A grim warning that the A&E department at Swindon’s Great Western Hospital will face severe pressure again this winter has come from the hospital’s Foundation Trust chairman Bruce Laurie.
He told a Health Forum meeting in Marlborough that attendance at the emergency department had already increased substantially by 10 to 12 per cent in the past year and, worse still, the funding now available for A&E this winter was below that of last year.
The biggest pressure came from the elderly and the hospital was working successively with primary care and working pro-actively with GP practices to new find ways of helping them without the necessity of automatically going to the Great Western for help.
“That’s the daft way it used to happen – and quite frankly it still happens all over the country,” he declared. “So we’re proud of what we’ve done in successfully keeping people out of hospital.
“But on the evidence of last winter, we’re going to get a lot of older people who definitely need to be admitted.
“And we are very sad and dismayed to find that we don’t have the money to rectify that. We haven’t even had the money we had to spend last winter. Wiltshire CCG are trying to dig their hands very deeply in their pockets to see if we can have some more money.
“But Swindon are in dire straits and that’s going to be a real problem.”
This was one of the mixed messages of good and bad news announced at the Forum held at St John’s Academy with Devizes Tory MP Claire Perry taking the chair – see panel piece below on new £6 million funding for social care.
Eight experts were assembled across the whole range of medicine in Wiltshire to be quizzed by the public following the introduction of the new Clinical Commissioning Groups in the NHS.
But a total of just nine people were in the audience, among them Paul Lefever, from Healthwatch Wiltshire, and Val Compton, the activist who led the unsuccessful legal battle to save Savernake Hospital as a minor injuries unit.
And it was a question from Mrs Compton that sparked Mr Laurie’s review of Swindon’s A&E difficulties while last Thursday’s event also gave the audience a welcome insight into improvements, now and in the future.
Dr Steve Rowlands, who chairs the Wiltshire Clinical Commissioning Group, said its aim was to get GPs to work together in clusters on a population basis of 20,000 around a designated Care Co-ordinator, an untried system designed to predict where problems are going to appear.
“We are quite positive that it will take pressure off of A&E,” he said. “The other thing we are looking at is end of life care, and obviously again a tricky subject we don’t culturally enjoy talking about as a nation, but it is a very important part not only from the standard of care but also the finances involved in it.”
And Dr Jonathan Rayner, the Ramsbury surgery GP and vice chair of the NEW Group, added that two non-clinical advisers were being attached to local GP surgeries to support families and vulnerable patients.
“The first one is starting literally this week in this area and already she is showing enormous promise,” he declared. “We are very excited about that. But the system is relatively new and we shall have to see how it works.”
Maggie reveals her personal mission to help the elderly
One woman’s mission to discover the health problems of the elderly was revealed by Maggie Rae, dynamic director of Wiltshire Council’s adult social care services and public health, who welcomed the changes introduced in the NHS.
They provided an opportunity to understand the inter-connections between the clinical world and social care. “The system is getting more joined up now and that is a good thing,” she told the Forum.
“With myself and colleagues in primary care we can have the right conversations and put patients at the heart of what of what we’re doing and improve their quality of life.”
The £6 million funding Wiltshire Council had received from the NHS was a “fantastic opportunity when we are still in a recession to see what we can do. Wiltshire never gets money for anything because everyone thinks we’re quite well off.
“We managed to demonstrate to the government that we do have a problem with fuel poverty. It’s a case where people may well have a roof over their head but they cannot afford to heat it.
“They may be asset rich but revenue poor but they can’t afford to turn on the heating. And that is one of the most tragic things.”
And she revealed: “I do quite a lot of visiting because I like to see what’s going on. You walk into the house and you notice they suddenly switch on the heating while they have been sitting without it.
“What happens clinically is that people are sitting in cold houses, their circulation doesn’t work and it is quite easy for older people to get hyperthermia and end up in hospital.”
There were improvements to be made in treating dementia, and for the first time the average lifespan of men in Wiltshire had now reached 80 after years lagging behind women, which was in part due to encouraging men to take early GP health checks.
“What’s more important than public health?” she asked. “What could be more important than housing for social care? It all makes sense. And it makes our life easier.”