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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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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Centralisation of hospital services could be on the agenda

hinchingbrooke_hospital07:26 Friday 11th March 2016
BBC Radio Cambridge

DOTTY MCLEOD: Uncertainty this morning over the future of Hinchingbrooke Hospital, and it’s causing upset for patients, according to the local MP. Huntingdon’s MP Jonathan Djanogly has accused two local hospital trusts of using weasel words to try and cover up plans for a merger. There are proposals to extend an agreement for closer working and to merge certain services with Peterborough City Hospital. Jonathan Djanogly wants what he calls a secret document from the health regulator Monitor to be revealed. Dr Nik Johnson is a pediatrician at Hinchingbrooke Hospital. He also stood as the Labour Party candidate at the General Election. Nik, is this paranoia from Jonathan Djanogly, or is he right to be worried?
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John Lister on a Cambridgeshire Health Service in Crisis

The CCG, Clinical Commissioning Group, is now facing a massive deficit, and still haven’t told us what they’re going to cut to try to put it right.

waiting_room07:07 Wednesday 24th February 2016
BBC Radio Cambridgeshire

DOTTY MCLEOD: Accident and Emergency departments across Cambridgeshire are under severe strain at the moment, according to the county’s Clinical Commissioning Group. They’ve contacted BBC Radio Cambridgeshire asking us to re-emphasise their message, only go to A&E if it really is an emergency. The news comes ahead of a meeting in Cambridge tonight about the problems faced by the NHS in Cambridgeshire and Peterborough. Before we find out more about that, here’s reporter Julia Greenaway with a reminder of just what’s been happening with our health service locally.
JULIA GREENAWAY: Thanks Dotty. Well it’s been a torrid few years for the NHS in Cambridgeshire. Things started well when Peterborough’s brand new City Hospital opened in 2010, but in the past five years it’s been dogged by the multi-million debt incurred by the financing package. Hinchingbrooke Hospital in Huntingdon then became the first NHS hospital ever to be run by a private company. Then Circle pulled out of the ten year deal last April. The Hospital was placed in special measures, and patients warned that departments could close. Cambridgeshire was again chosen to try something never before done in the NHS, when the £800 million Older People and Adult Social Care Services was outsourced. This was the biggest outsourcing contract in the history of the NHS, and it collapsed within months. And finally last year inspectors said that while Addenbrookes Gospital’s quality of care was outstanding, it had to go into special measures due to failures by senior managers. The Hospital is predicted a £60 million debt this year.
DOTTY MCLEOD: Well listening to that is Dr John Lister, who studies health policy. He’s also a campaigner against the privatisation of the NHS. He’s one of the speakers at this meeting tonight, and believes there are particular reasons to be concerned about the NHS in Cambridgeshire. So John good morning.
JOHN LISTER: Good morning.
DOTTY MCLEOD: These particular reasons, what are they?
JOHN LISTER: Well I think Cambridgeshire, as your summary has well pointed out, has been used as a kind of a testing bed for all kinds of experimental policies, which we have been warning as campaigners, we as researchers have been warning, would not work. And they haven’t worked. And of course it’s led to disastrous consequences.
DOTTY MCLEOD: But one man’s experimental might be another man’s innovative John.
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Questions around a failed £800 million NHS outsourcing experiment

It became clear that costs were emerging which the CCG hadn’t anticipated, and which it said it could not fund.

elder_care17:22 Thursday 21st January 2016
BBC Radio Cambridgeshire

CHRIS MANN: One of the big stories of the last few weeks in the county is to do with the NHS, and that is the failed £800 million older people’s health contract. Cambridgeshire county councillors have finally been allowed to question the Chief Executives of the two trusts involved. UnitingCare was owned by the Cambridge University Hospitals NHS Trust, in other words Addenbrookes, and the Cambridgeshire and Peterborough NHS Foundation Trust. The contract was the biggest outsourcing of services in NHS history. It failed last months after just eight months of its proposed five year tenure. Well the BBC Look East Political Reporter Tom Barton has been at today’s meeting and joins me in the studio now. Hello Tom.
TOM BARTON: Good afternoon Chris.
CHRIS MANN: Extraordinary story when it happened of course, out of the blue, suddenly this contract torn up. It had taken so long to put together. So we’ve been waiting for answers for several weeks now. What’s happened today?
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Gauging support for the junior doctors

Out on the streets, testing the mood of the nation.

nhs_banner10:26 Tuesday 12th January 2016
BBC Radio Cambridgeshire


“Paul I heard you picking on me earlier. I’ve been all behind this morning. When it comes to the doctors which we were talking about earlier, I’m in full support of them going on strike today. I don’t want someone who’s mentally and physically worn out making a decision on my loved one’s life or my own. This government is messing up all the emergency services in my opinion, and the armed forces. They got one over on the police as they can’t strike. It’s time we looked after those who look after us. If this carries on, we’ll end up with all the doctors and nurses who can’t speak English making decisions on our lives. It’s too late to complain when it’s happened.”

says Dee this morning.” Yes, doctors are on a 24-hour strike. It started at 8am this morning. Many many people across Cambridgeshire have had their operations and hospital appointments cancelled because of the strike. The doctors say it’s about pay, it’s about working hours, it’s about safety. The Government say they’ve offered more money, they’ve offered better conditions. But the two sides are way way off, and that’s why the strike’s been called today. Poll for the BBC suggests two-thirds of people support the strike, as long as emergency care is being provided, which it is. Well Johnny D has been out on the streets of Cambridgeshire gauging support.
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Controversial care contract folds without warning

UnitingCare17:09 Thursday 3rd December 2015
BBC Radio Cambridgeshire

CHRIS MANN: It’s been revealed this afternoon that a consortium which was set up to look after community care in Cambridgeshire has ended, with all parties saying it’s no longer financially sustainable. The consortium was made up of Addenbrooke’s Hospital and the Cambridgeshire and Peterborough NHS Foundation Trust. The £800 million contract was the biggest outsourcing of the NHS care in its sixty year history, and yet eight months later it has apparently broken down. Only back in July, just three months into the contract, the Chief Executive of UnitingCare, Keith Spencer, told BBC Radio Cambridgeshire they’d made a promising start.
KEITH SPENCER: From 1st April we managed to transfer services safely, and 40 from the Community Services staff transferred to the Cambridgeshire and Peterborough NHS Foundation Trust. But we’ve also introduced two new services. So on 6th May we introduced OneCall, which is a 24/7 single point of contact co-ordination and source of advice, in the first instance for GPs. But we will be extending that to patients later in the year.
CHRIS MANN: So that was Keith Spencer speaking in July, the Chief Executive of UnitingCare. Then today came that news. Well earlier I spoke to Jo Rust. She’s the Regional Organiser of Unison, and she began by giving me her reaction to the news.
JO RUST: Well I’m totally shocked, because we were actually at a management meeting with senior managers in CPFT the mental health trust that oversees UnitingCare, and there was no inkling of it whatsoever there.
CHRIS MANN: When was the meeting?
JO RUST: Yesterday.
CHRIS MANN: And they didn’t say anything?
JO RUST: No. Nothing at all. We know that the Finance Director wasn’t there. He was at a meeting with the CCG, so it could well have been that was the reason for his absence.
CHRIS MANN: I think ordinary people will be baffled. Patients will be baffled at what’s going on here. Give us your interpretation.
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Cambridge Health Emergency – a voice for Addenbrookes

addenbrookes07:26 Wednesday 14th October 2015
BBC Radio Cambridgeshire

DOTTY MCLEOD: A few weeks ago when the Trust that runs Addenbrookes and the Rosie was put into special measures plenty of you got in touch wanting to show your support for the hospitals. Well three weeks on it seems that the fightback for those places is starting to find its voice. Last night a meeting took place in Cambridge for people who want to defend Addenbrookes. They formed a campaign group called Cambridge Health Emergency. Martin Booth joins me, a retired Addenbrookes worker who helped organise last night’s meeting. Morning Martin .
MARTIN BOOTH: Good morning.
DOTTY MCLEOD: So why organise this meeting last night?
MARTIN BOOTH: Well as you said a lot of people have already expressed their concern and alarm really about events at Addenbrookes over the last few weeks. First of all we had the Chief Executive and the Finance Director resigning out of the blue with no notice at all. And then following that the Care Quality Commission report saying that the Trust was ‘inadequate’, something which a lot of people would disagree with to be honest, but at the same time highlighting very serious problems, which the report indicated many of them were caused by a lack of sufficient funding and resources, particularly the lack of staff to fully provide the services that are needed. And then the Trust being placed in special measures.
DOTTY MCLEOD: But what’s your campaign group going to do? What’s your aim Martin with this group?
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