By Cllr. Ketan Sheth
The term ‘winter pressures,’ is a phrase we hear regularly at this time of year as hospitals struggle to meet demand. But what does it mean in practice? That’s what my scrutiny committee wanted to find out when we discussed this issue earlier in the year.
It has, for many years, been commonly perceived that winter pressures are the NHS’s problem. But is this really fair given we serve the same communities and the pressure on health and social care are significant?
In response, Brent Council, Brent Clinical Commissioning Group and London North West University Healthcare NHS Trust have teamed up to address the problem in recent years.
It is no small challenge as parts of Brent are among the most deprived places in London, and Northwick Park Hospital is one of the busiest A&E departments in the capital. Early planning and a co-ordinated cross organisational approach have helped us shape a robust winter plan that maintains patient experience, safety and clinical effectiveness during the most demanding period of the year.
This planning began with lessons learnt during the winter of 2017/18, which were subsequently built into our current plan. It boils down to keeping people out of hospital; ensuring patients who are admitted are treated and discharged quickly (and safely); and provision of adequate home support in the community.
Brent CCG responded by giving patients access to GP appointments from 8am-8pm seven days a week via a network of GP hubs. The hubs play a crucial role in curbing the number of people going to A&E with minor ailments. Their use rose by 42% between Oct-Dec 2017 and the same period a year later. The CCG also provided an enhanced service in care homes, a targeted approach to flu vaccinations and developed a closer working relationship between acute and primary care providers.
The Department of Health provided the council with a one-off payment of £1.3M to support hospital discharges. It ‘purchased’ an additional 15 beds, provided reward payments to care homes that could quickly assess and accommodate patients as well as provide an additional handyman service for home adaptations. It also invested in additional social worker, OT and co-ordinator capacity to boost its Home First initiative to get patients home with the minimum of delay.
Ambulance handover times between crews and A&E staff at Northwick Park Hospital has improved and benefited from an additional paramedic/nurse to assist with triage and advanced assessment triage area.
These plans have helped but under pinning it all is the dedication and hard work of staff on the front line.
The reality is that we face a growing population that is living longer and increasingly troubled by a host of long-term conditions. The only way we can manage this, aside from promoting greater personal responsibility for health, is for the public sector and its partners to develop a healthy working relationship, which recognises this is everyone’s problem.
Ketan Sheth is Councillor for Tokyngton Wembley and Chair of Brent Council’s Community and Wellbeing Scrutiny Committee
All views in this blog are those of the author and not INLOGOV or the University of Birmingham.