THE independent panel set up to review the new contract for medical cover of community hospitals, including Thame, has concluded that thit offers a “good service” and that it should stay in place.
However, the panel report, which was published on Tuesday, November 24, 2009, also recommends that the hours GPs spend on average in each hospital should be extended for a limited time period, while nurses undertake development training to enable them to develop their management skills. The report adds that The Practice, the group of Buckinghamshire GPs which won the community hospital contract, should be asked to take on these additional hours as they would have won the contract on this basis anyway.
The report, which was chaired by NHS Buckinghamshire Non-executive Director, David Lunn OBE LLB, endorses the way in which the procurement process was managed, but is critical of the lack of patient and public involvement. The report also urges NHS Buckinghamshire to define the role of community hospitals, as a matter of urgency, so that patients, the public and staff are clear about the way in which they will develop in the future.
The report concludes that the contract does not represent a significant service change, which would need public consultation, and that the new arrangements offer improvements in several ways. The review panel report will be considered by the Board of NHS Buckinghamshire at its public meeting on 24 November, when a decision will be made whether or not to accept its recommendations.
Chairman of the review panel, David Lunn, said: “I was not involved in the decision to agree this contract and like everyone else on the panel, went into this process with an open mind. Over the weeks of the review, as we heard evidence from GPs, nurses, patients and others who support our hospitals, such as the Leagues of Friends, it became clear that what was in place prior to the contract was far from satisfactory. While clinical care for individual patients might have been good, the way in which it was organised was not. In some areas, cover was being provided much as it is under the current contract. In others, however, GP trainees who changed every three months were being used. We even heard stories of patients being refused a place in a community hospital, because the GPs covering it would only look after their own patients.
I have no doubt that the procurement process had to take place. I also have no doubt that it was conducted properly. It is a great pity, however, that there was no dialogue with patients and the public during the process, as this would certainly have helped us to avoid the level of public concern which the issue raised. For example, people expressed concern that the service was being provided by a ?commercial? organisation, forgetting the fact that all GP practices operate as independent businesses.
As a panel, we are unanimous in our view that the current contract should continue, but with extended GP hours in the short term. Community hospitals are intended to be nurse-led environments. Our community hospital nurses do a fantastic job, and should be given the opportunity to develop their skills so that they are in charge of their own units, with good access to medical support when they need it.
Finally, I would like to thank my fellow panel members and the many people who gave up their time to talk to us and to tell us their experiences, their views and concerns. Listening to all the people involved has served to remind me how much our local communities value these hospitals. As the PCT moves forward with plans to determine the future role of community hospitals, I hope that this review will remind them of the importance of discussion with local people about what the future holds.”
The report will be looked at by NHS Buckinghamshire prior to the report going to the Buckinghamshire Public Health Overview and Scrutiny Committee on December 11.
READ DR Duncan Keeley’s response, on behalf of the Rycote Practice, by clicking HERE