LAY MEMBER’S HEADLINE FEEDBACK FROM THE NHS WANDSWORTH PROFESSIONAL EXECUTIVE COMMITTEE (PEC) MEETING WITH THE MANAGEMENT TEAM ON 13 APRIL 2010

Self-Referral Physiotherapy Service Update

The PEC has been supportive of self-referral to physiotherapy.  A successful pilot is running in West Wandsworth (through Queen Mary’s) and a pilot is soon to start in Central Wandsworth (through Wandsworth  Medical Centre at the top of Garrett Lane).   Self referral will be a recognised referral route and will be imbedded into the referral pathway.  There will be a further report on developments in 3 to 4 months.

I welcomed this development, having raised the issue some months ago about self-referral to therapists.  We need to understand the user feedback/evidence  in the West Wandsworth pilot.   This is a good focus for  shifting services, if the community service is robust enough and seeing the right people and changing user behaviour about where they might choose to go and what services they can access. 

Ethical Framework for Priority Setting

This is a draft framework to facilitate the decision making process around priorities, especially in a time of financial restraint and competing demands for funding.  The NHS Constitution has been referenced in compiling it and it reflects the legal and ethical duties of the PCT.   PEC welcomed this tool and it was agreed that when it was fully fledged, it would be used to revisit earlier decisions made about funding obesity (bariatric) surgery and funding for fertility (IVF).    There is an aspiration to share this process with Local Authority councillors (Health OSC in particular) and officers. It can support the new LCCBs (Local Clinical Commissioning Boards).  The June meeting will consider an amended version including weightings for value for money, feasibility and service fit. 

I welcomed this approach to decision making and support sharing the process in a public seminar.  Planned differences in services are acceptable – even desirable – when they reflect evidence based decisions about health needs of the local populations.

Cancer Prevention Action Plan

Cancer and CVD (cardiovascular disease) are the two main causes of death locally.  The mortality rate for cancer is rising and as currently set, the local target (reflecting previous unmet targets) to reduce cancer deaths is not achievable.  Wandsworth is the worst performer in the sector for cancer deaths in people under 75.  Smoking is the greatest cause of cancer locally and the PCT is not doing enough to achieve stop smoking targets.  Reducing smoking  would be the most cost effective thing the local NHS could do to reduce deahs and make savings from smoking-related problems.  Performance on colorectal cancer was also cause for concern locally and there was unsatisfactory uptake of the national bowel cancer screening initiative. Other key areas of activity in the cancern prevention plan included:

• raising awareness and needs assessment
• smoking cessation
• obesity control
• increasing physical activity
• alcohol reduction,
• cancer screening – breast, cervical and bowel
• sun protection and early detection of skin cancer
• HPV vaccination.

Obviously the public’s awareness and willingness to come forward for screening and when symptoms are suspected or detected is essential for success in any prevention programme.   Steps have been taken to address gaps in the PCT’s understanding of how local people understand cancer, eg about skin cancer risks and testicular cancer in younger men. Social marketing aimed at high risk groups is the main tool used to discover user-focused views and a tendering exercise to appoint a company to undertake this work is nearing completion.  

GP Performers List Update

PEC discussed the issue of strengthening language competency for GPs, including those providing out of hours services, and other health care professionals.  The General Medical Council registration procedure did not offer sufficient assurance and as EU/EEA qualified doctors were not required to demonstrate competency in English, it was up to local processes to do this. The PCT’s letter to applicants for the Performers List had been strengthened about language proficiency and the Primary Care Support Service was putting in place a language test. Patients have a right to assume that a doctor who comes to see them at home is competent in English. There was a problem with locums who were not on the Performers List who come from agencies.  The PCT’s out of hours contract (currently with Harmoni) would also be strengthened as part of the current rewriting of the specification prior to re-tendering.  Local GPs using agencies for locums will be advised only to use agencies that require standards of English testing.  The same would be applied to nurses and therapists employed through agencies.  PEC agreed it was essential to assure the public on this issue.

I support this move and would encourage any patient or carer who has had an unsatisfactory experience with a clinician having poor command of English, whatever the setting,  to tell the PCT about this.  

Other Business

It was announced that contracts had been terminated with the folowing three GPs and that they had ceased to trade.  Patients of these practices had been informed and been offered allocations to other practices. 

Dr Daud Khan  87 Northcote Road; Dr Mohamed Sultan and Dr Jawed Ali   138-140  Mitcham Road

 PEC and PCT Board papers are available on the NHS Wandsworth website: www.wandsworth.nhs.uk   contact  Sandra Notridge on 020 8812 7740 or e-mail sandra.notridge@wpct.nhs.uk

Next Meeting of the NHS Wandsworth Board: 

Balham Park Surgery, 236 Balham High Road,  not the Town Hall, starting at 09h30 on Wednesday 28^th April.

Next Meeting of the PEC: 09h30 on Tuesday, 11^th May 2010.