Justin Madders

Working Hard for Ellesmere Port & Neston

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Blog - 22nd February 2016

My short time as a Shadow Minister for Health has taught me a number of things about the way our NHS operates. Two of the most important of those things are that the goodwill and dedication of the staff are critical and that difficulties in one part of the system can cause problems everywhere else. Whilst many of my portfolio responsibilities are in acute healthcare I know that demand here can often reflect logjams elsewhere so I have used part of last week’s Parliamentary recess to see for myself how effective systems can improve the system as a whole. I was fortunate to have two excellent examples of this in my own constituency and spent a morning at each of them.

The first was at the Neston Medical Centre a long established GP Practice in the town. When I arrived at 8am I expected to see the queues outside the door of people waiting to see a GP but there was literally nobody there at all. I had thought maybe I’d come too early but in reality this is now the norm for the surgery such is the reputation they now have amongst their patients for people being able to be seen when they need to be, nobody feels the need to camp outside before opening time. Their secret? They have developed a highly efficient system of telephone appointments where patients are booked in for a call first thing in the morning and if they or the Doctor feel they need to come in then a personal consultation is arranged, at the patients convenience and usually the same day. I stayed in the surgery for the whole morning and you could count on the fingers of one hand the number of patients who actually came into the surgery. Routine prescriptions renewals and test results were nearly always dealt with over the phone and patients never felt under any pressure just to accept a phone call if they wanted to see the Doctor in person.

It seemed to me that the key to this was time and trust. Time is needed for staff and patients alike to grow used to a relatively new way of working but which in reality is how many interactions between the public and many officials actually occur. In a pressurised world and an under resourced health service there isn’t always time to let these methods mature and develop. I think the trust element is particularly important when looking at GP appointments; Dr Steere, the GP I shadowed had been working there many years; he knew his patients and they knew him. They had developed a level of trust that left them confident that if their GP felt it was fine to deal with things over the phone then they were comfortable with that as well. With the recruitment and retention difficulties currently facing General Practice the level of consistency and trust seen here may not be as easy to replicate elsewhere. That and the relentless pressure many GP’s surgeries face may well explain why not every practice is running this system already. If they had the breathing space and resources to do so then I am confident that within a few years the whole system would benefit, with reduced a & e admissions being an obvious improvement.

The second visit was to Ellesmere Port Hospital, or as it is known locally , “The Cottage Hospital”. It doesn’t have an a & e unit and offers a number of services. What I found most interesting though was how the hospital was adapting its services, with the help of the third sector, to cope with the increasing demands of an ageing population. A significant number of patients attending have some form of dementia and many are elderly and frail. What was particularly impressive was the way they have been given a significant amount of latitude to develop the services as they felt fit. A good example of this was the way they had changed their pillow case colours to red. These pillows are placed at the end of the bed to raise patients feet and reduce pressure on them. They found that making the pillow cases red ensured it was easy to spot if a pillow had slipped down and has led to a dramatic reduction in the number of bed sores. What they really excelled in though was working with other agencies and elderly patients to provide a stepping stone between hospital and home and at the other end working with people to ensure that they were fully supported so they didn’t end up being another a & e admission. What was clear was that they do a tremendous job and have a dedicated and caring set of staff but as always, they could do so much more with more resources and staff and the continuing pressure in the social care sector was a challenge with the difficulty in finding suitable placements for people with dementia a particular issue. I am sure though that if they were given the resources and the time to demonstrate the savings they can deliver in terms of reduced admissions to a & e in the long run they could do even better than they are now.

What both my visits taught me though was that there are ways in which innovation that needn’t cost the earth can deliver significant benefits to patients and savings in the long run. Recognising the experience our NHS professionals have and giving them the time and space to develop services is therefore surely part of the answer to meeting the ever increasing demands of an ageing population.

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