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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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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Peterborough District Hospital – proposed development ‘a complete mess’

pdh_demolition07:08 Thursday 2nd July 2015
BBC Radio Cambridgeshire

DOTTY MCLEOD: Our top story for Cambridgeshire this morning, “It’s too slow and it’s too messy.” That’s the verdict of some people in Peterborough on the work going on at the old District Hospital site off Thorpe Road. It’s been just under a year since it was announced the old PDH site would be turned into 350 new homes and a brand new primary school. Twelve months on, and many people not too happy with the progress. Our reporter Sophia Alipour has been speaking to some of them outside the old hospital remains.
(TAPE)(OB)
PUBLIC ONE: It looks disgusting.
PUBLIC TWO: Yes it’s horrible from the outside.
SOPHIA ALIPOUR: What would you like to see built here instead?
PUBLIC ONE: Something nice to look at. Not something ugly. Maybe a homeless shelter, ‘cos I think homeless people live there.
PUBLIC TWO: Something like flats or houses, which is what it was meant to be.
SOPHIA ALIPOUR: Could I ask you to describe what the front of the old hospital currently looks like?
PUBLIC THREE: Half falling down and derelict.
PUBLIC FOUR: I’m surprised they haven’t done much more than they have.
PUBLIC FIVE: We work opposite the building. There was a little bit of noise a couple of weeks ago, but that’s been it. A slow process.
PUBLIC SIX: A mess. A complete mess. I wish they would get on with it.
(STUDIO)(LIVE)
DOTTY MCLEOD: Well Peterborough’s MP Stewart Jackson has told BBC Radio Cambridgeshire he’s happy with progress at the site, despite work apparently slowing down around the General Election. But Peterborough City councillor Ed Murphy has expressed his concerns, and he joins me now. So what do you think to the progress there Ed?
ED MURPHY: I’m not too concerned about the progress, which has been very shortcoming. The Hospital has now been there for fifty years. I’m looking at it at the moment. It’s still up, and it’s going to take some time to take it down, because it’s going to be quite a feat to take it down. What I’m concerned about is the current plans. The school hasn’t got adequate play facilities for the children, and they need to extend the site. And I think the developers are probably going to come in and try and go up more stories than they really should. So I’m hoping that the City Council do their utmost to ensure that development benefits local people, not just the bottom line profits of the developers.
DOTTY MCLEOD: So I was looking at this site on Google Maps last night, because when you drive past on Thorpe Road you might glance to your left, but you don’t always get a proper look, do you? And what surprised me was actually the size of this site, because 23 acres, it sounds quite big, but when you factor in a primary school, presumably some houses having gardens, car parking as well, maybe it’s not actually that big for 350 homes.
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Healthcare assistants employed while nursing posts remain unfilled

healthcare_assistants08:09 Monday 23rd March 2015
BBC Radio Cambridgeshire

DOTTY MCLEOD: Would you be happy for a healthcare assistant rather than a fully trained nurse to take your blood, to dress your wounds, or to give you injections while you’re in hospital? Well healthcare assistants from Cambridgeshire have told the BBC that is exactly what they are being asked to do in some cases. An investigation for Inside Out spoke to staff from ten hospitals across the Eastern region. Let’s find out more about exactly what a healthcare assistant is. Joanne Bennis is the Chief Nurse at Peterborough City Hospital. Joanne, roughly how many healthcare assistants do you have at PCH?
JOANNE BENNIS: Good morning Dotty. We have on average on clinical area about 65% of the nurses that we have on the ward are registered nurses, and 35% of those are unregistered, or healthcare assistants.
DOTTY MCLEOD: And let’s talk about the training. What is the difference between the training that a nurse has and the training that an HCA has?
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