Ex-chairman’s survival plans

A COMMUNITY health trust should be set up in Huntingdonshire, with the future of Hinchingbrooke Hospital as part of its remit. This is the proposal of Michael Lynch, former chairman of the disbanded Huntingdonshire Primary Care Trust. The three options fo

A COMMUNITY health trust should be set up in Huntingdonshire, with the future of Hinchingbrooke Hospital as part of its remit.

This is the proposal of Michael Lynch, former chairman of the disbanded Huntingdonshire Primary Care Trust.

The three options for the hospital's future being consulted by the East of England Strategic Health Authority were too narrowly focused on the hospital rather than patient care, Mr Lynch said.

"Given that there is a limited pot of money available, which is not going to change in the foreseeable future, we need to focus on what we can do with the money for all health services in Huntingdonshire," Mr Lynch said.


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He sees GPs and other community healthcare professionals taking a pivotal role in shaping patient care, with hospital-based clinicians also working more extensively in the community.

Patients want "fast, convenient services, often delivered very locally and shaped around people's needs and preferences, and high quality, integrated emergency, urgent and specialist services for patients wherever they are in the country," he said.

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"Healthcare is not about the retention of buildings and institutions, it is about patients and the quality of healthcare they need, at the right time, in an appropriate setting, which need not necessarily be a hospital."

The three current options for Hinchingbrooke - keeping services at the hospital broadly the same as now, streamlining them to provide most of them more efficiently or shipping services out wholesale to Addenbrooke's or Peterborough - all involve reducing the hospital's caseload, the first two by 20 to 30 per cent, the third by rather more.

But Mr Lynch said they "totally ignore the vital and increasing role played by GPs and Community Healthcare workers across Huntingdonshire and within Hinchingbrooke Hospital".

He called for a debate on which services are best provided locally and by whom, which services are best provided by working with other partners within the NHS, which are best provided by the NHS outside Huntingdonshire, and which best provided by other providers of care. The debate, he added, was "too important to be left only to those who have got us into the present mess".

He said: "If the SHA and the Hinchingbrooke board are serious in seeking a long-term solution for the future of healthcare within Huntingdonshire, we have to stop thinking about what is best for Hinchingbrooke Hospital as an existing institution, be it a district general hospital or future community hospital."

The underlying principle should be that care should be provided as locally and conveniently for the patient as possible, subject to the need to ensure that patient care is safe, effective, accessible, reliable, efficient, timely, equitable and patient-centred.

"Patients require integrated services. True service integration grows upwards from clinical practice and innovation, not downwards from organisational structures. Models of care should reflect local conditions, and local commissioners, providers and partners must act flexibly, and should not attempt to enforce one-size-fits-all solutions."

Mr Lynch predicted that, if Hinchingbrooke lost its maternity services in the shake-up, women's and children's services would swiftly follow. One solution to keeping services at Hinchingbrooke might be for them to be remotely managed, such as from Addenbrooke's. He called for the expansion of "clinical networks", which involve clinicians working for more than one organisation - many consultants at Hinchingbrooke also hold posts at Addenbrooke's - but Mr Lynch sees them also working in the community, such as in GPs' surgeries, and the role of GPs in the hospital expanded.

"Local GPs, operating within a community health trust ethos, are currently working alongside consultants in A&E at Hinchingbrooke and are already saving the hospital (and the taxpayer) hundreds of thousands of pounds by diverting patients to appropriate care.

"There is also a variety of minor tests and procedures which when carried out in the hospital cost hundreds of pounds but when done by a GP cost only £50 to £80. This type of inappropriate use of taxpayers' money has to change, as part of the vision for the future of healthcare in Huntingdonshire.

"We must resist the strategic health authority's bias towards centralisation and 'bigger is best' approach, and we must continue to demonstrate that we value our local services.

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