Gloucestershire LINk held an information event for members on Wednesday 11th, with presentations on some aspects of the government’s proposed changes to the NHS, and a brief discussion about the LINk’s work for the coming year.
The event was well attended by around fifty people. It was held in a room next to a bar, which was noisy. When I went to register I found my name had been crossed out, but despite this ominous sign I came to no harm.
Jan Stubbings, Chief Executive until June of NHS Gloucestershire (the primary care trust, PCT) gave a talk about how the PCT is preparing to hand commissioning over to a GP consortium. Her talk was densely packed with detailed information, impossible to take in.
She described the government’s proposed changes as the:
biggest reforms to the NHS since…1948
I would have thought the introduction of prescription and dentistry charges in 1952 was the biggest reform, but I suppose it depends how you look at it. She moved quickly on without explaining how she looks at it. (By the way, there’s a nice Flash timeline here: NHS history timeline )
She explained that there will be a single GP consortium for Gloucestershire, and that NHS Gloucestershire and NHS Swindon are getting together to form a PCT Cluster which she will be head of. Gloucestershire’s 85 GP practices have all agreed to these plans.
Gloucestershire will be divided into seven localities, which match the six county council districts except that Cotswold will be split North and South.
Although she supports the proposed changes, and the GPs she is working with are also keen, she made various condescending remarks at their expense. They are having to learn how a PCT works, she said, and she wondered how they would make the savings that they will have to make when they are put in charge.
My impression was that she is arranging for the PCT’s existing structures to be transferred in their entirety to new structures, and it is unsurprising that no cost savings can be seen from that perspective. I also felt that there was some suggestion she has been picking and choosing which GPs to work with, to ensure she has support for this approach.
I suspect that as things progress the old PCT way of doing things will come under scrutiny and be found to be too costly. That is, after all, the point of the whole exercise.
There were about half a dozen questions from LINk members.
Several of the questions referred to specific instances of the NHS’s past failings: a carer who felt ignored by NHS staff, GPs who withheld treatment or refused to refer to a specialist, a specialist who didn’t know what to do, and groups in the community whose needs are not understood. She countered with stories of her own about the NHS in Oxfordshire (where she lives), and the ways members of her family have suffered there.
I was disappointed that she was unable to respond more positively. Probably everyone in that room, and I do not exclude myself, has sad stories to tell about the NHS’s past failings. The proposed changes, however, will introduce transparency and local accountability to the NHS as never before, and the people in that room joined the LINk to be part of it. It seemed to me she hadn’t really grasped who her audience were.
Barbara Marshall, who chairs the LINk, gave a presentation about the proposals for local HealthWatch, setting out the structure of boards, roles and relationships within which the new body will operate.
It was unfortunate that her diagram of the wider picture of public involvement showed health and social care not meshing with each other, just touching at a corner:
Progress is being made in Gloucestershire, where the Health and Wellbeing Board is an early implementer, the GP consortium is a pathfinder, and the LINk has applied to be a pathfinder HealthWatch, too. She ended by referring to the pause in the passage of the Health and Social Care Bill, and the Department of Health’s listening exercise (which I have been participating in on the website).
She noted that 62 groups are members of Gloucestershire LINk (though I do not think I have ever seen a list of them), and that HealthWatch would need an even stronger collective voice than that. The LINk’s funding had been cut compared to last year, but only by a little, unlike some other LINks.
I felt her presentation was made from a top down point of view, not particularly tailored for LINk members. It was not clear what members should be doing to help the LINk to make progress with the transition.
There was a brief group discussion to prioritize seven proposed task groups for the coming year, as the existing task groups are winding up. It was not clear where the proposals had come from and there was no background information about them.
I didn’t find any of the proposals very interesting. I voted to follow up some work that had already been done, because it seemed to me good to let it be known that once the LINk gets its teeth into something it doesn’t let go.
Part of the transition to HealthWatch, it seems to me, will have to involve making the LINk more nimble so that it can respond to hot topics in the media while they are still hot. This annual lottery for task groups means it can take a couple of years for anything to happen.
There were two calls for volunteers at the meeting.
One was for anyone who knew of an elderly person living in a rural setting in Gloucestershire, who had moved in or out of hospital care in the last nine months, and who would be willing to be interviewed as part of a research project.
The other was for anyone computer literate who would be prepared to help with a new website for the LINk. Three people volunteered for this. I will be leading the group, and I’ll no doubt write about the project here at some time in the future.