News from Cumbria Action for Health

The latest news, brought to you by Jozi Brown, Senior Engagement Officer at Cumbria CVS

Annual Compact Conference
Thursday 6 November 2014
Newton Rigg, Penrith CA11 OAH
9.30am – 1pm followed by networking lunch
Join us at this Annual conference and learn more about the (Cumbria) Compact; how it is used in practice and explore how we can use it to benefit our organisations and partnerships. The morning will include a range of presentations, workshops and a Talking Wall and will be followed by a networking lunch. It is Free and open to public sector and third sector delegates.

Complete and return a booking form to Cumbria CVS, 6 Hobson Court, Gillan Way, Penrith CA11 9GQ. Email: info@cumbriacvs.org.uk or call 01768 800350.
Please pass this invite on to your colleagues too.

Cumbria County Councils Cabinet have agreed and launched the Councils Public Budget Consultation ‘Securing our Future’.
This document highlights the challenge ahead and also indicates that over next three year the council is likely to lose a further 1,800 jobs as we intensify our efforts to save £83 million in an effort to balance our books by 2018. Most of the savings affect the way the council is organised, but some will affect services directly – so the council is keen to hear everyone’s views. In the consultation they are also seeking everyone’s opinion on a 2% rise in the county council’s share of council tax.

Changes affecting services and external organisations include: reforms in the way health and social care services are delivered so there’s a greater focus on independent living and a tighter remit on commissioning; cuts in grants to partner organisations including the Lake District National Park and Cumbria Tourism; and reductions in funding for recycling. The council is also proposing to save money in the long run with extra investment in the road network and increasing tourism spend in the county by supporting key activities like the Tour of Britain.

More than three-quarters (79%) of next year’s proposed savings are ‘internal’ ones to be delivered within the four walls of the organisation. This will involve changes to the way the council manages its money and works with partners or contractors to deliver services.

The consultation document also explores the potential savings that could be made from having one or two unitary councils in Cumbria. This work indicates that one unitary council could achieve between £22 million and £27 million of savings across county council and district council budgets. Having two unitary councils could achieve savings of between £13 million and £16 million. This work is based on 2013/14 data.

This would help ease the financial strain and protect some services, but our consultation document makes it very clear that this is not the council’s decision to make.

The county council is very keen to hear as many views as possible on the difficult road ahead so that councillors can make informed choices when they agree the Budget in February 2015 and we would appreciate your help in getting as many people as possible to respond to our consultation. Therefore we would be grateful if you could forward the link to our budget consultation on to as many of your contacts, partners and other organisations as possible.

All of the savings proposals, issues of discussion and further background on the scale of the challenge are available www.cumbria.gov.uk/budgetconsultation and the consultation document is also being circulated through libraries and council offices. The consultation, which is now open, will run until 20 January.

Project to improve access to GP services launched in West Cumbria – funded by Prime Minister’s Challenge Fund
The five GP practices in Workington who received £511,000 from the Prime Minister’s Challenge Fund to provide 8am-8pm, seven-day-a-week GP services in the town, are set to launch the service this month.

Working together with support from NHS Cumbria Clinical Commissioning Group (CCG) and Cumbria Partnership NHS Foundation Trust (CPFT), the Workington doctors made the application to create a Primary Care Access Centre within Workington Community Hospital. From 14 October 2014, those registered with the Workington practices wishing to arrange an urgent same day appointment should contact their GP surgery as they do now. The appointment may not be with their usual doctor but they will be able to see a local GP who has access to their medical records. The service is currently available Monday – Friday 8am-8pm. Appointments for Saturdays and Sundays will commence in November.

The GPs from Beechwood, Orchard House, James Street, Solway Health Services and Oxford Street practices believe the new way of working will avoid unnecessary A&E attendances, hospital admissions and ambulance journeys. The Workington project aims to redesign and modernise health services to provide more sustainable and higher quality care.

NHS Cumbria CCG’s Lead GP for Allerdale, Dr Niall McGreevy said: “This is great news for patients in Workington. The five GP practices who serve 33,900 people in Workington and surrounding villages have worked closely together to develop this new way of working to improve access to GP services for patients. “Each practice has contributed to the development which will see a new Primary Care Access centre open seven days a week, from 8am until 8pm at Workington Community Hospital.

“The centre will offer same-day urgent appointments and minor injuries care. In parallel with this, we will be implementing new ways of improving the care of people with long term conditions and working closely with Cumbria Partnership NHS Foundation Trust to integrate community and primary care. This will create Cumbria’s first Primary Care Community, which we hope will act as a blueprint for the development of this kind of care across Cumbria. “This funding has enabled us to work towards a ‘one team’ approach to care for our patients.”

The Workington project is one of twenty pilots across England to benefit from the Challenge Fund which will test new ways of improving access to general practice and innovative approaches to providing primary care services. Leaflets explaining more about the service will be available at all the GP practices.

Richard Parry to leave Cumbria County Council for top Kirklees post
Richard Parry, Corporate Director for Health and Care Services, is to leave Cumbria County Council in January next year. He will take up the post of Director for Commissioning, Public Health and Adult Social Care at Kirklees Council.

Council Leader Stewart Young praised Richard, saying: “Richard has made a massive contribution to Cumbria in the eight years he has been with us. He has helped to forge both a closer working relationship with health and the integration of services delivering many benefits to local people.” Councillor Young added: “Richard has helped to move Cumbria on in what have been some of our most difficult years. He has overseen big changes across social care especially in people maintaining independence and being cared for in their own homes. I am confident that we have been able to create better services for vulnerable people in Cumbria as result of Richard’s excellent leadership and uncompromising dedication.”

Chief Executive Diane Wood added: “Whilst we will be sad to lose Richard, we understand his need to locate closer to his family and I am really grateful for all his hard work and dedication to Cumbria.
“It is testimony to his intellectual and managerial strength that he has developed his staff. I know that he will be working with his team in the coming months to ensure that there will be no change in the quality of the directorate’s work. In the meantime, we will begin our search for his successor.”

Richard Parry said: “It has been an enormous privilege to work with Cumbria County Council. I have worked with many outstandingly talented members and officers. It will be a wrench to leave but I am confident that we have the strength and depth in our directorate that will ensure our good work continues, in spite of the financial challenges ahead.”
Richard Parry joined Cumbria County Council in 2006

People in Control Conference
If you were unable to attend the ‘People in Control’ conference held in Penrith on the 6 and 7 October – you can view the collated information from the conference, plus the recorded streaming online through the CLIC Website http://www.theclic.org.uk/clic/events

South Lakeland Mind – HELP crisis fundraising campaign – what people can do
As things are today South Lakeland Mind will begin the process of closure in early December, in the run-up to Christmas (about 6–8 weeks away). It would be a desperately sad moment, the charity having been there for people in South Lakeland for more than 30 years. Jonathan Ingram, Chief Officer, said ‘It was good at our public meeting this week to be able to explain about the charity’s very difficult situation, but more importantly we had lots of positive suggestions about what to do. Now we have to make sure that those suggestions reach as many people as possible. We just can’t do this alone, we need people to step up and take action. ‘The thought that the community could so easily sleepwalk into the closure of such an important local organisation, supporting so many vulnerable people, is deeply worrying.’

North Cumbria outlines thinking on future clinical options
North Cumbria University Hospitals NHS Trust has today outlined its early thinking and an initial ‘clinical options appraisal’ to help ensure the delivery of safe and sustainable services, delivered by a permanent workforce, across its hospitals in Carlisle and Whitehaven.

Following a special meeting of the Trust Board held on Tuesday 21 October, the ‘clinical options appraisal’, which is the result of extensive work since early 2014 with senior clinicians, will now be used to support further widespread clinical engagement with frontline teams, partners, patients and the public at large.

As part of wider plans to improve health and care services right across north Cumbria and in line with the ‘Together for a Healthier Future’ programme*, the Trust’s clinical options appraisal is focused on core clinical areas where significant challenges remain which simply must be addressed in order to help the Trust emerge from special measures. These include:

– Acute care for high risk medical patients
– Obstetrics in particular anaesthetics
– Paediatrics
– Planned care and outpatients

After detailed work with the Trust’s senior clinicians and in partnership with NHS Cumbria Clinical Commissioning Group (CCG) and the North Cumbria Programme Board*, the Trust has now detailed its early thinking on the potential future solutions to the problems it faces. To be clear, however, the vast majority of patients would continue to receive their care locally with the aim to provide even more care closer to people’s homes.

To address its particular challenges, the Trust has outlined its clinically preferred way forward (please see accompanying briefing document), based on the current evidence available and subject to further discussion, as follows:

For acute medical care, the transfer of a very small number of emergency high risk medical patients from West Cumberland Hospital to the Cumberland Infirmary in order to improve clinical outcomes. Over 8,500 lower risk medical patients would continue to be admitted and treated in Whitehaven.

For paediatric care, the creation of a 24 hour short stay paediatric assessment unit at West Cumberland Hospital supported by 24 hour consultant paediatrician access and low acuity beds, with a full inpatient unit at the Cumberland Infirmary working as part of a system-wide child health network. Over 80% of children would still receive their care locally in Whitehaven.

For maternity, although the Trust has discussed potential future solutions, particularly to help address critical safety issues with regard to anaesthetic cover, no preferred option is stated and all potential solutions are fully dependent on the outcome of the independent maternity review being led by NHS Cumbria CCG.

For planned care and outpatients, widespread positive work is already underway to enable more planned care to be delivered at the new West Cumberland Hospital, which will in turn help the Trust meet national waiting standards moving forward. This includes plans to bring back over 4000 outpatient appointments to West Cumbria.

These potential solutions will now be discussed widely with all stakeholders before the Trust makes its final recommendation to NHS Cumbria CCG. It is at this point that the CCG, as local leaders of the NHS, would carry out any formal public consultation, if required.

Dr Jeremy Rushmer, medical director at North Cumbria University Hospitals NHS Trust said:

“We have now reached a critical milestone in the Trust’s improvement journey and welcome an open and transparent dialogue with all of our stakeholders about the challenges we face and the potential options available to us.

“As our staff, patients and the public would expect, we simply cannot ignore concerns which have been raised to us by our regulators in relation to clinical standards and expectations and we now must work together to tackle these issues once and for all.

“Change, by its very nature is always difficult and we recognise the challenge this brings particularly for our staff who continue to put their patients first and respond fantastically well embracing the challenges faced on a daily basis. We also recognise concerns raised by the local communities, particularly those in West Cumbria and we are committed to engaging with people fully over the coming weeks and months.

“To be clear, our ambition for North Cumbria is to deliver the safest and highest possible quality of care for the communities we serve and to make our hospitals as good as, if not better, than the best in the NHS. We are already making great strides towards this but there is still a long way to go and further change is vital if we are to succeed.”

Many positive improvements have taken place over the past 18 months, most notably the reduction in Trust’s mortality rate with less people now dying in North Cumbria’s hospitals and more people surviving serious injury or illness and living longer. In addition, staff should be rightly proud of the fantastic achievement of a ‘good’ caring rating for all services and departments from the Care Quality Commission in July 2014 following a visit from the Chief Inspector of Hospitals.

Despite this however, the Trust is acutely aware that the way some services are currently delivered (acute medicine, maternity and paediatrics) is still not as good as it should be, or to the standards expected of the professional bodies and Royal Colleges of nurses, midwives and doctors.

Of particular concern is the extreme fragility of the acute medicine service at West Cumberland Hospital which is largely staffed by locums and rated as inadequate under the safety domain by the Chief Inspector of Hospitals, preventing the Trust from coming out of special measures. This situation requires active and exceptional day-to-day oversight to ensure safe care.

Dr Jeremy Rushmer added: “Our most critical issue is acute medicine at West Cumberland Hospital and the fragility of this service should not be underestimated. The potential solution we have outlined to transfer certain patients to Carlisle, will not only will help us provide a sustainable model of care that is robust in the long term, this will also help us attract aspiring candidates, working as part of wider clinical teams, to West Cumbria so that we can stabilise the local workforce.”

Over the coming weeks and months the Trust will engage in detail with all clinical teams across the organisation, as well as with all key partners and has also commissioned independent public engagement regarding the potential solutions outlined. More details about this will be shared in due course.

Care Quality Commission ‘State of Care’ Report
Their fifth annual State of Care report shows there are many excellent services but the variation in quality in England is unacceptably wide. They have identified several key areas where action is needed – the public should be at the heart of good care, providers should accept where there are problems and use our inspections to drive up quality, the wider health and care system needs to work together and help to put things right when services need to improve. To view the report http://www.cqc.org.uk/content/what%E2%80%99s-state-care-england

Jozi Brown
Senior Engagement Officer
Cumbria CVS
01768 800350
jozib@cumbriacvs.org.uk