Saturday, 24 December 2016

The Workforce - the sixth priority

In reality the Sustainability & Transformation Plans (STP) are all about reducing costs and in the NHS the cost of the wonderful staff is the biggest part of the overall cost to providing care.  So any good planners will be taking a close look at staffing costs and performance.

Prioity 6 for Buckinghamshires STP is:

"Establish a flexible and collaborative approach to workforce."

Their initiative is:

"A shared workforce plan to support rotation of staff across organisations to increase quality of care and staff retention."

Motherhood and apple pie! The NHS locally has been talking about improving retention of staff for years yet it is still a problem. Staff morale is low. Staff select to wok in some areas and avoid others. Much of the care is provided by locum staff rather than permanent staff.

In Buckinghamshire we have been short of A&E consultants for many years. GPs and Practice nurses, District Nurses and other specialities are also Report vacancies.

So there suggestion is to share staff across different trusts. But as the nurse taking my Blood Pressure on her evening ward round said: "Every trust is in the same situation. Every day I get asked by an agency to work for more money"

We need more permanent staff!

We need to have enough staff to cover illness, holidays, training etc.

There have rumours that across the STP, that is in Bucks, Oxfordshire & West Berks, £34m is to cut from staff budgets. This figure is in the published document but they do not explain how this will be achieved. As I type this on Christmas Eve they are trying to move an experienced nurse from my ward to one that does not a enough staff. This is dangerous. I do not know the outcome of the discussion.

This is the reality of 21st century hospitals across the country.

I do not think that this priority has a viable solution yet.

Wednesday, 21 December 2016

Improving Mental Health Services - the fifth priority

Mental Health Services have to be specifically included in the Sustainability and Transformation Plan for Buckinghamshire.  These services are already provided across Buckinghamshire by a range of providers, the main Trust covering both Bucks and Oxfordshire already.

The priority for the Clinical Commissioning Groups (CCGs) is:

"Mental Health development to improve the overall value of care provided."

They describe this as :

"Develop a network of providers of specialist mental health care across a larger footprint of STPs coordinating inpatient and community based services."

What do I think this means?

Well this is a guess but I reckon this means they want to increase the number of organisations that provide specific services. They want to do this across a bigger area than they do at present. This might mean that patients have to travel further for their mental health care.

They realise that this means an increase in the number of organisations providing services and that they will be spread across the SE of England. This in turn means that this care needs to joined up and seamless. Good communications are essential as is an improvement in transport for patients across our poor road & transport network.

Do they have the resources to coordinate the fragmented nature of this care? Will they be able to influence the Councils responsible for roads and public transport to improve the roads and buses?

I am not sure!

Tuesday, 20 December 2016

A recap on Buckinghamshire's STP - my thoughts

Ten days ago I wrote a number of blogs before I went for the operation to remove the subcutaneous lump on my shoulder. I am just about over the GA and the couple of big bleeds post-op and somewhere close to normality. Well .... there is a short period each day when I can concentrate for more then 5 mins.  Will that do for normal?

Anyway I am now a cancer survivor.

Hopefully, beds providing, I will heading to another hospital for a skin graft over the Christmas festivities.  Such fun!

Anyway....the blogs were about the Sustainability & Transformation Plan for Buckinghamshire (STP).  I have tried to put in my terms an explanation of a summary document that our CCGs circulated at their recent set of public engagement events.  They have tried to explain why they needed to develop the plan in association with local hospitals and the county council. They were very honest and said that it is because the increasing activity they will have to fund over the next five years will not be covered by the budget given to them by the Government.

Can't be clearer than that.

But sadly people still don't get it. Some people still believe the Government will throw money at the hospitals again. It didn't work in the past and it won't work this time.

Tonight and tomorrow I will try to finish what I started last week. I have their final three priorities to finish.