August 2015

"Be prepared this bank holiday weekend," say local doctors

27 August 2015

Doctors in Devon are urging people to put a few extra things on their shopping lists ahead of the weekend.
 
Most GP practices are closed over the bank holiday weekend and many pharmacies will be closed or have limited opening hours on bank holiday Monday.
 
Stocking up on plasters, painkillers, antiseptic cream and more won’t just come in handy this bank holiday weekend - it could really help ease pressure on local NHS services.
 
Having a well-stocked medicine cabinet means you won’t have far to go to treat a grazed knee, a sore throat or a headache.
 
Other ways you can be prepared include making sure you order any repeat prescriptions early so you have them in time for the weekend, and making sure you know when your local NHS services are open.
 
Dr David Jenner, a GP from Mid Devon and a clinical chair for NHS Northern, Eastern and Western Devon Clinical Commissioning Group, said: “We are reminding people to stock up ahead of the weekend so they don’t get caught out.
 
“Many minor illnesses and injuries can be treated quickly and conveniently at home with a well-stocked medicine cabinet.
 
“Not only does this help ease pressure on the local NHS, it also means less time spent waiting for treatment, which means people can get straight back to enjoying their long weekend.”
 
There are a number of steps people can take to make sure they are prepared for the bank holiday weekend.

These include:

  • Requesting repeat prescriptions in good time to cover the few days when surgeries are closed
  • Taking sufficient quantities of medicines away for holidays or weekend breaks
  • Stocking up the medicine cabinet with over the counter remedies for ailments such as headaches, stomach upsets and indigestion, including remedies for children
  • Checking the opening times of local pharmacies and GP surgeries.
If you find you need treatment over the bank holiday weekend, NHS NEW Devon CCG has issued some tips to help you choose the right NHS service:

  • Self-care - for minor illnesses, combine medicines for coughs, colds or flu with plenty of rest
  • Pharmacies - pharmacists are trained to help people with minor illnesses and can advise on medicine that can be bought over the counter. You can check your nearest pharmacy’s opening times over the bank holiday weekend here: www.nhs.uk
  • NHS 111 – for non-emergency health needs, 24 hours a day, as well as help to find services. Go to www.nhs.uk or call 111
  • NHS minor injuries unit (MIU) and Walk-in Centres (WICs) - for treatment of minor illnesses or injuries, without an appointment. For details of your nearest MIU or WIC, go to www.nhs.uk
  • Most GP surgeries are closed on bank holiday Monday. Check with your GP practice for their opening times
  • Hospital emergency departments or 999 – please only attend hospital emergency departments if you have an immediate and serious problem that cannot be dealt with by the other services. 999 is only for critical or life-threatening situations.

NHS organisations in Devon working together to implement Monitor findings for the benefit of patients

26 August 2015

The approach of the CCG covering most of Devon has been endorsed by a national health regulator following an investigation into the organisation’s procurement process for community services in East Devon.

Monitor found that NHS Northern, Eastern and Western Devon Clinical Commissioning Group’s (NHS NEW Devon CCG) procurement process was in line with regulations and its own procurement guidance.

The findings give the green light to a process that, if finally approved, will see the transfer of NHS community services in East Devon from Northern Devon Healthcare NHS Trust (NDHT) to the Royal Devon and Exeter NHS Foundation Trust (RD&EFT).
 
NHS NEW Devon CCG was exonerated by Monitor following an investigation into the organisation’s procurement process for the services.
 
All three NHS organisations involved will now work together to demonstrate this procurement presents value for money to the taxpayer through a due diligence process.
 
Monitor launched its investigation in January 2015, following a complaint by NDHT over the CCG’s decision to name the RD&EFT as its preferred provider of community services in the area.
 
Doctors say the findings are good news and in the best interests of patients in East Devon.
 
Monitor found the CCG took into account patient needs and the service improvements required and designed a process to select a provider from a number of proposals.
 
The findings, which were published today, found that:
  • given the circumstances and the work the CCG had done, it was acceptable and consistent with the requirements of the Procurement, Patient Choice and Competition Regulations for the CCG to have invited prospective providers to propose solutions and based on that to select a preferred provider with which to do further work
  • the CCG reasonably concluded that the Royal Devon and Exeter NHS Foundation Trust’s proposal was more likely to meet its commissioning objectives than Northern Devon Healthcare NHS Trust’s proposal
  • the CCG had not failed to act in a proportionate way
  • the CCG had not failed to comply with the requirement to treat providers equally and in a non-discriminatory way 
  • the CCG had not breached the transparency requirements 
  • the possible conflicts of interest examined were not material and did not affect, or appear to affect, the integrity of the CCG’s decision to select the Royal Devon and Exeter NHS Foundation Trust as the preferred provider

Rebecca Harriott, chief officer of NHS NEW Devon CCG, said: “Today’s report supports our approach to identify a provider who will improve the quality and efficiency of services, while also meeting the needs of the public who use those services.
 
“We are extremely grateful to Monitor for producing such a thorough report, but at the same time we are delighted that what has been a long and arduous process has finally come to an end. 
 
“We now look forward to working with NDHT and the RD&EFT on the next steps and pressing ahead with the pre-planned work to ensure value for money – ahead of awarding the contract in November.”
 
Roger French, Northern Devon Healthcare NHS Trust chairman said: “We accept the findings of the Monitor report entirely. Our main objective was to ensure that value for money was taken thoroughly into account before any decision to procure the Eastern community services.

“These are health and social care community services that support 7000 patients in their own homes as well as in our community hospitals.

“That their future is clinically and financially sustainable is really important to the patients who rely on their support and the staff who work in them. We are really pleased that the outcome of the Monitor report means there is now clear guidance as to what now needs to happen to ensure a robust way forward.”

James Brent, Royal Devon and Exeter NHS Foundation Trust chairman said: “This outcome marks an important point in a process that will lead to much closer integration of acute and community services in East Devon to the benefit of our patients and communities.

“We look forward to working with our NHS colleagues to complete the procurement process and then working with our communities and colleagues within the NHS and outwith to further develop integrated health and care services in a way that best meets our communities' needs.”

Dr Tim Burke, a GP in North Devon and chair of NHS NEW Devon CCG, said: “We have always maintained that we were taking decisions in the best interests of patients, so we are very pleased that Monitor has found in our favour. It’s great news for patients.
 
“All NHS organisations involved will now work together on the next steps.” 

The full Monitor report is available here. 

New clinics and services launching at Crediton Hospital

18 August 2015

New clinics and services promised by the NHS have recently been introduced at Crediton Hospital, as part of the development of a Health and Social Care Hub. 

The GP involved in leading the project, Dr Alex Degan, has thanked local people for their ideas and support, stating their input has been ‘invaluable’.  He added that as more space becomes available at the hospital, additional services will be considered. 

Over 20 different clinics are already running from the Hub, including community nursing, bladder and bowel services, clinical psychologist, physiotherapy, midwives, chiropody, audiology, cardiac rehab and the Multiple Sclerosis (MS) exercise group.
 
New clinics and services recently introduced at Crediton Hospital Health and Social Care Hub include geriatrician clinics, a stop smoking group and new children’s services such as baby clinics, health visitor and school nurses.
 
The Depression and Anxiety Service (DAS) has also been greatly expanded. 
 
Work to identify further outpatient services is ongoing, however with these new and expanded services the outpatient department is now at full capacity. The group is therefore reviewing the use of space in the hospital to see if additional capacity could be created for new services.
 
Members of the local planning group for the development of Crediton Hospital heard from local NHS staff this month about the range of new services and clinics launching at the Crediton Hospital Health and Social Care Hub.

The community and NHS have been meeting regularly since early 2014 to discuss how the hospital could be of most benefit to Crediton and the surrounding areas in the future.

The planning group is made up of local members of the community including representatives from the Hospital League of Friends and Patient Participation Groups (PPGs) from local GP practices, the Town Council and the voluntary sector.

It also includes clinical leads and managers from NHS Northern, Eastern and Western (NEW) Devon Clinical Commissioning Group (CCG) (the organisation in charge of buying services at the Hospital) and Northern Devon Healthcare NHS Trust (the provider of services at the Hospital).
Dr Alex Degan, a local GP and Chair of the Crediton Hospital Steering Group, said:
 
“We are extremely grateful for the input of local people into the planning and design for the Crediton Hospital Health and Social Care Hub.  Their involvement has been invaluable.
 
“The introduction of new and expanded services at the Hub is really pleasing to see and will bring a range of benefits to local people.  We are looking forward to seeing these develop.”
 
Over the last month, the planning group has been looking at the potential for voluntary sector services to be based at the Hub. They are also looking to see how links could be strengthened between voluntary organisations providing services in the community and in the Hub.
 
There are already many voluntary services in the local area. With this in mind, the group is focusing on how to improve links between the Hub and these services, through a signposting service.
 
Healthwatch Devon recently spoke to over 200 people in Crediton and the surrounding areas about health and social care services they would like to see in the town.  The information collated will be used in the future planning for the Health and Social Care Hub at Crediton Hospital.

New transfusion service at Moretonhampstead Hospital Health and Social Care Hub

18 August 2015

A NEW medical day treatment service is to be launched at Moretonhampstead Hospital Health and Social Care Hub next month.
 
It means local people will be able to have treatment such as blood transfusions and other infusions in Moretonhampstead, saving them a regular journey to Okehampton or the Royal Devon and Exeter Hospital.
 
The Northern Devon Healthcare NHS Trust is to run clinics one day per week, starting on Thursday 3 September.
 
Further services will be brought into the hospital over the coming months as part of its transformation into a health and social care hub.
 
Emma Bagwell, matron, said: “An infusion is an important procedure and our analysis of patients in Moretonhampstead and surrounding areas showed that it could be really beneficial to introduce clinics at the hospital.
 
“We’re keen to bring more services into the hospital so local people can be seen and treated close to their homes and avoid a trip elsewhere.”

Care Closer to Home position statement

18 August 2015

NHS Northern, Eastern and Western Devon Clinical Commissioning Group (NHS NEW Devon CCG) is temporarily pausing its consultation on the future of community services in North Devon.
 
It follows Northern Devon Healthcare NHS Trust’s (NDHT) own decision to combine consultation to make services more efficient, with the CCG’s consultation of the longer term future of the services.
 
The CCG was concerned that combining the two issues would complicate the process and has therefore paused its consultation.
 
NDHT announced its intention last week (11 August 2015) to begin a six-week public consultation on maintaining safe and effective care in the North Devon area, within its existing budget.
 
The CCG understands that NDHT has put forward a range of options in its consultation related to a reduction of community hospital beds.
 
NHS NEW Devon CCG welcomes alternatives to community hospital provision, which has been shown work in Devon, as well as other parts of England.
 
The CCG also welcomes the Trust’s commitment to provide more publicly-available information about home-based care, including the North Devon District Hospital (NDDH) site for community beds and criteria for assessing the various proposals. 
 
The CCG supports NDHT to deliver cost-effective and safe services, but remains concerned that some of the options proposed do not align with NHS NEW Devon CCG’s strategic direction. It also has misgivings about the speed and impact of change being proposed.
 
The CCG does not support permanently closing beds in community hospitals in North Devon without first increasing out-of-hospital support, and it is the CCG’s view that investment by NDHT is needed in community services to enable them to thrive in future.
 
The CCG believes this can be achieved by rebalancing resources from community hospitals towards community services.

The CCG does support flexing the number of community beds to meet patient demand, but not the closure of beds.
 
The CCG says proposals to permanently remove any inpatient beds in community hospitals in North Devon require a full assessment of their impact on the community.
 
Due to the points above, NHS NEW Devon CCG is yet to be assured that the current NDHT proposals increase overall service efficiency, rather than reduce the service itself.
 
The CCG has concerns about the impact on community services at the very time when we are trying to assist acute units by providing more robust and sustainable community services.
 
The CCG will continue to talk with NDHT about the issues outlined.
 
The NHS is experiencing unprecedented growth in demand in a tough financial environment.
 
The CCG, which is responsible for commissioning healthcare services in most of Devon, is itself trying to balance a £40 million budget deficit.
 
NDHT remains the CCG’s only major NHS acute healthcare provider to plan a budgetary surplus in Devon.
 
Negotiations on this year’s contract to provide healthcare services, including community hospitals and related services, concluded in May 2015.
 
The agreement again provided NDHT with sufficient funds to continue to provide a high level of service in its acute and community hospitals. 

Latest update on the Exeter NHS Walk-in Centres

12 August 2015

As the clinical commissioner for services in most of Devon, we acknowledge the public support for the Walk-in Centre (WIC) facilities in Exeter. It is important to note, however that no decision has been made about the future of either WICs in Exeter at the Royal Devon and Exeter Hospital or at Sidwell Street.  Indeed, the current review of these services is on hold.

Last year Professor Sir Bruce Keogh, NHS England Medical Director, led a national review of urgent and emergency care. This review emphasised the need for services that were clear and of high quality so that people with urgent care needs would be treated in the most appropriate setting.

In future, we should expect that patients with urgent, but not life threatening injuries or illnesses, will be treated in Urgent Care Centres, rather than Walk-in Centres.

Urgent Care Centres will provide high quality care, with consistent opening hours and clearly specified roles. This will be an improved level of service that will hugely benefit patients in Exeter and surrounding areas.

At this early stage in the process, we don’t have all the answers and we are awaiting further national guidance, which will help us make decisions locally.
What we do know is that we will commission these services through what is known as a procurement process, with times and dates yet to be agreed.  This is also dependent on national guidance that is not yet finalised.  Further public information will follow once this national guidance is received.

Should the guidance and associated local reviews lead to a proposal for a different model of care to that presently in place in Exeter, or one that differs to the proposal that NHS NEW Devon CCG recently consulted on, then further consultation would take place.

In the meantime, we expect the urgent care services currently available at the two Walk In Centre's in Exeter to continue in the present form for the foreseeable future.

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