Big Breakfast October 2017: NHS
We have just entered our 3rd season of Big Breakfasts, during which time we have heard from and questioned many of our local representatives involved in managing the infrastructure and services of our village and locale. We have also lightened the content at times by sharing the life experience stories of some exceptional people.
Saturday 21st October 2017 saw the return of Dr Minesh Patel, the Chair of our local Health Commissioning Group. When here a year ago, Minesh was asked to return to let us know how things were progressing against the backcloth of a challenging and somewhat depressing landscape for the NHS.
Minesh asked the group to tell him what issues were uppermost in their most recent concerns, he got a good response!
The first issue raised was why new health premises at Crawley Down still remained only partially occupied. More concerns came forward. How the significant Primary Health Care demand driven by the amount of new housing planned for Copthorne and in the area generally could be serviced? Demand is rising at circa 5% per annum we learnt. How 111, the replacement call support service, is faring given the problems of its’ predecessor. Whether Brexit is, or is likely to, affect UK Heath services.
So what did we discover?
Specifically regarding the Crawley Down premises utilisation, it has finally been accepted that receiving a lower rent than the asking level is better than no rent at all when a public asset has been created. So watch to see what well-being practitioner occupies the available space.
The housing question revealed that planning is not as joined up as perhaps we would all prefer. Whilst it is a relatively simple matter to provide buildings to satisfy growth, finding the Health Professionals to occupy the said properties is not! Local authority budgets are under pressure which is beginning to threaten the protection of services provided to society’s’ most vulnerable, and thus the dilemma will only be solved by finding new ways of delivering the support and services needed directly to peoples’ homes by means other than appointments at local establishments. EG has created a Primary Care at Home initiative which is gathering momentum designed to co-ordinate and provide support more quickly and efficiently across the various agencies. Primary Care Co-ordinator roles are being created to facilitate this improvement.
The Pharmacist role is being expanded, although this is not a quick fix as the training needed to allow pharmacists to prescribe and dispense will take time and we start behind the model some of the audience had experienced in Europe. The benefits are significant as we discovered that 20% of hospital admissions are caused by the cumulative impact of prescribed medicines and their side effects! So bringing the pharmacy community into a decisioning position has clear benefits, reducing costly hospital demand.
Keeping the elderly out of hospital must also be a priority, it was disturbing to learn that the mortality rates of those over 75 are dramatically increased after a 4 day stay in hospital compared to being at home.
The direct and self-help provision of healthcare has been improved under the new 111 service. Self Learning software, increasingly being able to recall and track issues relating to an individual from previous contact with the NHS is being developed, alongside sophisticated prescribed algorithms, supported by on-hand clinicians, ensuring a more valuable solution for callers rather than redirections and a call centre approach.
Digital support will increase and has a massive part to play but will not remove the need for human intervention and judgement.
One of the audience asked why the Fire Service could not be up-skilled to include a paramedic service as in other countries. Minesh confirmed there was a real opportunity here but understandably the Fire Service were thoughtful about such a change and the impact upon providing their core response requirements, given budgetary pressures created by such a role expansion. We learnt that all Public Services structures and cultures were finding it hard to be as innovative and reactive as the modern world desires!
As far as Brexit is concerned there has already been an impact as higher inflation and the weakness in the pound has made the case for immigrant healthcare workers less attractive, with a 90% lower recruitment take up being seen from this area of the workforce, creating vacancies that cannot currently be filled. The issue of data sharing is a key one for resolution in the negotiations, although it seems that we are perhaps more rigid in in applying EU requirements than our fellow member states.
So another engaging and interesting event and my thanks once again to Minesh, who it is pleasing to report is feeling more positive about tackling the challenges than before. We must not forget that whatever concerns we have about our NHS it remains in the top 2 providers in the world in terms of quality and value for money and is stuffed full of caring and professional people as are the other support services providing care.
Our next Big Breakfast event at The Hub is on February 10th 2018! No speaker has yet been booked, in fact I am asking for somebody else to step up and lead this community service for the next season to ensure the widest spread of interests and topics can be dealt with. If that is you, then please let me know via the Parish Office. I am keen to ensure continuity and wider engagement, please be assured that the organisational side of things and the catering are already well established but fronting and speaker provision might well benefit from a fresh perspective.
My thanks to Julia for a great meal and to the whole team who set up, serve and clear up. A Happy Christmas and New Year to you all.