The Community Voice

June meeting of the Community Voice

2009-05-11T00:06:00.004+01:00

Our June meeting will be at 7.45pm on Thursday 4th June in the

Post Graduate Centre Mount Vernon Hospital.

Our guest speaker will be Barbara Gill, Project Director Mount Vernon Cancer Services Development Project, speaking on “Making progress on cancer services” – the way ahead for the Mount Vernon Cancer Centre

Visitors are welcome as guests

A whirlwind of change in community health services!

2009-05-11T00:01:00.007+01:00

Maria O’Brien was guest speaker at the Community Voice May meeting.

She covered so much ground that we felt a whirlwind had hit us! Her enthusiasm and dedication to patient services was transparent and exciting. Summarising is an impossible task.

Traditionally PCTs have commissioned services – which means planning and purchasing – and they have also provided community health services. NHS national policy now obliges PCTs to separate theses two roles. The former PCT provider services are now called Hillingdon Community Health which, from 1st April 2009, has been designated as an autonomous provider by NHS London. Maria O’Brien is its Managing Director.

However, Hillingdon Community Health is still responsible to the PCT Board although it is now an independent organisation with its own £30.5 million budget from Hillingdon PCT. It employs 550 staff to provide 32 different health services in patients’ homes and 19 clinics.

Its Adult Services include district and specialist nursing, podiatry, specialist dentistry, community matrons, various therapies, infection control, wheelchairs, rapid response teams, safeguarding adults service. It is responsible for two GP practices in the south of Hillingdon and also for the 22 bed in-patient facility at Mount Vernon in the Northwood and Pinner Community Unit.

Its Children’s & Young People Services include health visiting, child development, community paediatricians and nursing, various therapies, school nursing, safeguarding children, looking after children and also family planning and sexual health.

Various options are open to this new organisation. It could remain as it is or become a Community Foundation Trust. It could integrate with an acute NHS Trust or a Foundation Trust, or the Local Authority. It could become a Social Enterprise, outside the NHS, or merge with another PCT Provider. It could even become a private enterprise.

In 2009-10 it aims to focus on expanding and improving clinical services for local users, but it will also consult with staff, patients and the public, the local authority, hospital, and GPs before making recommendations about its future framework in Autumn 2009.

Within the next two months it hopes to achieve a wait of no more than two weeks for physiotherapy. It also plans to develop a “home” intravenous antibiotic service, expansion of the Rapid Response Service, a new wound care service, more community matrons to support patients with long term conditions and expansion of other services including diabetes, rehabilitation, immunisation and children’s services.

Hillingdon PCT has been very supportive, more so than many PCTs, with investment in community services and an extra 110 front-line posts in Hillingdon.
Questions came thick and fast. All were answered. It was a highly informative and interesting experience for the audience.

Many thanks to Maria O’Brien!

Joan

North West London Hospitals, April 2009

2009-05-05T20:40:00.003+01:00

Principal items only. Altogether a very satisfactory report of what has been happening.

1. CEO report A variety of interesting items reported here. The trust has received full registration by the (new) Care Quality Commission (CQC), which came into being on 1 April. Like many other hospitals NWLH has a shortage of midwives. In London there are 400 vacancies for midwives but there are only 200 being trained. Trouble ahead!

2. Annual Performance This was very good in many areas. The A&E target of 98% patients being treated within 4 hours was reached, for the whole year, in spite of an increase in the number of patients being treated. The MRSA target of 28 cases was met – ‘target’ is the wrong word, it’s actually a permitted maximum. Regarding C.Diff there was a 40% improvement over the last year’s figures. The ‘18 week’ target of 90% (for referral of a patient for tests, diagnosis and treatment) was met comfortably, with 98% and this earned an efficiency bonus of £700K.

3. Swine flu The Trust is well prepared, one of the ‘London referrals’ had been to NPH. Staff in infection units are being advised to have vaccinations. Alert precautions will remain in force for a long (unspecified) time.

4. Cervical screening There is a 14 day target for screening. Numbers have recently increased greatly, referred to as the ‘Jade Goody’ effect.

5. Mid-Staffordshire check list Trusts have been asked to compare their performance against the recent report of multiple failures at the Mid-Staffordshire Trust. Our trust has a clean bill of health in this comparison.

6. Finance With some heroic work on non-recurrent items, the trust finished the financial year with a positive balance of about £170K. An adverse balance is expected for next year.

Paul

What's new in April in Hillingdon Hospital?

2009-05-03T10:58:00.004+01:00

Resignation of the Chairman

The Chairman, Tony Valentine, has announced his resignation, effective on the 1st July.

Accident and Emergency Department activity

Demand has recently escalated with an extra 35 to 40 patients per day in A&E, mostly between 8pm and midnight. So Hillingdon Hospital failed to meet the national target of treating all A&E patients within four hours of arrival. In April its rate dropped to 96.4%, bottom for London and in the lowest quartile nationally. So, the Trust has been summoned to discuss its action plan with NHS London. Additional staff are being introduced on evening shifts.

Finance
2008-09 was very challenging, with the combined pressures of achieving the 18 week target, very high energy and utility price rises, and a large increase in agency staff use. Never-the-less, the Trust delivered its best performance on national and local targets and ended the year with efficiency savings of £4.7m. The highest earning departments were Obstetrics and Trauma / Orthopaedics, followed by Accident & Emergency.

Flu Pandemic
In a recent audit of preparations for a possible ‘flu pandemic the hospital scored an assessment of 98%. This was a national audit, in which the London average was a score of 82%, so The Hillingdon Hospital was considered well prepared

MRSA Screening
It is hoped that all elective patients will be screened for MRSA by the end of April or early May. All inpatients after two weeks are now re-screened every 14 days to assist in the identification of high-risk patients.

Pressure ulcers
A successful pressure ulcer awareness week was launched in March to raise awareness among both staff and the public.

Joan Davis

A walk-in GP centre is coming to Hayes!

2009-04-21T12:40:00.004+01:00

Hillingdon PCT has announced that from autumn 2009 there will be a walk-in medical service in the town centre of Hayes. This free NHS service will be open 8am - 8 pm with a GP available 365 days of the year.

This service will be provided by Bondcare Medical Services Ltd, an independent provider of healthcare services across the UK.

Joan

NHS Harrow, 14 April 2009

2009-04-19T21:19:00.003+01:00

NHS Harrow is the new working name of Harrow PCT. Apparently several PCTs have adopted this style, as it is clearer to the public what the function of the organisation actually is.

This report covers main items of the recent Board meeting, held on 14 April

1. Performance All seems quite satisfactory. The (98% in less than) 4 hour A&E target (at Northwick Park, of course) has been achieved for the whole year, in fact NPH is the only London hospital that has gone from ‘red’ to ‘green’ within a single year. Regarding immunization there are variations in the GP records and the PCT’s own counting.

2. Finance and Budgets The overall closing balance will be very near the target of a surplus of £1.7 M, there may be some changes because the Pharmacy contract has been changed nationally. No major changes are expected for the coming year.

3. Sustainable Health Care This was presented by the Director of Public Health. It is concerned with saving carbon in the borough, everyone agrees it’s a good thing to do but no one knows what the costs will be. One suggestion that met with general approval was the suggestion that people should write shorter reports.

4. Primary Medical Services in East Harrow This was about the provision of new services, to replace a Health Centre that was closed about 2 years ago and some GP practices that have closed. Three alternative proposals were presented, each involving the Community Health Centre in Belmont, supported by a 2 GP led Health Centres. A local consultation is to be held shortly.

Paul

Voluntary Services in Hillingdon & Mount Vernon

2009-04-18T17:09:00.003+01:00

Voluntary Services for both Hillingdon and Mount Vernon Hospitals have proved to be invaluable. There are the volunteer drivers who transport patients to and from the hospitals in their own car; others work in the charity shops raising money for the hospitals. In the past the Comforts Fund has provided funding for many projects and equipment in both hospitals. Another aspect of their work is escorting patients to and from reception to the correct clinic, doctor or ward. They certainly are an asset.

YOUR HOSPITAL NEEDS YOU - BECOME A VOLUNTEER

New Watford and Three Rivers Health and Social Care Group

2009-04-11T23:40:00.006+01:00

On 7^th April, in Watford Town Hall, a new health and social care group was launched by Hertfordshire Local Involvement Network. That LINk covers a very wide area and it is therefore setting up a number of sub-groups, of which this one, covering Watford and Three Rivers, is among the first.

The event was a great success. Over forty people attended, including representatives from Herts. County Council, Watford Council, Three Rivers Council, West Herts PCT, West Herts Hospitals NHS Trust and various voluntary organisations. Donald Edwards, our Publicity Officer, and I represented The Community Voice but it was good to see a number of other members present too.

As our two organisations share much common ground, we were allowed to display Community Voice publicity boards, to show our own range of interests. I was also invited to speak briefly to welcome the new organisation on behalf of our members. Increasing public awareness and input into local health and social care services will benefit us all. We look forward to working closely with the new group and are confident that this will be to our mutual advantage.

Joan

Next Meeting, on Thursday 7th May 2009

2009-04-10T09:26:00.007+01:00

At this meeting, Maria O’Brien, Interim Managing Director of Provider Services, Hillingdon PCT, will be our guest speaker, speaking on: “The whirlwind of change - in local NHS services”.
As always we will meet at 7.45pm in the Post Graduate Centre at Mount Vernon Hospital. Visitors are welcome.

Do you know about all the changes that are taking place? If not, come and find out!

Joan

Our April Meeting

2009-04-10T09:21:00.007+01:00

David McVittie is always a popular guest speaker. He has charm and is frank. As Hillingdon Hospital’s Chief Executive, his news is up to date and correct. So, he enchants his audience – and our April meeting was a great success.

Firstly, his Board intends to rebuild Hillingdon Hospital on its present site. It looked at all options and this was the best. In an ideal world the RAF site at Uxbridge might be first choice, but in practice it is not a front runner.

No London acute hospital has been successful so far in achieving foundation trust status in under three years, so his Trust is not alone in its disappointment that its application is on hold. It remains confident of ultimate success. It already has over 5,500 Foundation Trust members and has recently held elections for Governors.

He spoke about the current trauma and stroke public consultation. His hospital receives less than one major trauma case per week, so it cannot not match the criteria for a major trauma centre, but the proposals will allow it to continue, as now, to deal with the majority of local trauma cases.

However, his hospital already provides a hyper-acute-stroke service for most of the day, so it is disappointed by the consultation proposals, which would send all local stroke patients to Northwick Park Hospital for the first 72 hours of a stroke attack. His hospital would then become a local stroke unit, dealing only with transient ischaemic attacks and rehabilitation.

His Trust’s vision for Mount Vernon is unchanged. The new car park outside the Mount Vernon Treatment Centre will open in June. Various old buildings must be demolished. New cancer wards are needed, also new staff accommodation and new wards for elderly care. A joint venture with the private Bishopswood Hospital could lead to shared accommodation for endoscopy services.

The Trust is proud of its two new facilities. Bevan Ward in Hillingon Hospital provides en-suite single rooms. The Mount Vernon Treatment Centre provides top class elective care.

The Trust has also done well in meeting national targets, in achieving a small financial surplus, in the outcome of staff surveys, in its thriving Patients in Partnership programme and in introducing its consultant-led Emergency Admissions Unit which is open 24 hours a day, seven days a week.

The speaker stayed late to answer questions and to hear audience comments. As always our meeting provided an opportunity for members to relate directly to the speaker - interchanging views and information, to mutual advantage, we hope.

Joan

Hillingdon Round-Up late March 2009

2009-03-28T09:03:00.002Z

Hillingdon Hospital’s Foundation Trust application
This application is now on hold. The fact that the Trust has not met its MRSA target is a factor, but not insurmountable as the numbers are actually low. The valuation of the Trust’s estate appears to be the main stumbling block.

The Hospital Trust’s Finance
A surplus is still forecast for the end of year despite a very difficult month in February.

Hillingdon PCT’s Finance and Performance
The PCT is forecasting breakeven for 2008/09, meeting its statutory duty for the second year since 2002 – this achieved despite in-year repayment of £9m for its historic debt (leaving £35m debt to carry forward into 09/10).

On performance of national priorities and targets, Hillingdon is in the top half of London PCTs, which is very encouraging.

However there are problems between the PCT and Hillingdon Hospital over signing 2009/10 contracts – the due date was missed due to differences about coding and local prices for non-tariff services. NHS London has asked both parties to resolve their differences locally.

PCT’s Commissioning Strategy
Preliminary results from the World Class Commissioning process showed Hillingdon PCT’s scores to be mid-table for London, with it named as an exemplar by NHS London for information based decision-making. This accolade is very sweet in view of the PCT’s chequered history.

NHS London is working with all 31 PCTs to implement sector commissioning arrangements. The North West London Commissioning Partnership, an acute services commissioning vehicle covering 8 PCTs - Brent, Ealing, Hammersmith & Fulham, Harrow, Hillingdon, Hounslow, and Kensington and Chelsea, and Westminster - expects to go live on 1st July 2009.

Third Runway at Heathrow
In response to the PCT’s letter, the Permanent Secretary of the Department of Transport has confirmed that a formal health impact assessment will need to be conducted as part of any planning application by BAA, if further development were to be supported by the government. He reiterated the government’s firm commitment that Heathrow will not be extended until the air quality and noise limits have already been met.

PCT’s Premises
The PCT’s Public Health and Joint Commissioning teams moved to the Civic Centre on 16th March, signifying the PCT’s intention to work jointly with London Borough of Hillingdon.

Provider Services
By end of March the PCT’s Provider arm expects to be accredited as an Autonomous Provider Organisation (APO) ready to start operating independently, although still a sub-committee of the PCT operating with delegated powers. Its key priorities for investment in 2009/10 are: safeguarding children and adults, health visiting, speech therapy, community dentistry and TB.

Joan

The Mount Vernon Cancer Centre is safe!

2009-03-28T08:41:00.005Z

Success, at long last! The 2002 Varley Review recommendations have been overturned – so, no more talk about moving the Cancer Centre away from Mount Vernon.

Instead all efforts will be directed towards making Mount Vernon the hub of a system with satellite services further north, in Hertfordshire or Bedfordshire, to provide routine radiotherapy for those who currently have very long journeys.

The current Review’s Interim Report is being launched on Monday 30th March, at a stakeholders’ conference, but the document is already in the public domain. The main issue now is to ensure that services remain first rate in both Mount Vernon and any satellites. No one wants second-class services, even if they are close to home.

This success is a triumph for local people. The two Community Voice petitions – each with over 70,000 signatures - were a lot of hard work, but the outcome is very sweet. When ordinary people pull together, they can make things happen!

Joan

West Herts Hospital Trust better and better!

2009-03-25T07:23:00.002Z

On 19th March, again it was all good news for the Board of this Trust.

The move of all acute services from Hemel Hempstead Hospital to Watford General Hospital was concluded without a hitch. This is a triumph as the move is acknowledged to be the biggest such project in today’s NHS. The Chief Executive, Jan Filochowski, had insisted that the original date be put back, to allow step by step transfer, and the outcome fully justified his caution, as all went well. Both staff and patients like the new Acute Admissions Unit (AAU) at Watford and the Urgent Care Centre at Hemel is thriving too, with over 350 patients per week.

Disclosures about Stafford Foundation Trust have made all hospitals edgy, but this Trust has below national average mortality rates in all departments, so it has no concerns of that kind.
Furthermore, it is meeting all those elusive NHS targets. Its infection control is first rate, well within target for MRSA cases and a national star for reduction of clostridium difficile cases. Performance on 18 weeks waiting list targets is above national targets. It continues to exceed all three national cancer targets. Bed pressures have eased slightly. Delayed transfers of care have reduced in number in recent weeks.

The Trust's Healthcare Commission Quality of Care rating is now balanced between “good” and “fair” depending on it achieving 98% for the A&E target over the whole year (it reached 100% on the previous day!). This target was not in doubt until the February snow storms caused unusual pressures and caused a temporary fall below target.

Add to all this that the Trust has a small financial surplus this year and expects to clear its historic debt next year. All good news.

But what about the patient experience? Are patients happy too? Survey results indicate that there is an improvement in patient satisfaction. So, what more can anyone want? I guess there are cracks somewhere and some patients fall down them – but the general picture is still amazing, unusual and good.

Joan

Hillingdon Hospital update from David McVittie on Thursday 2nd April

2009-03-14T00:34:00.003Z

Everyone knows that The Hillingdon Hospital is long past its “sell-by date”, with dilapidated buildings too old to repair. So where should the hospital be rebuilt? The Board of The Hillingdon Hospital has well developed plans to rebuild on the present site but some people, led by John Randall MP, call for the rebuild to be on the old RAF site in Uxbridge.

Why does The Hillingdon Hospital Board reject that proposal? Has the current recession changed the options? Come to our 2nd April meeting, at 7.45pm in the Post Graduate Centre Mount Vernon, to have an update from David McVittie, Chief Executive of The Hillingdon Hospital.

He may touch on other issues too so come with your questions ready. Why does the Healthcare for London consultation propose to stop Hillingdon Hospital from providing 24 hour care for stroke victims, despite it offering an excellent service? Should we be fighting to keep what we’ve already got? How is the Trust’s foundation trust application faring? These and other questions may feature in our meeting. Visitors are welcome, as always.

Joan

Good News for Cardiac Patients!

2009-03-11T01:54:00.004Z

Dr Nigel Stephens charmed his audience at our March meeting, talking about the Cardiology Department at Northwick Park Hospital, which he has led for 13 whirlwind years of change.

He noted that before 1961 there were no visual pictures to assist cardiologists, so little could be done to help patients. However, in the USA between 1959-61, there were major advances with the development of angiograms, open-heart surgery and heart-lung machines. By 1976 balloons were being introduced into arteries and ten of the early patients are still alive today. By 1988 the first coronary stent was introduced, a flexible tube supporting the artery and this technique is still in use today.

The last five years have seen even more advances, with more emphasis on speedy treatment and primary angioplasty now the favoured method of combating heart attacks. As a result there is now only a 5% chance of dying during a heart attack compared with a 20% chance only a few years ago.

At Northwick Park, angioplasty was introduced in 2002 in an exclusively consultant service. It has had outcomes second to none, with a total of over 2000 patients treated.

Heart failure used to be a cinderella discipline but cardiac resynchronisation can now transform life for some patients and 50 cases have received that treatment at Northwick Park.
However there is no open-heart surgery or heart transplants at that hospital.

Over the last five years national waiting–time targets have led to many improvements. In 2004 16 people waited 18 weeks for treatment – in contrast today 230 people are waiting barely six weeks - and the wait for angiograms is only three weeks.

Surprisingly, although many people go to A&E departments with chest pain, only five in a 100 cases are due to serious conditions - and today, new A&E technology can identify which of these are heart attack cases needing urgent treatment.

Dr Stephens talk was entitled “Good news for cardiac patients”. We came away convinced that this was an apt title.

Joan

Good and Bad News from Hillingdon Hospital

2009-03-11T01:18:00.003Z

Firstly the good news
Both Mount Vernon Treatment centre and Bevan Ward are open and much appreciated by both staff and patients.

It is encouraging that there have been no cases of infection in Bevan Ward – single rooms and isolation remain the most powerful tools against infection.

The Treatment Centre is receiving out-patients as well as elective surgery patients, but the operating theatres are not yet being used to full capacity.

Now for the bad news
There were three cases of MRSA in January and two more in February making a total in year of 16 cases, four above target. Everyone was clearly devastated.

27 pages of the Board papers and most of the Board Meeting discussion were devoted to MRSA. Every case is documented and analysed in detail. All elective surgery patients are now pre-tested for this infection. Hand hygiene is closely monitored. Pressure sores are vigorously avoided. It is difficult to know what more could be done.

And no news on the Foundation Trust application
At the time of the Board meeting hopes were high that there would be an announcement within hours – but these hopes were dashed by silence. Until such an announcement is made no one can be sure of the outcome.

Joan Davis

Hillingdon Primary Care Trust News

2009-03-11T01:14:00.003Z

The February PCT Board meeting was jam-packed with facts, so here are a few snippets of special interest to patients:

The Hillingdon Referral Medical Centre The RMC currently processes over 80% of GP referrals to hospital consultant services. Patient satisfaction surveys for dermatology patients are currently underway – so these patients can say what they think of the service.

Physiotherapy Services Additional investment is being provided to reduce waiting times. No one in Hillingdon should then wait more than two weeks to see a physiotherapist. Weekend services are to be developed and the “physio-direct” telephone service.

Early intervention for psychosis The PCT has failed its target of treating 38 new patients in the year. However the new consultant started in post on 1st January 2009 so the PCT hopes to do better in future.

GP surgeries extended hours Good news for patients - over 55% of surgeries now offer extended hours – so fewer patients now need to go to A&E in hospitals.

Patient Choice From 1st April 2009 patients will have right to choose where they have treatment when referred for their first outpatient appointment, but this choice is at Hospital Trust level, not site level – so, if you choose The Hillingdon Hospital, you could find your treatment is provided only at Mount Vernon Hospital, since both these hospitals are part of the same Hospital Trust. Patients can choose any hospital in England that provides the required service and meets the NHS standards, including independent and private hospitals that appear on the Choose and Book list.

Podiatry Service This service is supporting the Hillingdon Age Concern’s Toenail Cutting Service by providing training and support when problems arise – good news, particularly for older people.

The Rapid Response ~Service This service, started in September 2006, to look after patients for a short time in their own homes, has now extended its hours to 8.30am to midnight, for 365 days per year.

Health Visitors The national shortage is being tackled locally by supporting staff to undergo part-time training – so the PCT is trying to grow its own Health Visitors!

Parkinson Disease Specialist Nurses A bid for funding two part-time specialist nurses is underway and appointments are expected early in 2009.

Joan

Harrow PCT Board, 3 March 2009

2009-03-04T12:26:00.003Z

Interesting highlights only.

1. Rebranding As from 2 April the PCT is to be known as ‘NHS Harrow’. It is believed this will be more meaningful to the public than ‘Harrow PCT’. On legal documents, however, it will still be ‘Harrow PCT’, as that is the officially registered name.

2. Operating Plan for 2009/10 A huge item, of some 140 pages, but discussion took no longer than 10 minutes. It is the detailed plan covering just about everything the PCT expects to do during the next year, spelled out in excruciating detail.

3. Emergency Planning Annual Report How to cope with emergencies that can be foreseen, such as a potential influenza pandemic..

4. The ‘World Class Commissioning’ Panel Report In spite of the rather fatuous name, this is the report of a panel of NHS experts, aided by some with healthcare experience abroad, on how well Harrow PCT does its work. According to the panel, not as well as the ‘self assessment’ that went alongside. But they recognised that the PCT had a bad period in the past and has come out of that, with a largely new team that shows promise.

5. Transfer of Commissioning Responsibility for Social Care Needs from PCT to Harrow Council This considered the transfer of people with learning disabilities from the PCT (i.e. NHS) to the local Council (i.e. local government financing). The number of people involved is not very large, the sum involved is under £4 M, but the problems involved are very major. Very few other councils have shown any willingness to accept the financial responsibility as this will be in competition with all other local authority funding instead of being safely sheltered within NHS funding. It will be interesting to see how Harrow and NHS Harrow cope with this.

Paul

North West London Hospitals trust Board, 25 February 2009

2009-03-04T12:19:00.003Z

1. The fire and the power failure. The fire at NPH on 11 February started with the generators in the basement, causing a lot of smoke to rise through the main ward block. Nobody was injured, about 170 patients had to be moved, no one suffered more than ‘some discomfort’. A culture of regular fire drills helped, with staff knowing what to do. Problems included moving patients connected to various items of (electrical) equipment. A & E was out of action for a few hours. Some patients were moved to other hospitals. One of the consequences of the fire is that there is a temporary reduction in the number of beds available but it is hoped this will be only for a short time.
A few days earlier there had been a power failure, soon after midnight on one of the coldest nights. The power supply in Sudbury failed, affecting about 900 homes and the hospital. The emergency supply kicked in immediately apart from one unit, which had to be started manually. The whole incident took about 4 hours to resolve.

2. Finance. There has been a lot of newspaper publicity about the reduction of next year’s budget by about £32 M and naturally this was an important item. The expectation is that the in-year financial outcome will be a ‘break even’ situation. As the stated intention is to make these savings without affecting the quality of the service there is much interest in how this can be done but nothing was said about this.

3. Performance All quite satisfactory. The number of MRSA and C. Difficile cases is well down on the (not to be exceeded) targets. The trust gets some bad ratings from the Healthcare Commission surveys but the reason is interesting. Patients are given questionnaires, to be returned by them to the Commission. It seems that the proportion of NWLH patients who submit such questionnaires is lower than the HC would like – and the trust gets a bad grading because of this. This seems unfair to me. There is more: the questionnaires are only in English yet the NWLH Trust clientele is roughly 50% non-English and the questionnaires are many pages long.

Paul

Our next meeting

2009-02-16T21:46:00.004Z

We next meet on Thursday 5th March, as usual in the Post Graduate Centre, Mount Vernon Hospital, at 7.45pm.

There is plenty of parking in the nearby main car park. Doors open at 7.30pm.

Our guest speaker will be Dr Nigel Stephens, Consultant Cardiologist at North West London Hospitals NHS Trust, speaking on: "Good news for cardiac patients".

We are always pleased to welcome visitors, as our guests.

Joan

North West London Hospitals Trust Board, 28 Jan 2009

2009-01-29T21:26:00.004Z

Highlights of the meeting

1. Maternity figures are lower than expected It seems that people register with the hospital but then do not come for the birth. One theory is that several of these expectant mothers are East Europeans who are returning home because of the economic situation.

2. Infection Prevention and Control The number of MRSA cases is below the target, at 22 instead of 24 so far (32 for the whole year). In fact there have been no new cases since November. C.Diff cases are also well below the expected numbers.

3. Overall Performance The numbers of patients arriving at A & E has reached record levels. Cold weather and staff sickness contribute to the difficulties. Actually, this is a general London problem, even if not national. The healthcare Commission’s survey of A & E departments has found that there are major differences in responses between national figures and London figures, reason not readily explainable. The trust performs quite well when compared with other London trusts, not so well on a national comparison.

Paul

Winter takes its toll at Hillingdon Hospital in January 2009

2009-01-28T21:38:00.003Z

A very cold December combined with outbreaks of flu put The Hillingdon Hospital Trust under intense pressure. In January the Trust continues to have 30 additional beds open, to meet demand, as well as keeping more beds empty than is usual.

Winter vomiting virus is now imposing additional pressures. Some wards are already infected and are closed to new patients. The virus is more easily caught than the common cold and to curtail the risk of it being brought into the hospital, friends and relatives of patients are asked to make only essential visits.

Infections
The Trust had two MRSA cases in January making a total of 13 so far in year, breaching the whole year target of 12 cases maximum. The Board learned that three of the patients identified with MRSA had no symptoms, so it is possible that contamination of samples could have occurred. It was also noted that in January last year that there were 28 cases of MRSA in year, so there has been dramatic improvement despite failing the target. (Note too that every Trust has a target based on its own past performance, and that Hillingdon Hospital’s target is lower than many similar hospitals.

FinancesDecember’s financial performance was better than the same month last year and so the Trust’s financial position is as planned for this point in the year.
Joan Davis

Cancer Waiting Time Targets

2009-01-28T21:35:00.002Z

The following targets were introduced between 2002 and 2005:
Two Week Wait Rule:
If a GP suspects cancer, the patient must be seen by a consultant within two weeks

31 Day target:
A cancer patient must receive first treatment within 31 days of “decision to treat”

62 day target:
A patient referred by a GP must receive first treatment within 62 days of GP referral.

Targets from January 2009 are:
Consultant upgrades (62 day pathway)
If a consultant makes a cancer referral, treatment must start with 62 days.

Screening Referrals (62 day pathway)
Similarly if screening leads to a cancer referral, treatment must start with 62 days.

Subsequent treatments:
Patients with a recurrence of cancer or needing subsequent cancer surgery or chemotherapy, should be treated with 31 days of being fit enough to have the treatment.

From 1st January 2010
All referrals to a symptomatic breast service, regardless of suspicion of cancer, must be seen within two weeks

From 1st January 2011
Patients with a recurrence of cancer or needing subsequent radiotherapy or other cancer treatment, must be treated within 31 days of being fit enough to have the treatment.

There are also new rules about how 31 days and 62 days are counted. The clock cannot now be stopped for patients to consider options or go on holiday, so reported compliance is expected to fall.

Joan

Hiilingdon PCT can see light at the end of the debt tunnel

2009-01-28T10:07:00.002Z

Last month it was proposed that London’s 31 PCTs should all pull together to resolve London’s historic debts. The Department of Health offered a sweetener of £100m, so the deal has now been agreed, throwing a life-line to Hillingdon PCT which is still burdened with huge debts.

Providing Hillingdon PCT breaks even financially up to March 2011, including debt repayments of over £8m in each of those years, then its remaining £19m debt will be met by the other London PCTs. In the meantime Hillingdon PCT can borrow from the other PCTs to enable it to provide essential local investment. This is all fantastic news.

Less good news is that Hillingdon PCT and The Hillingdon Hospital are facing some difficulties in resolving coding problems that govern how much the PCT pays for the hospital’s services. Pending resolution, Hillingdon PCT is withholding payment above the level of its commissioning agreement. It is hoped that mutual understanding will be reached, but the hospital could seek resolution via arbitration.

The Urgent Care Centre at Hillingdon Hospital is breaking even for the PCT, but the hospital’s A&E Department is losing income in consequence. In contrast, the PCT’s Audit Committee found that the Referral Management Centre (designed to keep people out of hospital and provide services closer to home) shows no evidence of value for money, nor of improving the patient experience and it has had a negative impact on the relationships with The Hillingdon Hospital and GPs - but it has been successful in providing services more locally for 70-80% of GP referrals. This sounds like win some, lose some

Targets and ratings continue to absorb much time and energy. Sub zero temperatures in December plus a local flu outbreak caused The Hillingdon Hospital to breach its A&E target to treat all patients within four hours of arrival. It also had two MRSA cases that month, one above target, but this target demands reduction of previous performance, which started from a low number. So, despite breaching its target for this time of year, this hospital continues to have relatively good MRSA infection control compared with similar hospitals.

The PCT’s Healthcare for London event in the Chimes, Uxbridge, last November, showed that the public has little awareness of what the PCT actually does. The PCT’s new strategy aims to improve public awareness and participation in its affairs and it is inviting both Hillingdon Local Involvement Network, LINk, and other lay representatives to join a number of its committees.

Joan

West Herts Hospitals under winter pressure

2009-01-22T22:31:00.007Z

The Board of the NHS Trust heard both good and less good news at its first meeting in public in 2009.

Good news is that it is keeping MRSA numbers low with only 11 cases so far this year. It is also meeting national targets to treat patients within 18 weeks of referral by their GP. Its £1m surplus so far this year is further good news, although this is a smaller surplus than forecast, so it was greeted with muted approval.

However there were some bad things too, including seasonal pressures on beds impacting on A&E performance in December, which therefore failed to treat 98% of patients within four hours of arrival.

Worse from the patients perspective, was an admission that for some aspects of mandatory staff training there is currently a compliance of only 40% - this appeared to shock some members of the Board and certainly shocked the public who heard the report.

Also there was an admission that some wards are operating with less that their agreed complement of staff, because recruitment of additional staff has not been sufficiently successful. Bank and agency staff have been used, but they are costly, and that expense has undermined the Trust’s financial planning.

After a number of Board meetings with only good news, this meeting was less self-congratulatory than other recent meetings. However this Trust’s remarkable recovery from dismal failure must not be forgotten. It has accomplished near miracles and it is that success which makes this Trust well on its way towards achieving foundation trust status, which at one time was unthinkable.

Joan