In an exclusive story, the Health Service Journal (HSJ) says the government has found another £150 million to help ease this winter’s pressures on hospitals.
It is now clear the government is petrified that the NHS may face unsustainable pressures in the coming months – especially in already over-busy A&E departments.
The HSJ says this new money will be announced within days. It will be on top of the £250 million already allocated and will go to help hospital trusts which, like the Great Western Hospitals Foundation Trust (GWH), got nothing from the original £250 million fund.
GWH applied with the Swindon Clinical Commissioning Group (CCG) for a share of the first £250 million. That money went to 53 CCG’s to support their local acute hospitals – the average amount was £4,170,000.
The money was allotted to trusts that had not coped well last winter or that are considered to be in such financial straits that they would not cope this winter. Some said the money was a reward for failure.
GWH got none of that £250 million and has been putting into place its winter planning using its own funds and financial assistance from CCGs.
During last winter GWH saw a ten per cent increase in people coming into its A&E department as well as a 6.7 per cent rise in emergency admissions. This winter’s pressures are already being felt at GWH’s A&E department.
GWH’s bid for extra funding included extra spending on community health services, on end of life care, increased staffing in A&E and support for the timely discharge of patients.
As MNO has reported GWH have already recruited more nurses and midwives and a full re-design of their A&E department will be completed before Christmas.
Working with Wiltshire and Swindon CCGs, GWH have already put in place a number of steps to alleviate this winter’s pressures on staff and facilities.
They have invested £3.2 million in extra medical beds and doctors. And have employed three extra emergency medicine consultants – bringing the total up to nine consultants. And they continue to recruit more nurses.
Wiltshire’s community health services – run by GWH – now have Care Coordinators in each locality to help patients live well at home for longer and reduce unnecessary and unwelcome stays in hospital.
GWH have also launched an incentive scheme for nursing staff, midwives and health professionals like physios. This will enable staff to earn extra pay for working extra shifts – reducing the use of agency staff who may not be familiar with the hospital or with patients.
A GWH spokesman explained: “Paying staff in this way is better value for money for the taxpayer as it’s more cost effective than using agency staff. Our staff work incredibly hard 24/7, 365 days a year, often in challenging circumstances and this is an extra thank you to those who are willing to help out at our busiest times.”
It’s not just the number of people arriving at the front door services like A&E that cause problems. It’s also pressures at hospitals’ back doors: patients who cannot be allowed leave hospital wards once their treatment is complete because they have nowhere appropriate to go.
These are called ‘Delayed Transfers of Care’ or DTOCs and they cost CCGs a great deal of money. They used to be called ‘bed blockers’ - as though it was the patient’s fault.
Reducing the time patients wait to leave hospital involves close coordination with local authorities’ social care services who have to ensure patients – often the frail and elderly – go to an appropriate nursing home or rehab ward or can be cared for safely in their own home.
Oxfordshire CCG, which has had one of the worst DTOCs record in the country, has allotted more than a fifth of its £10 million extra winter funding to Oxfordshire Council to help reduce its costly level of DTOCs.
It is worth noting that Oxfordshire CCG identified 23 temporary schemes to alleviate winter pressures at their hospitals. Some of these are to last six months.
Oxfordshire CCG aims to recruit skilled staff to fill more than 50 new full-time roles to work over the winter period – as well as an unspecified number of other extra nursing staff. Whether they will be able to recruit this number in time and within budget will doubtless feature on their risk register.
But the scale and cost of winter measures in Oxfordshire, underlines the seriousness with which the NHS is facing the approaching cold weather.
GWH’s A&E or as they call it ED for Emergency Department: Some days ago we published a story headlined “Twelve patients a day had to wait on A&E trolleys in great western hospital probe reveals.”
This was a report of story first published in the Daily Mail. MNO understands that GWH’s Freedom of Information response stated that “up to twelve patients” in a day had been waiting on trolleys in a corridor.
This, by some sleight of hand, was changed in the published story to read “12 patients a day have to wait on trolleys in corridors in A&E” – clearly implying it happened every day.
Having looked back at the wording of their FOI response, GWH have now issued another statement:
“The number of patients treated in ED can change greatly from one day to the next. We have never shut our doors and always do everything we can to treat and care for our patients using the space and resources we have at the time.”
“There are occasions when we have been extremely busy, this means we have asked patients to wait on a temporary trolley until a suitable bed is available. Any patient waiting on a trolley will have been assessed and will have a dedicated nurse caring for them and observing them until they are moved to a ward.”
Podiatrist Emma Ansell giving Karen Shields a Med-pedA Marlborough physiotherapy practice is offering an exclusive Hollywood-style treatment for something that is walked all over every day – feet.
Clients from as far away as Bath and Gloucestershire are already coming to the Hughenden Yard practice for this new exclusive treatment, which has previously only been available in London.
Podiatrists – the new name for chiropodists – and salons usually concentrate on one thing: either foot health or foot beauty.
Now, James Hatt & Associates has combined both approaches in its new glamorous med-ped treatment.
The Medical Pedicure is given by a highly trained and qualified podiatrist. It involves a comprehensive health check and treatment of the feet followed by a pedicure.
But this goes even further than feet feeling and looking great. Many musculoskeletal problems, such as with knee joints and backs, can be caused by feet, and the early warning signs of some illnesses - such as the increasingly common diabetes and the number one cause of death, blocked arteries - can be spotted through foot examinations.
“Feet are important to health, so we thought: why not make it a luxurious experience? We want to encourage younger women in particular to have their feet pampered and their health checked at the same time,” said practice director, Amanda Hatt.
“We also didn't want to send clients away to a salon for the finishing touches of a pedicure, and perhaps not having such a good service as they would with our podiatrist.”
Karen Shields receiving her Med-ped from Emma AnsellIn the hour long appointment, the med-ped offers a diabetic, neurological and vascular screening; a foot bath, foot scrub and foot mask; gets rid of the dreaded cracked heels in one treatment – with, unlike salons, the added hygiene security of medically sterile equipment – and nails cut and painted.
And feet are left looking like they belong on a movie star.
To offer this treatment, James Hatt refuses the bread and butter of most podiatrists, the fifteen minute toenail-cutting service.
“We would be doing our clients a disservice with such a short treatment. It's better to offer a proper, rounded consultation.” Amanda adds: “It may not the quickest way to way to grow this new part of the business, but it's the best way for our clients.”
Regular client Karen Shields, from Pewsey, pictured receiving a med-ped from Heath and Care Professions Council registered podiatrist Emma Ansell. “I came in for knee problems, and I've had physio, massage and podiatry.
“This time I've tried the med-ped. I love Emma's approach with a comprehensive overview of the problem. It's a long term solution rather than a quick fix.”
For more information visit www.jameshattphysio.co.uk or ring 01380 730473.
Reader offer: get a Hollywood-style med-ped treatment with James Hatt Associates. Pay for a podiatry treatment (£45)and upgrade to med-ped (normally £65) free of charge only with the coupon on this week’s Marlborough News Online newsletter. Not currently a newsletter recipient? Sign up for free today!
Christine Gale It was the first demonstration that Christine Gale had ever been on. On the last Saturday of September when the Tories were assembling in Manchester, she – with her partner Guy – and about 49,998 other activists marched to protest against cuts and in favour of protecting the NHS from the coalition government.
There were several other protestors there from Wiltshire and the Devizes constituency.
Saving the NHS has become Christine’s mission in life. Disarmingly she says: “I’m just an NHS user.”
She and Guy live in Castle Combe. Both are retired and Guy brings to her campaign a career’s worth of experience in design and typography.
Christine is no ordinary protestor. She has always been a ‘political person’ and a life-long Conservative voter.
Her grandfather was a traditional hardworking Tory who stoked boilers. Her father was a very successful self-made businessman who was a tremendous admirer of Prime Minister Thatcher.
Looking ahead to 2015, she told Marlborough News Online: “I’m going to vote for the party that reinstates the NHS as a public service.”
She was cheered to hear Labour’s Andy Burnham say at the Manchester rally that they would repeal the Health and Social Care Act that’s the basis of the current £3 billion reorganisation of the NHS. But before Labour gets her vote she wants to see that promise in their manifesto.
Christine & Guy ready for the Manchester protest marchShe believes that it is a waste of time campaigning on small, local issues, and that defenders of the NHS should concentrate on campaigning nationally: “What we can do is to say to MPs ‘In the next election we won’t vote for you unless you protect the NHS’.”
By protecting the NHS she means keeping it as a National service rather than a ‘notional’ service; keeping it public and out of the hands of private providers or profiteers; and stopping the Americanisation of the NHS.
Christine finds it ‘really scary’ that the forthcoming trade deal with the USA (watch out for its full name –Transatlantic Trade and Investment Partnership or TTIP) will leave the NHS open to almost mandatory privatisation by big American corporations.
Under this agreement the NHS would never again be able to be the ‘preferred provider’ of health services so campaigners are demanding the NHS is exempted from the TTIP.
She has mixed feelings about doctors and the part doctors have been given in commissioning NHS services: “Doctors should be making people well and efficient and accountable managers should be running everything else.”
Why did Christine take on the role of defender of the NHS? After her parents had a bad accident, she saw how the private sector could not cope but the NHS gave them ‘fantastic care’.
Later, when two other family members had cancer she saw again the worst of private care – but also great NHS treatment and some very poor NHS care leading to a case of MRSA and terrible bed sores. She knew then that the NHS must be protected and improved.
She did not believe the current government’s reorganisation and its firm belief in privatisation was the way to do it.A banner that caught Christine's eye: 'NHS is for people not for profit'
“When I started campaigning, I found it very difficult to get people interested enough to run local groups.” So she took her campaign out and about – and onto the internet.
She and Guy spent two days at the music festival at Little Somerford – going to a music festival was another first for them both. They handed out 1,500 of Christine’s wallet-sized protest cards and she was asked to give several short talks from the platform about the threats to the NHS.
She joined 38 Degrees activists for the Wiltshire petition against privatisation that was delivered to the new Clinical Commissioning Group at its Devizes headquarters in April. And she was appalled when she heard a politician dismiss 38 Degrees as people making vulnerable people anxious.
As someone who missed out on further education, she has surprised herself by making speeches at events. She once introduced herself as a “Wiltshire bumpkin” and had the audience enthralled by her passionate defence of the NHS.
Now she has taken to the internet and become part of the very busy network of campaigners aiming to keep the NHS strong, free and un-privatised. She started with a Yahoo group site but now has a website of her own which carries lots of evidence of what is going on behind the daily headlines.
She is in touch with NHS Action who want to put up NHS candidates in the 2015 general election – though Christine is not quite sure about single issue MPs - and with the KONP (Keep our NHS Public) campaign.
She certainly got fresh impetus for her campaigning from the Manchester march and was especially enthused by the ‘passionate speech’ by the TUC General Secretary, Frances O’Grady.
But she was utterly appalled to find barely any mention in the newspapers or on the BBC of the Manchester demonstration – the biggest the north-west of England has ever seen. “Even in what we call a democracy it seems it’s becoming harder and harder to get heard.”