Labour’s response to NHS consultation: Confused disengaged and late.

Labour-run Greenwich Council has produced a confused, disengaged and late response to the Greenwich Clinical Commissioning Group’s(CCG) consultation on urgent care in the NHS across the Borough.

 

The CCG consultation led by local GPs, was consulting on better ways that the borough can deliver its Urgent Care services including the future of the out of hours service, Grabadoc and the development of an urgent care service in the new Eltham Community Hospital when it is built later this year.  But Conservatives have accused the Labour-run Council of not caring about this important consultation after its response focused purely on the walk in centres in the North of the Borough, and did not oppose any closure of Grabadoc and did not even mention the possibility of an  out of hours urgent care centre  in the new Eltham hospital.

 

Leader of Greenwich Conservatives and Parliamentary Candidate for Eltham Cllr Spencer Drury said “It is quite unbelievable that on such an important issue as the NHS urgent care provision across the borough, the Labour-run Council has simply refused to engage, and  has not mentioned anything that matters for Eltham.  Instead, they have focused on their own agenda of walk in centres in the north of the borough showing, in my opinion, a typical lack of care for anywhere else across Greenwich.    On top of that their response was late.  It is not unusual for Greenwich Council to miss a consultation deadline, but this one had already been extended at their request.

 

“In Eltham we are particularly disappointed, as a strong intervention now by the Council could help ensure that an urgent care centre or even out-of-hours provision could be included in the new Community Hospital just off the High Street.  Conservatives have been leading the campaign for this but Eltham barely even warrants a mention in Labour’s response and there is certainly no support for this proposal.  Worse still, despite the fact that the Grabadoc contract with the NHS runs out this spring, there is no statement of support for continuing with that. 

 

“Labour say they care about the NHS, but when a proper vision of healthcare in the Borough is needed they are indecisive and weak which means residents will have worse services in the future.  I want an urgent care centre in the new Eltham Community Hospital, but Labour can’t even be bothered to support that.”

 

Notes for interested readers:

 

  1. Confirmation that Greenwich requested an extension to the deadline can be found at http://www.greenwichccg.nhs.uk/Get-Involved/Consultations/Pages/Right-Care,-First-Time.aspx where it states:

“NHS Greenwich CCG has received formal representation from the Royal Borough of Greenwich and Healthwatch Greenwich to extend this consultation, particularly given the fact that the consultation took place over the Christmas period.  In view of these representations, we have agreed to extend the consultation period until 31st January 2014.”

 

  1. The Council’s final decision on the consultation response was taken on 6th February 2014 and can be found at http://committees.greenwich.gov.uk/ieDecisionDetails.aspx?id=2520.  The only mention of Eltham in the response is under point 10, which reads:
    1. “Whilst the local consultation document reflects some of the themes andissues outlined within these policy statements, we wish to see further analysisof our local position. We hope to have a comprehensive picture of thestrengths and weaknesses of local provision. The council believes that thiswork should include an assessment of the capacity of the acute sector, theNHS 111 service and the London Ambulance Service in order to ensure thatall the elements are co-ordinated. We would also like to see the position ofGrabadoc and the new Eltham Community hospital set out in this context.”

 

  1. Questions asked in the consultation which the Council fails to address include:

 

  1. What do you think about the proposal to relocate the out of hours GP service from Shooters Hill Road to the urgent care centre at Queen Elizabeth Hospital?
  2. What do you think about the possibility of providing additional out of hours facilities in Thamesmead and Eltham?

 

  1. A transcript of Cllr Drury’s comments at the January full Council can be found below:

 

I obviously want, as a Councillor in Eltham, to make sure that our view of an Urgent Care Centre in the new Eltham Hospital was absolutely vital as represented.  But really I was wondering about two things.  I think partly, building on what Councillor Grant was saying, in the documents there appears to be a certain cynicism I think possibly is the right word about the effectiveness of the Walk-In Centres and I’m wondering, really, why that is.  Is in terms of the limited number of services they can provide and also I’m struggling slightly with some of the terminology about where Grab-A-Doc fits into this, which I think is an excellent service and is well used by many residents and I think it would be an enormous shame to see that go and I was wondering if you could comment on any of those points?”

 

  1. In response to Cllr Drury’s comments representatives of the Greenwich Clinical Commissioning Group said:

 

Dr Wahba                    Thank you very much Councillor Drury, I will address the issue of Walk-In-Centres and why the services are perceived not to be as good as the patient’s own GP’s.  From experience, if I see a patient of mine that I know, I know their history; I know their medications; I know how to trust what they’re telling me; I’ve got a relationship with them and I can bring them back the following day for follow up if I need to.  So, that’s why patient’s own GP is the most sufficient way to deal with the problem.  In a Walk-In-Centre, you are seeing a patient, you don’t have access to their medical records; you don’t know whether they giving their full medical history or not; they often do not know all their full medications; you don’t know their allergies; you spend a very long time trying to get to the bottom of all that; you don’t have any access to any diagnostics; you can’t arrange blood tests or x-rays as you will not get the results back, so you are very vulnerable in making a decision, a clinical decision, to treat someone you do not know very well and it takes a considerable length of time.  So, it is not as safe, clinically, as seeing one’s own GP and also not financially efficient because it takes so long to deal with one patient when you could have dealt with several patients.  Hence, the Walk-In-Centre may not always be as efficient. Of course they provide a, I am not saying that the quality of the service they provide is poor, I’m not in a position to judge the quality because I have not looked into that, but I am saying in terms of time efficiency and clinical safety, they certainly come second to the patient’s own GP.  So, whenever possible, it is better to see own GP but where {….} of access, as we mentioned earlier on and out of hours GPs do not work 24/7, so there is a need for patients to go to a Walk-In-Centre either to an existing one or the Urgent Care Centre at the QE.  We are trying to make these services staffed with competent GPs.  As far as Grab-A-Doc is concerned, if I can venture into answering the second part of your question, Grab-A-Doc uses only local GPs who work in practices within Greenwich and Bexley, so they know each other; they can talk to each other and they are familiar with the area that they work in, so are slightly in a better place to deal with this walk-in patient that you do not know. I’ll hand over to David, to maybe take over the rest.

 

David Sturgeon             Yes, I just want to say something about Grab-A-Doc and thank you very much for your comments.  Actually they accord with what an awful lot of people are telling us when we are talking to them, either at the consultation or when we had the focus group of patients that picketed for us, so Grab-A-Doc has come across as rated very highly.  What we have to do is to obviously make decisions on our contracts and we have a contract with Grab-A-Doc that is due to finish in a few months’ time and, ideally, we would like to ensure that we include that contract in a new arrangement but with such positive feedback from patients one would imagine they’d be in a very strong place to actually get awarded that contract.

 

6.       At the July 2013 Council meeting, Eltham Conservative Councillors Spencer Drury, Nigel Fletcher, Matt Clare and Adam Thomas presented a motion which called for:

“As a result Council calls upon the Leader of the Council and the Cabinet to investigate the creation of a Council sponsored Minor Injuries Unit (or similar) with the specific purpose of reducing the numbers of people attending the A & E Unit in Woolwich.”

The Council rejected this wording and replaced it with some comments about the A&E in Lewisham.  The motion can be found at http://committees.greenwich.gov.uk/ieListDocuments.aspx?CId=151&MId=3122 under item 15.

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