We meet Nerissa Vaughan as Great Western Hospital makes some good news

Written by Tony Millett.

Last week was a good week for Great Western Hospital: it did not get caught in the headlines over increased waiting times for elective surgery, or in those lurid headlines about patients being sent home at night – and then it scored a first with a new heart operation.

GWH has checked its records and found that a tiny proportion of those discharged from its wards do so between eleven at night and six in the morning – about three per cent.  And the great majority of those are pregnant women who come in but find it’s a false alarm or new mothers keen to get their babies home as soon as possible.

Patients are only discharged if they want to be, are fit to be and if support is in place at home.  One patient looking forward to going home was 76-year-old Derek Wakefield who lives near Malmesbury and has just had a pioneering operation to insert the country’s first ever defibrillator implant that is safe under an MRI scan. A patient with one of the normal defibrillators, which are inserted to prevent cardiac arrest, cannot have an MRI scan because the instrument reacts badly and can seriously damage the heart.

When Marlborough News Online met GWH’s chief executive, Nerissa Vaughan (pictured right), she was keen to point out that the hospital had recently been in the Secretary of State for Health, Andrew Lansley’s list of the top ten hospitals for keeping waiting times for elective surgery within the eighteen week target.  And the average wait was lower in 2011 than in 2010.

Nerissa Vaughan has only been chief executive at GWH (officially Great Western Hospitals NHS Foundation Trust) since last October.  She came from King’s Lynn hospital which was her first appointment as chief executive.  She joined the NHS in 1991.

She is openly bullish about the process of change that is affecting all parts of the NHS: “The NHS is going through a lot of structural change – but it’s remarkably good at coping with structural change – because it has so much experience of it.” 

What does she think about the new Clinical Commissioning Groups (CCGs) led by GPs that will be taking over from the Primary Care Trusts in April 2013?   “What I think is good is that GPs are already opening up direct dialogue with our consultants in a way that they wouldn’t have done without CCGs.  In the past they talked about individual patients, now they are beginning to decide how services are planned and finding new pathways.”

And the bad things about the changes? “Reorganisation inevitably means disruption – but it’ll be resolved over time.”  She admits the Wiltshire GPs have been a slower than most in getting themselves setup: “But they’ve done a lot of in depth thinking about what works for Wiltshire.”

One of Nerissa Vaughan’s priorities is the county’s community health services which GWH took over in June last year after the Primary Care Trust was forced by the government to give up providing services as well as commissioning them.  “There are things we can do to improve community services – like embedding better technology in people’s homes.”

These services will be part of GWH’s changing workload due to the aging population: already the average age of patients in their general medical wards hovers around the late 70s: “We’ve got to find better ways to meet the needs of the elderly – this will mean redesigning care to help more of them to live at home.”

Ms Vaughan sits on Wiltshire’s shadow Health and Wellbeing Board which under the new Health and Social Care Act will, from April 2013, bring councillors onto the commissioning stage.  She believes these Boards could turn out to be the best thing in the current NHS reforms: “If they work effectively, they’ll bring agencies together and provide a democratic link.” She’s not worried by any political input the Boards may bring to the NHS.

Finally, what about the future of Savernake Hospital?  GWH are using more beds at the hospital for recuperation, for patients on their way from surgical wards to their homes. They have just announced an increase in these beds at Savernake to thirty-four.

“The direction of travel will mean moving care away from hospital’s and into communities – where it’s appropriate to do so.”  But she’s also certain that this will not endanger GWH’s income stream from services provided on the hospital site.

To round off GWH’s week, the now spritely sounding Mr Wakefield was interviewed on BBC Radio Wiltshire about his new-style defibrillator implant: “I can’t praise the gentleman that put this in and all his staff enough…It’s been absolutely fantastic…If you’re frightened to come into hospital, don’t be frightened to come to the Great Western.”

Bruce Laurie, who chairs the Great Western Hospitals NHS Foundation Trust, will be speaking at the annual general meeting of the Friends of Savernake Hospital on May 16 at 7pm in Marlborough Town Hall.