Announcements

The National Media is plagued with stories of vital charities having their budgets cut by Local Authorities, and Wandsworth is no different. The Council, in what many will see as a misguided attempt to meet budget cuts, have just slashed ¼ million pounds from the funding for some of the Boroughs most valued Voluntary Sector Organisations.

The cuts, which will come into place in April, will see Age Concern losing £83,000 from their budget, Wandsworth Community Transport standing to lose £20,000 and the Care’s Centre will be without £5,000, if proposals go ahead.

The implications of cutting the vital services these organisations provide has far reaching implications as Jenny Weinstein, the Chair of Wandsworth LINk, which is a voice for care users, carers and patients has pointed out:

‘These are very substantial cuts for the Voluntary Care Sector and they will directly impact on some of the most vulnerable people living in Wandsworth. In LINk’s view cutting voluntary sector budgets that provide vital preventive services is short sighted.  It will not only hurt the most needy people in the Borough, but, in the longer term, it will put more pressure on expensive statutory social care and NHS services which are also seeing their budgets slashed… `

Central Government says it wants charities to start providing more services as part of it’s ‘ new ‘Big Society,’ and its right to believe that local and voluntary organisations are often more effective than the State in tackling social problems. But, if cuts like this continue, they will destroy the very organisations which could and should, form the foundations of this new ‘Big Society’.

Every GP practice in England needs to save £2,500 a day over the next three years to hit NHS efficiency targets, according to a senior DoH adviser.

By Nick Bostock, 26 January 2011

In an exclusive interview with GP, national clinical commissioning network lead for England Dr James Kingsland warned that the government’s NHS reform plans would fail without a ‘cultural shift’ among GPs.

To save £5 billion a year, the NHS needs to save around 40p per patient every working day of the year, Dr Kingsland said.

‘For a practice of 6,000 patients, that’s about £2,500 per day you need to save by doing something remarkable in your prescribing, in urgent care, in long-term condition management,’ he said.

GPs need to apply the management skills they use to run their own practice finances to their use of wider NHS resources, Dr Kingsland said.

‘That’s where it starts – within consultations, recognising that you align your clinical decision-making with the resources that are deployed.

‘If we don’t get that right in every consultation, in every general practice in England, the reforms can’t work.

‘Every GP needs to recognise that when you make a referral that is a commissioning act.’

Pathfinder bid for the GP Commissioning group.

 Wandsworth LINk supports the ‘pathfinder’ bid by local GPs and the Wandsworth PCT. If successful, this would enable the new NHS reforms in the NHS White paper to be trialled in Wandsworth so that GPs can take the lead in Commisioning health services.

 Jeremy Ambache asked, on behalf of Wandsworth LINk, if the concept of patient representation and a strong ‘patient voice’ can be included within the bid. Also, it was suggested that this will include full patient participation in all the Commissioning groups of the new emerging organization.

Wandsworth PCT Board will this morning, be deciding whether or not to approve, Wandsworth’s GP Consortium’s application to become a Pathfinder Commissioning Consortia.

The 46 GP practices in Wandsworth, who intend to work together to form one commissioning Consortium, with three strong localities, have submitted their application for approval with an intended start date of 1^ST April 2011.

The application gives details on the vision of the consortium,  how the consortium will work with its constituent GP Practices and key pertners, a proposed process for decision making within the consortium, including identification of who will hold accountability within it.

Click on the link to read the full Wandsworth’s Pathfinder Application

To see the full PCT Board papers follow this link

www.wandsworth.nhs.uk/About/board/Pages/NHSWandsworthboard.aspx

By Ian Mason, Wandsworth Guardian

The man responsible for running the borough has unveiled a “revolutionary” plan to give residents control over a raft of council services.

Council leader Edward Lister claims the plan – dubbed the Wandsworth Challenge – will give service users an opportunity to change the way they access services currently run by the council.

Councillor Lister, who has held the position of council leader for 16 years, went on to suggest that the level of user involvement would become so great that residents would soon be shaping the services themselves.

He used the example of the controversial Bolingbroke Hospital school project as an example of community members taking on a responsibility traditionally associated with Wandsworth Council.

The authority has just bought the site for an estimated £13m but, rather than establish a school itself, is taking on the role of landlord and handing the running of the establishment over to a group of parents living in Battersea.

Coun Lister said: “It’s not us saying ‘it’s not our responsibility’ – we are not saying that because it is – but we are saying if you can do it we will support you. You might be able to do it better than us.”

In addition to schools, Coun Lister cited the Battersea Arts Centre and Wandsworth Museum as examples of the council cutting costs by giving the power over running institutions to other organisations or trusts.

He admitted, in theory, York Gardens Library – currently earmarked for closure – could be saved through such a process, if money could be brought to the table with which to invest.

Each council department has been asked to put together a report looking at the possible impact of the Wandsworth Challenge. The move comes in response to last year’s Government spending review, which has forced the council to skim £55m from its running costs over the next two years.

Coun Lister said: “The cuts come in because we are no longer going to be the provider of the services, we are going to be the commissioner of them.

“We’ve got to take out the back office costs in all this and spend less on bureaucracy and administration.”

He added job losses would be “inevitable” in the wake of the “revolutionary” Wandsworth Challenge, but said they would be “kept to a minimum”.

Coun Lister said changes to adult and children’s services would soon be seen, with any user capable of supporting his/herself being asked to manage their own budgets and or care.

He said: “We are not going to give you a meal, we are going to give you the money to buy a meal.

“We are not going to provide a day care facility, we are going to help you get to one.”

Under the Wandsworth Challenge, the council will also be taking on new public health responsibilities and is now in discussions with GPs about fulfilling commissioning for them in the town hall.

By Rebecca Smith, Medical Editor The Telegraph 6:30AM GMT 25 Jan 2011

Up to 50,000 people with dementia may be forced into care homes early at a cost of £70m a month because services are failing to support them at home, a report has warned.

A highly critical report by the Alzheimer’s Society has found substandard care was resulting in patients being admitted to care homes sooner than necessary.

There are 500,000 people living with dementia at home currently, but a report has suggested that up to one in ten of them may end up in a care home early. For each extra month they spend in care, rather than in their own home, it costs the taxpayer £70m, the report said.

Tens of thousands more patients are admitted to hospitals unnecessarily, adding even more costs, it warned.

The report Support Stay Save Care found that half of carers who said patients were not well looked after at home, reported they were being left bedridden, in unchanged incontinence pads and were malnourished.

The survey suggested more than half of carers were also being put at risk of stress, depression and other serious illnesses because they were being left to struggle unsupported.

In the current environment of spending cuts, Alzheimer’s Society predicts the situation is set to get much worse.

Jeremy Hughes, chief executive of Alzheimer’s Society said: “It is an absolute travesty that so many people with dementia are being forced to struggle without the care and support they need. The consequences of this represent an unacceptable human and financial cost.

“Half a million people with dementia live in the community and many will need help with everyday tasks such as eating meals, washing or going to the lavatory. This help not only maintains dignity but prevents serious health issues. While staying at home is not right for everyone we know many people want to remain in the familiar surroundings they are used to with family or loved ones. Only with the right support will this be possible.”

Care Services Minister Paul Burstow said: “The Alzheimer’s Society is right to turn the spotlight on home care for people with dementia. While there are some outstanding services, as this report demonstrates too many people with dementia and their carers feel let down.

“What needs to be done to put things right is not rocket science, it requires compassion, common sense and a determination to treat people as people, not boxes to tick.

“This is not about spending more it is about spending better. We know we are already spending at European levels but not achieving the right results. As this report shows there would actually be savings made if people were helped to stay at home for longer.”

On 17th January Wandsworth LINk held elections for 4 of the 12 Executive Committee places. There was a rush of of people wanting to cast their votes and tensions were running high on the night. A total of 54  people cast their vote and the outcome of the vote was extremely tight. There was a tie for the fourth position, and according to LINk procedure, a show of hands from LINk members present at the meeting was taken for the two tied candidates. Roger Appleton received 17 votes and Joy Miller 13, meaning that Roger Appleton was re-elected to the LINk Executive.

  Candidate                                       

Jeremy Ambache -  45

Roger Appleton -32

Joy Miller -  32

Abdul-raheem Saalwu - 7

Jenny Weinstein - 54

Barbara Willerton - 50

It seems fitting that the person to receive the highest votes has also been nominated as the new LINk Chair, congratulations to Jenny Weinstein.

 Under the current agreement the elected candidate will serve for 3 years until January 2014.

19 January, 2011 | By Steve Ford

The precise make-up of the new health and wellbeing boards has been set out in the Health and Social Care Bill.

The bill confirms that local authorities will have a duty to establish the boards, which are intended to lead on improving the strategic coordination of commissioning across NHS, social care, and related children’s and public health services.

It states that each board must include the following:

• at least one local authority councillor,the director of adult social services for the local authority,
• the director of children’s services for the local authority,
• the director of public health for the local authority,
• a representative of the local healthwatch organisation for the area of the local authority,
• a representative of each relevant commissioning consortium,
• and such other persons, or representatives of such other persons, as the local authority thinks appropriate.

A representative of the NHS Commissioning Board must also sit on the board when local authorities are drawing up joint strategic needs assessments and related strategies.

The bill states: “The National Health Service Commissioning Board must appoint a representative to join the health and wellbeing board for the purpose of participating in its preparation of the assessment or (as the case may be) the strategy.”

The wellbeing board may also request a representative from the commissioning board if it is “considering a matter that relates to the exercise or proposed exercise of the commissioning functions” of the commissioning board “in relation to the authority’s area”.

It states: “If the health and wellbeing board so requests, the National Health Service Commissioning Board must appoint a representative to join the health and wellbeing board for the purpose of participating in its consideration of the matter.”

However, the bill says that the representative “may, with the agreement of the health and wellbeing board, be a person who is not a member or employee of the National Health Service Commissioning Board”.

Additionally the bill says the elected mayor or the executive leader of the local authority may sit on the board as the sole council representative or as well as another councillor.

The bill also sets out the main functions of the wellbeing boards, which are to:

• encourage persons who arrange for the provision of any health or social care services in that area to work in an integrated manner,
• provide such advice, assistance or other support as it thinks appropriate for the purpose of encouraging the making of arrangements in connection with the provision of such services,
• encourage persons who arrange for the provision of health-related services in its area to work closely with the health and wellbeing board,
• encourage persons who arrange for the provision of any health or social care services in its area and persons who arrange for the provision of any health-related services in its area to work closely together.

Commissioning consortia are also required to consult with wellbeing boards when drawing up their annual plan “setting out how it proposes to exercise its functions in that year”.

Additionally the bill says health and wellbeing boards may group together to discharge their functions.

It states:  “Two or more health and wellbeing boards may make arrangements for any of their functions to be exercisable jointly; any of their functions to be exercisable by a joint sub-committee of the boards; a joint sub-committee of the boards to advise them on any matter related to the exercise of their functions.”

The Government have today published their Health and Social care Bill which many are describing as the ‘biggest shake up the NHS has seen since its inception’, you can read the full Bill by clicking on http://www.publications.parliament.uk/pa/cm201011/cmbills/132/11132.pdf

A round up of responses….

Rethink

Changes to the NHS can only work in the best interests of patients if their voices are heard, warns Rethink.

Plans to reform the NHS will be a risky gamble if they are not supported by rigorous local scrutiny, the national mental health charity Rethink has warned.

Speaking in advance of the publication of the NHS Health and Social Care Bill tomorrow, Chief Executive Paul Jenkins said:

“It is vital patients have a strong and powerful voice under the new system and that local communities have a say in what services are needed.

“Without that safeguard ministers will be taking a big gamble over the future of the NHS.”

It’s essential that new bodies like HealthWatch are given the power and resources to hold the NHS to account and ensure it meets the needs of everyone, not just those who shout the loudest.

“Debate will be passionate over the coming months, but no voice is more important than that of the patient. Rethink will be campaigning to make sure that this new NHS is accountable to everyone it serves, particularly the most marginalised groups.”

Rethink also wants to see more support for GPs in the plans.

“GPs will be responsible for commissioning mental health services, but tell us that they need more training to understand those specialist services.

“Cases of severe mental illness, while more common than often thought, are not on the day to day appointment list in GPs surgeries.

“They tell us they want more training and support to help some of the most vulnerable people in our society. Over 40% of GPs we spoke to say they’re worried about their own lack of knowledge about the services available.”

RCGP
The RCGP said it ‘makes sense’ for health professionals to be involved in the planning of services, but the proposals risk ‘destabilising the NHS and causing long-term harm to patient outcomes’.

RCGP chairwoman Dr Clare Gerada said ‘we must guard against fragmentation and unnecessary duplication within a health service that is run by a wide array of competing public, private and voluntary sector providers, that delivers less choice and fewer services, reduces integration between primary and secondary care and increases bureaucratic costs’.

Patient choices as outlined in the Bill ‘run a risk of destabilising the NHS and causing long-term harm to patient outcomes’. The RCGP has also yet to receive sufficient evidence to be reassured the plans would prevent this from happening.

She concluded: ‘The NHS has for more than 60 years delivered a fair and efficient system of healthcare for millions of patients. We acknowledge that improvements can always be made, but we must work with the Government to protect the founding principles of the NHS; the stakes are too high to lose it now.’

BMA
The BMA said ploughing ahead with the reforms at the speed proposed was a ‘massive gamble’.

Dr Hamish Meldrum, chairman of council at the BMA, said: ‘The BMA supports greater involvement of clinicians in planning and shaping NHS services, but the benefits that clinician-led commissioning can bring are threatened by other parts of the Bill.’

He added: ‘Forcing commissioners of care to tender contracts to any willing provider, including NHS providers, voluntary sector organisations and commercial companies, could destabilise local health economies and fragment care for patients.

‘Adding price competition into the mix could also allow large commercial companies to enter the NHS market and chase the most profitable contracts, using their size to undercut on price, which could ultimately damage local services.’

Royal College of Physicians
The Royal College of Physicians (RCP) supports the shift towards putting clinicians and patients in the driving seat but is concerned the Bill doesn’t require specialists to be at the heart of commissioning.

Sir Richard Thompson, president of the Royal College of Physicians, said: ‘The scale and pace of change – and the challenge of unprecedented efficiency savings – should not be underestimated. Neither should the risks if we get this wrong.’

Unison
Unison, the public sector union, called the Health Bill a ‘disaster’ of Titanic proportions’. Karen Jennings, head of health at Unison, said: ‘This Titanic health bill threatens to sink our NHS. The only survivors will be the private health companies that are circling like sharks, waiting to move in and make a killing.

‘Lansley has turned his back on the warnings from across the medical establishment that these changes are unnecessary, undemocratic and unlikely to deliver improvements in patient care. We need a U-turn from the Government.’ 

Unite
Unite said the Bill is ‘a charter for private profit at the expense of patients care’.

Unite’s national officer for health, David Fleming, said: ‘It is clear that one of the biggest influences on Tory ideology regarding health policy has been the massive and insidious lobbying by the  private healthcare companies, which have opened their cheque books for David Cameron big-time.’

He added: ‘The GP consortia, the supposed vanguard of this so-called reform programme, will be juggling financial decisions with the help of the private healthcare companies they will buy-in, versus the needs of their patients – this is a stark conflict of interest. Patients should always come first.’

The Nuffield Trust
The Nuffield Trust said the planned reforms are ‘broadly in the right direction’ but they will have to be judged on the extent to which they deliver – with minimum disruption – sustained improvements to patient care during a period of major financial challenge for the NHS.

Dr Jennifer Dixon, director of the Nuffield Trust, said: ‘The NHS is at a fork in the road. It embarks on this period of reform with much strength but the pressures it faces over the next four years will continue to rise.

‘Given the reforms over the past 20 years the Government’s decision to devolve more responsibility to the front line is logical. However, this approach carries significant risks in today’s financial climate and needs to be managed very carefully.’

General Healthcare Group
General Healthcare Group, the UK’s largest private hospital group, welcomed the proposed reforms and said it was ‘only right’ the NHS, private and third sector providers worked together in austere times.

Adrian Fawcett, chief executive of General Healthcare Group, said: ‘In our view, the challenge for instituting these reforms will be about maintaining the pace of change and how instability during the period of transition is minimised.’

The Royal College of Obstetricians and Gynaecologists
Allowing GP consortia to commission maternity services will impede creation of a high-quality service, warns the Royal College of Obstetricians and Gynaecologists (RCOG).

RCOG president Dr Tony Falconer said: ‘Our concern, at all times, must be that the women in our care have access to the best available services and RCOG will be monitoring standards as well as supporting their development.’

The King’s Fund
The Bill signals the biggest shake-up of the NHS since its inception, the King’s Fund has said.

Chris Ham, chief executive of The King’s Fund, said: ‘The last decade has seen significant progress in the performance of the NHS. While ministers are right to stress the need for reform to make it truly world class, these gains are at risk from the combination of the funding squeeze and the speed and scale of the reforms as currently planned.’

Mr Ham added: ‘But, while the government’s reforms have the potential to improve the NHS, they will be implemented against the backdrop of the biggest financial challenge in its history.

‘Finding the £20bn in efficiency savings needed to maintain services must be the overriding priority, so the very real risk that the speed and scale of the reforms could destabilise the NHS and undermine care must be actively managed.’

NHS Confederation
The NHS Confederation urged MPs to ‘forensically analyse’ the Health Bill.

NHS Confederation acting chief executive Nigel Edwards said: ‘We support the objectives behind this legislation but there are huge risks and major uncertainties associated with it.

‘The system is already geared up for change and we can not afford for these reforms to fail – the public will not forgive us. The focus in parliament has to be on making this work on behalf of patients.’

CBI
John Cridland, CBI director-general designate, said: ‘We support the Government’s plans to modernise the NHS, because this will lead to better services for patients, and ensure taxpayers’ money is spent wisely.

‘Allowing the best provider to deliver healthcare services, whether they are a private company or a charity, will spur innovation and choice. But bidders must be able to compete for contracts on a level playing field.’

Pharmacy Voice
Pharmacist union Pharmacy Voice believes the focus on GP-led commissioning risks overlooks the contribution of other healthcare professionals.

Pharmacy Voice chief executive Rob Darracott, said: ‘The NHS is about more than doctors, and GP commissioning has to be about more than GPs. The Health Secretary acknowledges that pharmacists have an important and expanding role in supporting better health, but we now need to see his words backed by action. Pharmacists see more people, more often, even than GPs do.’

THE PCT MANAGEMENT TEAM ON 11 JANUARY 2011

These headlines are for rapid briefing purposes about the lay/user issues arising in the meeting. It is not a full report from the meeting.

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

The contents of this briefing note are for information only and are solely the responsibility of Andrew Craig, PEC Lay Member, including errors and omissions. They do not necessarily represent the views of the PEC or NHS Wandsworth.

Matters Arising

COPD and Pulmonary Rehabilitation Needs Assessment

Both of these related areas are being targeted for service redesign. The report stated that “patient and public Involvement is key to these projects and a patient group will be established to work with the clinicians to develop the proposals.” The PEC recommended that an “invest to save” model be used, reflecting the importance of COPD to the QIPP programme.

I asked that user engagement begin before the formulation of proposals – reflecting the government’s commitment to “nothing about us without us” – so that it would be clear that the redesign of the pathway reflected service users’ contributions. The national literature on patient views on these services should be used to test out local views.  Having one patient on the working group was tokenism and inadequate and must be reconsidered.

Items for Discussion

Teenage Pregnancy Performance Update

This subject is really about young people’s sexual health and wellbeing, not just teenage pregnancy.  Funding streams were coming to an end and there was a need to integrate activity with the local authority to get the right reach into the target group.  There was good evidence of service user input to this work.  Reliable data showed Wandsworth pregnancy rates falling, but the overall rate remained above the London and national averages. The rate of conceptions in young women under 18 was still the 10^th highest in London and 43^rd highest in England. 

Wards with the highest numbers of under 18 conception rates are: Queenstown; Nightingale; Latchmere with rates nearly three times that in low rate wards.  Numbers of conceptions are highest in Latchmere, Queenstown, Roehampton and Furzedown.  Black and minority ethnic groups had much higher probability of pregnancy than the white population and this had to be addressed in terms of vulnerability and aspirations from an equality point of view.  The emergency contraception pathway and access to it was not clear enough to young people.  A text service had been used for this, but it had been discontinued.   

I supported the integration with the local authority approach for strategy and funding and hoped that the action plan would be considered by the new Health and Well Being Board led by the Council at an early point.   This subject should be part of the Joint Strategic Needs Assessment.  Any communications method that increased awareness and access to emergency contraception had to be used with this target group.  We needed to understand why comparison boroughs like Westminster and Hammersmith and Fulham had achieved greater success than we had in Wandsworth.

Breastfeeding Update

Evidence was that breast feeding initiation rates were high immediately post birth, but in the 6-8 week period after that things broke down, especially for some groups of white mothers. The target for 2010/11 is that 75.7% of infants are recorded as being partially or totally breastfed by the GP practice at the 6-8 week check. Mothers from black and ethnic minority groups were much more likely to continue breast feeding. Locally, we were only just meeting this target and the evidence suggested performance was slipping as mothers were reporting not being advised by health visitors about breast feeding.   PEC agreed that this had to be a mainstream service and must not be left to a specialist.  The outcomes in the contract had to be tightened, including financial penalties for not meeting breastfeeding targets, rather than funding found for a specialist post.  

I expressed strong concern if the so-called “universal service” provided by midwives and health visitors locally seemed – on the basis of this report at least – to be failing where adherence to breast feeding was concerned. This is such a crucial issue that it cannot be left to a specialist to pick up the pieces.  The Health and Well Being Board should consider this as a public health priority and the message to Community Services Wandsworth needed to be strong that performance had to improve.

Items for Approval

TB Needs Assessment and Action Plan

Tuberculosis is a significant public health problem in Wandsworth, with the highest TB mortality rate in SW London and the biggest incidence (new cases per year) 29/100,000. Most cases occur in non-UK born ethnic minorities from sub-Saharan Africa (particularly Somalia) and the Indian sub-continent (India, Pakistan and Bangladesh).  This is reflected in the considerable geographical variation in incidence that is seen within the borough, with the highest rates occurring in Tooting, Earlsfield, Graveney, Roehampton, Furzedown and Latchmere.   

Drug resistance is an emerging problem within Wandsworth with 13% of culture-confirmed cases resistant to at least one anti-tuberculosis drug and 3.5% resistant to more than one drug in 2008. The problem is compounded by considerable stigma around TB in minority ethnic populations, which results in late presentation and poor treatment rates.  Against this, local providers are meeting local and national metrics for finding and treating cases. Universal BCG vaccination about to start.  Wandsworth Prison is included in the action plan as TB is a significant problem in that facility.

PEC agreed the action plan and recommended it to the Board

Reports for Information

Cancer Diagnosis Audit

This is another area where late presentation and delays in treatment make the problem much worse than it should be in terms of survival rates.  An audit across the sector showed: 46% of patients diagnosed with cancer had been referred via the two week wait rule (ie 56% FAILED to be referred within the required time; 47% of the audit patients were referred to secondary care after one visit to the GP surgery, ie for 53% it took MORE than one visit and in some cases many more.

The median average total pathway was shortest in breast cancer cases (27 days) followed by lung cancer cases which took an average of 27 days in total.  Colorectal cancer cases took 54 days on average whilst prostate cancer cases took longest of all at 64 days.  The biggest reason for the variance was patient delay, see below.

GPs participating in the audit identified that there had been 146 (22%) avoidable delays out of 704 cases.  Of these:

45 cases (31%) were due to the patient delaying presentation, investigation or hospital referral, 

34 cases (23%) were delayed due to the GP not initially thinking about diagnosis,

27 cases (18%) were delayed after referral to secondary care,

16 cases (11%) could have been referred earlier using the two week rule

14 cases  (9%)  were delayed due to communication problems between primary and secondary care and

10 cases (7%) were delayed due to other causes.

PEC agreed the action plan of the Cancer Network and recommended it to the Board.  The February PEC will receive a report based on interviews with the public analysing views about signs and symptoms of common cancers.

Open Space

I raised two issues

Comparative GP practice performance data.

Despite promising to produce it since July last year, the PCT has not delivered comparative GP practice performance data accessible to the public to facilitate choice and changes of GP practice. Work to make this suitable for the website was done by the comms department but never materialised.  Government has confirmed it is proceeding in the forthcoming HSC Bill with abolition of practice boundaries, so user friendly comparative information to enable choices and changes is essential.  It is not acceptable to the public to say that NHS London is doing this work – there is no sign of it on their website –  so the PCTs do not have to.   

PEC agreed that a “balanced score card” showing comparative performance of all Wandsworth GP practices by name will be completed in the next 4 weeks and put up on the PCT website.

Hospital discharge.  

Wandsworth LINk published its hospital discharge study in mid December based on patient and carer interviews.  This is important user-focused intelligence, so how will the existing and future commissioners take account of it?

Next Meeting of the NHS Wandsworth Board: Wednesday 26^th  January 2011 in the Richmond/Barnes Room at Queen Mary’s Hospital, London SW15.

Next Meeting of the PEC: 09h30 on Tuesday, 8^th February 2011.  I have given my apologies and there will be no Lay Member’s report from this meeting.