In recent weeks there has been a lot of debate about the future of Health Services in the light of pressure on hospitals and other services in the first few weeks of 2015. As we approach the general election I think that many people will be interested in talking about the health service they would like to see by 2020. NHS England published its five year vision at the end of 2014 and our Governing Body at its meeting in January considered the contents of a paper about the work of the Lancashire Leadership forum who want to take the initiative and plan for a Healthier Lancashire. The issues raised in both reports are familiar to us all, they include;
- How do we support people to care for themselves as far as possible
- How do we best support family and friends to care for people.
- How should we provide care for the very many people who now live well into their 80s and 90s but who also have an increasing number of conditions with which they have to live including Diabetes, Cancer, Heart disease, Dementia, Arthritis and Respiratory Disease. Many people have two or more of these conditions.
- How we find money to spend on prevention as well as treatment.
- How we get health and social care to work more closely together.
- How we increase the number of people treated outside of hospital.
- How we make sure that we have the full range of specialist treatments of the highest quality available to treat people.
- How to make sure we have the numbers of people we need with the right skills in the right places to deliver health and social care. View the Report.
There are other topics but I think this gives a flavour of the wide range of concerns that are on the minds of people as we hear stories about problems in Accident and Emergency Units which hit the headlines but are really just one sign of and NHS and Social Care system that is under pressure. Many of the initiatives which will make a difference are not seen as the traditional business of health services but as our Director of Public health Dominic Harrison points out in his annual report action is needed from the very local community level to that of national legislation. His report contains some examples of what is happening locally which should make a difference.
However services are also important and what will be available where and when needs to be considered. I think that it is understandable but perhaps not the most helpful way to raise the profile of the future of the NHS if we start with a constraint that we should under no circumstances move any services away from a hospital. With such a restriction change becomes more difficult to achieve. Like most people who live and work in BwD I want to be able to receive care when I need it as close to home as possible but I am willing to trade going further to a specialist regional centre such as Christie Hospital for a better outcome. This is not new as in the early 1980s when one of my children was ill I asked the GP who they considered was the best person to treat the child and was advised to contact a specialist who worked in a Manchester Hospital and subsequently had to make daily visits when in-patient treatment was needed as well as regular 60 mile round trips to outpatients. I will never know if the outcome would have been better or worse if I had used a more local service but can see the potential benefits from treatment being given by someone who is both a specialist and regularly delivers certain types of treatment.
The picture is complex and as a group responsible for commissioning services as well as playing a full part in the work of the Health and Well-being board we in the CCG do want to hear opinions about the best way forward.