Transcription of Meeting
Meeting the Challenge Consultation
Pontefract
19th March 2013
40
M = Male; F = Female; PM = Unidentified Panel Member
Steve Richards:
…do stuff for the BBC. And I'll be chairing this evening. And this is the way we're going to do it. We've got a very panel here who, very shortly, will be making a presentation to you. Before then, I'm going to introduce you to each of the various specialists who've come here tonight who'll be able to answer some of the precise questions that you've got. And then after the presentation, we'll open it out to questions from you. And it's a good number this one, you will all have a chance to raise the questions that you wish.
So before we hear from the panel, let me just ask each of the specialists to introduce themselves. And the reason I'm wandering around with the mic is that, even though you can all hear me without one, it's being recorded tonight, so do bear that in mind. When questions come up, if you could just wait for the mic to come, not for our benefit but it's been recorded, so the whole world can hear the outcome of today's meeting.
Anyway, I'm going to introduce you now to our specialists. If you could just say your name and your specialism.
Karen Stone:
Hello, I'm Dr Karen Stone. I'm a paediatrician working in the Mid Yorkshire Trust.
Kathryn Fishwick:
I'm Kathryn Fishwick, I'm a consultant gynaecologist and obstetrician at Mid Yorks.
Anne Ward:
Evening, I'm Anne Ward. I'm Head of Midwifery at the Trust.
Steve Richards:
And also on call. So if there's a sudden departure, that's the reason.
Matt Shepherd:
Hi, I'm Dr Matt Shepherd. I'm a consultant in accident and emergency at Mid Yorkshire.
Adam Sheppard:
Good evening, I'm Adam Sheppard. I'm a GP in Wakefield and Assistant Clinical Chair of Wakefield Clinical Commissioning Group, and I lead on urgent care.
Mike Potts:
Hi, I'm Mike Potts. I'm the Chief Exec of Calderdale, Kirklees and Wakefield Primary Care Trust. And I'm not a clinician, so I'm not a specialist in any of these areas.
Steve Richards:
Okay, thanks very much, Mike. I'm now going to ask Jo Webster, the Chief Officer of Wakefield CCG to start the presentation. Then she will, one by one, introduce each of the panellists. And then we open it up to all of you. Jo?
Jo Webster:
Thank you, Steve. Can everybody hear me? It sounds really quiet when you're stood here, so I have to make sure. So welcome and thank you for coming along to talk to us about these important changes. In a moment, we are going to pass over to Dr Shepherd and Dr Jenkins, to take you through the detail of the proposed changes. But I thought I just really wanted to take this opportunity to tell you how passionate I am, as the Chief Officer of Wakefield CCG, about why I believe that these changes are a priority for Wakefield residents.
One of the main reasons for the CCG is the ability to make sure that we buy services on your behalf, that delivery high quality safe care. And that is a real, real important priority for us, it's paramount. And I think we know that there's many reasons that face us locally, regionally and nationally that are going to actually face challenges in relation to being able to continue to deliver that care in a way that it's delivered currently. So we know that change is not an option, and we've experienced that every day in our lives, that we're constantly looking for how we can improve things.
So we can see, we know that there's a rise in population increase. And over the next 20 years, we'll see a 60% increase in 65 to 84 year olds; the number of 85 year olds will double; and that there'll be a 210% increase in long term conditions, and especially around dementia. So I believe that these changes give us the best possible chance of making sure that you continue, as residents, to have high quality care delivered from a local hospital, that will be sustainable for the future, that you can continue to keep your care as closer to home as possible.
So today is about making sure that you understand what proposals are being presented to you today; that we have an opportunity to listen to you; and that you can understand the impact, the wider impact that these proposals may present to you. This is not about closing A&E services. We have no intention of closing A&E services at Pontefract. And obviously, you'll want to challenge us on that, I'm sure, and talk to us more about that in the question and answer session.
So today is one of a number of ways in which you can get involved over the next 12 weeks. So it'll be ten weeks because I think we're two weeks into our consultation. We plan to have eight public meetings. So there's four at the beginning of the 12 weeks. We've already held three, this is the third one. We've got another one tomorrow in Morley. And then there'll be four at the end of the process as well. So there'll be another opportunity for local residents to come to a formal public meeting.
We've got a summary document that's been delivered to 242,000 households, not 42,000 households, across Wakefield and North Kirklees. And we've got a website where you c- questionnaire, that you can actually complete that online, should you wish to do so as well. On the website, there's a number of things that you can look at on the website. There's clips of some of the clinicians, our local clinicians that are here today, talking about the proposed changes. And there's lots more information on that, including a document that is more detailed around the changes than what you've got presented to you today and what you've received through your door.
We're going to have around 36 road shows across the district. And we have, over the last 12 months, tried to work with local residents, to make sure that we understand how you want us to communicate with you as well. So we believe we've got a comprehensive plan in place, but if you think that we're missing something, then please come and tell us, because what we want to do is make sure that everybody has every opportunity to understand what we're trying to do.
So I'm not going to say anything else. I'm going to pass over to Dr Earnshaw, who's going to take you through some of the more detailed changes. Thank you.
US:
Can I ask a question, please?
Jo Webster:
I think we're leaving questions 'til the end, sir.
Steve Richards:
If you could just wait, there'll be plenty of time, I promise you, I'll bring you in at the end of the presentation.
Dr Phil Earnshaw:
We'll be asking lots…you'll get chance to ask lots of questions. And, in fact, we'll extract them from you, so that you've got no more questions to ask, I promise that. That's the main focus of what this is about tonight.
Good evening, everybody, it's great to see you. Thank you for coming along. I really appreciate you giving up your evening to come and discuss what's really important to us, which is our healthcare and how it's organised.
You may ask yourselves if this is about hospitals, why is a GP - which is what I am - and Jo speaking to you. Well, from the 1st April, the way healthcare is organised is changing and the people that were responsible to make sure that you get the right healthcare services and purchase healthcare on your behalf, will be a clinical commissioning group. And for Wakefield and its district, it's NHS Wakefield District.
But a CCG sounds like a quango, but actually what it is, it's a membership organisation of 40 local practices in Wakefield District. This is why, fundamentally, these changes are different because, as local GPs, hopefully we can act on your behalf and actually get closer to the population, understand better what is needed. And Jo's already said it but our aim is just to make sure we've got quality services. And by that, I mean safe, efficient, with great health outcomes and great experience. So great care. And the one that, you know, we're really interested in is dignified care. That's something that's been in the press a lot very recently.
And this time round - and you're probably struggling to believe this - there are no reductions in service across Wakefield District. And for the people of Wakefield, it is a good news story, and we'll explain that over the next few presentations. So whenever I go around Pontefract, I always says things are not what they used to be.
And if nurses looked like that, perhaps that's a bad thing. But, you know, care has changed significantly. We all remember the entrance to Pontefract General Infirmary, it's still there. But if you go back a few years, things were markedly different from what they are now. My mum's in her 80s - she won't thank me for saying that - but when she was just 12 years of age, she spent six weeks in hospital with scarlet fever. And as a result, she's got aortic valve disease and mitral valve disease, and she may be looking at a heart operation, because of the effects of the infection all that time ago. If you think how TB and polio were treated in those days, people were in hospital for a year, 18 months, long term. Like you say, well, that's a long time ago.
Just recently, with the public health team, we were looking back to the last time public health was under the care of the local authority. It's going back to the local authority next month, but that's 40 years ago in 1974. And at that time, infant mortality was four times greater than it is now. So things have changed. And looking back, things weren't always that great.
I'm really telling you some inside stories now is that almost 30 years ago, as a house officer in Pontefract Infirmary. In those days, if people had a heart attack, they would spend up to ten days on our wards. And now, if you're having chest pain, the way care's organised is, you ring for an ambulance. That ambulance sends your ECG to a cardiologist and they decide whether you need a procedure there and then. And if you do, you go to the Leeds Heart Centre and you have that procedure there are then, no matter what time of day or night that happens. And the investment required is massive.
So care has changed significantly. Today, more than 70% of surgery is done as a day case. We've got a new eye centre at Pontefract Infirmary. One of my friends has just had her cataracts done, she was just there for half a day and she was out; not just out but she was out and about the next day. So things have changed significantly. And I don't know whether it's next month or in a couple of months, orthopaedic surgery is coming back to Pontefract. So that's good news.
We do need to move forward. This is some quite sad pictures really of the old hospital being demolished. I don't think that really enough has been made of the fact that we've got fantastic new hospitals in Pontefract and Wakefield. The buildings are great. And, if you like, improving the hospital estates was the first base, it was the starting point.
I remember, it's a few years back now, but my son, Andy, we were visiting my grandfather, his grandfather, rather, in Pinderfields Hospital. And as we were going into the old hospital and we went past the rambling bit, you know what I mean, and he said to me, he said, why have we got chicken sheds, dad, in the hospital? And I had to tell him, son, they're not in the hospital, they are the hospital. And I think we forget that we've moved from estates hospital buildings that were well past their sell-by date a couple of decades ago, and things have changed remarkably.
And I think that story sort of really spoke to me and told me that things needed to change. And they have changed. And now these are some pictures of the new hospital. We've got a new hospital in Pontefract and we've got a great new hospital in Pinderfields. And if the first base was sorting out those buildings, the second base is actually getting the services right and modern, and ready for the future in those hospitals.
I think we all admit that when the hospital staff moved into the hospital, there wasn't enough cultural and organisational change that happened, which modernised how we worked when we moved. There was some of that but we only did half a job. And really this is what this consultation is about now, which is moving forward and getting services aligned with the needs of the future.
Last week, I was at a meeting that was sort of looking forward to the new system. And all the messages nationally about what needs to happen to hospitals, what needs to happen to care, how we need to focus on different things, I closed my eyes, I could think well, that's Wakefield again. Because the same things are replicated throughout the country and we aren't any different, other than the people being special, but you don't do compliments either here, do we?
It's a shame that Dr Simon Enright's not with us tonight. Dr Jenkins is going to do a fantastic job telling you about the changes, but Dr Enright spent six months looking at making best use of Pontefract. And it was quite interesting to find out that we'd moved into new hospitals but there was actually lots more that could be done with the hospitals. And that's already started to happen. Pontefract Hospital, this year, is far busier than it was last year. And as I say, we've got a new eye centre; we're looking forward to a new orthopaedic centre; outpatients are up, day cases are up, and the diagnostic tests are up in Pontefract. So what we're about now is continuing that and making the best use of a great resource.
Before we talk about the hospitals though, I just want to put it in context that all these hospital changes are only part of making our services fit for the 21st century. As a CCG, as a group of doctors, we're all about promoting good health; about improving primary care; being able to get that appointment with the GP when you need it; getting community care and social care to work together - the jargon that we use is integrated - get them to work as one; to communicate far better. Whenever you've got a medical problem, it doesn't take long to realise that all the different services act as though they're on their own and they're not connecting up as good as they need to do. And we've got to solve that. And as well, I've deliberately put it last, but it's part of the jigsaw, but it's only part of the jigsaw, which is high quality hospital facilities. And it's the CCG's job, it's your doctor's job to get all these pieces to fit together and work well together, and much better than they have done in the past.