Integrated healthcare not new, but not allowed

MAY I concur with your editorial regarding a proposed integrated primary care/secondary care solution for our much loved Hinchingbrooke Hospital (October 8)? However, what was not stated is that such an option is no longer acceptable under the NHS Pract

MAY I concur with your editorial regarding a proposed "integrated primary care/secondary care solution" for our much loved Hinchingbrooke Hospital (October 8)?

However, what was not stated is that such an option is no longer acceptable under the NHS Practice-Based Commissioning (PBC) agenda, as both the chief executive and Hinchingbrooke board are only too well aware.

It is therefore disingenuous of the chief executive to be promoting a solution that he knows to be a non-starter to the Huntingdonshire public, to his excellent clinicians and all the loyal, hard-working Hinchingbrooke staff.

For clarity and avoidance of doubt, primary and secondary care integration was a governance solution (to be managed and operated by the private sector) that was proposed by Anglia Health Solutions (of which I am now a director) and Interhealth Canada to the East of England Strategic Health Authority in July/August 2007.

Indeed, when I read in The Hunts Post of the Hinchingbrooke board's enthusiasm for this integration, I was reminded of "horses and stable doors" as the Hinchingbrooke Board refused outright to contemplate or even discuss the potentially innovative solution of integration in 2004, when invited to do so by the Huntingdonshire Primary Care Trust.

The integrated governance solution identified in your editorial is not new. This form of "governance arrangement" was first identified by Professor Kieran Walshe, director of research at the Management Centre for Healthcare Management, Manchester University, in a paper Returning to Local Governance in Health Care, published in 2004.

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Having studied this paper, I realised that there would be enormous benefits from integration for the healthcare system in Huntingdonshire and so I contacted Professor Walshe and invited him to facilitate a seminar here in Huntingdon so that the Huntingdonshire health system could commence the process of pursuing such a solution in order to ensure that "a sustainable healthcare service for the people of Huntingdonshire - into the foreseeable future" would be developed. Professor Walshe duly accepted the invitation, and the seminar took in the autumn of 2004.

I would add that, before organising this seminar, I sought the approval of the then head of the NHS, Sir Nigel Crisp, to explore this "integrated solution". Indeed, Sir Nigel was present when I formally announced the PCT's intention of doing so at our AGM of 2004.

Unfortunately, on the day of the seminar, to which many stakeholders were invited, the chairman and chief executive of Hinchingbrooke arrived over an hour after the seminar had started to announce formally that they did not wish to pursue this option, as the Hinchingbrooke board had decided their future was down the Foundation Trust Hospital route. This decision was just one of a number of subsequent misjudgements and mismanagement by the Hinchingbrooke board.

I could say a great deal about the financial mess in which the hospital finds itself. Suffice to say, the financial mess began to unravel (much like today's banking fiasco) on March 15, 2006, when the Huntingdonshire PCT first began to rumble the gross financial mismanagement taking place at Hinchingbrooke. The current problems all stem from that date, and the Hinchingbrooke board 'spin' since that time cannot change those very unpalatable facts, which are matter of record.

Sadly, the excellent clinicians, nursing staff and all support staff at Hinchingbrooke have not been well served for many years. They deserve first-class leadership and support, and a board that is worthy of their own efforts.



Huntingdonshire Primary Care Trust 2001- 2006