Health Services

report by Roger Appleton

The financial challenges facing St George’s Hospital were set out clearly in a report considered by the Council’s Adult Care and health Overview and Scrutiny Committee recently.  Although the trust achieved financial balance in 2010/11, it did not achieve its savings target and this failure has contributed to its decisions to delay its application for Foundation trust status.  In the current year, the trust faces a double problem of anticipated reduced demand for its services amounting to some £15 million pounds in income, alongside the challenge of achieving its own savings target of a further £38 million.

Under questioning from the LINk representative, the Trust confirmed that it had faced some self-inflicted problems during the past year with reduced clinical activity because of Consultant unavailability but promised that this problem would not recur during the current year.

Much of the anticipated reduced demand in the current year relates to treatment for non-Wandsworth patients but the Trust still could face a problem of having to re-expand its services in an unplanned way during the year if the planned demand reductions do not take place and more patients are admitted than were expected.

As well as these financial challenges, it appears that the pressure on the A&E services at St George’s remain and it is not clear that the alternative walk-in arrangements put in place by NHS Wandsworth have had a significant impact of attendances at A&E.  The LINk will take this up with NHS Wandsworth at its next meeting.

NEWS RELEASE

Date of issue: 6^th May 2011

David Astley has announced his decision to step down as chief executive of St George’s Healthcare NHS Trust in south west London.

Since he joined St George’s Healthcare in December 2006 the trust has become a major trauma centre, a hyper-acute stroke unit and, in October 2010, successfully integrated with community services Wandsworth. In addition, St George’s Healthcare was named `Large trust of the year` by Dr Foster Intelligence for 2009.

Speaking about his decision David said: “I had always planned to retire from the NHS when I reached the age of 60 which is now just two years away. The board’s recent decision to delay our foundation trust (FT) application to April 2013 has led me to consider my position.  It is important that the trust has a chief executive who can drive the organisation forward to achieving its goals for 2013 and beyond. Therefore I have taken the difficult decision, in the long-term interests of the trust, to step down. I am immensely proud of what has been achieved during my time at St George’s Healthcare although none of this would have been possible without the support, hard work and dedication of colleagues from across the organisation.”

Naaz Coker, chair of St George’s Healthcare, said: “On behalf of the trust board I would like to thank David for the valuable work he has done over the past four years. David has decided to step down now to allow a new leader to take St George’s forward as a foundation trust. David is very well respected by his colleagues and will be missed at the trust and we all wish him well for the future.”

Ruth Carnall, chief executive of NHS London, said: “David’s leadership over the past four years has been instrumental in the transformation of many of St George’s services. The trust is now amongst the best in the country for its care of stroke patients, heart disease and major trauma. With his support, a number of the trust’s leading doctors have also been involved in clinically-led reforms to improve health services across the capital.”

The trust has started the process of appointing a new chief executive and, in the meantime, Patrick Mitchell, chief operating officer, will act up in an interim capacity.

On Monday night, the Council’s Adult Social Care Overview and Scrutiny considered a report on the out-of-hours GP services provided by Harmoni.  NHS Wandsworth recently extended Harmoni’s contract for the second time, arguing that Harmoni was achieving good results on all of its performance indicators.  Results from the recent GP Survey tell a different story, with local patient satisfaction scores being lower than both the London and national average in every case.  More than one half of all respondents were unhappy about how quickly Harmoni provided care and a similar percentage were unhappy about the quality of the care they received.  The Councillors questioned why NHS Wandsworth was extending the contract given these levels of dissatisfaction.  Full details are available at http://www.wandsworth.gov.uk/moderngov/mgConvert2PDF.aspx?ID=13588

Wandsworth LINk has been hearing reports about long waiting times at St George’s, one lady arrived at 9.30 and was number 80 in the queue and by lunchtime she was  number 47.

Have you recently attended a St George’s clinic? And if so did you have a similar experience?  How long did you have to wait? what was the waiting are a like and how did you find the staff attitude?

Please let LINk know so we can get your experiences heard by the people at St George’s who make the decisions. The LINk Executive is meeting with David Astley St George’s CEO and Peter Jenkinson Trust Secretary on Thursday 24 th March

Roughly two thirds of England’s population is now covered by ‘pathfinder’ GP consortia following the acceptance of a further 31 groups onto the scheme.

Health minister Andrew Lansley said the varying shapes and sizes of the groups piloting GP commissioning showed there had been a ‘truly bottom-up response’ to his reforms.   A number of consortia from the second wave have now merged, meaning the total number of pathfinder consortia is now 177, according to the DoH.

But  Dr James Kingsland, the DoH’s national clinical network lead, admitted little information had been fed back about the programme so far.

Pathfinders by region

Pathfinders by wave

East of England

Cam Health Integrated Care       

Geographical area:  Cambridge

Number of practices: 8
Population size: 72,564

East and North Herts GPCC

Geographical area:  East and North Hertfordshire

Number of practices: 50

Population size: 463,692

Luton GPCC

Geographical area:  Luton

Number of practices: 32

Population size: 210,447

West Norfolk PBC Consortium 

Geographical area:  West Norfolk

Number of practices: 22

Population size: 156,021

South West Essex Federation of GPs

Geographical area:  Thurrock and Basildon

Number of practices:  34

Population size: 179,170

South Essex Managed Care Consortium LLP

Geographical area:  Wickford and Basildon

Number of practices: 10

Population size: 51,268   

East Midlands

North Derbyshire

Geographical area:  North Derbyshire

Number of practices: 31
Population size: 230,000

Crescent

Geographical area:  South East Leicestershire & Rutland

Number of practices: 33
Population size: 311,000

North and West Leicestershire

Geographical area:  North and West Leicestershire   

Number of practices: 49
Population size: 360,000

Nottingham West Consortium

Geographical area:  12

Number of practices: Broxtowe locality, which encompasses Beeston, Chilwell, Bramcote, Stapleford, Kimberley and Eastwood
Population size: 93,000

Newark and Sherwood Health

Geographical area:  Market town of Newark and surrounding villages extending to Sherwood and A1 border with Lincolnshire

Number of practices: 14
Population size: 115,231

Erewash

Geographical area:  13

Number of practices: The towns of Ilkeston and Long Eaton including surrounding villages
Population size: 102,000

Corby           

Geographical area:  Corby

Number of practices: 6
Population size: 67,124   

Skegness and Coastal    

Geographical area:  Skegness and Coastal

Number of practices: 7
Population size: 72,000

London    

The Federation      

Geographical area:  Sutton & Merton

Number of practices: 32

Population size: 262,557

Wandsworth           

Geographical area: Wandsworth

Number of practices: 46

Population size: 370,366

Lambeth Commissioning Collaborative         

Geographical area:  Lambeth     

Number of practices: 52

Population size: 377,624

Richmond & Twickenham GP Consortium

Geographical area: Richmond & Twickenham

Number of practices: 32

Population size: 197,524

United Medical Consortium (UMC)

Geographical area:  Barking & Dagenham (part of)

Number of practices: 15

Population size: 71,098   

Havering First Consortium         

Geographical area:  Havering (part of)

Number of practices: 27  

Population size: 108,994 

Havering Premier

Geographical area:  Havering (part of)

Number of practices: 22

Population size: 143,416

Camden Commissioning Consortium

Geographical area:  Camden

Number of practices: 39  

Population size: 224,450

Hillingdon

Geographical area:  Hillingdon

Number of practices: 49

Population size: 273,256

Barking & Dagenham Quality Healthcare Commissioning Consortia (BDQHCCC)   

Geographical area:  Barking & Dagenham (part of)

Number of practices: 26

Population size: 123,000 

Newham Commissioning Group (NCG)

Geographical area:  Newham (part of)

Number of practices: 11

Population size: 68,199

North West

Lancaster Morecambe Carnforth Garstang Practice Based Commissioning Consortium   

Geographical area:  North Lancashire

Number of practices: 13  

Population size: 160,000

Wylde Commissioning Consortia

Geographical area:  North Lancashire

Number of practices: 21  

Population size: 157,000

South Cheshire Commissioning Consortia (SCCC)           

Geographical area:  South Cheshire

Number of practices: 16  

Population size: 164,000

Warrington  

Geographical area:  Warrington

Number of practices: 28  

Population size: 208,000

Ashton Wigan and Leigh with 5 consortia: (62 Practices)

ALPF Health Commissioning Consortium     

Geographical area:  Ashton Leigh and Wigan

Number of practices:

Population size: 90,832   

TABA Consortium

Geographical area:  Ashton Leigh and Wigan

Number of practices:

Population size: 45,127   

North Wigan Consortium                        

Geographical area:  Ashton Leigh and Wigan

Number of practices:

Population size: 54,946   

Wigan Commissioning Consortium

Geographical area:  Ashton Leigh and Wigan

Number of practices:

Population size: 75,998

United League Commissioning                        

Geographical area:  Ashton Leigh and Wigan

Number of practices:

Population size: 106,837 

South West

Swindon NHS Consortium: The Transitional Leadership Group

Geographical area:  Swindon

Number of practices: 30

Population size:  250,000

West Cornwall Commissioning Consortium

Geographical area:  West Cornwall

Number of practices:  23

Population size: 160,457 

Newquay Commissioning Consortium

Geographical area: Newquay, Cornwall

Number of practices: 3    

Population size: 28,000   

West Midlands

Nuneaton & Bedworth     

Geographical area: Nuneaton and Bedworth

Number of practices: 11

Population size: 40,000   

South Warwickshire Consortium

Geographical area:  South Warwickshire including Leamington Spa, Warwick and Stratford-upon-Avon

Number of practices: 36

Population size: 270,000

HealthWorks Commissioning Consortium

Geographical area: Birmingham and Sandwell

Number of practices: 13

Population size: 124,340

Intelligent Commissioning Federation

Geographical area: Heart of Birmingham (Ladywood, Aston and Sparkbrook areas of

inner city Birmingham)      

Number of practices: 29

Population size: 134,000

Yorkshire and the Humber

North Kirklees Health Alliance (NKHA)

Geographical area:  Kirklees

Number of practices: 31  

Population size: 183,000

Greater Huddersfield Commissioning Consortium (GHCC)

Geographical area:  Huddersfield

Number of practices: 41  

Population size: 237,000 

Rotherham Commissioning Executive                                               

Geographical area:  Rotherham

Number of practices: 41  

Population size: 255,500 

Closure of wards and loss of staff for a hospital already struggling to meet patient needs.

Wandsworth LINk was horrified to hear  that St. George’s hospital is due to close 3 wards and lose 500 staff, in a bid to make £55 million of savings in the next financial year. This decision was made without any prior consultation with the community or patients’ groups and at a time when the hospital’s services are already stretched to breaking point.

St. George’s has been failing to meet its targets to admit patients within 18 weeks of referral during the first months of 2010/11. They have also failed to meet their target of a waiting time of no more than 62 days for urgent cancer referrals. At LINk’s last meeting with the Trust, held on 12^th January, we were informed that the `Winter pressures` – increased numbers of very unwell patients – meant that A&E waiting time targets could not be met and there was overcrowding on the Wards and problems with maintaining single sex accommodation.

The government made a commitment that the current financial restraints would not apply to front line NHS services. Wandsworth LINk, is concerned that the loss of so many jobs will have “serious consequences” not only for the local community and London, but for patients across the south-east. LINk will be writing to St. George’s NHS Trust to seek the reasons for these drastic cuts and to challenge them on their failure to consult.

Note to editors:  The failure to meet targets was reported to Wandsworth Council’s Overview and Scrutiny Committee which met on Tuesday 15^th February Paper No 11-163

The Wandsworth LINk is a statutory body, funded by government, to monitor and bring about improvements in health and social care locally by involving local residents, patients and service users.  The LINk meets regularly with representatives of the Trust in order to ensure an exchange of information between the hospital and the community

Jenny Weinstein Chair Wandsworth LINk

C/o Wandsworth Care Alliance  3^rd Floor

Trident Business Centre

89, Bickersteth Rd

SW17 9SH

Tel: 0208 516  7767

12:11pm Thursday 17th February 2011

• By Ian Mason »

Bosses at St George’s Hospital have refused to confirm how many jobs will be axed as they attempt to cut costs by £55m this year.

Unison members claim 500 posts, including frontline doctors and nurses, are under threat along with wards, the number of beds available and a cap on the number of births in its midwifery unit.

The sweeping changes at the Tooting hospital are being blamed on the Government’s £20bn NHS cuts programme.

A spokeswoman for St George’s Healthcare NHS Trust, said: “St George’s Healthcare is not immune from the financial challenges currently facing the wider NHS and we have been open with staff and Unions about the need to achieve £55m savings during 2011/12.

“The trust is a major trauma centre, hyper-acute stroke unit and centre of excellence for cancer, cardiac and women’s and children’s services and we are committed to providing quality care to our patients.

“We cannot speculate at this stage on the exact number, or nature, of posts that will need to go but we aim to protect frontline staff and hope to avoid the need for compulsory redundancies.

“Our main focus is to reduce our temporary staffing bill, which is currently £30m per year, and we are also reviewing non-clinical services.”

The spokeswoman added no further comment would be made at this time.

Dear Colleague
A SEMINAR: BME Mental Health & Well Being Seminar – Service User Involvement and Personalisation

Date:  Thursday 3^rd March 2011

Venue: Mushkil Aasaan, First Floor, 222 Upper Tooting Road, London, SW17 7EW

Time:  10.00am –3:30pm

The Asian Health Agency in partnership with South West London and St Georges Mental Health Trust, Open Up Time to Change, Mind and Power Up are organising a seminar to explore the mental health issues

Objectives of Seminar:

• Empowering Black & Ethnic Minority community members particularly service users & carers to have their voices heard.

• To reduce stigma and discrimination and promote Social Inclusion and better mental health care for the BME communities.

• Promoting awareness and sharing latest information on the current state of health & social care of BME people.

• Exploring vital and relevant issues related to user involvement & Personalisation within BME communities.

• Increasing understanding on ways of influencing the decision making process of the local health & social care agenda.

• Developing innovative ways of addressing the existing health & social care inequalities by building new means of partnership and collaboration

• Facilitating opportunities for healthcare professionals to come together with community members and groups to share areas of common interests and concern

Cost

Free but places must be booked in advance.

Please find attached the leaflet on the above seminar:

If you wish to organise a similar event in your area or need further information please contact me on: farah.chaudhry@taha.org.uk

This is a free seminar, however you must book your place in advance.

I shall be grateful if you could circulate it to your colleagues, members, as well as people on your mailing list.

Thank you for your support.

 Kind Regards,

Farah Chaudhry.
BME Leadership & Engagement Project

For further information and to book a place contact:

Farah Chaudhry      020 8981 2146 / 07961 712 392        

farah.chaudhry@taha.org.uk

Jessie Jandu    020 8571 7928  admin2@taha.org.uk

Mr Burns was repeatedly questioned on the section of legislation in the Health Bill that aims to protect the NHS from political interference

A lengthy list of amendments was discussed, including changes that would delay the abolition of PCTs and ensure the NHS Board has a role in managing the NHS as a whole.

During a noisy exchange with the Health and Social Care Bill committee, health minister Simon Burns was repeatedly pressed on the section of legislation that aims to protect the NHS from political interference.

Labour MPs warned that in its current form, the Health Bill absolves the secretary of state responsibility for the provision of NHS services. But Mr Burns said accountability was already ‘integral’ to the Bill. He was eventually warned by the committee chairman to ‘stop being so provocative deliberately’ as he fended off criticism.

None of the amendments debated was passed. The committee will continue to consider amendments to the Bill until the end of March. After the report stage, MPs will vote on the Bill at its third reading in Parliament, before moving to the House of Lords.