Gloucestershire, Covid19 and Cheltenham General – an update

Today the county’s Health Overview & Scrutiny Committee (HOSC) met in private for a joint Q&A session with the parallel scrutiny committee on adult social care and with senior local health and social care managers. I was part of this meeting as Cheltenham Borough Council’s representative but I don’t think it should have been held in private – and I said so. The county’s planning committee managed to hold a public virtual meeting last month yet the HOSC – which hasn’t met properly since January – isn’t even going to try to meet formally and in public until July. And this at a time of obviously heightened concern about public health, the NHS, care homes and the reconfiguration of local services like Cheltenham’s A&E during the crisis.

So here’s my public report back on some of the key questions raised and points made:

  • We did take time to thank the NHS, public health and social care teams and all their staff. And I added thanks to managers for innovations like mobile chemotherapy and online GP appointments that we should stick with even after the virus is defeated!
  • I questioned hospital chief executive Deborah Lee and Mary Hutton from the Gloucestershire clinical commissioning group (the NHS body that pays for local NHS services) about the planned reconfiguration of local services during the coronavirus crisis and whether or not these were genuinely temporary. The changes are aimed at separating Covid19 and non-Covid19 patients as far as possible, limiting the risk of transmission and enabling other services to return to something like normality. But they do involve temporarily downgrading Cheltenham A&E to a minor injuries unit (and possibly only a daytime one) while Gloucestershire Royal becomes the ‘front door’ for emergency admissions where Covid (‘red’) and non-Covid (‘green’) patients are separated, as well as centralising general surgery and possibly other surgical specialities in Gloucester while Cheltenham is kept clear of Covid for other intensive care cases, oncology, acute stroke care and some ‘elective’ or planned surgery.
Local Lib Dems have campaigned for years to protect the future of Cheltenham’s A&E department

What’s worrying local campaigners like REACH is that this doesn’t obviously reflect a neat red/green split and looks suspiciously like the rejected plan to downgrade Cheltenham General emergency and general surgical care that we all thought had been ditched. I was assured that the detailed changes were genuinely aimed at separating red and green patient pathways and that, yes, a full ‘Type 1’ A&E would be restored at Cheltenham in the end. I hope so.

  • Local Director of Public Health Sarah Scott reported the latest county statistics on the coronavirus. Following the national trend, they show fewer cases and deaths from Covid19 in Gloucestershire. Our total of 1369 confirmed cases (national data) and 533 deaths remains higher than more rural areas further south west but comparable to neighbouring counties and to statistically similar ones across the country. The urban areas of Gloucester (402 cases) and Cheltenham (320) are highest, again reflecting the pattern elsewhere. Questioned by Lib Dem representative from the Costwolds Paul Hodgkinson, she said there was no evidence that the Cheltenham Festival had caused extra deaths, not least because no attendees were traced or tested. The racecourse itself took the decision to carry on, following government guidance at the time.
  • Leckhampton & Warden Hill county councillor Iain Dobie raised the sharp drop in cancer treatment reported by the hospitals trust. He was told that referrals in from GPs and elsewhere were still running at only 55% of the normal rate suggesting many people with worrying symptoms are still staying away, even from their GPs. If that’s you, don’t delay.
  • I asked about the government’s test & trace strategy announced as ‘live’ on 28 May. It clearly isn’t up and running at full tilt locally with some data already coming through from national level but not yet in a format that allowed local public health teams to act on it effectively. We were told that could still be weeks away. Which makes the ongoing government lifting of lockdown measures look risky in the extreme.
  • The county council reported on the situation in care homes which is still concerning but at least testing and personal protective equipment (PPE) provision are now much better. Still, we were told some care homes had refused training in the proper use of PPE and that this training has only just started for domiciliary care workers who visit vulnerable people at home. Another alarming statistic was that there had been no great rise in hospital admissions fom care homes despite Covid. While some very frail residents wouldn’t have wanted admission regardless of illness, that still suggests to me that elderly people who should have gone to hospital didn’t. Perhaps part of the emerging national picture that government simply wasn’t on top of the lethal crisis in our care homes.

Several of the senior public health and NHS staff agreed we are not out of the woods yet. In the absence of widespread vaccination or more effective treatment, Covid19 may be a real threat for at least a year more. A second surge in infection is quite posssible. So please abide by the measures still in force including keeping your distance, regular handwashing and limiting contact with those from outside your household. More details here.

Lib Dems pledge cash for NHS as Gloucester A&E wait hits SIX HOURS

Outside Cheltenham A&E at the last election. Photo: Anna Lythgoe 07801819711

The Liberal Democrats have announced they would plug funding gaps for the NHS and social care by putting a penny on income tax, in their first major manifesto commitment of the election campaign.

The tax would raise an additional £65m for Gloucestershire, with £42m for the NHS, including mental health, and £23m for social care each year.

This is the party’s flagship spending commitment and its first major policy announcement for the election. The Liberal Democrats will also set out a ‘five-point recovery plan’ for NHS and social care services in their manifesto.

At least 70% of Brits would happily pay an extra 1p in every pound if that money was guaranteed to go to the NHS, an ITV poll found last October (link).

Former Liberal Democrat MP and now parliamentary candidate, Martin Horwood, said:

“This morning in Gloucester the waiting time to be seen by a doctor or nurse hit a staggering six hours while Cheltenham A&E was still turning away ambulances until half an hour ago because of the night-time downgrade.  This can’t go on.  It’s blindingly obvious we need two fully-functioning A&E departments in this county and that Gloucester Royal just can’t cope on its own at night.”

“This is a national problem as well as a local one.  Our NHS Trust isn’t the only one that has plunged into deficit in the last two years of Tory government.  And the Conservative candidate here voted for all the spending plans and Budgets that are making this happen.  He didn’t even mention Cheltenham A&E in Parliament for the best part of two years.

“The Liberal Democrats are prepared to be honest with people and say that to secure the future of the NHS we will all need to chip in a little more.
A penny in the pound here could be used be to pay hard-to-recruit rates and get the doctors we need into both A&Es, while the extra money for social care would ease pressure on the NHS too.  Only the Lib Dems seem to want to make this happen.

“This Conservative government has left our health and care services chronically underfunded – and while the crisis gets worse they just don’t seem to care.

“We cannot continue asking the system to deliver more and more without giving them the resources they need.”

Liberal Democrat Health Spokesperson and former health minister Norman Lamb said:

“The NHS was once the envy of the world and this pledge is the first step in restoring it to where it should be.

“A penny in the pound to save the NHS is money well spent in our view.

“But simply providing more money on its own is not enough and that’s why this is just the first step in our plan to protect health and care services in the long-term.”
NOTES

  • The Liberal Democrats manifesto will set out a ‘five-point recovery plan’ for NHS and social care services. This will include a 1% rise on the basic, higher, additional and dividend rates of income tax in the next financial year raising around £6bn per year, which will be ringfenced to be spent on NHS and care services and public health.
  • A regional breakdown of how the £6bn would be distributed, based on current funding allocations for both the NHS and social care, can be found here
  • Emergency departnment (A&E) waiting times at Gloucester Royal and Cheltenham General can be checked online here
  • Alex Chalk’s failure to mention Cheltenham A&E in parliament until 11 January 2017 can be checked on the independent website theyworkforyou.com.  He is no longer technically the MP following the dissolution of Parliament for the election.