I want the whole healthcare wheel!

Yesterday, along with a large group of Buckingham residents and interested parties, I attended a meeting organised by Buckinghamshire Healthcare NHS Trust. The purpose of the meeting was to continue a dialogue about the future of healthcare provision in the town, this time with a focus on outpatient and inpatient services.

Both Thame and Marlow community hospitals are in a transformation towards becoming 'hubs' for healthcare with a stated ambition to bring healthcare closer to home. We were presented with some of the details of these projects and then asked to discuss our views on how something similar might happen in Buckingham. The appraisal so far of these two projects is mixed, we were told:

Here is the agenda we were given as we arrived:

It was a busy morning and I hope that the notes of what was discussed will be out soon. Once they are, I will make sure a link is provided here to them (both slides presented and the feedback from the discussions recorded by the facilitators)

Anything to do with healthcare is complex and a wide range of views were offered. There was a concern that any new arrangements might (or might not be...) a threat to the Community Hospital which of course is a very special part of the town. There was little discussion about the move of the GPs to Lace Hill but clearly the size of the building being talked about there could well be a place for outpatient clinics too. Will the building of the Lace Hill centre have an impact on the Hospital? We didn't really get any answers on that question.

The senior nurse, Carolyn Morrice, who presented most of the slides and chaired the whole event was at pains to say that the developing service would be co-designed with local people using a stakeholder group (yet to be established - but soon hopefully). Having been involved with the health service as an adviser, worker, carer and patient over many decades... I remain just a tad cynical about whether co-design means what it says on the tin.

For example I noted that a new body 'FedBucks' suddenly made an appearance on the slides as one of the organisations working with the NHS to plan these changes. What, I asked, is 'FedBucks'. I was informed it is a federation of GP practices, in their role as providers of healthcare. GPs of course, are also heavily involved in running the Clinical Commissioning Groups too... As poachers and gamekeepers (as such!) they are therefore well represented. But funnily enough I did not see HealthWatch or any other patient representative body on the slides as part of the 'Accountable Care System' determining the future of health and social care provision in the county... I will have more faith in 'co-design' when the patients/users/carers/residents have equal status on the partnership bodies making the decisions...

This could be a very long blog - and long blogs don't work very well, I know that. So I will finish on a few points that I made during the event: here is my scribbled notes that I gave to the facilitator to state my key design criteria for any new service

And I will finish with the point I finished with yesterday to the meeting: whatever happens there must be parity between physical health care and mental health care. Why is it that someone who needs some kind of talking therapy may have to wait up to six months for an appointment (the set of which is then limited to six sessions, say) but a person needing cancer treatment gets it within days? And they get unlimited treatment too? Surely we should have parity here?!

Should we not?

I want the whole healthcare wheel for our town - hub, spokes and rim!!