NHS Services

SWLondon & St. George’s MH Trust are aiming to become a Foundation Trust By 2012.

The Trust will be implementing a new approach known as the triangle of care whereby  the carer is more integrated as part of a three point approach with the service user and the professional.

The Trust has commissioned Canerows and Plaits to provide peer support and befriending to patients within the hospital.

The first recovery College has opened on the Springfield site offering training and support to users, carers and mental health professionals who are all treated equally in their roles at the college.

Dear colleague,

We wanted to update you on progress we are making in south west London towards implementing transitional arrangements as we move towards the plans described in the Health and Social Care Bill, following consultation on the White Paper “Liberating the NHS; Equity and Excellence” last year.

In November 2010, the PCTs in south west London agreed to work together more closely to manage the transition from PCT-led commissioning to GP and Local Authority Commissioning, and also make significant management cost savings.  Although individual PCTs will remain as statutory organisations, we will now operate as one management team across south west London to share resources, roles and functions. We will continue with a strong borough focus and work closely with GPs and Local Authorities. This will take effect from 28 February 2011.

As you know, Ann Radmore was appointed as Sector Chief Executive in January and will become the accountable officer for all five PCTs in the cluster, subject to the approval of the five Boards: Croydon, Kingston, Richmond, Sutton & Merton and Wandsworth.  The appointment process for a single chair for all five PCTs is also underway. 

We are also now able to announce the new South West London management team. 

South West London Team

• Bill Gillespie, Director of Strategy and Performance
• Jonathan Hildebrand, Director of Public Health
• Jill Robinson, Director of Finance
• Dominic Conlin, Managing Director of the Acute Commissioning Unit
• Amanda Philpott, Managing Director for Croydon
• Penny Taylor, Managing Director for Merton
• Dominic Wright, Managing Director for Richmond 
• Graham Mackenzie, Managing Director for Wandsworth
• David Smith, Director of Health and Adult Services for Kingston

(Joint appointment with the Royal Borough of Kingston-upon-Thames)

• Simon Currie, Interim Managing Director for Sutton, for four weeks whilst a substantive post holder is selected. 
• Charlotte Gawne, Director of Communications and Corporate Affairs
• Jocelyn Fisher, Director of HR, OD and Workforce

The remaining director posts to be appointed are Medical Director and Director of Transition. 

The key role for the Managing Directors will be to lead the local work for the borough and a small team of commissioners focusing on the needs of the borough’s population, working closely with their local authority and GP clinical leaders.  They will also form part of the management team for south west London. 

We would like to take this opportunity to thank the Chief Executives from each PCT for their hard work and dedication over the past years to improve the health and health services of local people in South West London.

Arrangements for the governance of how these arrangements will work will go to our public PCT Board meetings in February. Please contact Ann’s office or your PCT if you would like a copy of the Governance Proposals.

These director level appointments are an important step towards making this transition. The coming period in the NHS in south west London will be challenging – all parts of the NHS system are changing.  We are confident that this new team can successfully lead us through this process.

This is the first phase in these changes and unfortunately the overall management cost reduction will mean redundancies for a number of our managerial and administrative staff.  Staff consultation for the majority of our staff ended in January 2011 and an appointments process will follow.

We have been briefing staff frequently throughout this process and working closely with our union representatives to ensure staff are supported throughout this process.  The new structure will be in place by April 2011, and I know all our staff would appreciate your patience and support as we continue through this difficult time.

Kind regards,

Ann Radmore, Chief Executive, and Sian Bates, Chair, of the NHS in South West London

8 February 2011  BBC article

NHS shake-up ‘risks diluting patient power’By Nick Triggle Health reporter, BBC News GP consortia should be up and running by 2013

Patients risk having less of a say in the running of the NHS in England under the proposed shake-up, eight leading health charities say.

GPs are being given control of much of the NHS budget under the changes laid before Parliament last month.

Part of the reasoning was that it would help empower patients, but the groups, including the British Heart Foundation, said it could weaken their involvement.

 The government insisted the changes would give patients “real clout”.

The intervention by the health charities – in a letter published in the Times – follows widespread criticism of the reforms by health unions and MPs last month when the bill paving the way for the changes was published.

Accountability

Managers working for primary care trusts (PCTs) are currently responsible for planning and buying local services, but GPs working together in consortia would take on responsibility for this from 2013 under the reforms.

Pilots are already starting and once the process is complete, two tiers of management – PCTs and the 10 regional health authorities – will be scrapped.

The letter, which was also signed by the Alzheimer’s Society and mental health charity Rethink, questioned the powers and resources being given to the local Health Watch bodies, which will be set up across the country to represent patient interests in the new NHS structure.

“If we don’t do this well and thoroughly we could end up with patient and public involvement weaker than it is and no-one really wants that” 

End Quote Andrew Chidgey Alzheimer’s Society

It states: “If the new NHS is to properly serve patients and the public, this democratic deficit must be addressed and the voices of patients heard by those making crucial decisions affecting their lives.”

The letter also said the proposed scrutiny arrangements – local authorities are being put in charge of monitoring GP consortia – meant the lines of accountability were “too weak”.

Andrew Chidgey, of the Alzheimer’s Society, told the BBC the issues needed addressing now that the bill was working its way through Parliament.

“If we don’t do this well and thoroughly we could end up with patient and public involvement weaker than it is and no-one really wants that.”

The eight signatories to the letter are the Alzheimer’s Society, Asthma UK, Breakthrough Breast Cancer, Diabetes UK, National Voices, Rethink, the British Hearth Foundation and the Stroke Association.

Their criticisms represent a new area of concern about the changes.

A Department of Health spokeswoman said the letter raised “constructive” points, adding: “We will work together to ensure the bill, which is in its early stages, delivers the reality of improved patient involvement.”

However, she disputed the suggestion that patient power could be diluted, citing the ability of Health Watch to trigger official NHS inspections.

Last month, the House of Commons’ health committee said the plans had taken the NHS by surprise and could threaten its ability to make savings.

Meanwhile, in another letter, also published in the Times, six health unions, including the British Medical Association, warned of their “extreme concerns” that greater commercial competition in the NHS would end up undermining care.

The NHS Confederation, which represents managers, has also suggested hospitals may have to close.

Wandsworth Councillors, at the last meeting of the Adult Care and Health Overview and Scrutiny Committee, agreed to set up a Shadow Health and Wellbeing Board.  This will have representation from local voluntary agencies as well as from the primary care trust and the local GPs and Councillors on a broad partnership body and there will also be a more limited Executive Group which will have representatives from local GPs, the Council and the PCT.  Wandsworth LINk has been given a seat on both the partnership and the Executive Group.  The first meeting will consider the updated Joint Strategic Needs Assessment.

A major item on the agenda of the OSC was the approval of the closure of Hartfield House, a residential respite centre for Adults with a Learning Disability.  Councillor Clare Clay, as the Carers’ Champion gained an agreement from the Committee that Hartfield House would not close until its replacement services were in place, that these services would have sufficient capacity for friendship groups to be able to have their respite stays together and that the total respite resource would be large enough to accommodate emergency placements which had been steady at around five people at any time without impacting on the respite service.

Changes in the arrangements for the mental Health Resource Centres were also approved.  These signalled a move away from building-based services towards a more one-to-one support service to help users who had suffered from mental illness to return to normal life and employment.  The LINk representative made the point that the availability of social outlets for people recovering from metal illness was still an important part of the recovery process for many and that this need should still be addressed.

For the full details of the reports discussed at the meeting go to

http://www.wandsworth.gov.uk/moderngov/ieListDocuments.aspx?CId=498&MId=3506&Ver=4

roger

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 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.”

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.”