Sunday, 11 December 2016

Access to high quality care - the Second Priority

The second priority area for the Clinical Commissioning Groups is:

"Access to the highest quality Primary, Community and Urgent Care".

They explain this in their words as:

"Create robust out of hospital services operating from community hubs and coordinated by GPs to maintain independence of elderly and frail patients in their own homes"

What do I think it means:

They do not want so many elderly and frail people in expensive hospital beds. They want to improve the care and support that people receive in the community. There is a widely held opinion that people want 'care closer to their homes' and this is their way of providing that care.

During 2016 there were a number of engagement events run by Buckinghamshire Healthcare NHS Trust called 'Your Community Your Care' where they asked our opinion on what sort of services could be provided outside the hospital. The Trust provides community services as well as acute services.

The different groups of people from different areas of Buckinghamshire provided different thoughts on what they wanted. Most of us thought it was a good idea and should include a wide range of services either based on a building or as a virtual service.

But at the moment there is no clear description of what a community hub would be like, or who would provide it and who would run it.

For a few years before 1999 GPs offered a wide range of services from their surgeries but that came to an end when yet another of the redisorganisations of the NHS took place. District Nurses, Health Visitors, Midwives and other care workers were based around GP surgeries. Now they form teams and don't have the links they used to have with the GP surgeries.  So recreating those teams with lots of different care staff all talking to each other and working together sounds like a good idea.

There are already community hospitals in some parts of the county but not in the big population centres such as Aylesbury and High Wycombe. Will the CCGs be able to fund a base or will the community hub just be a virtual group in the big towns?

Will the Trust be able to employ the right staff given the problems of recruiting healthcare staff in Buckinghamshire. The salaries are higher in London!

This idea could work but it assumes that the GPs are willing to take on the extra role of coordinating the care?

There should also be a big role for the voluntary organisations and charities who already provide a lot of support for the elderly.

The CCGs hope this will reduce the attendance at A&E!  But they have said that many times before and the numbers keep going up.

We need to see the detail of this idea before we can say if it will really achieve the results they want.

Added 21.02.2017

The problem with putting this idea into practice is the need to find the money to set up the new Community Hubs while at the same time keeping the patients in hospital. You cannot stop people going into hospital or transfer them out of hospital until the services are available in the community to look after them.

As I understand it there is no extra funding for Buckinghamshire for this new service

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