Huntingdonshire doctors reporting unmanageable pressures on general practice

“The relative share that the NHS spends on general practice has fallen from around about 10.5% down to 7.5% of the NHS budget, and that’s simply not sustainable.”

gp08:19 Friday 10th June 2016
BBC Radio Cambridgeshire

DOTTY MCLEOD: We were hearing earlier on from a GP in Huntingdon who says his workload at the moment is just getting impossible, family doctors in general in Huntingdonshire saying their workload has become almost unmanageable. The revelation came to light after the doctors’ union the British Medical Association published its latest results to its Heat Map survey. This map shows how GPs are coping with increased pressures, increased workloads, and it shows that doctors in Huntingdonshire have the highest workload in the county. Doctor Ian Sweetenham is a GP in Huntingdon.
IAN SWEETENHAM: I think unmanageable is a good word for it. We just have enormous amounts of work to do, and we don’t have the resources to cope with it. So I spend my days and my evenings just working. There’s too much paperwork, a large amount of regulation, the level of demand has gone up enormously. There’s something like another 40 million consultations done in general practice a year. That’s extra since 2008. We’re now at 340 million consultations every year. There are not the resources, there’s not the doctors, there’s not the investment. In fact the funding has been cut.
DOTTY MCLEOD: Well GPs in only one constituency in Cambridgeshire, North West Cambridgeshire, say their workload is manageable. All of the others said that it was often unmanageable, and Huntingdonshire says it was just unmanageable. We can speak to Dr Richard Vautrey who is the GP Committee Deputy Chair for the British Medical Association. Richard, are you surprised at these results from Cambridgeshire?
RICHARD VAUTREY: Not at all. They replicate the results from around the rest of the United Kingdom. The pressures on general practice are increasing dramatically, and yet the funding has not kept pace with that. And that’s also meant that practices don’t have the resources to not only appoint new GPs if there were any GPs, but also extend their practice staff to cope with patient demand.
DOTTY MCLEOD: So Huntingdonshire has the worst rating on this Heat Map. How many other areas are like that?
RICHARD VAUTREY: I couldn’t give you a specific number, but certainly it’s replicated in many other parts of the country, particularly where GP practices are struggling to recruit new GPs. That then adds extra pressure onto those doctors and nurses left within the practice, because we’re dealing with more and more patients with more complex problems. Many of the problems that were once dealt with in hospital are now being dealt with by GPs and their teams within their practices. And we simply haven’t got the capacity to meet that need, and that’s why many of your listeners will be struggling to get a GP appointment, because there simply isn’t enough time in the day and enough appointments available to meet their growing needs.
DOTTY MCLEOD: Is there a sense that the culture has changed, that more people are requesting GP appointments more often?
RICHARD VAUTREY: It’s partly because we’re living longer, which is a good thing. But we’re living with more complex problems, so people are not only living with diabetes, they may have heart disease, they may have lung disease, they may be frail and elderly. And where once they may have seen their GP two or three times a year, now they may be seeing their GP almost every month in some cases. And so we’re finding that we simply don’t have the capacity to meet the needs of those patients. And at the same time the relative share that the NHS spends on general practice has fallen from around about 10.5% down to 7.5% of the NHS budget, and that’s simply not sustainable. We have to reverse that. We have to significantly invest in general practice and build up community-based services, to meet the needs of our patients.
DOTTY MCLEOD: Well let’s get another view on this. Thank you Richard. Dr Richard Vautrey there who is the GP Committee Deputy Chair for the BMA. Listening to that is GP Dr Emma Tiffin, who works in a surgery in Cambridge, also a spokesperson for the Cambridgeshire and Peterborough Clinical Commissioning Group. That’s the body that’s responsible for NHS-funded health care in the county. Morning Emma.
EMMA TIFFIN: Good morning Dotty.
DOTTY MCLEOD: Do you recognise this situation that’s being described by Richard, that’s being described by Dr Ian Sweetenham in Huntingdonshire, where workloads for GPs are just unmanageable?
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Cambridge – housing demand and the limits to growth

“There’s a grave concern I feel that if it gets much bigger .. it won’t be the attractive place it currently is.”

fen_road11:20 Wednesday 8th June 2016
BBC Radio Cambridgeshire

PAUL STAINTON: Thousands of homes already planned for Northstowe, Waterbeach, Bourn Airfield, but we need more. We need to build a town the size of Ely. That’s the conclusion of a report by Savill’s. 43,000 more homes are needed they say by 2031, 10,000 more than are currently planned. This is David Henry who we had on earlier, Head of Planning at Savills in Cambridge. He says the area should go for growth.
DAVID HENRY: It’s an awful lot, but there again we are in one of the fastest growing parts of the country. We have clearly the effect of that all around us in terms of the infrastructure, the house prices going through the roof, and firms moving into the area. So it’s the big question really, isn’t it? It has been for a number of years. How do we respond to that? Do we simply say enough is enough? Or do we say OK, let’s go for it and as part of the leaders of UKPLC go for growth.
PAUL STAINTON: Well let’s speak to David Shaw. He’s a Chartered Town Planner and he worked on the New Town Development Corporation in Peterborough of course many many years ago now. Morning David.
DAVID SHAW: Good morning Paul.
PAUL STAINTON: So we just keep building and building and building do we on new towns and on our countryside? And eventually we might build enough houses so that everybody’s got somewhere to live.
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Discussion curtailed on destruction of Milton Road trees

blossom17:10 Thursday 2nd June 2016
BBC Radio Cambridgeshire

CHRIS MANN: Plans to close key commuter roads in Cambridge during peak hours have passed their first hurdle. The proposals have been approved by business leaders and councillors at today’s City Deal Assembly. Our political reporter Hannah Olsson was there and joins me in the studio now. Hannah evening.
CHRIS MANN: Remind us what was being discussed today.
HANNAH OLSSON: Well Chris it was the eight part plan to tackle congestion in Cambridge that I told you about last week. It was outlined by City Deal officers. It includes as you say peak-time road closures in some key roads in the city, including Hills Road and East Road, charging some of the larger businesses in the city for commuter parking spaces, and increasing the number of park and ride and residential spaces. What it doesn’t include is a congestion charge, an idea that lots of people believe is the solution to Cambridge’s traffic problems, but that the City Deal officers say wouldn’t necessarily work, and would be unfair to people who live outside the city. Changes to Milton Road and Histon Road were also discussed today. They proved very controversial, because widening Milton Road involves cutting down the trees that line each side of it. Now if you travel up and down there at the moment, of course it’s near our studios here, you can see people have tied yellow ribbons to all the trees. Have you seen those Chris?
CHRIS MANN: Absolutely.
HANNAH OLSSON: Yes. The people that are campaigning to save those trees.
CHRIS MANN: So what was the point of today’s meeting?
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Peterborough Willow Festival impasse – organisers blame Council officers

“We’re in the dark, and we believe there are clandestine reasons behind this. We don’t know what they are.”

willow08:25 Thursday 26th May 2016
BBC Radio Cambridgeshire

DOTTY MCLEOD: Peterborough City Council are saying the Willow Festival won’t be allowed to take place on the city’s Embankment. The Council says they’ve withdrawn permission to use the land because they haven’t received payment or documents that they need from the organisers. The event’s due to return to the city in July after being cancelled last year for financial reasons. Let’s see if we can get to the bottom of this. The organiser of the Willow Festival Mark Ringer joins us now. So Mark, is it all off this year then?
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EU funded think-tank Brexit brochure austerity warning

“The IFS are part of this cosy establishment which desperately wants to keep us in the European Union.”

turkeys17:23 Wednesday 25th May 2016
BBC Radio Cambridgeshire

CHRIS MANN: There’s been a mixed response to a report from an economic think-tank suggesting that quitting the European Union could cause two more years of austerity. The Institute for Fiscal Studies accepts that savings would be made if the British people voted to leave in next month’s referendum, but its boss Paul Johnson says that the benefits would be offset with the economy set to shrink.
PAUL JOHNSON: The immediate effect of leaving the EU would be that the Government would have an extra £8 billion or so to spend, money that currently goes to the European Union. But it wouldn’t take very much at all to change in the economy to lose that very quickly, and our best estimate is actually you’d lose quite a lot more than that £8 billion, because the economy would grow less quickly than otherwise.
CHRIS MANN: But the Leader of the UK Independence Party Nigel Farage is questioning the impartiality of the organisation.
NIGEL FARAGE: They take in millions of pounds of money from the European Union. So once again, it’s the same old game, it’s taxpayers’ money being used to tell us what we should think, and what you should do. And frankly the scale of this now is outrageous. The Government and all their friends, taxpayer funded friends, are frankly cheating.
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A Royal visit and a summer of celebration at Grafham Water

Fifty years after its construction, Prince Philip returns to open expanded facilities.

grafham07:56 Wednesday 25th May 2016
BBC Radio Cambridgeshire

DOTTY MCLEOD: A royal visitor is returning to Cambridgeshire today, returning to Grafham Water, 50 years after officially opening the reservoir there.
ANNOUNCER: The opning of Grafham Water by His Royal Highness the Duke of Edinburgh was the climax of years of planning, to meet the future demands for water in the Anglian region. This need for additional water storage in one of the driest parts of the country was identified in the early 1950s, after water shortages were experienced in the Northampton and Cambridgeshire areas.
DOTTY MCLEOD: I just love listening to that archive. I think it really evokes a completely different era. Prince Philip then back again today, unveiling a £28 million storage reservoir and pumping station at Grafham. Emma Staples is from Anglian Water and joins me now. So Emma what was it exactly that Prince Philip opened back then?
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East Anglian devolution process questions arising

08:07 Friday 20th May 2016
BBC Radio Cambridgeshire

DOTTY MCLEOD: A deadline of next Friday has been set to reach an agreement on East Anglian devolution involving Cambridgeshire and Peterborough. This timescale was revealed in yesterday’s BBC devolution debate, organised by BBC Radio Cambridgeshire, Radio Norfolk and Radio Suffolk. In the meantime a former civil servant has told me he also believes that unnamed local partners suggested Cambridgeshire joins the devolution arrangement, not the Government. Antony Carpen says he reached this conclusion after submitting Freedom of Information requests to the Government.
ANTONY CARPEN: Well I asked whether there was any formal commission or any request to Cambridgeshire, and the answer was again no commission from Ministers or private office exists. I’ve asked them. They’ve stated local partners put forward the proposals. I’ve asked them further who were those local partners, where is the transparency in this? And as we heard in your debate earlier, many people are complaining about lack of transparency.
DOTTY MCLEOD: So the reason that could be significant is because we’ve always been told before that it was the Government who suggested adding Cambridgeshire to a Norfolk and Suffolk devolution plan. The Government saying in these answers to Freedom of Information requests that actually that’s not the case. Who are these ‘local partners’ who stepped forward and suggested Cambridgeshire join in? Lots of unanswered questions then, and just seven days to reach an agreement on this. Our Political Reporter Hannah Olsson has spoken to the head of the East Anglian Devolution Leaders’ Board Andy Wood.
ANDY WOOD: The timescales as they stand, we really ought to be going back to Government next Friday with a good bit of the deal done. Of course after that there are a number of processes that kick in that lead through the summer and then into the autumn. And if we do finally get a deal done, to mayoral elections in May ’17. But as you can see from the discussions today, we are some way away from that. But we are making progress.
HANNAH OLSSON: So what’s happening at the moment in the next couple of weeks? Lots of meetings I imagine.
ANDY WOOD: Yes there are a number of meetings. Of course there are lots of people behind the scenes, employed by county councils and district councils, who are doing lots of work. So there’s lots of stuff going on, in the anticipation that we probably will get a deal. So there will be a number of meetings in that timescale as well of course, because I have no decision making powers in this. This is for local leaders, leaders of their places, to ultimately reach agreement and carry forward to Government. And I’m happy to carry that forward to Government for them.
HANNAH OLSSON: You have got people that are from all sorts of different areas, trying to bring those together to find a bit of common ground. Difficult job?
ANDY WOOD: Well there is. There’s a clearly a sort of county county county council boundaries.(sic) So there’s Cambridgeshire, Norfolk, Suffolk. That’s one dimension. There’s an urban rural dimension. So there’s much of East Anglia is rural. But we’ve got Cambridge, we’ve got Norwich, we’ve got Peterborough, we’ve got Ipswich. We’ve got towns like Bury St Edmunds. They have a different feel to them. And then of course there’s a different political complexion. So there’s quite a bit of complexity in all of that. But actually overall leaders are focusing on can they get the best deal for their place, and can they get the best deal for East Anglia.
HANNAH OLSSON: So what will you be taking back to leaders from today’s discussion?
ANDY WOOD: Well I suspect a number of them heard it live. I suspect a number have followed it on Twitter. So they probably know anyway, but of course I’ll be talking to them. The big message I think has been the lack of transparency and the lack of communication around this. Now you can’t carry out a negotiation in public of course, and that may have been the reason why there has been a bit of radio silence. But actually we need to step up the communication. There’s no doubt about that. And that’s a big message from today.
DOTTY MCLEOD: That’s our Political Reporter Hannah Olsson talking with the head of East Anglian Devolution Leaders’ Board Andy Wood, who is also the CEO of the Suffolk brewery Adnams. Now Clare King who lives in Cambridge raised several concerns on Twitter while listening to our three county debate yesterday. Morning Clare.
CLARE KING: Morning.
DOTTY MCLEOD: So certain aspects of the way these devolution plans are working out really trouble you. What in particular has made you angry?
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Hospital merger proposal decried

“This document that came out today talks about savings in the region of £9 million. Well Peterborough has got a deficit of over £40 million. So there has to be more than that.”

j_djanogly17:11 Wednesday 18th May 2016
BBC Radio Cambridgeshire

CHRIS MANN: A merger between Hinchingbrooke and Peterborough City hospitals is looking ever more likely after senior bosses at both hospitals backed plans for a full merger between the two Trusts. An outline business case has been published recommending the merger. From April 2017 four options are being explored by the two Trusts. They say integrating services could save money. Option one would be to do nothing; two would see back offices merged; three the same but with just one executive team; option four would see a full integration into just one organisation. So they’re talking about saving money, but will it improve health care? A really key question, one we want to put now to the MP for Huntingdon, Jonathan Djanogly, who joins me now. Afternoon.
JONATHAN DJANOGLY: Good afternoon.
CHRIS MANN: Four options. Which one would you press?
JONATHAN DJANOGLY: We would go for no merger, but we accept that where savings can be made, they should be made. And where there’s joint working to be had, that should be encouraged. But in terms of the merger, it’s absolutely the vast majority position in my constituency that that would not be welcome.
CHRIS MANN: OK. So which of the options, one, two, three or four are you going for then?
JONATHAN DJANOGLY: Well they have gone for option four, which is a full merger. Although I think it’s very important to say that this is not their fixed outcome. This is basically their proposals, and now they sit down and go through the figures, and go through how the services would be split between the hospitals and so forth. So it’s actually at a vital stage over the next few months, and we will want to keep up the pressure then.
CHRIS MANN: So saving money is what appears to be top of the managers’ agenda. But improving health care is what the patients are worried about.
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