Support for Children\u2019s Health and Wellbeing Continues to Deteriorate in Ealing<\/b><\/p>\n
On 1 July 2015, Ealing future would-be parents suffered the closure of Ealing Hospital\u2019s Maternity Unit. On 30 June 2016, Ealing Hospital\u2019s Paediatric services were withdrawn, along with the closure of the children\u2019s A&E unit in the hospital. Anecdotaly, concerned parents still arrive in the middle of the night with seriously ill children only to discover to their horror that A&E specialist support for children no longer exists at the hospital.<\/span><\/p>\n On 6 July 2019 Ealing Council decided to close the Children\u2019s Centres at Wood End and North Ealing. The annual budgets of 11 other Children\u2019s Centres in Ealing were cut by 24%. Apparently, the Council insists that the level of midwifery, health visitor and other specialist services for children will be unaffected. Some parents will take this insistence with more than a little pinch of salt.<\/span><\/p>\n <\/p>\n Are the Goals for Primary Care Networks a Case of \u2018Mission Impossible\u2019 or \u2018Mission Irrelevant\u2019?<\/b><\/p>\n As part of NHSE\u2019s Long Term Plan published in January 2019, about 1,000 Primary Care Networks (PCNs) have been set up and are now in operation across England, with 76 of them in north west London. There are eight PCNs in Ealing, each PCN between 5 and 15 GP practices, and each handling between 36,661 and 77,731 patients. For each PCN a Clinical Director has been appointed. PCNs are not statutory bodies.\u00a0<\/span><\/p>\n But what problems are PCNs supposed to fix? Apparently PCNs will bring General Practices together to work \u2018at scale\u2019. What exact problem or problems will this togetherness solve? No real clarity on that one from NHSE. As for \u2018at scale\u2019 I can only presume that in this context this means handling larger volumes of patients (presumably more efficiently and more quickly) than is the case currently.<\/span><\/p>\n Simplistically though, only many more GPs and Practice Nurses will facilitate handling larger volumes of patients (with hopefully reduced waiting times). And unless we all get much healthier or doctors\/medicines\/Primary Care treatments improve radically, with more GPs handling more patients we\u2019ll need more hospital beds, consultants, operating theatres, psychologists, ICUs, A&E units etc, etc.<\/span><\/p>\n The PCN approach tries to negotiate the current and likely future shortage of GPs by offering cash inducements for GPs, via their PCN, to gain shared access to other kinds of healthcare professionals \u2013 initially pharmacists and physiotherapists. Another cited reason for PCNs is to enable the integration of Primary Care with other services. The track record of attempts to integrate healthcare and social care services in England however is strewn with failures. It\u2019s suggested that with each PCN Clinical Director sitting on the new Ealing Integrated\u00a0 Care parthership (ICP) \u2013 in 2020 or 2021 – that this will somehow help to enable integration. The final NHSE PCN justification is \u2018to improve population health\u2019. How this might be achieved is not spelled out and is quite frankly an unsupportable claim.<\/span><\/p>\n NHSE\u2019s ambitions for PCNs are quite breath-taking. PCNs are expected to deliver co-ordinated health and social care. This will involve co-ordinating local government, community pharmacies, dental providers, social care providers, mental health staff, hospitals, dementia workers, podiatrists\/chiropodists, voluntary sector organisations and community service providers. Each PCN will hire (fire), manage and somehow share the following staff around its network of GP surgeries \u2013 clinical pharmacists, physiotherapists, Social Prescribing Link Workers (SPLWs), physician associates and paramedics. SPLWs, by the way, aim to connect people to community groups and statutory non-clinical services for practical and emotional support. Maybe they are what in the 1960s we called social workers.\u00a0<\/span><\/p>\n As from April 2020, PCNs will provide structural medication reviews and optimisation; enhanced health in care homes; anticipatory care; personalised care; and supporting cancer diagnosis. As from April 2021, PCNs will deliver cardiovascular disease diagnosis and prevention, and locally agreed action to tackle inequalities.\u00a0<\/span><\/p>\n PCN funding seems to be either \u2018by April 2021\u2019 or \u2018by 2023\/24\u2019. It\u2019s \u00a31.8 billion over five years. 70% of the cost of hiring specific new clinical staff will be provided by NHSE. This 70% funding will commence this financial year with clinical pharmacists. SPLWs can be 100% funded right now by NHSE.<\/span><\/p>\n PCNs will need more than just a Clinical Director to handle personnel, financial, management and\u00a0 recruitment duties \u2013 as well as functioning as a GP. Is there money from NHSE to run this small PCN business? 0.25% of a person apparently. It seems inadequate. In the Acton PCN in Ealing, 15 GP surgeries are supposedly working together to collectively provide Primary Care for a registered patient population of 77,731. (This is a larger population than that of Macclesfield, Maidenhead, or Scarborough). Running this lot is akin to running quite a large small business.<\/span><\/p>\n According to a survey carried out by \u2018GPonline\u2019 in May 2019, 48% of GP practice partners think PCNs will increase workload amid fears of rising bureaucracy.<\/span><\/p>\n <\/p>\n NHS NWL Gets \u00a3ZERO To Plug its \u00a3739+ Million NHS North West London Hospital Repair Backlog \u2013 in Johnson\u2019s \u00a3850 Million Pre-Brexit Give-Away\u00a0\u00a0<\/b><\/p>\n El Presidente Johnson announced on 5 August 2019 his first pre-Brexit \u2018give-away\u2019 to selected NHS Trusts and CCGs. 20 NHS bodies throughout England will receive \u00a3850 million for building work. However the NHS North West London (NWL) region (or \u2018Footprint\u2019 in NHSE speak) with the largest repairs backlog will receive zero funds. To refresh your eyes and minds with some of these repair bills as reported in the \u2018Sunday Times\u2019 on 10 February 2019, they were:\u00a0<\/span><\/p>\n + Charing Cross Hospital: \u00a3312 million<\/span><\/p>\n + St Mary\u2019s Hospital: \u00a3229 million<\/span><\/p>\n + Hammersmith Hospital: \u00a3108 million<\/span><\/p>\n + Hillingdon Hospital: \u00a380 million.<\/span><\/p>\n Why do I think NHS NWL has been given no cash whatsoever? Here is my take on it:<\/span><\/p>\n <\/p>\n Beware of Geeks Bearing Gifts!<\/b><\/p>\n Artificial Intelligence (AI) is a barely 70 year old branch of computer software. AI is often simplisticly linked to robots (who, allegedly, might kill all humans and run the world ). However the mundane truth is that the best AI can offer now and within the medium term future is useful \u2018decision support\u2019 information to healthcare professionals.<\/span><\/p>\n AI might be able to predict a diagnosis or treatment protocol extremely precisely, but it can\u2019t, intrinsically, tell a doctor, nurse (or patient) the cause of or reason for a medical condition. An AI algorithm (piece of software) is only as \u2018right\u2019 as its design. If the sotware designer gets it \u2019wrong\u2019 then the AI algorithm will consistently get it wrong over and over again. This amounts to \u2018Artificial Ignorance\u2019.\u00a0<\/span><\/p>\n Of course it\u2019s very fashionable these days to support and eulogise about AI. Our new Prime Minister and our Secretary of State for Health and Social Care are literally gushing about it. President Johnson on 7 August 2019 threw \u00a3250 million at an NHS AI laboratory. Press reports quote how this investment would improve cancer screening and identify patients most at risk from heart disease and dementia. These are credible claims. However the claim that this investment in AI will \u2019end bed blocking\u2019 has no credibility at all.<\/span><\/p>\n <\/p>\n Climate Change is Now the Excuse for Disastrous A&E Performance in July 2019<\/b><\/p>\n In July 2019, no London NHS hospital met the NHS A&E 95% target for ward admission, transfer or discharge within four hours. Kings College Hospital was the worst performer at 73.6%. Apparently nationally in July 2019 A&E admissions were up year by year by 4.6%. Apparently the weather was responsible for increased admissions and poor performance.<\/span><\/p>\n The reality in NHS North West London is that hospitals have been underfunded for years, two hospital A &E units were closed down in September 2014 and two other hospital A&E units have had the real threat of closure hanging over them for seven years.<\/span><\/p>\n The chronic shortage of doctors, nurses and mental health staff is a national disgrace. No amount of NHS money for hospital repairs or AI will directly help to fund, hire and train more NHS doctors and nurses.\u00a0<\/span><\/p>\n <\/p>\n NHSE Paid $226 Billion US Healthcare Giant \u00a37 million to \u2018Help\u2019 CCGs Cut Costs, Integrate Their Care Systems and Embrace Accountable Care<\/b><\/p>\n UnitedHealth Group, in association with management consultants PriceWaterhouseCoopers (PwC), was last year paid \u00a37 million by NHS England (NHSE) to help 55 Clinical Commissioning Groups (CCGs) cut their costs. The turnover of UnitedHealth last year was $226 billion. Simon Stephens, the boss of NHSE, knows the company very well as he\u2019s a former President of UnitedHealth Europe.<\/span><\/p>\n The Optum Alliance (UnitedHealthcare and PwC) have been acting as \u2018programme coach\u2018 (US management consultancy jargon) to, for example, Harrow CCG. The alliance has extolled the virtues of \u2018demand management\u2019 (in simple language restricting care service supply) with specific targeting of restricting unplanned hospital admissions. The alliance has also been proselytising about US-style Accountable Care. Central tenets of the Accountable Care shibboleth involve financial incentives to improve \u2018performance\u2019 and cost control.<\/span><\/p>\n Thanks to Calderdale and Kirklees 999 Call the NHS for spotting this NHSE \u2018investment\u2019.\u00a0<\/span><\/p>\n <\/p>\n Friarage Hospital A&E Closure: NHS Bosses Get Cold Feet After Campaigners Mount Judicial Review<\/b><\/p>\n A&E services at Friarage NHS Hospital in North Allerton, South Yorkshire were closed in March 2019. Local campaign group \u2018Save Friarage Hospital\u2019 mounted a challenge to this and began Judicial Review proceedings. In July 2019 NHS bosses (Trust and CCG) announced there would be a full consultation into services at the hospital. As a consequence, the campaign group has shelved legal action.<\/span><\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Support for Children\u2019s Health and Wellbeing Continues to Deteriorate in Ealing On 1 July 2015, Ealing future would-be parents suffered the closure of Ealing Hospital\u2019s Maternity Unit. On 30 June 2016, Ealing Hospital\u2019s Paediatric services were withdrawn, along with the closure of the children\u2019s A&E unit in the hospital. Anecdotaly, concerned parents still arrive in […]<\/p>\n","protected":false},"author":2,"featured_media":1243,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[],"tags":[],"class_list":["post-1878","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png","uagb_featured_image_src":{"full":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",1024,512,false],"thumbnail":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2-150x150.png",150,150,true],"medium":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2-300x150.png",300,150,true],"medium_large":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2-768x384.png",640,320,true],"large":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2-1024x512.png",640,320,true],"1536x1536":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",1024,512,false],"2048x2048":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",1024,512,false],"td_0x420":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",840,420,false],"td_80x60":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",80,40,false],"td_100x75":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",100,50,false],"td_180x135":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",180,90,false],"td_238x178":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",238,119,false],"td_265x198":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",265,133,false],"td_300x160":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",300,150,false],"td_300x194":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",300,150,false],"td_300x350":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",300,150,false],"td_341x220":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",341,171,false],"td_341x400":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",341,171,false],"td_511x400":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",511,256,false],"td_537x360":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",537,269,false],"td_640x0":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",640,320,false],"td_640x350":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",640,320,false],"td_681x0":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",681,341,false],"td_681x400":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",681,341,false],"td_741x486":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",741,371,false],"td_1021x580":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",1021,511,false],"mailpoet_newsletter_max":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2013\/06\/Traveling-in-London-2.png",1024,512,false]},"uagb_author_info":{"display_name":"Eric Leach","author_link":"https:\/\/ealingsaveournhs.org.uk\/?author=2"},"uagb_comment_info":0,"uagb_excerpt":"Support for Children\u2019s Health and Wellbeing Continues to Deteriorate in Ealing On 1 July 2015, Ealing future would-be parents suffered the closure of Ealing Hospital\u2019s Maternity Unit. On 30 June 2016, Ealing Hospital\u2019s Paediatric services were withdrawn, along with the closure of the children\u2019s A&E unit in the hospital. Anecdotaly, concerned parents still arrive in…","jetpack-related-posts":[],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts\/1878","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1878"}],"version-history":[{"count":1,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts\/1878\/revisions"}],"predecessor-version":[{"id":1880,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts\/1878\/revisions\/1880"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/media\/1243"}],"wp:attachment":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1878"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1878"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1878"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n