Agenda item

The following representatives will be speaking about the outcomes of the Dover

Project and general health issues within the Dover area:

Jenny Knight, Assistant Director, Patient and Public Engagement

Andrew Coombe, Interim Senior Locality Lead (Dover, Deal)

Allan Stibbs – Practice Based Commissioning (PBC) Business Manager

Dover Project Update

 4.1      Andrew Coombe, Interim Senior Locality Lead (Dover, Deal):  since Dover Project in 2006 5 Primary Care Trusts (PCTs) had merged and a Strategic Commissioning Plan was being developed for 2008-2013 with the underlying aim of providing world class health services comprising “better, faster care closer to home”.

4. 2      Commissioning locally needed services, based on factual input from GPs,  aimed to achieve best value from available funding and improve quality of patient care.  Dover and Deal were growth areas with areas of deprivation in Dover and significant immigration issues.

4.3       Five priority commissioning goals:

·        to break cycle of inequalities

·        to revolutionise services for older people

·        to tackle key killers: vascular disease, cancer and respiratory disease

·        to promote well-being and good mental health

·        to transform life chances for disadvantaged children

4. 4      Dover Project made some progress but circumstances had changed and now the Dover Commissioning Intentions was examining community needs:

                        Dover and Aylesham consortium approved July 2008

                        delivering more services locally in Dover

                        improving accessibility to services delivered outside Dover  

                        improving overall service performance and continuity of care

4.5       Key areas  identified:

4.6       Discussion session:

Ø      What is percentage of agency staff used and is it reviewed together with outsourcing services such as transport?  PCT is working with providers to improve all the time; supply of nurses is a problem, recruitment is partially successful but more nurses needed to be trained locally and discussions with learning institutions are on-going. Transport and access are acknowledged as important areas and Integrated Transport Group is investigating issues of transport to and car parking at hospitals.  Leaflets available and details on website. Age and location of person taken into account when making appointment and will look at sending out leaflets in post with appointments.  Instances given of where practice was failing.

Ø      Money spent on replacing Buckland Hospital has been wasted, proposals for replacement will not provide proper hospital with beds but glorified health centre, it will be on a one-way traffic system and on a floodplain. Intermediate beds in other locations will not have adequate nursing care;  patients from Dover and Deal should not have to travel to Canterbury, Ashford or Margate. Andrew Coombe replied that no intermediate beds were proposed at the moment and a review process into local needs was currently being undertaken with GPs. District Council, Environment Agency and Southern Water had all investigated the town centre site.

4.7       Allan Stibbs, Practice Based Commissioning  Business Manager, reported on the structure bringing practices together to discuss their needs and control over commissioning budget in order to buy better health services.  Some influence achieved on new Dover hospital by reflecting services needed in the community including orthopaedics, diagnostics, ophthalmology and allergy service now included in an Intention Document.  Health services in Eythorne and Elvington had been reviewed together with more rural villages and the new Aylesham Health Centre.  Leading GPs helping with Intermediate Care review and representations on Health & Wellbeing group, developing children’s’ trust, community nursing, midwifery and mental health access. Transport recognised as vitally important and PCT’s Chief Executive would attending a meeting to consider this.  Future Plans: continue with current plans; resource GPs; design services; be advocate for patients linking needs to services and delivery.  Representatives on new Dover hospital group will put forward local Dover views and encourage services outside the hospital to return to Dover, meeting patients needs.

4.8       Discussion session:

Ø      What improvements will we see?  Better, faster care closer to home.

Ø      We still have no appointments/cancelled appointments/missing notes; what concrete improvements will there be?  Have seen improvements in audiology – hearing aid waiting lists reduced; Minor Injuries Unit at Buckland increased opening hours as result of pressure; major recruitment of respiratory nursing team and supporting therapists means care closer to home for patients; heart failure nurses in post now to deal with cases in or near home.  All these driven by practice based demand. Want to improve ultrasound service in Dover.  Allergy services only at Guys or Medway because is highly specialised and are struggling to find local provider.

Ø      Buckland Hospital: replacement will not be a hospital, no-one listens to local views, should have refurbished old hospital. Allan Stibbs responded: not our brief to decide location of new hospital; key issues around intermediate beds, transport, parking – won’t get it all, won’t be perfect but will continue to lobby. Decision had been made on building a new facility, debate cannot be re-opened but your views will be taken back.

4.9       Jenny Knight, Assistant Director Patient and Public Engagement, explained the Dover Health & Wellbeing Fund: a joint initiative between DDC and PCTs linked to health inequalities and locally identified needs.  Projects supported include:

Dover Silver Song Club, Teenage Harm Reduction project

Get Active for Life, Bereavement Counselling,

IMPACT, Wild Food Walks, Promoting Active Children Everyday,

Food for All Looking good feeling good    

            Details of the Fund should be included in village and parish magazines or newsletters.