"The problem is not down to staff shortages in the hospital's A&E deparment, The Whitehaven News understands, but a lack of available beds. Without free beds patients cannot be moved out of A&E and onto the wards."

(You can read the full article by Gillian Ellison "here.)

I am seriously concerned by this situation, which cannot be allowed to continue. The demand for West Cumberland Hospital beds against availability must be carefully checked and if this situation is not found to be a one-off, then the number of beds at WCH must be increased. This is, after all, what we were promised at the time of Closer to Home.

A consultation on the Health Reforms

2011-05-21T04:46:00.000-07:00

Hat tip to Seth O Logue at "Political Betting" for drawing my attention to an audio recording on the Guardian site of a Q&A session with Professor Steve Field in 16th May. Field leads the NHS Future Forum, the ad hoc group set up by Cameron to listen to health industry professionals on the Health and Social Care Bill and report back to the government with proposals for change by early June.

The audio recording can be found at "http://bit.ly/l9uRLp"

The description and opinions below largely reflect Seth O Logue's post at Poltical Betting, with some minor editing.

The group assembled for Field are broadly hostile to the reforms - polls taken before his arrival showed circa 70% against the main proposals. Field handles the 80 minute session well: he is clearly not interested in partisan political debate and focussed only on health issues.

The audience consists of mostly of Guardian readers, and it shows. Badly.

The first 3 minutes and 25 seconds of the recording should be skipped, it basically consists of the meeting getting under way, slightly late, with various apologies for the delays getting everyone assembled and starting due to problems with London traffic. After this point the highlights are:

03:25 - 08:48 Introduction. Field’s experience and qualifications. His values and assumptions. Work, structure and goals of NHS Future Forum. Independence from government stressed. Main issue to date is the balance between patient choice vs. protecting key NHS services (i.e. competition). Next it the need to widen patient and clinical engagement in commissioning process. Education and training important but not urgent.

11:19 - 16:15 GP commissioning. Answer to first question on mental health commissioning but more general views on commissioning given first. Additional clinical and management expertise to be added to GP Consortia but basic Lansley reform of closing PCTs and moving to GP commissioning is supported. Need to develop networks of consortia to share specialist resources and for national commissioning of some clinical services. A good introduction but long winded and slow to get going.

19:15 - 22:24 Question on Ovarian cancer. Interesting as the question and Field’s answer shows that there are real problems with current NHS service provision. Those wanting to “save our NHS” should listen carefully. Field also gives balanced views on NICE standards, highlighting strengths and weaknesses of standards driven commissioning.

23:25 - 26:56 The need to improve the quality of Primary Care (GP services). A clinical (rather than political) definition of information sharing, integration and collaboration. Diabetes care used as example. Another eyeopener for anyone unaware that there are things we need to improve.

28:40 - 31:08 Field on “cherry picking”, accessibility and quality of GP services, greater use of nurses and pharmacists in treating long term illnesses.

33:23 - 36:40 Co-operation vs. collaboration. Competition can expand capacity in market, but improving collaboration and integration within NHS must be a priority. Patient choice is primary consideration and must be expanded and protected. Need for private hospitals to subsidise training in NHS hospitals. Looks like Field will recommend that private sector provision and competition between service providers is retained but ‘hidden behind’ patient choice.

37:45 - 39:55 Simon Leyton, a former Labour County Councillor from Copeland who was defeated in the Distington ward in this year's Copeland Borough Council elections, puts a question about GP commissioning which includes one good quote: “We need to reduce the number of marches so we can get on with the job”. From 39:05 Field gives reasons for success of Cumbrian GP commissioning: clinical leadership, management support and scrutiny. These will be Field’s key recommendations for changes to GP commissioning process.

40:19 - 44:50 Hackney GP in diatribe against the Lansley reforms. Every word could have been penned by a Labour spinner. After she damned the proposals, it turns out her own practice has signed up to participate in the GP Pathfinder pilot project. Cue the justification: “Just because people get into a lifeboat doesn’t mean that they are in favour of sinking the Titanic”. A very good defence line to remember if you're caught out in an action which doesn't match your words, but I'm not sure that the argument is 100% valid in this instance.

58:34 - 60:44 A ‘constructive proposal’ by a woman who believes Lansley should be done for “criminal insanity”. She wants democratic governance of the NHS by setting up elaborate elected commissioning bodies who then elect a “lay chair”.

62:48 - 63:20 Retired Health Professional: “In the interest of democracy and accountability the Secretary of State must have a legal legal duty to provide NHS free at the point of need [?]“. Lansley is proposing to move the commissioning of NHS Health Services out of the direct control of the Department of Health and to transfer it to an arm’s length body, the NHS Commissioning Board. Lansley justifies the move as getting politicians out of the business of micro-managing the NHS, whereas opponents believe it lets the government off the hook of statutory obligations and democratic accountability for NHS performance (e.g. decisions on closing hospitals will no longer be ‘political’). Note Field’s silence in response to the suggestion. Either this aspect of Lansley’s reforms are outside his terms of reference or they are written in stone or he fully supports Lansley’s decision.

71:25 - 75:20 Field on Mark Britnell (insurance and opportunities for private sector providers), top-down reorganisation, the ‘kitchen cabinet’ conspiracy and David Cameron’s real care and love of the NHS. Cue much weeping, wailing and gnashing of teeth as the Guardianistas discover that Field trusts Cameron on the NHS reform and that he sees his role as being supportive of the government and that he is not about to sink Lansley.

76:43 - 80:22 Field concludes with his vision for the NHS’s future. He emphasises the need for the NHS to make productivity savings in order to free funds for the increased cost of new drugs (Herceptin used in cancer treatment as example) and other technological advances. Looks like Field’s main recommendation will be to slow down pace of change to reduce risk of destabilising the NHS.

Have your say on local NHS community services

2011-05-19T14:16:00.000-07:00

Cumbria Partnership NHS Trust suggested that the following article might be of interest to readers of my blogs, and although this blog is particularly aimed at hospital services I cannot believe that anyone with an interest in the hospitals in West Cumbria would not also be interested in the activities of the Partnership trust. So I am extremely happy to use it.

You can have your say in how your local community health services develop by becoming a member of the Cumbria Partnership NHS Foundation Trust – and have a chance to win £100 of M&S vouchers in our prize draw.

Your local NHS services, including community hospitals, community services such as district nursing, health visiting, children’s services, community dentistry, learning disability and mental health are now delivered by Foundation Trust.

The Foundation Trust is inviting anyone over 14 years old who lives in Cumbria or who cares for a person living in the county to become a Member.

It’s free to become a member and you get the benefits of the NHS discount scheme at a number of high street and online stores – saving you money on everything from meals out to holidays. And if you become a member before June 24, 2011 you will be entered into a prize draw to win £100 of M&S vouchers.

Plus you have the opportunity to get involved as much or as little as you like in the shaping of community health services in your area.

As a member of the local community, you will have a voice in how these health services develop to meet the needs of you, your family, your friends and your neighbours.

A Foundation Trust is still part of the NHS family, but it has some freedom from central Government control. Foundation Trusts can decide how to spend some of its money in partnership with local people.

Currently there are 8,000 members including service users, carers, staff and members of the public – but they are looking to recruit many more to reflect the interests of all the services provided by the Foundation Trust.

Some people like to get very involved, going to special members meetings or by nominating or voting for governors who advise the board of directors. Others prefer to sit quietly in the background and only contact the Foundation Trust if there is something they feel strongly about.

This summer the Foundation Trust will be taking their roadshow out to events and venues across Cumbria where you can find out more about becoming a member and sign up on the day – but you can do it now, online at www.cumbriapartnership.nhs.uk, by calling the Governor and Membership Support Office on 01228 603890 or email

communications.helpdesk@cumbria.nhs.uk

It’s your local, community health service – have your say on its future.

Public meeting this evening about WCH

2011-05-03T00:51:00.001-07:00

Reminder: there is a public meeting at 6.30 pm today (3rd May) at the United Reformed Church hall in the Market Place, Whitehaven about local hospital services in West Cumbria.

Prime Minister confirms the need for "swift" action to move forward WCH redevelopment

2011-05-01T06:29:00.001-07:00

David Cameron spoke at Prime Mininster's Question Time this week about the future of West Cumberland Hospital and assured local residents that the Department of Health is working closely with the local NHS to move forward the proposed redevelopment of the hospital.

In answer to a question from the MP for Copeland, David Cameron said:

"First, I well remember visiting the hospital in the hon. Gentleman's constituency. It is a fantastic hospital and it did brilliant work during those incredibly tragic times about which he spoke. I can absolutely reassure him that he does not need to worry about the future of the West Cumberland hospital.

"I understand that he has met the Minister of State, Department of Health, my right hon. Friend Mr Burns, to discuss the concerns, and they are in agreement that issues need to be resolved swiftly.

"The Department of Health is working closely with the local NHS to produce proposals to redevelop the hospital. That is what is going to happen: investment will be going into the NHS because of the commitments we have made."

Public meeting on Tuesday, 6.30pm URC Hall

2011-04-29T13:08:00.000-07:00

I was going to write a blog post urging everyone to attend the public meeting this coming Tuesday (3rd May) at the United Reformed church hall at Market Place about local hospital services.

But I can't find a better form of words than the letter which appeared in this week's Whitehaven News, written by the Rev John Bannister, and I am sure neither he nor the Whitehaven News will mind me quoting it in full.

I also quote letters on the subject from a consultant surgeon and from former councillor Ronnie Copeland.

Make your voices heard in defence of hospital services

SIR – On Tuesday, May 3, there will be a public meeting at 6.30pm in the United Reformed Church Hall on James Street. The meeting has been called by the ‘Save Our Services’ Group who have, over the past decade, acted as a pressure group for the retention of essential clinical services at West Cumberland Hospital.

A recently published report setting out the services which GPs and hospital consultants believe should be delivered at the two acute hospitals in this area, in Whitehaven and Carlisle, has created some concerns about a possible further downgrading of services at West Cumberland Hospital.

An example of our concern is the option, contained within the report, for all Intensive Care beds to be provided at Carlisle. Although much of the report shows a clear commitment from GPs towards a viable future for West Cumberland Hospital, the SOS group feel that some proposals may constitute a breach of the agreement previously given to this community as part of the outcomes of the ‘Closer to Home’ consultation which was undertaken three years back.

I urge your readers to show your concern and support for our hospital, by attending the meeting.

The Rev John BANNISTER

Rector of Whitehaven,
Save Our Services Group

SIR – What follows is my personal opinion.

I would urge you all to attend the public meeting about West Cumberland Hospital next week. It is time to go out and make your voice heard, as we have done many times before.

Make no mistake, the higher echelons of the Primary Care Trust (PCT) are working very hard to downgrade health care in West Cumbria. Certain acute services are still under threat.

The aim of the senior managers of Cumbria PCT since its formation has been to downgrade West Cumberland Hospital (WCH).

It is important to understand why they are producing a document which has as one of its options no ITU beds at WCH.

This is the only way managers can justify in the future – in the very near future – transferring all services needing ITU beds to the Cumberland Infirmary, Carlisle, leaving WCH without a critical mass of clinical activities needed to sustain an acute district general hospital.

First it was the consultant-led maternity service and paediatrics; then it was 24/7 emergency services. Now managers are trying to remove ITU beds from WCH.

If there are no ITU beds all other clinical services are under threat, and with that WCH would become unsustainable.

West Cumbria needs to send a very clear message to all the managers that we will not accept any thing less than what was agreed in the Closer to Home document

We West Cumbrians need, deserve and demand fully resourced health care as promised in the Closer to Home document. We might have to fight for it, and fight we will.

The chief manager of the PCT keeps talking about efficiency. WCH is already an efficient hospital, as we have been functioning with less and less funding for some time. Exasperation and frustration might be mistaken for lack of efficiency.

This funding cut by the PCT has had an insidious effect, driven politically, financially, and ideologically, and at least in case of Cumbria, it is also driven by whim and self righteous attitude, which has taken a ruthless momentum. This must be opposed.

There is evidence that acute hospitals in North Cumbria have been under-funded for at least the last three years.

The PCT is trying to convince everyone that Closer to Home is working and hence there is less work needed to be done in acute hospitals and so less funding is needed, decisions are made on statistics which has the feel of creative ambiguity about it.

However the evidence suggests that is not the case. More emergencies are admitted and more elective work is also being done.

There is confusion between demand and capacity. Managers seem to think that if capacity is reduced then demand will also be reduced. That has not happened. In fact demand should dictate capacity.

Mr Andrew Lansley has been telling all media and patient groups “No decisions about me without me”; however the goal has been decided in advance and all steps taken so far are a means towards that aim, which is to downgrade WCH, no matter what the consequences are.

The PCT is in a state of denial, managers from above and clinicians from below must own up about the decisions they are making, as it has a detrimental effect on health care in West Cumbria.

The latest clinical service strategy does not give power to the professional, patients are not in control, and services are not local.

Some of the senior clinicians and clinical managers do not think that it is safe and cost-effective to transfer emergency patients to the Cumberland Infirmary.

Unless a critical mass of clinical activities are maintained, medical and all other staff will be difficult to retain and impossible to recruit.

Mr Mahesh DHEBAR

Consultant Orthopaedic Surgeon
West Cumberland Hospital

SIR – Two years ago I wrote to you to highlight what was happening in our hospitals while warning against complacency for the future.

Our worries and concerns expressed for more than a decade have fallen on deaf ears. Carlisle’s obsession to be “The Hub” in their hub-and-spoke infatuation has resulted in West Cumberland Hospital being ridden over roughshod, particularly on services and staff.

Meanwhile, we filled to capacity the Civic Hall expressing to the then acute trust chief executive and her team our concerns and dissatisfaction; then near Christmas 2006 we held a public march to Save Our Hospital Services. One would have thought that such a show of concern, resolve and strength would carry a strong message. It certainly gave food for thought and for a time everything on the surface was Utopian. The rose-coloured glasses were worn by many but who could decry that when promises more profuse than pebbles on the beach were given under the guise of hospital consultation.

Consultation was to be the name of the game and the guidelines are set in stone provided they are carried out within an atmosphere of openness, integrity and trust. Such set standards were a non-starter, for despite promises made and repeated denials, a hidden agenda was wheeled out item by item affecting all departments, but none more so than cardiology.

Testing the water was the terminology quoted to me when personnel were first rostered to Carlisle Hospital – just for one day, then a couple of days, now at least 50 per cent of their time, some even for ever. There was no such testing of the water regarding hospital services. The dagger was thrust fast and deep. In the cardio unit consultants had carried out not hundreds but thousands of heart operations in the form of angiograms and the insertion of pacemakers and the manner of their removal was a matter of grave concern which has to be highlighted, for in the middle of March the given promises commenced to crumble like pie crust and emphasised the saying: “You can fool some of the people some of the time, but you cannot fool all of the people all of the time.”

Our Heart and Angina Support group received information that the services of angiography, and insertion of pacemakers were to be withdrawn. This initially was denied by the Trust. However, good investigative reporting by The Whitehaven News acting on information given by our group resulted that in the March 18 issue last year the story was carried re transfer of patient heart services from West Cumberland Hospital to Carlisle. Well, talk about “egg on the face” – the embarrassment at board level was intense, resulting within 24 hours the dispatch of a personal letter from the North Cumbria University Hospitals Trust’s Chief Executive. I quote the gist of the letter from March 19 2010:

Dear Mr Copeland

I am writing in connection to the angiography provision at West Cumberland Hospital and the proposed changes to this service, and in particular the support of the Copeland Heart and Angina Group.

Please accept my apologies that I have not been in touch with you by now, however, the press story on this overtook events and I would have preferred to speak to you personally prior to this.”

So in a couple of days the bubble had burst – what price now “no hidden agenda”? With this type of going on behind closed doors, no department is safe. Rehab, trauma, palliative care and ITU spring to mind. The WCH is being decimated and, worse, its staff are having their lifelong dedication sucked out of them.

I forecast there will be no respite in the movement of staff and services from WCH and when NCUHT are forced to present the true facts and figures, all hell will break out.

R COPELAND

Whitehaven Castle

AN NHS Cumbria spokesperson told the Whitehaven News: “Hospital and family doctors have been working hard to deliver on the promises made to the people of north Cumbria through the 2008 Closer to Home consultation. The Clinical Strategy has been developed by GPs and hospital consultants from West Cumberland and sets out how the rest of the changes agreed in Closer to Home will be delivered over the coming years.

“It includes a commitment to a new West Cumberland Hospital which clinicians want to develop into a hospital of choice for patients undergoing planned operations from across Cumbria and other parts of the region.

“Importantly, the strategy reaffirms the commitment of GPs and hospital doctors to consultant-led maternity and accident & emergency services at the hospital - a key component of the original closer to home plan. The clinical strategy is currently being assessed by independent health economists to make sure it remains sustainable.”

Minister offers meeting with Copeland MP re hospitals

2011-03-10T00:52:00.000-08:00

During Health questions in Parliament on Tuesday of this week, after Andrew Rosindell MP had asked about measures to protect against MRSA and C-Diff (on which West Cumberland Hospital has an excellent record), the following exchange took place:

Jamie Reed (Copeland, Labour)

"As the Secretary of State knows, the north Cumbrian health economy is in crisis. GP commissioning is providing £30 million less for acute hospital services in north Cumbria this year than it did last year. This has resulted in the trust being unable to seek foundation trust status, and it is seeking a merger which minutes leaked to me by consultants say could lead to the closure of the West Cumberland hospital. Will the Secretary of State meet me as a matter of urgency so that we can collectively find how we can get the hospital out of that hole? Will he also consider a delay to foundation trust status to give the hospital trust more time to get back on its feet?"

Simon Burns (Minister of State (Health), Conservative)

"I am a bit confused, Mr Speaker, as the question is about MRSA and C. difficile, and I did not hear any specific question from the hon. Gentleman on that subject."

John Bercow (Speaker)

"I am grateful to the Minister of State. My sense is that Mr Reed is seeking a meeting. The Minister is perfectly at liberty to say more if he wishes, or if he does not think it is worth it, he does not have to do so."

Simon Burns (Minister of State (Health), Conservative)

"Mr Speaker, you are a wise owl to be able to interpret what Opposition Members are thinking but may not be saying. If the hon. Gentleman has concerns along the lines that he mentioned, I or one of my ministerial colleagues would be more than happy to meet him."

John Bercow (Speaker)

"Wise owl is the kindest description that the hon. Gentleman has ever offered of me. I shall take it that he means it. It's the best I'll get."

(For anyone reading this who does not follow affairs in parliament, the last comment from the Speaker is a joke which refers to a heated argument last year about a matter of parliamentary procedure, when the same minister notoriously referred to the Speaker in uncomplementary terms.)

Changes at West Cumberland Hospital:

2010-11-25T05:04:00.000-08:00

The Whitehaven News reports that changes to services at West Cumberland Hospital are taking place – including rehabilitation, palliative care and children’s ward.

Local NHS Trust's management chiefs say the changes – which have been worked on by hospital clinicians and GPs – do not mean a reduction in the quality of service or safety, and are in line with the national shift of care away from acute hospitals towards more people being treated in the community they say.

The number of beds on the hospital’s stroke unit (Ullswater) has reduced from 18 to 14, because rehabilitation beds for head injury patients (but not stroke patients) has moved to Carlisle.

Mike Walker, director for the North Cumbria University Hospitals Trust, told the Whitehaven News:

“The consultant retired and it was a difficult model to run for the whole of North Cumbria.

“It was decided that it was more efficient to run the inpatient service on one site. There is also a move to have more of those patients treated in the community so there is less need to have neuro rehabilitation beds.”

Palliative care has currently been moved to the stroke unit due to a shortage of staff as a result of sickness, added Mr Walker. He said it was not something that had been done through choice and that the plan in the hospital redevelopment was to locate those patients in the Copeland Unit (community beds unit managed by GPs on the WCH site).

Under the plan, the Copeland Unit is to move to Overwater Ward, which is said to be bigger and will also provide room for palliative care (a total of 25 beds). Palliative care staff will move with the patients, providing the same specialist care in a specialist area. Some nursing staff currently on the Copeland Unit will be upskilled in palliative care, said Mr Walker, to care for the lower dependency patients on the unit.

The children’s ward was reduced from 21 beds to 15 over the summer and is said to be working well. Of those, eight are for assessment and seven are inpatient beds, although the assessment beds can also take children overnight if needed.

“We are trying to focus on the whole service provided rather than just counting beds,” said Sandy Brown, a Trust director. “The vast majority of children get assessed and are able to be discharged the same day.”

The aim is to have one team of staff providing a service between a child’s home to hospital treatment. Depending on what level of care is needed, some may be assessed at the hospital and then cared for in the community while others may need to stay in hospital. It means that some staff in the community would have to be “upskilled”, said Mr Walker, so that more children can be cared for in the community. “The teams do work together but we need to make that bridge stronger.”

“There is a fine balance as we are down-sizing, sometimes it doesn’t quite match. There are very good skills in the community, but what we need to do is upskill them more. There has always been a good flow of patients (between the hospitals and the community) and we need to build that bridge even stronger.”

Moving more complex out-of-hours surgery to Carlisle’s Cumberland Infirmary, from West Cumberland Hospital, is expected to start in January. It was agreed as part of Closer to Home consultations and was said to affect only a small number of patients and that if someone was not well enough to travel, the surgeon would have to go to the patient.

There are difficulties in recruiting anaesthetists to both hospitals, said Mr Walker. He said there was currently enough to cover the work but there are problems in recruiting middle-grade staff.

He said they were looking at different ways to provide the service and said that there needed to be anaesthetics on both hospital sites.

Other services at the hospital will remain, such as A&E which will become part of an ‘emergency floor’ which will include hospital doctors, GPs and out-of-hours teams; maternity services, and intensive care unit (six beds in total).

Osborne confirms WCH rebuild is safe

2010-10-20T05:20:00.000-07:00

I was delighted while watching the hancellor's statement today, in which he announced some very difficult decisions to tackle the government deficit, that he specifically confirmed that the West Cumberland Hospital rebuild and refurbishment will go ahead. (This was one of three hospital rebuild programmes mentioned in the speech.)

He also confirmed that total NHS spending is being protected from the cuts and will increase be more than inflation every year in this parliament.

Lansley confirms WCH rebuild will be funded

2010-07-15T13:51:00.000-07:00

Conservative Health Secretary Andrew Lansley has visited West Cumberland Hospital and confirmed that the hospital will get at least £70 million from the government for the redevelopment project.

The Health Secretary met staff to thank them for their hard work following the tragic shootings, and said:

"I and my colleagues in Government have looked with great care at the case for finding support for the rebuilding of West Cumberland Hospital.

"While other new hospital schemes are being considered in the context of the spending review, West Cumberland will be treated on an exceptional basis, given its stage of development, evident priority and the relationship with local economic redevelopment through the energy coast programme."

Following the election the new coalition government put a hold on all major health projects. This freeze initially included the £100 million redevelopment of the hospital, because despite work being under way and buildings demolished, the previous Labour government had not actually got around to approving even the outline business case.

On top of the £70 million confirmed as coming from the new coalition government, £10million is coming from the North Cumbria University Hospitals Trust and £10million from the Strategic Health Authority.

There is a potential £10 million shortfall representing money which had been due to come from the North West Development Agency (NWDA), which is said to be the subject of current discussions between health bosses and the NWDA.

The Department of Health will provide up to £70 million for the redevelopment of the hospital over three years. Andrew Lansley told the Whitehaven News:

"I have visited the hospital twice in the past. We appreciate how important their services are to the people of West Cumbria. The need to maintain access to emergency care was reinforced by the tragic circumstances following the recent shootings.

"This is the most significant investment into the healthcare of West Cumbria and I am overjoyed for the community that they will now have brand new clinical facilities that will provide high-quality care for the future."

Hospital boss, Carole Heatly, said:

"This is just fantastic news and I am absolutely thrilled we have been provided with the major part of our funding and the redevelopment of the West Cumberland Hospital can progress full steam ahead."

Davic Cameron praises WCH

2010-06-09T15:27:00.000-07:00

I arrived home after the minute's silence in memory of the victims of last week's shootings just in time to catch the second part of this afternoon's session of questions in the House of Commons to the Prime Minister.

Consequently I heard David Cameron's responses to a number of questions from Cumbrian MPs, and I also heard him give the strongest possible endorsement of West Cumberland Hospital.

David Cameron was fulsome in his praise for West Cumberland Hospital, which he visited on Friday, and for its staff: he particularly praised the work of the hospital in caring for the victims of last week's shootings.

Hospitals a huge issue on the doorstep

2010-04-11T12:56:00.001-07:00

During the first week of the General Election campaign the future of our local hospitals has been a huge issue on the doorstep in Copeland. This has been common to Whitehaven, Millom, Keswick, and points in between, and the only difference being which hospital was of most concern to local people.

One good thing about this was that there is tremendous goodwill towards the NHS and most of the people who work in it.

Farewell to the NHS Blog Doctor

2010-04-11T12:55:00.001-07:00

I wish "Dr Crippen" a happy retirement on learning that he has ceased to publish the "NHS blog doctor" weblog.

It was always one of the best of the medical blogs.

His retirement is marked here and here.

Lansley: we support WCH rebuild

2010-04-04T17:11:00.000-07:00

Conservative shadow health secretary Andrew Lansley gave West Cumberland Hospital's rebuild/refurbishment as an example of an NHS capital programme which the Conservatives want to protect.

He told Sky News last week that the Conservatives are committed to real terms increases in spending on the NHS.

He stressed that the Conservatives would protect capital expenditure for the NHS and said that the Tories would build new hospitals, invest in diagnostic equipment, and in primary care facilities, although they plan "to get rid of the bureaucracy".

You can read a Politics Home summary of the Sky News interview here.

West Cumberland Redevelopment: website launched

2010-01-19T14:24:00.000-08:00

During the Executive report to Copeland Borough Council this afternoon, it was reported that the long-awaited website to keep patients, residents and staff in touch with the redevelopment of West Cumberland Hospital has finally been launched. The URL is www.buildingyourhospital.ncuh.nhs.uk.

Having had a look at the website which I warmly welcome, I noted that the formal submission of the full business case is due by the end of this month: it is described as being on track.

I asked the leader of the council if it would be worth contacting the NHS Trust to ask if there is anything the council can do to help and support the submission of the final business case, and she agreed to do so.

Millom Hospital

2010-01-19T14:23:00.000-08:00

I attended the Millom Neighbourhood Forum at the network centre, Millom School yesterday.

The first item discussed was the future of Millom Community Hospital. The timetable for the proposed redevelopment and improvement for the hospital has slipped a bit, and the previous decision that the new services to be provided can best be done on the existing site is being reviewed. Nevertheless the project is still going forward.

Snow and Ice force hospital cancellations

2010-01-06T01:27:00.000-08:00

The extreme weather has forced health bosses in Cumbria to cancel all non-emergency hospital appointments.

NHS North West told the BBC that staff were focusing on emergency cases and said it hoped patients would understand.

Even though the county has escaped the worst of recent snowfalls, more than 140 schools have been closed.

The Highways Agency said it had about six days of grit and salt left and that at the moment it was coping with road treatment operations.

Jane Cummings, director for nursing, quality, performance and commissioning at NHS North West, told the BBC: "At the moment our priority has to be to maintain patient safety and treat emergency and urgent cases.

"This may mean that some patients may experience a slight delay to some services, or that services are delivered in a slightly different way.

"Staff throughout the NHS are doing all that they can to ensure essential services continue to run efficiently.

"We can confirm that some hospitals across the region have taken the decision to postpone all non-essential out-patient appointments.

"If you have an out-patient or day-patient appointment scheduled for the next few days, please contact your hospital clinic and check whether any arrangements have been changed."

Mountain rescue teams have been drafted in to help the North West Ambulance Service, which is only responding to the most urgent calls.

Cameron and Hawking defend the NHS

2009-08-14T02:58:00.000-07:00

David Cameron and Professor Stephen Hawking are among those who have defended the NHS from ludicrous and inaccurate criticisms made in America. David Cameron sent an email to supporters saying that he and his family had been grateful for the work of the NHS.

The most absurd of the attacks made by US critics of the NHS was the claim in an American newspaper that 'People such as Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.'

Professor Hawking himself, while in Washington to receive America's highest civilian honour, the Presidential Medal of Freedom, hit back at these attacks on the British health service, saying 'I wouldn't be here today if it were not for the NHS. I have received a large amount of high-quality treatment, without which I would not have survived.'

A British woman, Kate Spall, who was quoted in adverts for an American group calling themselves 'Conservatives for Patients' Rights (CPR) opposing the President's health legislation, said that she had been misrepresented and felt duped by these adverts.

She told the Times: "It has been a bit of a nightmare. It was a real test of my naivety. I am a very trusting person and for me it has been a big lesson. I feel I was duped."

No organisation should be above constructive criticism, but some of the attacks on the NHS in the USA have been disgraceful and inaccurate.

I mostly reserve party political comment for my main blog rather than this one, but I will make an exception by quoting David Cameron's email here to confirm that the Conservative Party is totally committed to the NHS: an effective National Health Service which is free at the point of delivery is one of the things we wish to conserve.

David Cameron writes:

"I've been enjoying the sun and touring my beautiful constituency of Witney today. But it goes without saying that just because I and most other politicians are not in Westminster at the moment, politics isn't somehow put on hold.

People still care about the issues they care about, and thanks to the internet they can voice their concerns whenever they want. Just look at all the support which the NHS has received on Twitter over the last couple of days. It is a reminder - if one were needed - of how proud we in Britain are of the NHS.

Millions of people are grateful for the care they have received from the NHS - including my own family. One of the wonderful things about living in this country is that the moment you're injured or fall ill - no matter who you are, where you are from, or how much money you've got - you know that the NHS will look after you.

That's why we as a Party are so committed not just to the principles behind the NHS, but to doing all we can to improve the way it works in practice. So yes, we will spend more on the NHS, but we will also improve it so that it is more efficient and responsive to patients. People working on the frontline will actually be able get on with the job they signed up for, without getting tied up in a web of targets. And we will put more power in the hands of patients by giving them better information about the care they can expect to receive.

Underlying these reforms, and our whole approach to the NHS, will be one big ambition - that future generations will be even prouder of the NHS than we are today."

Diagnosing Swine Flu

2009-08-05T01:00:00.000-07:00

A survey of 251 Doctors in General Practice reported on the ITN website this morning found that 90% of them are concerned that diagnosing swine flu over the phone could lead to other diseases, like meningitis, being missed.

It's a small sample, but the overwhelming nature of the response is enough to be statistically significant and to suggest to me that the fears described by the NHS Blog Doctor and referred to in my post below "How not to deal with swine flu-or anything else" are shared by a large number of doctors.

While the levels of suspected swine flu are above what normal NHS capacity can deal with, it may be regrettably necessary to keep the current special measures such as internet and telephone diagnosis in place, but this survey reinforces my view that we should return to normal methods of diagnosis as soon as practical when infection rates trend down.

In the survey, 87 per cent of family doctors questioned, answered yes when asked: "Does diagnosing swine flu over the phone mean other diseases may be missed?"

Of the 251 polled, 10% were unsure and just 3% said no.

The associated report highlights their concerns, one stating that they had seen a case of measles misdiagnosed as swine flu. Again, this echoes the concern of the NHS blog doctor: he gives details here of a case where a teenager with life-threatening meningitis was misdiagnosed with swine flu and had to invent a false medical history to get a hospital to look at her.

West Cumberland Hospital Meeting

2009-08-03T15:10:00.000-07:00

This post will focus on the discussion which took place in the Boardroom at West Cumberland Hospital on 24th July. I have addressed the political controversy over the meeting on my blog at Chris4Copeland.blogspot.com or see link at right.

I have heard from several people who were there that it was a positive and constructive meeting.

Highlights included:

Out-of-hours emergency services.

The lead surgeon at the hospital, Mike Walker, said that the trust is exploring a less than 24/7 emergency surgery service for the West Cumberland Hospital, as agreed in Closer to Home.

He said it would be based on need but that no detail had yet been discussed.

Mr Walker said: “All patients will come to the West Cumberland Hospital whether it is in or out-of-hours and be assessed here.”

If a decision was made that emergency surgery was required and it was out-of-hours then, he said: “If they are unstable to travel (to the Cumberland Infirmary) then a consultant will come here (to the West Cumberland Hospital).”

Normal working hours could be, for example, 8am-9/10pm weekdays and 8am to 5pm weekends, he said.

Consultant anaesthetist, Ian Ulyett, asked if such a patient required an intensive level of care would they have to go via ambulance to Carlisle.

Mr Walker said: “It will be decided on a case by case basis, in some cases they will go there and in other cases the surgeon comes here. It will not be the case that surgeons won’t come here.” He said if someone was unstable then the surgeon would come to the patient.

It would mean that West Cumberland Hospital would still provide a 24-hour consultant-led emergency medicine care but not 24-hour surgery. “The frequency to transfer patients for out-of-hours operations will be very small.”

He said only a very small number of patients are ever operated on out-of-hours, that the aim for any hospital is always to operate in-hours.

The Reverend John Bannister, the Save Our Services spokesman, asked about the reasons for this. Mr Walker explained that it was to ensure there was a clinically safe service and robust out-of-hours rota for vascular and emergency surgery. He said there would be eight surgeons on the rota for out-of-hours surgery (with two on at any one time) that will cover the whole of North Cumbria. He said the hospital would still have a resident operating team available 24/7.

Charles Brett, A&E consultant, said there has never been any suggestion the A&E service would be reduced, that it is consultant-led and would remain so. “We are signed up to deliver the services outlined in Closer to Home and look forward to being an integral part of that.”

The subject of emergency out-of-hours surgery would be discussed at length and a plan agreed with consultants, said Mr Walker, before being tested on, for example, a nine month basis.

Microbiology and Pathology

It was confirmed that some microbiology services are being centralised in Carlisle which means that certain tests would be transported there to be analysed on behalf of patients at West Cumberland Hospital instead of being done on site. A ‘hot lab’ facility however would remain to ensure that emergency specimens could still be done there and then on site.

Consultant orthopaedic surgeon, Mahesh Dhebar, said: “I think we should retain this service.” And a hospital physician said he did not want to have to telephone around for test results for a suspected acute meningitis patient as he would require them within 30 minutes. “We are very stretched on the floor with regard to juniors and seniors and if juniors are required to ring Carlisle for results then that is not an efficient service.”

Mike Walker said that would be sorted out to make sure the service remained efficient.

Regarding pathology, Mr Clarkson said: “It is not a loss of service. There will be a quicker turnaround time for people in West Cumbria and for cancer work.”

Nick West, said he thought there was a drip drip of centralisation of services regarding histopathology and microbiology. “It’s a loss to this hospital and this community. Each one is a little drip drip which demoralises staff and doesn’t help recruitment.”

Mike Walker said services needed to be safe and that occasionally it would mean that services have to be delivered from another site.

What is planned for the new and refurbished hospital

Gerard Richardson, of the Save Our Services group, asked “Is the hospital we are planning now any different to the hospital we were promised?"

Carole Heatly, Trust chief executive, said: “No. We are committed to everything in Closer to Home.” She said the only changes there would be is if they were for clinical safety reasons, and such a decision would be made by the clinicians themselves."

David Hounslea, project director for the £100million hospital redevelopment, said visible work would be evident by the end of the financial year.

He said there would be an improved environment on wards, efficiency changes so that services were grouped together properly and that views from the hospital would be maximised on wards.

The need for support

Concern was expressed about the impact on morale, recruitment and retention of the perception that services are gradually slipping away to Carlisle.

Soonu Verghese, consultant ophthalmologist at West Cumberland, said: “All the drip drip has been towards Carlisle. Why can’t management think about services coming this way? It has to be a two-way process. People should be made aware of the fact that they will have to travel. A lot of my patients are elderly.”

Liz Twist, Unison regional representative, added: “There is a real concern over here about the drip drip of services. People fear that even with a great building that the hospital may not provide all the services. So it would be good to open early dialogue with staff and address issues.”

Kevin Clarkson said: “People are not applying to Cumbrian posts. We are not down-grading the service, we are trying to build it up and make things sustainable for the workforce. We are continually advertising.”

Carole Heatly said: “There are national shortages of histopathologists. We also cannot get anaesthetists and it is a major worry. We are really trying to promote the area and get doctors to come and work here.” She said the Trust had even made a DVD to send out promoting its hospitals and the area.

Mahesh Dhebar said: “Unless you guarantee the future of this place (West Cumberland Hospital) you will not recruit. Unless you have a hospital that will be there 40 years from now, you will not recruit. Also, there are problems recruiting to a split site (ie two separate hospitals).

Rev Bannister said there were underlying and historic reasons why hospital staff and the community were often concerned about hospital services. “For the 10 years I have been here there’s been fear over this hospital. I am not sure we will actually be able to alleviate that until the day the (redeveloped) hospital opens its doors.

“We have a responsibility not to hijack this process with issues that do not warrant public concern. But," he added: “The Trust needs to look at its communication policies.”

Trust chairman, Mike Little, said: “Our Trust Board is committed entirely to this hospital here at West Cumberland and all its services. There is £100 million coming to this hospital.

“We need support for moving this hospital forward. We have got a contractor, we are making a start. But as we go through the next few years there’s going to be far more problems than we are discussing here,” he warned. “There are always financial issues, we have to live with them. Our board has turned around this Trust.”

Carole Heatly added that nationally there was going to be a significant reduction in the amounts of government money coming into the NHS so it would mean that things would have to change.

“We can do this together and we can make this a success. If we don’t, it will be a disaster,” she added.

The main source of information for this post was the Whitehaven News report which can be read in full here.

Contractor chosen to rebuild WCH

2009-07-22T11:39:00.000-07:00

Tomorrow's Whitehaven News reports that Laing O'Rourke has won the contract for the rebuild/refurbishment of West Cumberland Hospital in Whitehaven.

Earlier this month I met NHS Trust CEO Carole Heatly with Cllr Yvonne Clarkson, chair of the Copeland council overview and scrutiny committee dealing with health. We had a constructive discussion about a number of issues, and one thing which Yvonne and I were keen to see was that the hospital project went forward as quickly as was compatible with due diligence and getting the rebuild right to deliver a safe and effective service. We were assured that progress was happening to achieve this this and this week's announcements backs up that statement. This his progress on assigning the contract is most welcome.

The Trust told Speaking exclusively to The Whitehaven News, health bosses announced that they have chosen construction giant Laing O’Rourke. The company has given an undertaking that the majority of the workforce needed for the £100million redevelopment will be sourced locally through its approved contractors and supply chain.

North Cumbria University Hospitals Trust said it would generate a significant boost to the local economy and contribute to the regeneration of West Cumbria. Carole Heatly said: “In selecting Laing O’Rourke, we have an understanding that they will use the local workforce as much as possible – this is good news especially in times of economic recession and should do much to strengthen the local economy of West Cumbria.”

It is expected that early preparatory work on the site will start before Christmas this year to allow for the major construction to begin in 2010. The hospital will include a new-build emergency care centre, new theatres, new outpatient area and new wards.

Laing O’Rourke is the largest privately-owned construction firm in the UK. It owes its own foundations to Cumbria where it was started by John Laing, in Cockermouth, in 1848. It was acquired by O’Rourke in 2001 and is said to be the premier health contractor nationwide with projects including the recent redevelopment of the Freeman and Royal Victoria Hospitals, in Newcastle.

The redevelopment of West Cumberland Hospital will be a publicly-funded capital project and will not be through the Private Finance Initiative which was used to fund the construction of the Cumberland Infirmary.

Health chiefs say they are committed to three ‘givens’ – providing all the services as agreed following the Closer to Home consultation; providing a facility to ‘modernise, improve and deliver care to all patients in West Cumbria’ and to move the development forward quickly.

Mike Little, Trust chairman, said: “This major project will provide a new healthcare facility that will see great improvements for all our patients in West Cumbria along with providing a great boost to the local economy.”

Ms Heatly added: “This is an immensely exciting time for healthcare in West Cumbria. £100 million is a significant investment and the first significant investment into healthcare for West Cumbria in over half-a-century. Working closely with our clinical staff and stakeholders, we will develop a healthcare facility that will offer the best to our patients.”

The full report is on the Whitehaven News website here.

Cumbria LINk survey on WCH rebuild

2009-07-16T12:48:00.000-07:00

Cumbria LINk is carrying out a survey into the views of local residents about the rebuild of West Cumberland Hospital.

They are asking

a) WHAT IS THERE

With regard to the existing design and layout of this hospital, they are asking residents to give details of three problems or issues (NOT including the well known parking issues)

b) WHAT YOU WOULD LIKE TO SEE

They are asking residents to suggest up to three new facilities or services they would like to see provided in the rebuilt/refurbished hospital

c) Any other comments

They have asked for any other comments on the rebuilding of the hospital

Comments can be made via the Cumbria LINk website at

http://www.cumbrialink.org.uk

or via email to link@cumbriacvs.org.ul

or by post to

Cumbria LINk support team
27 Spencer Street
Carlisle CA1 1BE.

How not to deal with Swine Flu - or anything else

2009-07-12T07:51:00.000-07:00

I was deeply concerned to read posts by the NHS Blog Doctor and Guido Fawkes about how inquiries about Paul Staines' daughter were dealt with by his local NHS when she developed a fever.

"Doctor Crippen" writes that

"I am ashamed to say that swine flu is being seen by some of my cynical colleagues as a perfect excuse with which to fob off a large number of patients."

As he points out, during the current fuss about swine flu, "other illnesses continue as normal. Children still get meningitis, and may well present with high temperatures, tummy ache, headaches and a dry cough. Children still get bacterial pneumonia and may well present with high temperatures, tummy ache, headaches and a dry cough. Children still get pyelonephritis (kidney infections) and may well present with high temperatures, tummy ache, headaches and a dry cough. Children still get acute appendicitis and may well present with high temperatures, tummy ache, headaches and a dry cough. Children still get acute leukaemia and may well present with high temperatures, tummy ache, headaches and a dry cough."

Unfortunately the symptoms which small children present when they get ill can be very similar for a wide variety of illnesses, some minor, some presenting a risk of permanent injury, and some life-threatening. That's why we must avoid the trap of diagnosing over the phone that every child with a fever has swine flu, prescribing Tamiflu, and assuming that this will deal with it.

Otherwise as he points out, we will have a tragedy like this:

“Mrs Jones phoned the GP/the hospital/the walk-in centre and was told over the telephone that her daughter, Mary, had swine flu. They left out a prescription for Tamiflu but Mary died the next day from meningococcal septicaemia.”

You can read the NHS blog doctor's comments in full here, and he expresses his disapproval of some of his NHS colleagues a lot more strongly than I have.

Putting Patient Safety First

2009-03-24T15:22:00.000-07:00

The Conservative’s five-point plan to avoid a repeat of the tragic events at Mid Staffordshire NHS Foundation Trust

1. Tougher inspection to root out failure

Mid Staffordshire failure. The Healthcare Commission’s report raises concerns about weak patient and public involvement in the activities of the trust. It said that:

‘One of the former members of the forum, however, considered that the [patient and public involvement] forum had not been sufficiently robust in scrutinising standards’ (p.35). There were also concerns about the trust not being sufficiently open with the forum. The Healthcare Commission said that the trust ‘did not welcome concerns being raised by individual members of the forum’ (p.109) and that: ‘A former member of the patient and public involvement forum (PPIF) commented that it was difficult to obtain information from the trust on C. difficile. He felt this should be in the public domain. He obtained a copy of the infection control minutes for the meeting on 21 September 2006, which recorded that there had been 341 cases in total, of which 285 were inpatients, averaging 36 per month between January and September 2006. The minutes were not marked as confidential. When this information was released by him to a newspaper, he was expelled from the forum for breaching the code of conduct of the PPIF. He told us that the chair of the trust met with the chair of the PPIF and said that confidential documents would not go to the PPIF any more’ (p.89).

Conservative plan. Under Labour there has been constant upheaval in public and patient involvement in the NHS, with three different mechanisms for patients and members of the public to engage and involve themselves in the development of NHS services in just five years. Labour are currently establishing Local Involvement Networks (LINKs) in place of Patients’ Forums. In keeping with our commitment to avoid organisational upheaval, we will not abolish LINKs. However, LINKs – as currently planned – are too weak and will have too few powers to command the confidence of patients and members of the public. For example, they cannot summon documents in their own right, only access them through the Freedom of Information Act which has a number of exemptions built in.

Conservatives will make sure that LINKs are made independent of local authorities so they are not swayed by local politics, as Labour are proposing. And they will be given tough powers of inspection to hold the NHS accountable and the ability to act as advocates for patients who complain about NHS services. We also want serious NHS complaints (second-stage) complaints to be dealt with by the health regulator (the Care Quality Commission) not the Health Service Ombudsman, as the Government has said. The regulator is the body best placed to take action if complaints raise concern about systemic failings, as was the case in Mid Staffordshire.

2. A strong voice for patients

Mid Staffordshire failure. Overall, the Healthcare Commission report shows that patients did not have enough say over services at their local hospital, and although they were suffering from its failings, it took to long for the patient voice to be heard.

Conservative plan. Conservatives will establish a strong, independent, national consumer voice for patients: HealthWatch. HealthWatch will provide support to patients at a national level. Crucially, it will work closely with LINKs so that concerns raised at a local level can be escalated nationally, where necessary. It will also provide help for patients in dealing with complaints. HealthWatch will have a clear statutory right to be consulted over guidelines issued nationally concerning the care NHS patients should receive (‘commissioning guidelines’); and over decisions which affect how NHS care is provided in an area.

3. Power for patients to hold failing hospitals accountable

Mid Staffordshire failure. The Healthcare Commission’s report makes clear that local GPs were aware of problems at the hospital. It says that: ‘Just prior to the Healthcare Commission’s investigation… the PCT then contacted its two local commissioning groups to ascertain the views of GPs on standards of care. The responses were highly critical and further raised the concerns of the PCT’ (p.119). However local GPs and their patients had little power to do anything about the problems because it was the local Primary Care Trust that was responsible for purchasing services from the hospital and therefore setting standards for patients. It failed in its duties, with the Healthcare Commission reporting that: ‘it was initially distracted by the organisational change following the merger that created the PCT in 2006, and then focused on the number of patients treated and the cost. They had few measures of the quality of care or outcomes at the trust’ (p.11).

Conservative plan. Conservatives would put real power in the hands of patients, together with their GPs. Instead of Primary Care Trusts, GPs will control the funding that hospitals receive when they treat their patients and the contracts that go alongside this funding. They are best placed to do this because, unlike Primary Care Trusts, they have a personal relationship with their patients so they know their needs, can keep an eye out for problems and are in a better position to withhold payment if things go wrong.

Together with their GP, patients will be given the right to go to any hospital they choose for treatment. That means that they will be able to go elsewhere if a hospital is failing.

4. An end to box-ticking and targets

Mid Staffordshire failure. The Healthcare Commission’s report found that: ‘Many staff that we interviewed volunteered their view that the approach of the trust meant that the care of patients had become secondary to achieving targets and minimising breaches’ (p.49).

Conservative plan. Conservatives will scrap Labour’s costly, bureaucratic targets, such as the four hour waiting time target in Accident and Emergency and instead focus on what really matters to patients, which is the results of their treatment. This does not mean there will not be any standards, but instead of these always being determined centrally we would give local GPs the power to agree standards with the hospitals where they send their patients. These standards would have to be kept as part of the contracts for their treatment. Doctors and nurses should never be put in a position where they have to choose between meeting a target and doing what is best for their patients.

5. Exposing hospitals to public scrutiny

Mid Staffordshire failure. The Healthcare Commission’s report shows that the awful treatment of patients in Mid Staffordshire only came to light as a result of concerns about mortality rates at the hospital. Mortality rates are not routinely published and were only available as a result of ‘internal’ analysis by the Healthcare Commission and independent analysis by the Doctor Foster group (p.4).

Conservative plan. Conservatives will make sure information on the outcomes of patients’ treatment at individual hospitals is freely available to the public, so that it is clear which hospitals are not doing well. We want to put power back in the hands of patients by ensuring that all the information necessary to them to assess the performance of their local hospital is made available. This will include more information on mortality and survival rates at each NHS trust. We are calling on the Government to include information on outcomes in the new quality accounts they are planning to introduce for hospitals in their current Health Bill. At the moment these are to be focussed on targets like the four-hour waiting time target for Accident and Emergency.

More detail on the above proposals can me found in

- our paper on Primary Care, ‘The patient will see you now, doctor’, published in September 2007;

- our Health Green Paper, 'Outcomes not targets', published in June 2008; and

- 'Renewal' Our plan for NHS improvement, published in September 2008. These documents can be found at:

http://www.conservatives.com/Policy/Where_we_stand/Health.aspx

A Cartoonist's view

2009-03-04T23:07:00.000-08:00

The front page of this week's issue of the Whitehaven News carries the cartoonists view of the decision to keep the hospital on its present site.

The cartoon shows two people carrying a very large sticking plaster in the direction of a sign labelled "WCH"

I have thought for a long time that the present site is the best site for the hospital. But to keep the hospital on it's existing site apparently because there is not enough money for a complete new build is not the reason I would have preferred to have had for that decision.

West Cumberland Hospital to stay on current site

2009-03-03T23:24:00.000-08:00

The Whitehaven News reports a decision by the local NHS Trust Board that West Cumberland Hospital will remain on its current site and be redeveloped.

The report says that the hospital "will be made up of a mixture of new buildings as well as extensively refurbishing current ones.

Health chiefs ruled that it would not be a complete new build hospital as that would cost in excess of £50 million over the maximum available funding of £100million.

The decision was made at the board meeting of the North Cumbria University Hospitals Trust today.

Professional experts brought in to look at what could be provided within the maximum budget of £100million concluded that a complete new build would require a significant reduction in service provision compared with Closer to Home.

Therefore, in a report to the board, EC Harris consultancy recommended that the Trust should look at re-developing the existing site, in order to provide a 220-bed hospital (with potential to increase to 250 if required).

They said that priority for the main areas of spend should be given to the hi-tech areas of the hospital such as operating theatres, ITU, A&E and diagnostics.
Redeveloping the existing hospital will enable the provision of modern, fit for purpose healthcare facilities in West Cumbria, they said."

White Young Green report into hospital sites

2009-02-27T12:14:00.000-08:00

Last year Copeland Council and Westlakes Renaissance commissioned the consulting firm White Young Green to report on the merits of two possible sites in Whitehaven for the new hospital in West Cumbria which had been promised.

One was the existing West Cumberland Hospital site, the other was at the Ginns.

White Young Green have now produced a report which was presented to councillors this week. The full report can be read here on the Copeland Council website. You can download it if you have a good enough internet connection, but be aware that it's a rather large file: if comes as a PDF for Acrobat to read and is about 27 Megabytes !

Since the report was commissioned it has become clear that the Trusts may have no option but to stick with the existing West Cumberland Hospital site. (See previous post on this blog) However, the White Young Green report is interesting because it does make a strong case for retaining the hospital in Whitehaven. The summary of Key Points made by the report reads as follows:

SUMMARY OF KEY POINTS

Strategic Context

* Cumbria Health statistics and future demographic change emphasise the need for a new health delivery model designed to meet future need in Cumbria

* Cumbria Health services require substantial restructuring to support closer to home delivery of the service

* Any new Acute hospital, and services, need to be fully accessible to the West Cumbria community

Site Considerations

Accessibility
· Equally accessible in travel time from north and south of the defined North Cumbria area and well placed to service urban and rural communities
· Equidistant in relation to coverage of communities by acute hospitals at Carlisle, Barrow and Kendal
· Meets the needs of emergency services
· The potential for maximising available public transport to the site
· Good road infrastructure to support patients/visitors/staff and emergency services for the hospital and wider health campus requirements

Site development
· Flexible development space to accommodate 270 bed hospital and changing demands on health services
· Sufficient space to accommodate car parking for patients/visitors/staff
· Additional land capacity to support health campus development

Fit with service delivery model
· Strategic opportunities for the hospital to align with partners to support integrated health services for local communities
· The location has flexible considerations to support changing services
· Enhances current and future patient flows
· Enables service dependencies to be achieved

Socially acceptable
· Consideration of the impact on the local communities and residents living within the immediate area

Regeneration
· Supports wider economic and regeneration principles of the Energy Coast Masterplan
· Aligns partnering opportunities in relation to education, research and development

News & Star reports "Major Cash Blow" to WCH

2009-02-13T07:35:00.001-08:00

The News and Star reports here that there has been a major setback in plans for a new hospital for West Cumbria.

The paper's article today says that the NHS trust "found out this week that a maximum pot of just £100 million will be available – which may not be enough to deliver the new-build facility they had envisaged.

They have now admitted they may be forced to look at a part-refurbishment scheme – using some of the existing West Cumberland Hospital in Whitehaven – instead."

The issue was discussed yesterday at the board of the North Cumbria University Hospitals NHS Trust.

Following the "Closer to Home" consultation, the trust is committed to providing new acute hospital facilities, with a minimum of 220 beds, in west Cumbria.

Up to now the proposal was for a complete new-build, possibly on a brand new site. After years of argument, there were signs that proposals for a new hospital would be put to public consultation later this year, although the date has kept slipping back.

I have been arguing that they must take a decision quickly, to ensure that we protect staff morale and keep good people at the hospital by giving them a secure future: this has become all the more important with the national economy going into severe problems and £35 billion sliced from government spending plans in the pre-budget report. The longer action is delayed, I said, the greater the risk that the money will no longer be there. Instead we should move forward as quickly as possible to provide modern services on the existing site.

Yesterday Kevin Clarkson, deputy chief executive of the North Cumbria trust, agreed that it is essential to resolved the matter quickly and put an outline business case to the NHS region bosses.

He also said the maximum amount of public funds available for the project will be £100 million – up to £70 million from the Department of Health and £30 million from the strategic health authority – which may not be enough. His report to the board states that

“A key issue for the project is the amount of capital that would be required for a complete rebuild to match the requirements set out in the Closer to Home consultation of 220-250 beds.

“Initial advice is that this may be challenging with the funding available.”

Instead the trust say they will now have to consider the partial use of the existing site rather than 100 per cent new-build. Professional advisers are being brought in to undertake a “rapid and focused” review of the options and report back to the board’s March meeting.

I am of course very concerned to hear about the money problems. However, as I was already of the opinion that the existing site is the best place for the hospital, if it means that the local NHS Trusts focus on providing the best available services on that site and moving forward to do so as quickly as possible, such a policy would be of benefit to patients and staff alike.

New Hospital to reject PFI

2009-01-17T11:55:00.001-08:00

I am not surprised that the NHS Trusts in Cumbria would prefer to avoid PFI for the new hospital building to replace the West Cumberland.

However much sense there may be in the principle of trying to get private sector money and business know-how involved in improving the services offered by the public sector, PFI has not been a huge success, and the Cumberland Infirmary in Carlisle has not been a good advert for the scheme.

However, the NHS Trusts really need to get a move on, or they may find that the money is simply no longer there. If course, if they rebuild and modernise the hospital on the present site, they don't to spend three months on statutory public consultation about the siting, they can just get on with improving the facilities and hospital services on offer.

Happy New Year 2009

2008-12-31T16:18:00.000-08:00

Wishing everyone who reads this a happy, healthy, and successful New Year 2009. May this be a year in which West Cumberland Hospital, Millom Community Hospital, and the Mary Hewitson Cottage hospital, all move forward in a positive way.

Good News on dispensing by Doctors

2008-12-26T15:41:00.000-08:00

I initially missed this because it came out just before the Kells & Sandwith belection, but I was very pleased to see the extract below from Hansard, making clear that the government has abandoned plans to stop GPs from dispending medicines.

John Mann (Bassetlaw) (Lab): Five thousand of my constituents have written to the Minister, via me, asking that their general practitioners be allowed to continue dispensing. Will he take heed of this Bassetlaw common sense?

Phil Hope: My hon. Friend has been at the forefront of the campaign on the issue of dispensing by doctors. We are analysing the responses to the consultation on pharmaceutical provision in England , and we will be making an announcement on these wider issues as soon as possible in the new year. I am aware of the strength of the responses we received on the various options for amending the criteria for dispensing by doctors. We have taken into account the views of those attending the listening events, the meetings and so on, and as a result I am pleased to announce to him that there will be no change to the current arrangements on GPs dispensing medicines to their patients.

We need to get moving on the new hospital

2008-12-02T23:00:00.000-08:00

At Copeland Council's December meeting, the council leader agreed with me that we need to press the NHS Trusts to take a decision as quickly as possible on the new West Cumberland Hospital.

Following on £35 billion of cuts in government spending plans in the Pre-Budget Report, the longer it takes to get a decision the greater the risk that when they are finally ready to start building the money we have been promised will no longer be there.

Of greatest concern was the comment from the leader that there does not appear to be an adequate process to get things moving.

The other thing we agreed on is that the hospital should be in Whitehaven.

Future of Millom Hospital

2008-11-25T00:31:00.000-08:00

Yesterday at the Millom Neighbourhood Forum the main item of business was two presentations about the future plans for a local Health Campus. About 60 people turned out to hear the current status of proposals to combine a number of medical facilities including a new home for the local medical practice and a new care home, and a rebuilt community hospital.

Lansley on hospital acquired infections

2008-10-23T13:30:00.000-07:00

Andrew Lansley has attacked Labour for failing to tackle hospital overcrowding after new analysis showed a strong link between overcrowded wards and the spread of deadly hospital infections.

The independent research by the House of Commons library revealed that NHS Trusts with a bed occupancy rate above the recommend level had an 18 per cent higher rate of C-difficile and a 21 per cent higher rate of MRSA.

Andrew, the Shadow Health Secretary, said, “Far too many patients are catching infections like MRSA as a result of having to share overcrowded wards.”

And he attacked the Government for denying there was a link between MRSA rates and high rates of bed occupancy in England:

“The Government urgently needs to stop burying their heads in the sand and take action. The price patients and their families in this country are paying because of their failure is far too great”.

Andrew promised that a Conservative Government would tackle overcrowding by providing 8,000 more single rooms across the NHS to ensure that infected patients can be isolated.

Hospital Sites

2008-10-21T14:47:00.001-07:00

The local NHS keeps saying that it will be consulting shortly on a new site for West Cumberland Hospital, although the date keeps going back.

They are currently talking about launching a consultation in the spring with a decision by May.

Copeland Council has been preparing proposals to put to the trust concerning possible sites. At one point the council had previously identified five possible sites, but had dismissed suggestions that the Pow Beck site was the preferred option.

The Executive report to today's full council meeting said that the council is concentrating on two of these sites, at Hensingham near the existing hospital and at Pow Beck. The site for the latter option was described today as being at The Ginns, which is subject to a lower risk of flooding than some parts of Pow Beck but still has access issues.

The final decision will be taken by the Trust, not the council. It may become very important for as many people as possible to lobby to make sure the hospital stays in Whitehaven.

No hospital decision likely this year

2008-10-02T14:30:00.001-07:00

The impression had been given, and reported both here and in the local media, that a decision on the future site of the hospital in West Cumbria would be taken by December this year. It now appears that it will take longer than that.

A meeting of the Children, Young Peopl,e and Families scrutiny committee of Copeland Council today heard a presentation from representatives of NHS Cumbria.

The most interesting thing to come out of the discussion is that it now appears to be impossible for a final decision on the site of the hospital in Whitehaven to be taken in 2008.

Cabinet office rules will require a full consultation lasting at least 12 weeks - possibly longer if it runs over Christmas, followed by consideration of the points made by doctors, nurses, other staff, and the patients and public. From the start of the consultation to the decision is likely to take four months, and the PCT is not in a position to start the consultation just yet (though I have heard informally that it will not be too long.) So if - and it is a big if - there are no significant further delays we are probably looking at a decision in February or March.

MRSA cases rise in Cumbria

2008-09-21T15:11:00.000-07:00

Although we recently had the welcome news that MRSA infections have been falling in NHS hospitals as a whole, there has been a spike in Cumbria.

I know that the staff at the West Cumberland have been working hard to maintain high standards and keep hospital acquired infections under control but this demonstrates that we cannot afford complacency - and for example, that means that when we debate how many hospital beds are needed we need to ensure that there is enough spare capacity that staff have adequate time to clean beds between patients.

In the three months to June, the there were six MRSA cases at Carlisle’s Cumberland Infirmary and the West Cumberland Hospital, Whitehaven.

This compares with four cases during the same quarter two years ago. Overall the number of cases has fluctuated over the two-year period, with a high of nine and low of four in any given quarter.

North Cumbria's acute hospitals trust say they are working hard to reduce the spread of infections and have introduced a number of initiatives. Measures launched over the past year include the appointment of two lead matrons for both hospital sites.

They have also appointed a lead hand hygiene nurse, who is developing campaigns to increase awareness, and two specialist infection prevention nurses to deliver specialist training for staff.

Sandy Brown, director of nursing for North Cumbria University Hospitals NHS Trust, said: “Infection Prevention is a top priority in our trust and across the health economy in north Cumbria.

“We place a great deal of emphasis on this issue to ensure that patients feel reassured and that we continue to deliver high quality patient-focused care. We have introduced many new measures in the last 12 months including developing particular infection prevention roles for a large group of staff.”

The trust recently revealed that cases of the more common superbug, C diff, have dropped significantly over the past year. It believes this is a result of improved infection control policies.

Source: Cumbria Newspapers website (article by Anike Bourley).

Copeland Council discusses Mental Health

2008-09-18T14:00:00.000-07:00

The relevant Overview and Scrutiny Committee at Copeland Council met today to discuss the current NHS consultation on adult mental health services in Cumbria and took evidence from a number of speakers including representatives of West Cumbria carers and of the NHS trust.

The NHS consultation will remain open until 30th September.

Copies of the consultation document can be obtained by ringing 08447 280107 on online at nhsconsultation@cumbriapct.nhs.uk

New site for WCH

2008-09-09T14:05:00.000-07:00

The issue of the new site for West Cumberland Hospital was discussed this afternoon at Copeland Council. As previously mentioned here and elsewhere a decision is expected by December.

Copeland councillors believe, and it is stated in the Masterplan, that the new hospital should be in Whitehaven.

Carole Heatly takes up the reins at WCH

2008-09-05T08:00:00.000-07:00

Carole Heatly, the new chief exec of the trust which runs West Cumberland Hospital and the Cumberland Infirmary, has taken up her post more than a month early. She started work on Monday, even though she had not been due to take over until the end of October.

Ms Heatly's premature arrival is a result of her securing an earlier-than-anticipated release from her previous post, as chief executive of the Kingston Hospital in London. She has now taken over the position formerly held by Marie Burnham as chief executive of the North Cumbria University Hospitals NHS Trust, previously the acute hospitals trust and will now oversee the running of the Acuute hospitals in both Whitehaven and Carlisle.

She is expected to spend the next few weeks getting to know the two hospitals and meeting her new team.

The source for this information is the Whitehaven News.

Pharmacy consultation begins

2008-09-04T00:01:00.000-07:00

A consulation document has been published on the future arrangements for pharmacies and dispensing practices. This concerns the proposals which are likely to affect the Seascale medical practice and may result in the closure of Bootle surgery if they go ahead as planned.

You can find the document online at

http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_087324

Hospital Site to be set by December?

2008-08-21T15:42:00.000-07:00

At a presentation this afternoon at a Copeland Council meeting we were advised that the Strategic Health Authority has given the green light for submission of a business case for a new Acute Hospital in West Cumbria and that it is hoped to make a decision on the siting by December.

There was some discussion on the siting. It has been erroneously suggested in some quarters that Copeland Council supports Pow Beck as a site for the new hospital. It was confirmed today that this is not correct.

The actual view of Copeland councillors, confirmed today by people of both parties, is that we support a new hospital in Whitehaven, on a sustainable site with good access to the A595.

David Cameron's support for local health facilities

2008-08-13T14:41:00.000-07:00

While David Cameron was in Cumbria today I raised with him some of the issues around health in Cumbria including the future of our local hospitals and the impact of the government's proposals to stop GP surgeries from being able to include a pharmaceutical dispensary if there is another one within a mile.

David Cameron confirmed that the Conservatives

1) Support District General Hospitals as the basis for Acute Healthcare

2) Oppose the forced imposition of "polyclinics" which may cut family GP services

3) Support the retention of dispensing in GP surgeries

If these policies were in place it would remove the current threat to Bootle and other surgeries.

Millom "Health Village" moves closer

2008-08-12T06:45:00.000-07:00

Proposals to concentrate more health services on the site of Millom Community Hospital look to be moving nearer.

The County Council's plan to improve six care homes in Cumbria, including the move of a home in Millom to a site adjacent to the hospital, appear to be attracting support, and NHS Cumbria, (e.g. the local PCT) has indicated that they are likely to approve the business plan for the Millom "Health Village."

The concentration of these facilities in new buildings adjacent to the hospital is good news and is likely to strengthen further the case for maintaining and supporting Millom Community Hospital.

Recession warning

2008-08-12T05:13:00.000-07:00

In this month's Business Gazette the head of Cumbria's chamber of commerce warns that there is a real danger of recession. This is correct. Promises of "no more tory boom and bust" from Gordon Brown have been shown up as the humbug they always were.

The government does not bear 100% of the blame for this recession - some of it is due to world factors. But Gordon Brown's failure to put more money aside in good times is exacerbating the problems now we have hit a bad season.

Packed meeting hears case for GP surgeries

2008-08-11T23:11:00.000-07:00

Over a hundred local residents attended a public meeting in the village hall at Bootle Station this evening, which was called to discuss the impact of the government's pharmacy proposals on rural GP surgeries, including the possible closure of the Bootle branch surgery as a result.

Strong opposition to the proposals was expressed. A more detailed report is on Chris Whiteside's blog, see link at right.

Trust gains University title

2008-08-01T14:15:00.000-07:00

The NHS Trust which runs the West Cumberland Hospital and Carlisle hospital has gained the University brand. It has been announced that the new title for the trust will be the North Cumbria University Hospitals NHS Trust.

This recovnises that north Cumbria’s two main hospitals have been working with local universities to train medical staff. That recognition should also make it easier to open up new opportunities for trainee doctors and nurses across the area, and this is greatly to be welcomed. The aim must be to establish a first class health education and training centre for Cumbria.

The trust’s bid to improve training has been made with the support of the Universities of Cumbria and Newcastle, which are both involved in new medical student teaching schemes, and the progress made has now been recognised by the Privy Council and the Department of Health.

The "News and Star" comment today summed the situation up very well:

"The NHS reached the grand age of 60 last month, and its core principles – providing free healthcare for all, regardless of wealth – are still admired by many. But it is also an institution beset with problems, and over the years the Whitehaven and Carlisle hospitals have not escaped the effects of inadequate funding and service cuts at a national level.

University status will secure investment and the continuing provision of healthcare for the people of north Cumbria. These are major developments which, if all goes to plan, will have wide-reaching benefits.

The county has been suffering from a brain drain for too long, and we need to not only attract young talent, but retain it too, if the much-anticipated regeneration of Cumbria is to be a success."

Feedback from Whitehaven Mental Health meeting

2008-07-22T13:46:00.000-07:00

This week in Whitehaven the NHS Trusts in Cumbria held one of their "drop-in" sessions as part of the current consultation on Mental Health services in Cumbria.

In spite of the fact that the consultation was held at what Copeland council had warned the NHS was not a terribly convenient time - the middle of the afternoon on a working day - more than 50 people listened to the consultation and Question and Answer session for nearly two hours and there was a constant stream of questions right to the very end.

This consultation affects everyone in Cumbria, from Millom to Penrith, from Carlisle to Barrow. It may be very important for the future of many local residents who might prefer not to think about the issue.

Unfortunately care for those with mental problems is often seen as a "Cinderella service" and does not get enough attention, which can be a tragedy both for those who suffer from mental illness and those family members who care for them and who are often the worst affected victims.

The fact that so many people turned out even at such an inconvenient time should be a signal to the NHS Trusts that they need to redouble their efforts to involve more people. To be fair to them, the people representing the Trusts at the meeting did promise that they would try to do this, but it is important that the rest of us both hold them to their word and give them someone to engage with - proper consultation is a two-way street.

Copies of the consultation document can be obtained by ringing 08447 280107 on online at nhsconsultation@cumbriapct.nhs.uk

The current consultation will be open until 30th September.

Public presentation tomorrow on Mental Health

2008-07-20T11:39:00.000-07:00

There will be a public display and presentation tomorrow in Whitehaven Civic Hall as part of the current Mental Health consultations.

Details are:

Monday, 21st July, Civic Hall, Whitehaven
Display boards available to read from: 2pm
Presentation & Q&A: 3pm

New boss for North Cumbria's hospitals

2008-07-10T00:38:00.000-07:00

Carole Heatly, currently Chief Exec at Kingston hospital trust in South London, has been appointed to succeed Marie Burnham as CEO of the North Cumbria Acute Hospitals Trust with effect from October.

As Mike Little has taken over from Eric Urquhart as Chairman of the Acute Trust, which runs both the West Cumberland Hospital in Whitehavem and the Cumberland Infirmary in Carlisle, and Marie Burnham had reshuffled the executive directors before announcing her departure, this represents a complete changeover from the trust's previous top management.

Ms Heatly has worked in the NHS for 25 years, starting as a general nurse in Edinburgh.

I wish Carole Heatly all the best with the challenges she will face in this exceptionally important appointment.

E-Health supplement in today's FT

2008-07-09T05:39:00.000-07:00

There is an interesting 70-page supplement in today's Financial Times about "E-Health" and particularly how electronic communications and data processing can support the NHS.

Save our Surgeries

2008-07-07T14:39:00.000-07:00

The issues around health care in Cumbria (and the rest of the UK) do not just affect hospitals. I am becoming very concerned at the impact of several government policies on the viability of local doctor's surgeries, especially in rural areas.

I attended a meeting of the Gosforth and Ennerdale neighbourhood forum this evening at which two of the local councillors present reported on a meeting they had had earlier in the day with one of the senior partners of the practice which runs Seascale Health Centre.

The government is proposing that GP practices will no longer be allowed to run pharmacies where there is an independent pharmacy within a mile of the surgery. This could be very bad news for the Seascale health centre, as the income from the pharmacy compared to GP salaries translates as 1.5 FTE (Full Time Equivalent.) In other words Seascale may lose the equivalent of one and a half doctors if the government proceeds with this policy.

Overall some 17 GP practices in Cumbria are affected including two or three in Copeland: apart from the impact on Seascale health centre, this evening's meeting was told that the proposed pharmacy policy if adopted would present a serious threat to the viability of Bootle surgery. There is also a practice affected in Whitehaven.

This would be bad enough if the pharmacy policy was the only thing the government is doing which is likely to harm rural GP practices, but in fact it is one prong of a three-pronged assault. The second is the proposal to promote large "Polyclinics" with up to 20 doctors, to resource which it is likely that some smaller practices are closed. And the third is that Alan Johnson has announced he intends to abolish the minimum guaranteed practice income scheme which keeps many small surgeries open.

Taken together these policies represent a serious threat to our rural GP services, which following on from the loss of other rural amenities such as Post Offices is bad news for rural communities and also for urban communities in sparsely populated areas such as Cumbria.

Trust denies threat to eye services at WCH

2008-06-25T14:24:00.000-07:00

The North Cumbria Acute Services NHS Trusts have denied that there is any truth in rumours of a threat to opthalmology services at West Cumberland Hospital.

The West Cumbria Society for the blind had heard rumours that the hospital might lose eye services and wrote to the PCT asking if there were any plans for such a change. According to a report which will be carried in tomorrow's Whitehaven News, both the PCT and the Acute Services Trust have categorically stated that there are no such plans.

Details of Mental Health consultation

2008-06-15T13:42:00.000-07:00

Details of Cumbria PCT's public consultation on mental health can be obtained by ringing 08447 280107 or by email on nhsconsultation@cumbriapct.nhs.uk

They can also be found on the Cumbra PCT website which is

www.cumbriapct.nhs.uk

NHS Mental Health services consultation starts

2008-06-05T15:03:00.000-07:00

Following on from "Closer to Home" Cumbria PCT is about to start another hospital consultation, this time on mental health.

This is a "Cinderella" service in the sense that it is much less glamorous that Acute or GP services and is often neglected. But many people depend on this servicemost of us will have someone in our family who needs this service at some stage during our lives.

I hope that as many people as possible will look at the consultation document and take the trouble to respond.

Another Dentist to leave the NHS

2008-06-05T15:00:00.000-07:00

Yet another Whitehaven dentist's surgery is to stop providing NHS services.

I understand their reasons for taking this decision but this is not going to be good news for local residents on low incomes.

It is essential that the government urgently reviews the provision of NHS dentistry, especially in remote areas like Cumbria, and establishes a more sustainable service.

Jobs to go at West Cumberland Hospital

2008-05-29T14:59:00.000-07:00

According to a report by Gillian Ellison in today's Whitehaven News, 400 jobs are to be lost at the North Cumbria Acute Hospitals trust which runs West Cumberland Hospital in Whitehaven and the Cumberland Infirmary at Carlisle, representing about 10% of the trust's employees.

There is expected to be a programme of voluntary redundancies combined with redployment and natural wastage: large scale redundancies are not expected.

West Cumberland hospital is one of the largest employers in West Cumbria and this is not good news for the area: it also comes at when the people employed by the trust have been having a difficult time and this will mean further stress for them.

I hope the trust will make every effort to resolve the situation quickly without compulsory redundancies so that the employees know where they stand.

The full Whitehaven News report is as follows:

"A REDUCTION of approximately 400 staff working across West Cumberland Hospital and the Cumberland Infirmary is anticipated over the next two years – but it is expected that many will be redeployed.

Health bosses have given assurances that there will not be any mass redundancies as has happened elsewhere in the country.

The Trusts’s draft Annual Business Plan 2008/09 gives an estimated 10 per cent reduction in the workforce anticipated over the next two years as a result of new ways of working under Closer to Home.

Marie Burnham, chief executive of North Cumbria Acute Hospitals Trust, which manages the hospitals, said: “This Trust Board has never been in the business of massive wholesale redundancies. Other trusts have done that but it’s never been our intention to do that.”

She said that there could be individual redundancies but not “large chunks of staff”.

A proposal for a voluntary severance scheme will be developed for posts that will no longer be required and many staff will be redeployed to work in a community setting.

As care starts to be provided differently, with less emphasis on acute care and more on community provision nearer to where people live, staff will be required to work differently.

The draft plan, presented to the Trust Board this week, sets out how health care, finances and staff will move forward over the next year.

Sustainable services have to be provided within health budgets. Expensive NHS locum staff will only be employed in an emergency situation and posts will only be replaced “if there is a clear need to do so otherwise the post will be disestablished”.

At this week’s Trust Board meeting, Christine Wharrier, Unison union convenor at West Cumberland Hospital, said: “Ten per cent – that’s quite a number of staff considering how many the Trust employs (about 4,000).”

Miss Burnham added that it has always been in the public domain that the Trust would be down-sizing as a result of Closer to Home but she stressed that many staff would be redeployed.

Mrs Wharrier said that there would be a need for in excess of 250 staff out in the community over the next three years.

After the meeting she added: “My main problem was where the projected figure came from.

“Unions are invited to all levels of meetings at the Trust – whether or not they influence decisions at those meetings remains a question.”

At the meeting, Caroline Griffiths, director of strategic planning, said the numbers were just estimates at the moment."

New Acute Trust chairman appointed

2008-05-14T00:17:00.000-07:00

The SHA has moved quickly to fill the post of Chairman of the North Cumbria Acute Services NHS Trust, following the retirement of Eric Urquhart. The new Chairman is Mike Little, and I was introduced to him by Eric Urqhart at last night's Annual Meeting of Copeland Council.

Mike Little is a former operations manager for Border/Granada Television and has many years experience as a magistrate. He chairs the family and youth courts and is a past chairman of Cumbria Magistrates’ Courts Committee. He was born in Cumbria and has lived in Whitehaven as well as Carlisle.

Mike will face a huge challenge with all the the issues facing both West Cumberland Hospital and the Cumberland Infirmary. On the basis of my initial conversation with him I did form the impression that he is well aware of the scale of that challenge and is willing to listen to people.

Superbugs and Bed Numbers

2008-04-28T05:53:00.001-07:00

Panorama ran a terrifying story yesterday about the problem for hospitals posed by the c-diff superbug which is now killing about 6,000 patients a year in British hospitals - worse than MRSA.

The story included an in-depth examination of one particular NHS hospital trust in Southern England where 90 patients had died from c-diff and there had obviously been some serious management failings. But although Health Secretary Alan Johnson claimed that the management of this trust was uniquely bad, the sheer number of deaths over the whole country indicates that c-diff is clearly not an isolated problem - only about 1% of deaths over the UK from this bug were in that trust.

And it would appear that we as a country are doing something wrong - if you look specifically at the age range and circumstances of the type of patients most affected in the UK, one of the experts who appeared on Panorama that UK death rates from c-diff are ten times worse than in other comparable countries.

The most frightening aspect of this is that once you get an major infection of the most virulent strains of c-diff it is almost impossible to eradicate the bug. Proposals to recruit more matrons and the fact that a "deep clean" of hospitals are a welcome indication that the problem is at least beginning to be addressed, although I note that some clinicians have been quite scathing about the effectiveness with which the "Deep Clean" policy is being implemented. But according to the Panorama programme, some strains of c-diff can go into a dormant state in which they can survive heat, broad-spectrum antibiotics, and disinfectant, then go active again and infect somebody years later.

The most effective defence appears to be to operate very high standards of hygenie so that the bud doesn't get well established in the first place.

The North Cumbria Acute Services NHS Trust which runs the West Cumberland hospital has one of the better records for controlling Hospital Acquired Infections but it would appear that no hospital or trust can afford to be complacent when confronted with the new superbugs.

In particular, the danger of a c-diff outbreak appear to be higher if

1) Bed occupancy rates are very high, making limited time to clean beds between patients and making it likely that patients will be moved between wards

2) Nurses are overworked

3) Management is fixated on central government targets and consequently paying less attention to the basics of cleanliness and good patient care.

Which means that the number of beds available at the West Cumberland, at Millom Community Hospital and Keswick Cottage Hospital will need very careful attention with the planned changes to make sure that bed occupancy rates do not get too high.

Marie Burnham to leave Cumbria

2008-04-08T06:20:00.000-07:00

It has been announced today that Marie Burnham, Chief Exec of the NHS trust which manages the West Cumberland hospital and Carlisle hospital, is leaving to take up a similar position at an NHS trust in Lancashire.

New Hospital for West Cumbria - where's the money ?

2008-04-07T14:27:00.000-07:00

A document about economic regeneration circulated at a Copeland Council committee meeting today by an officer of Westlakes Renaissance suggested that there is considerable confusion, including within the Primary Care Trust (PCT) about where the money for the promised new acute hospital in West Cumbria is coming from.

The exact quote from a document provided to councillors at the meeting read as follows:

"Clarification and confirmation of NHS funding is needed as there is confusion, not least within the PCT, about the commitment (or not) of funding for the proposed new hospital, despite the 'Closer to Home' consultation and assurances which have been given, following parliamentary questions, to Jamie Reed MP. If funding for the new hospital and supporting community hospitals in Cumbria is not in existing health budgets, we need guidance on what we need to do to ensure they are."

Apparently this came out at an officer level meeting last week.

This is rather alarming and attempts are being made to clarify the situation. Watch this space.

Wishing you a happy Easter

2008-03-23T09:57:00.001-07:00

A very happy Easter to everyone reading this, especially patients and staff at West Cumberland Hospital, Millom Community Hospital, and the Mary Hewitson Cottage Hospital in Keswick

Award Scheme launched

2008-03-19T19:29:00.000-07:00

The NHS in Cumbria has launched an award scheme to reward and celebrate good work, which was inaugurated this week at West Cumberland Hospital

PCT approves "Closer to Home" revised proposals

2008-03-14T16:10:00.000-07:00

Cumbria's Primary Care Trust has approved this week the amended version of the "Closer to Home" proposals for the future of NHS services in the northern two-thirds of the county.

The revised proposals include at least 220 beds at the West Cumberland hospital or its successor and that the hospital will continue to provide trauma care.

This is not the end of the story: we must continue to ensure that there is public involvement in protecting a full range of hospital services in Cumbria.

The trust's decision has been seen as paving the way to replace the West Cumberland Hospital with a new acute hospital in West Cumbria. However, there remains a great deal of uncertainty over where any new hospital will be and how it will be funded.

We must not get into a situation where money has to be diverted from patient care and providing health services to pay for new buildings.

"Closer to Home" announcement expected soon

2008-03-10T16:15:00.000-07:00

It has been suggested in the local papers that we might get some indication of the progress of the closer to home consultation in the coming fortnight. I suspect the local NHS Trusts will need a longer period of reflection to decide anything meaningful, but it will be interesting to see what they say at their forthcoming meetings.

Foundation Trust application to be delayed by resignation ?

2008-03-04T15:56:00.001-08:00

Representatives of the North Cumbria Acute Hospitals trust (which manages West Cumberland Hospital and the Cumberland Infirmary at Carlisle) gave a presentation at the Keswick Neighbourhood Forum this evening about the plans to apply for Foundation Trust status.

One of the issues mentioned was that the leadership of trusts seeking foundation status is reviewed and has to be seen to be strong.

In this context I asked whether the recently announced resignation of Eric Urquhart as Chairman of the Trust will affect or delay the application for FOundation Trustt status.

We were advised that the Trust would have to have their leadership in place before they could gain foundation status, so it is possible that the vacancy might cause some delay.

Debate continues on maternity beds

2008-02-26T10:20:00.000-08:00

A mother who recently gave birth at the West Cumberland has made an appeal through local papers against any reduction in the number of maternity and SCBU (Special Care Baby Unit) beds at the hospital.

The trusts have promised that they are involving the clinicians in the discussions about bed numbers at WCH, but this is one area which everyone will scrutinise in great detail. We must make sure the hospital has enough maternity beds.

What do you think? The consultation may have finished but we should all continue to make sure the PCT and Acute Hospitals Trust cannot ignore local views.

NHS Mental Health consultation deferred

2008-02-20T13:14:00.000-08:00

The consultation on Mental Health care in Cumbria which had been due to begin in March has now been deferred to begin in early May.

The reason given by the trust for the delay is that some parts of the county (such as Carlisle and Barrow) have council elections at the beginning of May, and the election campaigns might affect the consultation. It was therefore felt better to start the NHS consultation shortly after the local election campaigns.

Flower boost to WCH

2008-02-17T14:44:00.001-08:00

Congratulations to Boonwood Garden Centre near Gosforth, and their customers, who raised £662 for the A&E department at West Cumberland Hospital by putting out a donations bucket for the hospital over Christmas

WCH to lose maternity beds ?

2008-02-13T17:12:00.000-08:00

The Whitehaven News has a story suggesting that as part of the reduction in bed numbers resulting from the "Closer to Home" consultation, the West Cumberland Hospital in Whitehaven might lose eight maternity beds, (dropping from 23 to 15).

It is also suggested that two beds might be removed from the SCBU (Special Care Baby Unit) and five beds might be lost in paediatrics.

A bed planning exercise was carried out recently by the North Cumbria Acute Hospitals NHS trust following on from discussion about bed numbers during the the "Closer to Home" consultation period. At the moment the trust is refusing to comment about proposed bed numbers, although Marie Burnham did say that the review

"looked at potential areas of bed reductions to improve efficiency wihtout affecting patient care. This will be discussed over the coming months with clinicians."

I want to hear what the consultants have to say about these proposals before jumping to man the barricades but I think it is important that the impact is considered very carefully before any bed reductions are implemented.

NHS agency staff bill exposed

2008-02-04T15:45:00.000-08:00

Evidence released under under the Freedom of Information Act reveals that NHS Trusts across the country are paying agency staff extremely high hourly rates, sometimes to cover shifts, sometimes for administrative work. Examples include:

£100 per hour for an HR manager
£93.50 per hour for an IT consultant
£110 per hour for financial staff
£96.75 per hour for a GP
£121.59 per hour for an agency nurse

This comparies with average hourly pay rates in the NHS for permanent staff of about

£15.66 for a nurse;
£24.14 for a junior doctor; and
£60.31 for a consultant.

In 2005/6, the most recent year for which figures are available, the NHS spent £1.18 billion in total on agency staff.

NHS Trusts here in Cumbria have just finished a consultation about the future of our local hospitals. Senior officials in the trusts have said that the amount of money available to fund local health services is one of the factors affecting very difficult decisions they have to take. Meanwhile local doctors, nurses, and hospital staff have been put under enormous pressure, partly due to staff shortages and vacant posts left unfilled.

To learn that NHS trusts elsewhere in the country have been paying agency staff many times the salary paid to an NHS nurse or junior doctor, and much more even than a hospital consultant, makes you wonder whether the difficulties faced by NHS staff and the community in Cumbria might be less great if money throughout the NHS was spent more efficiently.

I would not suggest that there is no role for agency people in the NHS, or criticise the work they do. But when you read some of these rates, and learn that the NHS has been spending over a billion pounds a year on agency staff, you have to ask whether the balance as between permanent staff and agency staff throughout the health service as a whole is either fair to the staff involved or represents the most effective way to care for patients.

Copeland Conservative response to NHS consultation

2008-02-01T15:21:00.000-08:00

The following comments were made to the "Closer to Home" consultation on behalf of Copeland Conservatives.

Copeland Conservatives endorse the comments on the "Closer to Home" proposals made by both Copeland Council and Allerdale Council. We would particularly like to emphasise the following issues and concerns.

Firstly, the PCT and Acute Trust must learn from the difficulties experienced during this consultation about the need to improve communication with clinicians, GPs, other staff, and the public. Although there were eventually some welcome improvements made in the proposals as a result of feedback, particularly from Consultants at WCH, it was painfully apparent for most of the consultation period that the efforts made by the trust to engage with consultants and GPs were not working as well as we would all have wished. The commissioning model in "Closer to Home" will not work unless all GPs can be far more effectively involved with the process than many of them evidently were with the consultation.

Secondly, while the revised proposals for care of patients with significant trauma do appear to be a significant step forward, we wish to reiterate that the original form of words in the consultation document would not have been acceptable.

Thirdly, we welcome the proposals to invest more money in the ambulance service: this is and will remain a key part of providing medical care in an area with the sort of geography which Cumbria has, and it will be necessary to work to improve it.

Fourthly, while the new Acutue Trust proposals for the number of beds at West Cumberland Hospital have gone some way to reduce our concerns, we believe that it is essential not to implement any bed reductions in Acute or Community hospitals until replacement services are fully in place. The number of beds proposed in the original consultation document was not in our view adequate.

Fifthly we consider it most important that the issues raised during the consultation affecting stroke care and palliative care continue to be addressed.

Sixthly we are concerned that Millom and South Copeland to some extent fall between the areas affected by the "Closer to Home" consultation and the separate consultation for South Cumbria expected later this year, especially as regards trauma and emergency care. It is extremely important that the Millom and South Copeland area does not lose out as a result of this status.

Finally we believe that the financial model for the proposals will need to be very carefully monitored to ensure that it remains sustainable.

We welcome the constructive dialogue that community representatives have had with the PCT and acute trust over the past few months, and particularly in January, and look forward to working with them for better health care in Cumbria.

Cllr Chris Whiteside
Conservative Parliamentary Spokesman for Copeland

"Closer to Home" consultation closes today

2008-02-01T00:56:00.001-08:00

Today, Friday 1st February, is the final day of the "Closer to Home" consultation about Hospital and Health services in most of Cumbria.

I strongly encourage any resident who cares about local health services in West Cumbria (or North and Central Cumbria) and has not already taken the opportunity to feed your views back to the PCT to do so today.

You can still feed in your views to the PCT at www.closertohome.org.uk

"Closer to Home" consultation: one day to go

2008-01-30T06:19:00.000-08:00

The "Closer to Home" consultation about Hospital and Health services in Copeland and most of Cumbria is formally open until 1st February.

I strongly encourage any resident who cares about local health services in West Cumbria (or North and Central Cumbria) and has not already taken the opportunity to feed your views back to the PCT to do so within the next day or so.

You can feed in your views to the PCT at www.closertohome.org.uk

"Closer to Home" consultation: two days to go

2008-01-29T15:25:00.001-08:00

The "Closer to Home" consultation about Hospital and Health services in Copeland and most of Cumbria is open until 1st February.

I strongly encourage any resident who cares about local health services in West Cumbria (or North and Central Cumbria) and has not already taken the opportunity to feed your views back to the PCT to do so within the next two days.

You can feed in your views to the PCT at www.closertohome.org.uk

Health consultation: Five days to go

2008-01-26T16:25:00.000-08:00

The "Closer to Home" consultation about Hospital and Health services in Copeland and most of Cumbria is open until 1st February. I strongly encourage any resident who cares about local health services in West Cumbria (or North and Central Cumbria) to take the opportunity to feed your views back to the Primary Care Trust (PCT) before that.

You can submit your views to the PCT at www.closertohome.org.uk

Delayed "Closer to Home" meeting

2008-01-24T14:23:00.001-08:00

The delayed public meeting which had been due to be held on Monday in Millom about the "Closer to Home" NHS proposals was held this lunchtime in the Network Centre at Millom School.

About forty to fifty local residents attended, including doctors, nurses, health visitors, and concerned residents and patients.

From the viewpoint of Millom residents there are some positive aspects of the "Closer to Home" proposals. These include

* the prospect of a "Health Campus" bringing together the community hospital, Nursing home, and other services.

* Promised efforts to bring more patients back from acute hospitals many miles away from Millom to recieve care locally in Millom Community Hospital or other local venues.

However, there are also some understandable concerns about the propoals.

* Millom Community Hospital is likely to drop from the present 14 beds to 9 beds under the proposals.

* There are concerns about the financial sustainability of the proposed model, and whether the savings it is based on can be acheived

* The issue of Ambulance cover was raised: the PCT propose to invest £2 million of additional funding improving the ambulance service in Cumbria but concerns were expressed about the level of cover in Millom.

* There is still a great deal of uncertaintly about how the arrangements for Emergency services and services for patients with signifcant trauma will be provided. It was admitted at the meeting that they cannot yet say how this will be handled for residents in Millom and South Copeland. Another consultation, similar to "Closer to Home" but affecting hospital services in the Barrow and South Lakeland areas is about to start: because patients who have an accident or medical conditiopn requiring emergency treatment in the Millom area are often taken to Furness General Hospital (FGH) in Barrow the trusts cannot make a definitive statement about how this service will go forward until the South Cumbria consultation moves forward.

One of the most powerful contributions to the meeting came from an Emergency Services doctor who works at West Cumberland Hospital and lives in Millom: he emphasised the need for enough beds at the acute hospitals if safe emergency care is to be provided.

The consultation is open until 1st February: I would encourage any resident who cares about local health services in West Cumbria (or North and Central Cumbria) to take the opportunity to feed your views back to the PCT before that.

You can give your views to the PCT online at www.closertohome.org.uk

Millom public meeting postponed to Thursday

2008-01-22T15:09:00.000-08:00

The "Closer to Home" consultation public meeting which was due to take place in Millom yesterday afternoon (21st January) was postponed at the last minute.

It will now take place this Thursday (24th January) at 12 noon at the Millom Network Centre at Millom School in Salthouse Road.

The consultation remains open until 1st February. Copeland council agreed a response today which welcomed the fact that the PCT has improved the original proposals but still expressed concern at a number of areas.

Millom NHS public meeting in two days

2008-01-19T15:56:00.000-08:00

The "CLOSER TO HOME" public meeting in Millom will be held in the network centre, Millom School, Salthouse Road from 2pm to 4pm on Monday.

Civic hall crammed full for hospital public meeting

2008-01-14T15:25:00.000-08:00

Hundreds of local residents crowded into Whitehaven Civic Hall this evening to attend a public meeting about the "Closer to Home" proposals on local hospitals. The room holds about 250 seats but very large numbers of people stood for two hours at the back and sides of the room. There were probably at least 400 people there to send a strong message that local residents support our local hospital services and demand first class healthcare.

At the start of the meeting it was explained by the Reverend John Bannister on behalf of the "Save our Services" campaign group that there has been significant progress on improving the proposals in the past few days.

There have been substantial discussions between the PCT, Acute Hospitals Trust, local clinicians, and the Save Our Services group for several months, and over the past few days progress has been made on resolving the concerns of campaigners and doctors, which include substantial changes being made in the "Closer to Home" proposals.

In the first place, it is no longer proposed to centralise all Major Trauma care in North Cumbria at Carlisle.

The exact form of words which should be used to describe future arrangements for Trauma Care was the subject of debate between doctors at the meeting. However, it is clear that the Acute Trust and PCT have recognised that treating all patients in the most appropriate place will mean that arrangements are necessary to treat some badly injured or very sick people, who cannot safely be moved forty miles over bad roads, at the West Cumberland Hospital.

I asked a question about this at the meeting: there is clearly some welcome movement on this subject, but it is extemely important that we get a cast iron promise from the trusts, using a form of words acceptable to the hospital consultants and to the public, that emergency and trauma care will be retained at the West Cumberland hospital, especially for those for whom the absence of that care would cause a serious risk.

There has also been a change in the proposed reduction in bed numbers at the West Cumberland hospital - originally from the present 320 beds to 172 acute beds plus 20 community beds. The Acute Trust is now proposing a guaranteed minimum of 220 acute beds at West Cumberland Hospital, with the possibility of going up to 250 beds if the efficiency improvements they are working towards are not acheived.

There has been some confusion about whether the bed numbers quoted for the West Cumberland Hospital include or exclude the proposed 20 intermediate "step up/step down" beds to provide "Community hospital" type services. My reading of the original document is that the figure of 192 beds originally proposed in the "Closer to Home" document did include the intermediate beds, so that only leaves 172 acute beds. However, the statement read out on behalf of Save our Services group by John Bannister refers to there as now being 220 acute beds.

We must remain vigilant on this issue. A representative of the Primary Care Trust (PCT) referred to the number of beds at WCH by saying that the PCT is consulting on proposals for 192 beds but that Acute Trust has now proposed 220. However, it does seem that there is welcome progress.

There were also welcome signs of progress on issues of palliative care and of stroke treatment.

It remains extremely important that as many people as possible respond to the consultation and make clear that West Cumbria needs our hospital services. As speaker after speaker said at the meeting, this is not the end of the story and we need to keep up the pressure.

"Closer to Home" Public Meeting Tomorrow

2008-01-13T14:57:00.000-08:00

The Whitehaven public meeting about the "Closer to Home" hospital proposals is tomorrow at 7pm in the Civic Hall.

This meeting will probably focus on the future of West Cumberland Hospital, though the proposals also affect community hospitals and GP services.

Several more public meetings are planned including one in Millom on 21st January.

There have been encouraging signs in the past four days that the logjam of discussion between the trust and local doctors is beginning to move, and that a new consensus on issues like bed numbers may emerge which will address some of the public's main concerns.

However, it is still extremely important that there is a strong turnout to show how strongly the public feels about the need to support our hospitals.

"Closer to home" public meeting: six days to go

2008-01-08T13:37:00.000-08:00

The Whitehaven Civic Hall meeting to discuss the "Closer to Home" proposals for health services in North Cumbria will be held at 7pm on 14th January, six days from today. There will also be a public meeting in Millom, in the Network Centre, one week later at 2pm.

"Closer to home" public meeting - one week to go

2008-01-07T13:18:00.000-08:00

The Whitehaven Civic Hall meeting to discuss the "Closer to Home" proposals for health services in North Cumbria will be held at 7pm on 14th January, a week today. There will also be a public meeting in Millom, in the Network Centre, one week later at 2pm.

"Closer to home" public meeting - eight days to go

2008-01-06T09:32:00.000-08:00

The Whitehaven Civic Hall meeting to discuss the "Closer to Home" proposals for health services in North Cumbria will be held at 7pm on 14th January, a week tomorrow. There is a Millom meeting in the Network Centre one week later at 2pm.

Cumbria County Cabinet on "Closer to Home"

2008-01-03T15:27:00.001-08:00

The County Council cabinet is among those who are expressing concern at certain aspects of the "Closer to Home" proposals, particularly the cut in the numbers of beds.

I know that their fears are shared both by some GPs in West Cumbria and by some of the hospital consultants at the West Cumberland. One GP has pointed out to his colleagues that if the proposals go ahead the West Cumberland will be trying to treat over 40% of inpatient acute cases in North Cumbria with fewer than 30% of the acute beds.

An extract from a draft letter to be considered at the Cumbria County cabinet on 8th January reads as follows:

“The changes signal a considerable change to the size and scope of the acute beds at West Cumberland Hospital. We would wish to be reassured that sufficient capacity was retained to meet modern demands for acute care across two sites.”

Under the Trust’s plan, the West Cumberland Hospital would keep its accident and emergency unit but a trauma centre at The Cumberland Infirmary, Carlisle, would deal with life-threatening cases.

County Councillors, rightly in my view, have doubts about that too. Their draft letter says: “There are concerns about journey times for emergency ambulances, particularly from more westerly and southerly parts of north Cumbria. For patients admitted to the Cumberland Infirmary, there are also very real concerns regarding public transport arrangements and journey times for the relatives. The needs of West Cumbria need to be very carefully considered in this context.”

The letter adds: “There is a particular need to address and be clear about the level of emergency care at West Cumberland Hospital, to minimise the number of patients who will need to go to Carlisle.”

(The Whitehaven News and the News and Star was the source for the information in this post about the views of County Councillors. My comments to the effect that many local doctors share those concerns are based both on views expressed by doctors at meetings which I have attended and on documents provided by doctors to close colleagues.)

County expresses concern about "Closer to Home"

2008-01-03T00:47:00.000-08:00

Cumbria County Council's cabinet looks set to express some of the same concerns about the "Closer to Home" proposals, particularly the plan to centralise major trauma in Carlisle, as have been expressed by doctors at the West Cumberland.

There are signs of a consensus developing that some parts of the proposals are good but that the centralisation of trauma treatment is overdone and that more beds are needed than currently proposed.

More details to follow later today.

Happy New Year

2008-01-01T04:22:00.000-08:00

A very Happy, Healthy, and Prosperous New Year 2008 to everyone reading this blog.

Especially to all patients and staff at West Cumberland Hospital, Millom Community Hospital, and Mary Hewitson Cottage Hospital in Keswick.

To help ensure that the second of these wishes comes true, I would strongly encourage all readers in West Cumbria to attend one of the public meetings on the "Closer to Home" proposals for local health services and let the local NHS know of your views and concerns about out hospitals.

There are five meetings in Cumbria, including two in Copeland. The first of these will be held in Whitehaven Civic Hall on Monday 14th January at 7pm, and the other at Millom in the Network Centre, Millom School, Salthouse Road at 2pm on Monday 21st January.

"Closer to Home"

2007-12-31T11:51:00.001-08:00

I have taken part in a number of discussions at the "Save our Services" group in the past few weeks, including some with representatives of the trust and some with doctors.

There are a number of messages which are becoming very clear, but the most important single problem with the present consultation document is the statement that major trauma treatment will be concentrated at Carlisle.

This statement, if taken literally, represents a serious downgrading of the ability of the West Cumberland Hospital or its successor to cope with some of the most seriously ill or injured patients, and could be very bad news for those patients and for the hospital.

I believe it would be unacceptable to the community to approve the consultation document with this statement and I am hearing that it would also be unacceptable to at least some doctors.

I hope that everyone will send a clear message to the trusts that this policy should not be approved. The public meeting on 14th January at 7pm at Whitehaven Civic Hall is one place to do that but I hope that every resident reading this who agrees with me will also write in and send the same message to the trust in your own words.

Patients admitted to meet targets at cost of £2 billion

2007-12-24T09:17:00.000-08:00

According to today's Times, targets intended to cut waiting times for A&E have had the effect of causing two million extra hospital admissions over the past five years at a potential cost to the NHS of up to £2 billion.

The extra cost comes because patients who are in danger of having to wait more than the target time of four hours have been admitted to hospital "just in case".

The figure of two million extra admissions in England comes from research by the CHKS group, an independent provider of healthcare information. However, there has been no corresponding increase in admissions in Scotland or Wales, where the four-hour target does not apply.

Whenever you set a target or an incentive, it is important to think through what behaviour it is likely to encourage, and whether this is the behaviour that you want. It would appear that this had not been done in the case of the four-hour target.

Public meeting dates confirmed

2007-12-21T15:27:00.000-08:00

I have now had it confirmed to me in writing that the following meetings will be discussing the impact of the "Closer to Home" hospital consultation

Thursday 18th January, Copeland Centre - special meeting of Copeland Council's relevant Overview and Scrutiny Committee to discuss and question witnesses about the "Closer to Home" NHS proposals. The meeting will run from 10 am to early afternoon.

Tuesday 22nd January, Copeland Centre, 4pm. January meeting of Copeland Council. The agenda for this meeting of the full council will include consideration of recommendations from the Overview and Scrutiny committee about the hospital proposals.

It has also been confirmed that the PCT's public meetings in Copeland on the subject will be held on Monday 14th January from 7pm to 9pm in the Solway room, Whiteaven Civic Hall, and on Monday 21st January from 2pm to 4pm in the Network Centre, Millom School.

"Closer to Home" public meetings

2007-12-15T14:40:00.000-08:00

It was suggested at one stage that the public consultation meetings in Whitehaven and Millom on the "Closer to Home" proposals might be postponed. This does not appear to have happened.

The Whitehaven meeting is still scheduled to take place at 7pm on Monday 14th January in Whitehaven Civic Hall, Lowther Street.

The Millom meeting is still scheduled to take place at 2pm in the Millom Network Centre (at Millom School) in Salthouse Street.

These are two of the five public meetings being organised: there are three others in different parts of Cumbria.

You can keep a check on the progress of the consultation by looking at the "Closer to Home" website at

http://www.closertohome.org.uk/

Who runs the NHS in Cumbria?

2007-12-15T14:16:00.000-08:00

I was asked a question this week - which trust is responsible for the NHS in Cumbria?

It's a good question because there is no one answer.

The "Purchasing" authority for health services in Cumbria is the Cumbria PCT which commissions health care in the county. This body decides which hospitals and trusts to "buy" health care services from and can therefore effectively close hospitals or open new facilities.

However, the actual running of services is done by a range of different trusts and bodies. Acute hospitals serving the West, North, and East of Cumbria are managed by the North Cumbria Acute Services trust which runs the West Cumberland Hospital in Whitehaven and the Cumberland Infirmary in Carlisle.

Morecombe Bay NHS trust runs the acute hospitals in South Cumbria such as Furness General Hospital (FGH) in the Barrow area, though this trust also covers some of Lancashire.

Our Ambulance service has, sadly in the view of many people, been regionalised and is now run by a North West ambulance trust.

Overarching policy for the region is set by the Strategic Health Authority serving the North West.

Many of these trusts are in the process of applying for "Foundation Trust" status which would give them more autonomy and control over issues such as the right to raise their own funds but would also make them more subject to local democratic influence.

There is a strong argument that there are currently too many tiers of administration in the NHS and that the structure should be simplified. The Conservatives fought the last election on a platform of abolishing the Strategic Health Authority level, devolving responsibilities to the next tier down, and diverting any savings which resulted to patient care.

Though the present government attacked this at the time, they have since halved the number of Strategic Health Authorities.

Foundation Trust Status discussion

2007-12-11T13:29:00.000-08:00

The issue of "Foundation Trust" status for the North Cumbria Acute Hospitals was discussed at Copeland Council this afternoon.

Not for the first time, there was some confusion evident about which of the multiple NHS consultations which are in progress was affected.

By my count there are no fewer than five NHS public consultations affecting all or part of Copeland which are either underway now or due to start early next year.

1) The "CLOSER TO HOME" consultation about the future of the West Cumberland Hospital in Whitehaven, the Cumberland Infirmary in Carlise, and all the community hospitals in North Cumbria including those at Keswick and Millom. This consultation has been extended to 1st February and is the subject of heated debate.

2) An equivalent consultation about hospitals in South Cumbria and Lancashire which is due to start early next year and which may have significant implications for Furness General Hospital in Barrow.

3) A Mental Health care consultation for Cumbria as a whole, also due to start early next year.

4) Foundation Trust status for the North Cumbria Acute Hospitals Trust - this is about new governance arrangements for the part of the NHS which runs the West Cumberland and Carlisle hospitals.

The idea is that as a Foundation Trust the acute hospitals organisation would have more independence within the NHS and strengthen public participation. Local residents would be able to become members of the Trust, and would then have a vote in electing the "Governors" of the trust, who in turn would elect key members of the trust board.

5) There is a similar consultation about Foundation Trust status for the Morecombe Bay hospitals trust, and a number of parishes in the South of Copeland are among the consultees for this.

I gave a very guarded welcome to the Foundation Trust status proposals as they appear to address the democratic deficit which has been building up in the NHS in the past ten years, beginning with the abolition of Community Health Councils and continuing with the abolition of their replacements, the Patient and Public Involvement Forums.

If these Foundation Trusts do get set up, it will be important that as many residents as possible take up membership (which is free.) But in the meantime we need to be extremely vigilant about how the arrangements for Foundation Trust status are progressing and what the consequences are for funding and services.

"Closer to Home" public meetings may be postponed

2007-12-10T01:36:00.000-08:00

I was told on Friday that the public meetings for the "Closer to Home" consultation in Whitehaven and Millom had just been scheduled for 14th January and 21st January respectively.

However, I have now been further advised that, that evening, during discussions between the NHS trusts, local consultants, and civic leaders, the suggestion was made that it would be a good idea to put these dates back a little.

The purpose of the delay is so that the PCT and the acute hospitals trust can hold further meetings with the Consultants at the West Cumberland to try to address their concerns and provide agreed answers to some of the questions the public are asking.

Watch this space for further news on the revised dates.

Dates for Public Meetings

2007-12-07T05:20:00.000-08:00

The public meeting in Whitehaven to discuss the "Closer to Home" health proposals will be held on 14th January.

The Millom public meeting will be held on 21st January

Further details to follow.

POSTSCRIPT

I have now heard that these dates may be put back a week or so. Please see next post for more detail

"Closer to Home" discussed at Keswick Forum

2007-12-03T16:09:00.001-08:00

I attended an interesting discussion this evening at the Keswick neighbourhood forum about the "Closer to Home" proposals.

It was a very calm and civilised discussion. Two important things came out of it

1) Members of the public are very concerned about the number of beds which our hospitals will have. The impression most residents have from the document is that it will mean fewer beds at Keswick hospital. The Trust were not able to give a clear answer on whether this is correct.

2) One important aspect of "Closer to Home" is supposed to be that GPs will take a leading role. Local residents would be very interested to know what GPs think about the proposals.

Foundation Trust proposals to be postponed ?

2007-12-02T11:21:00.000-08:00

I have heard from two completely independent sources that the North Cumbria Acute Hospitals NHS trust will be dropping back the bid for Foundation Status from March to July.

Both sources also separately advised me that the Trust isn't planning to make any public announcement about this.

For all I know there may be very good reasons to delay the proposal, but I doubt if it is a good idea not to explain to people what they are.