The NHS White Paper Opportunities for Shipston-on-Stour

The NHS White Paper & Opportunities for Shipston-on-Stour Dr Andrew Whiteley

Background to White Paper • Spending on NHS • 1948 • 2008 £ 11. 4 bn £ 110. 0 bn (3. 5% GDP) (8. 2% GDP) • 2010 Spending Review stopped year on year increases in expenditure on NHS • Average growth per year since 1975 3. 1% • Growth for 2010/11 0. 5% • Growth per year 2011 -2015 <0. 1%

Background to White Paper • Current Financial Crisis • UK borrowed £ 500 m a day during March • During April slowed a little to nearer £ 350 m a day • Interest payments alone are £ 120 m a day • Ability to reduce borrowing not possible for 1 -2 years even with austerity measures so far announced • ‘Frontline Health Services’ are ‘ring-fenced’ against cuts

Summary of White Paper • Primary Care Trusts (PCT) are responsible for commissioning health provision for their community • From GP surgeries • From Hospitals • From Community Services (often providing by the PCT) • PCTs were felt by some to be • ‘top heavy’ with managers • Lacking clinical input • Ruled by regulations and ‘hoop-jumping’ unrelated to patient care • Held to ransom by Hospitals through the National Tariff

Summary of White Paper • Despite massive investment in the NHS, no great gains in Health Outcomes were seen • Coalition promised a radical rethink along the lines of the ‘Big Society’ • The Main points are…. .

Summary of White Paper • The Abolition of PCTs and SHAs • Handing the Power and Financial Responsibility of Commissioning Healthcare locally to ‘GP Consortia’ • Much closer links between Health and Social Services • Public Health moved from the PCT to County Council • Treating Patients closer to their home and ensuring they see the most appropriate person the first time

Summary of White Paper • Currently, White Paper is ‘paused’ for comments to be gathered and considered • Much opposition from professional and associated bodies • Government has promised to review all options before proceeding • BUT….

Summary of White Paper • The PCTs have reduced staff, merged with each other and appointed Consortia in shadow form • Public Health is moving to County Council • Community Services have been handed over to Warwick Hospital Foundation Trust (including District Nurses and the running of EBH) for the next 3 years • …and many other changes have occurred despite no legislation being passed!

Opportunity for Shipston • Shipston is in a unique position in Warwickshire • Equidistant from nearest hospitals (Warwick and Banbury) • Rural location with poor transport • Population almost totally looked after by Shipston Medical Centre • Achieved maximum Qo. F (quality and outcomes) points each year • Close links with the community (LF, Schools, Sports Centre, Social Services) • Ellen Badger Hospital inpatients cared for by local GPs • • • Minor Injuries unit Day Unit Rehabilitation Admission Prevention Out of Hours Care at weekends and bank holidays Minor Surgery • Fantastic Community Spirit and Support

Opportunity for Shipston • Our Vision is to develop the services locally to provide: • Better local diagnostics • More frequent Xray, Ultrasound, Blood Tests, mobile CT/MRI • Better local assessment • Enhanced / Integrated Nursing Teams • Allowing those with needs to be seen by a nurse with the expertise • Ending the boundaries between GP, Hospital and Community • Acute Medical Assessment Unit to • Offer early assessment and diagnosis of conditions • Treat those conditions that we are able to quickly and efficiently, reducing admissions to hospital and delays in A&E etc

Opportunity for Shipston • Better local assessment • More consultant out-patient clinics locally • Closer working between Consultants and GPs • Joint ward rounds on EBH ward for complicated conditions • Joint home visits for the house bound and in need • Better local treatment • Offer more treatment options locally • Intravenous medication (eg. for infections and rehydration) • Possibility of some chemotherapy and other day case treatments • Return the EBH to a true Community Hospital

Opportunity for Shipston • Better local ‘after care’ • Closer working with Social Care • Home based re-enablement teams • Aiming to maximise independence by reducing dependence • Joint Social/Medical Day Care • Build on existing Physio and OT • Better links with local organisations and charities • Co-ordination of available services to optimise benefits • Better local health and wellbeing for all our residents and from further away

Opportunity for Shipston • The Medical Centre • The practice has outgrown the building • • • (room conversions, No 8 Donnington Road) ‘Hot Desking’ and careful room management Use of upstairs rooms And we want to be able to do more! Parking • Low Furlong • The County Council have announced their intention to close 10 • • residential homes in Warwickshire Low Furlong is the ‘safest’ as no alternative provision locally Close links with the Medical Centre No local Nursing Home facilities Increasing need with ageing population

Opportunity for Shipston • Ellen Badger Hospital • In need of refurbishment and current repairs etc > £ 1 m • Facilities offered by design and layout not in keeping with 21 st Century Healthcare • Limited potential for development • Stricter guidelines for hospitals and previous building extensions • No other local alternative • Great resource, when beds available, to prevent hospital admissions • Though limited treatment options

Opportunity for Shipston • The Opportunity? • A New Health Park featuring: • New Medical Centre • Better facilities; dentist, optician, outpatients, coffee shop, crèche, minor operating suites, potential for more advanced treatments • Use of e-medicine where appropriate • Linked to • New Ellen Badger Hospital • • Acute Assessment Unit Wide range of diagnostics Acute Treatment Beds Rehabilitation Beds Terminal Care Beds Day Treatment Room Linked to…

Opportunity for Shipston • New Day Unit • Joined Medical / Social Teams looking after needs of patients • Physiotherapy and Occupational Therapy integrating with Day Unit and Hospital wards • Linked also to… • New Nursing Home Offering Longer Term Care • Offering local residents the ability to stay in Shipston when their needs mean they can no longer care for themselves • Immediate access to Doctors, Hospital beds, diagnostics, physio etc • Respite care beds available to help local carers have a break • Close to… • New Residential Care Housing • With 24 hour a day help at hand immediate access to all the above • Community Healthcare ‘Hub’ – extending out into the community

Opportunity for Shipston • There is an Opportunity to realise this vision now • The groundwork of the last 8 years has not been in vain • BUT… time is limited due to organisational restructuring • The Local Consortium supports the idea • The PCT (whilst they exist) support the idea • Our local MP and councillors support the idea • But without the total support of the community we serve, it can not move forward • There is little hope of another opportunity in the foreseeable future

What do we need? • Your views • Your ideas • Your shared vision for Shipston on Stour • Your support