NHS 70 and Health in High Peak –

Question Time

Glossopdale School, Glossop Thursday 5 July 2018

Speakers:

Ruth George MP (Chair)

Elaine Richardson, Head of Delivery and Assurance, Tameside and Glossop CCG

Dr Alan Dow, Chair of NHS Tameside and Glossop CCG

Val Cochrane, Community Specialist Paramedic, North West Ambulance Service

Peter Logan, Trustee, The Bureau (Glossop’s Voluntary & Community Network)

Dr Henry Ticehurst, Medical Director, Pennine Care NHS Foundation Trust

Dr Guy Wilkinson, GP at Manor House Medical Centre

Introductory Remarks

Ruth George MP

  • Happy birthday NHS; a service that evolves, changes and moves forward
  • Many thanks to everyone who has attended tonight.
  • We will do our best to answer the questions you raise tonight and if not will do some research and get back to you afterwards.
  • Glossop can feel out on a limb and has a different NHS experience from that in the south of the constituency.
  • The Shire Hill consultation has run its course so we move on to consider the future of the site.
  • The County Council is undertaking an assessment of needs and will consider Sir John Oldham’s proposals.
  • There will be a need to involve NHS Properties and the Borough Council.

Elaine Richardson

  • The CCG is working on joining up services; whole person care.
  • Looking at creative use of facilities.
  • Takes a consultative approach

Alan Dow

  • Paid tribute to Ruth for organising the event on the NHS 70th birthday
  • Gamesley is 50 years old this year; services were designed to meet community needs but the medical model is no longer good enough.
  • Need to consider the wider context of public health
  • Current CCG budget is £490 million.

Peter Logan

  • The Bureau is involved as there are wider determinants for health arising from civic society.
  • Services include community navigation, drop-in groups, and hospital arts.
  • Need to work with chaotic lifestyles
  • Two economies contribute: NHS and local authority
  • Needs to be good relationships with partners
  • The strength of the third sector is as strong as the people in the room

Henry Ticehurst

  • Pennine Care provides mental health service across six boroughs and Greater Manchester.
  • Issues include the waiting list for services and staffing problems
  • Recently a patient had to be sectioned to a bed in Bristol
  • Opportunities include building community resilience, co-production of provision, increased psychological literacy.
  • Mental health is fundamental and not an add-on.
  • Sanctuary as an alternative to admission?
  • More emphasis on prevention.

Val Cochrane

  • Has worked for NWAS (formerly GMAS) for over twenty years.
  • Returned as a community specialist paramedic which is a new role; in post for three years.
  • Involves integrated working; working with GPs, nurses, The Bureau etc.
  • Education and prevention work.
  • A&E is not always the answer.

Guy Wilkinson

  • GP at Manor House as well as a neighbourhood director and director of a GP federation providing out of hours services.
  • Recalled arriving in the area for the NHS 50th anniversary painting competition of which many entries featured Calpol.
  • Many changes in the last twenty years; computerisation; increased reach of General Practice to include services that had previously been provided by hospitals.
  • In 2004 GP was 9.6% of the NHS budget; now is 7.4%.
  • At a junction in NHS development; innovation is the answer.

Ruth George

  • Encourage people to complete the surveys placed on chairs
  • Thanked the speakers and invited questions from the audience.

Questions, comments and answers

Derbyshire County Council services (Colin Bannister)

  • DCC are proposing to cut funding for Healthwatch Derbyshire and Mental Health Together in Glossop.
  • Henry Ticehurstservices need to be shaped from the bottom up, for example Men in Sheds, so there is a need for a forum to influence the design of provision.

Experience of working in the NHS as a cadet nurse (Bob McKeown)

  • At Ancoats Hospital, the watchwords were care, compassion and comfort.
  • Matron took him to donate blood on his 18th

A walk-in centre for Glossop (Mrs Glover)

  • Had to take her nephew to Ashton, costing £30 by taxi and proposed that there should be a facility at George Street.
  • Elaine Richardson – no immediate plans for a walk-in centre in Glossop but people do want a quick response with a mix of improved Appointment access, 111, 999, A&E and walk-in services. The aim is to improve same-day appointments with a triage system helping to ensure people receive the most appropriate care first time. GP services are open 8 am to 6.30 pm on weekdays with appointments also bookable through the GP at George Street, 6.30 am to 8 pm weekdays and 9 am to 12 noon Saturday and Sunday. The GP has with access to medical records. Walk in services are available 8 am to 8 pm seven days a week at Ashton Primary Care Centre.

 111 service (Rees Jordan/Glover)

  • Took an hour and a half to get through to 111 and then waited a further two and a half hours for a return call which he ended up cancelling.
  • Val Cochrane – work is ongoing to improve the 111 service but when pain is severe, breathing difficult or there has been a fall from height, or similar, call 999. An ambulance at the door does not always mean a trip to hospital.

Ageing population (Simon Belt)

  • Are there social solutions other than care-homes or retirement villages?
  • Peter Logan – the ageing population is partly due to the success of the NHS but families are dispersed so there is a need to re-invent social support mechanisms. The Bureau does 1:1 consultation, signposts and does introductions as well as working out how needs/interests can be supported; example of rapid growth in walking football.

Services working together (Linda Walker)

  • The Government pays lip service; increased funding has been promised for the NHS but not for social care. How long can the NHS survive without the election of a Labour government? 
  • Alan Dow – health and social care services are working together; in Greater Manchester there are ten CCGs and many borough councils. Tameside and Glossop is considered to be the most advanced integrated service. In comparison with the health, social care is cheaper to fund and would save NHS resources; hospital beds are expensive and often occupied by people who should not have ended up there. The shortage of GPs is not easing. The most trouble arises from not enough proactive/preventative measures in place. Primary care sees seven times more people than A&E. Devolution Greater Manchester is a potential opportunity.

 

Why Glossop with Tameside? (Sheila Yamin)

  • Why was this form of organisation chosen rather than Glossop linking with Derbyshire services?
  • Guy Wilkinson – when CCGs were being set up the local GP view was that Tameside and Glossop was the better option.

Mental health and young people (Anne Slater)

  • There are real problems accessing mental health services/CAMS for young people and this leads to severe problems later in life.
  • Henry Ticehurst – the direction of travel is upstream so that mental health issues are dealt with earlier via CAMHS. The emphasis should be on needs ahead of diagnosis.

 The grief of losing Shire Hill (Helen/Ellen)

  • The population is large in relation to local services available; we need new services in place rapidly but what about the interim? 
  • Elaine Richardson – there are new beds in place and intermediate care established. Services for ENT and adult hearing have been brought to Glossop and there are other examples that show that where quality and cost effectiveness allow providers are asked to ensure access in Glossop. There is a need to identify areas of flat/even land to bring in mobile units as that can improve cost effectiveness when more specialist equipment is required.

Older people don’t want to live in a ghetto 

  • Multi-generational communities are better all round; people need hobbies.

Glossopdale Patient Neighbourhood Forum (Lesley Surman)

  • The third sector needs funding to be effective. The group has ideas for the Shire Hill site but what about consultation?
  • Peter Logan – Care Together is based in the third sector but needs to be properly funded; there are problems with commissioning services rather than funding them.

Neonatal service (Ed Kelly)

  • Local (neonatal) services are great; thank you.

A national service 

  • What about economies of scale by reducing localised administration with the associated indirect costs?
  • Alan Dow – local units tend to be more responsive to local need so there is a need to balance that with the potential for economies of scale that a uniform service might provide.

Minor injury unit 

  • There needs to be a minor injury unit at Shire Hill.
  • Parking at George Street is a problem. 
  • Alan Dow – at least Glossop does have a primary care centre unlike Hyde, for instance.

 

Presentation

  • Ruth presented Alison Bowry, from High Peak Community Arts, with a certificate in recognition of their contribution to community mental health as part of the NHS 70 awards and celebration.

 

Concluding remarks from Ruth George

  • Many thanks to speakers and all who have attended tonight.
  • Please sign the NHS 70 card and complete the survey.