Thursday 16 May 2013

Waiting for the Administrators.


For all of us who are concerned about the future of Mid Staffs and the health service for our future this is an anxious time.

We are waiting, because at this moment there is little else that we can do.

I know that many people feel frustrated that they are not doing something now. Lots of people have sent in lots of documents to the administrators, and received back lots of letters that effectively tell us very little. The Administrators have had many meetings with key people aimed at helping them to work out where the solution lies. The expressions of interest from a number of different bodies are in and are being scrutinised.

Within a matter of days now we will have a much clearer idea of where the administrators are pointing this process and the public consultation can begin in earnest.  

People will be aware of a number of things in the background that do have a real bearing on what will happen here.

Bruce Keogh from DoH  is coming to the end of his review of the first wave of 14 hospitals who were identified as having potential problems. (they are looking at over 50). He will be publishing this soon and it is likely to make interesting reading.  I would expect to see indications that that the underlying problems that gave rise to the pressures at Stafford are pretty widespread. The TSA certainly understand this clearly already.

There is recognition that the A&E system throughout the country is on the verge of collapse. The descriptions of what is happening and why mirror what we saw in the detailed evidence to the public Inquiry here, so there is now much clearer understanding that the problems we saw here are part of a much wider problem.



There is a lot of talk about integrated care. http://www.guardian.co.uk/healthcare-network/2013/may/14/how-to-enable-integrated-care?CMP The Staffordshire Partnership trust http://www.staffordshireandstokeontrent.nhs.uk/ is playing a pioneering role in trying to make integrated care a reality. We need to understand more about what they are doing, why it matters, and what the difficulties are.

Integrated care is being seen as the best way of relieving pressure on the Health service and making it affordable, whilst at the same time improving the quality of care for patients. Everyone agrees with the principle, but there are real difficulties in making it work in practise. There is potential for making Stafford the blue print to make integrated care work.

An interesting article from David Rose who works for the Mail on Sunday, and has been one of the leading writers on A&E downgrades raises serious questions on the effects that A&E downgrades may have on mortality with his report on Newark  http://www.dailymail.co.uk/news/article-2323141/Shocking-proof-Accident-Emergency-closures-cost-lives-Death-rate-jumps-THIRD-department-closes.html As it says a minister has ordered an investigation, and I am sure that the results will not be as clear cut as indicated here, but it does raise the question has anyone really done an effective impact assessment on the unintended consequences of A&E downgrades.

I have been asked to be one of the people in the HEIA team (Health equality impact assessment) Once I have a clearer idea of how this will operate then I am sure I will be looking for guidance from many people.

Another couple of comment pieces.



 

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