Message from Healthwatch Camden Director – Frances Hasler
But we’ll also be looking at some familiar challenges, not least the continuing pressure on health services.
The Kings Fund has published a summary of rising demand in the NHS, showing how activity in the acute sector has grown year on year, and how the growth in funding is not as big as the growth in demand.
The result is, of course, a squeeze on services. The pressures on our hospitals have been well publicised recently.
The focus on the acute sector is a sort of distorting mirror. It is the most expensive bit of the health and social care system, and it is also the bit with the most extensive published data. So we know all about how many people are seen in A&E, how long they have to wait and how many of them are admitted to hospital.
But the NHS does not keep centralised figures on how many people are waiting for podiatry, or a wheelchair, how long they are waiting and what happens to their health while they wait.
We know how many GP visits there are each week. We don’t know how many could have been dealt with better by a pharmacist or a counsellor. Maybe most of them could. Or maybe none of them could. Your GP knows – but the NHS is not systematically collecting this knowledge to share.
Without the data from community, primary and social care services, we are only getting half the picture.
So political attention continues to be focused towards hospitals, because that is where the data is clearest. As we’ve reported before local Healthwatch organisations, including Healthwatch Camden, are being asked to take part in creating Sustainability and Transformation Plans.
The North Central London one is similar to the others – it proposes a move to more community and primary care provision, to divert demand from acute care. How can we be sure that this will lead to improved experience and outcomes for local people, when we have such scant information on the current experience and outcomes?
Of course, the fact that data is not published does not mean that no-one knows what is happening. Local staff, as well as local people, are usually well aware of the state of local services.
We want service planners to make best use of this tacit knowledge, by doing more to involve their staff and service users in plans. Local Healthwatch organisations are committed to doing everything we can to help make this happen.
We recently wrote to Sir David Sloman, Chief Executive of the Royal Free London NHS Trust and also convenor of the North Central London STP. We told him that:
“Healthwatch organisations across North Central London came together to form a joint view on the proposed governance of our STP. First and foremost, we would like to emphasise our concern about the lack of any information or reference to accountability within the structure.”
We reminded him that:
“The experience and wisdom of people who use NHS services is a vital
contribution to planning and improving service. The goal of engagement should be
far wider than simply winning public support for change.”
We want to see engagement that enables patients and citizens to influence service design and to hold providers and commissioners to account.
One part of the planning where local Healthwatch is involved is around urgent and emergency care. So over the next few weeks we will be talking to different people across the borough about their experience and urgent or emergency care and about their ideas for improving it.
If you have any thoughts on this, please voice them below.