Today’s NHS – it’s a challenging time

Simon Truelove, Acting Accountable Officer

Not Salisbury (2)

The good news is that as a nation we are living longer – but what impact does our ageing population have on the amount of money we have available to spend on healthcare?

With increasing costs of medicines and treatments, and a national shortage of GPs and other health professionals working in the health sector, the NHS is currently facing one of its biggest challenges.

In Wiltshire we are definitely living longer, but not all of us are living well in our older years. A significant proportion of our annual budget is spent helping older people and people with a combination of lots of conditions like Diabetes and COPD to live well. In Wiltshire, over 22% of our population is aged over 65 – and 75,000 of us are living with long term health conditions.

Dr Richard Sandford-Hill, a GP at Market Lavington Surgery, says: “Providing medical care for an increasingly ageing population is difficult. In my own practice a majority of my routine appointments are attended by people aged over 65, and those people often have complex long term needs”.

The NHS is used to doing as much as it can with ever-stretched budgets.  The shortage of people working in social care means that together with Wiltshire Council, we’re doing our very best to make sure we can support people.  And it’s not all doom and gloom – we’re making some great strides forward to make sure we can properly deal with some of the issues we are facing.

Our number one priority is to make sure that older people can get the care and treatment they need either in their own home, or as close to home as possible.  Wiltshire has an overall population of over 480,000 and the geography of our county is a challenge.  But by working with Wiltshire Council, using a specially-allocated budget called the Better Care Fund, our GPs have established new ways of supporting people to receive care, stay independent and keep well without having to go into hospital.  We’re making a real difference to the lives of people in the Wiltshire by tackling head-on issues such as social isolation which can have a big impact on someone’s health and wellbeing.

We know that we face a tough road ahead, but by working in collaboration with our health colleagues right across Wiltshire we can carve the right path through, and continue to give people really good health care services.

For more information about the current challenges we’re facing, visit our campaigns page.

Current challenges are of real concern

An ageing population, increasing health care costs and a professional shortage in the health industry are all challenges faced by Wiltshire Clinical Commissioning Group (CCG).

Tasked with buying health services across Wiltshire, the CCG needs to make substantial savings in order to continue to provide the best health services for the people of Wiltshire.

Simon Truelove, Interim Accountable Officer at Wiltshire CCG comments:
“People are living longer which is a good thing, but they are not always living well. In Wiltshire, over 22% of our population is over 65 and there are 75,000 people in the county living with long term health conditions.

“A significant proportion of our annual budget is spent on helping older people and those with long term health conditions to live well. This does have an impact on our ability to provide services elsewhere in the system as we only have one pot of money available to us.”

Dr Richard Sanford-Hill a GP at Market Lavington Surgery said:
“Meeting the challenges of providing health care for an increasingly ageing population is difficult. In my own practice a majority of my routine appointments are attended by people aged over 65, and those people often have complex long term needs.

“Having a lot of people registered with our practice we are struggling to keep up with demand and are looking at ways that we can continue to support our patients by doing things differently. Our Emergency Care Practitioners (ECPs), are one example of how we are changing the way people access healthcare in the area. Our ECP’s are based in the community and provide health advice and support to people in their own homes. The fantastic service delivered by our ECP nurses means that we can free up GP capacity to review the care and support of people who are more vulnerable and at much greater risk of going into hospital.”

Simon Truelove continues:
“It is not only our ageing population that is of particular challenge, across the Wiltshire, BaNES and Swindon health and social care economy there is likely to be an annual funding gap of £100m by 2017 unless we can find ways to save money right across the system. In addition, a shortage of health and social care professionals, when demand is outstripping capacity, means that we are facing some very real challenges over the coming years.”
Dr Richard Sanford-Hill adds:
Financial pressures and an ageing population are not new issues but ones that we must address with some urgency. Key to relieving these pressures is by providing healthcare in or as close to home as possible and here in Wiltshire we are making good progress towards achieving this.

“I have been a GP in Market Lavington for over 20 years and over that time have seen considerable changes in the NHS. Compared with some areas of the country Wiltshire is doing relatively well retaining and recruiting GPs. However, some practices in the county are struggling to recruit and attract locums which does increase the workload for the remaining GPs. Unfortunately allied to this there is a big problem recruiting other health care workers, such as nurses and carers. This gap in resourcing places greater strain on the services we provide and means that we are continuously looking for ways in which we can provide services more efficiently.”

Simon Truelove continues:
“It’s not all doom and gloom though, we have made some great strides forward to help address some of the issues we are facing. Working together with Wiltshire Council through the Better Care Fund and the CCG’s Transforming Care of Older People programme is making a real difference to the lives of people in the county. Our joint approach has enhanced the support people receive in or as close to home as possible and we are tackling head on the issue of social isolation which can have a big impact on someone’s health and wellbeing.”

“We know that we face a tough road ahead, but by working with our health colleagues across the county we can carve the right path through. This will ensure that we continue to provide the best health services for the people of Wiltshire now and in the future.”

With a population of over 480,000 spread throughout a mainly rural county, delivering on its core objective of providing quality health services as close to home as possible is a challenge, but one that the CCG has defined as essential in order for health care provision in Wiltshire to remain sustainable.

Salisbury Walk-in Centre

The Walk in Centre will be providing a service for patients for advice and treatment when their GP surgery is closed from 6.30pm and extended until 10 pm every weekday evening, and 8am until 8pm every weekend and bank holiday as currently. There will be an increased GP presence over the later opening times to provide more GP advice and treatment.

Dr Hugh Bond, from Wilcodoc who runs the services says
“By being open until 10pm every weekday evening and from 8am to 8pm at weekends and bank holidays, we will be supporting our local Emergency Department (ED) by giving patients access to our service when ED is at its busiest, and the GP surgeries are closed. We also expect our waiting times to reduce enabling patients to see a health care professional more quickly”.

The most common problems patients attend the Walk in Centre for are minor illnesses such as respiratory infections and sore throats, and medication queries. During working hours, advice and treatment for these conditions can be advised through NHS 111 or talking to your local pharmacist or by a patient making an appointment with their own GP practice. If a patient’s condition is serious enough to warrant an on the day appointment then individual’s practice will be able to advise on this.

Patients are advised to attend the Walk in Centre during the opening times for minor illness and minor injuries rather than attending the Emergency Department which is for emergency situations only.

The decision was taken by the GP led Wiltshire Clinical Commissioning Group after due consideration and debate by clinical leaders. The changes are to ensure that our finite and precious GP resources are being used in the best possible way, at times when patients’ own GP surgeries are closed and working to provide an alternative service for patients than attending the Emergency Department.

The Walk in Centre will be open from Monday to Friday 6.30pm until 10pm and then on Saturdays, Sundays and Bank Holidays, from 8am until 8pm as currently.

If people need to access services during the day time Monday to Friday then they should ring their GP in the normal way. If an urgent appointment is required then all practices will be able to accommodate. Alternatively, people can ring 111 and they will be directed to the service which is most appropriate for their needs.

First patients from west of England recruited to 100,000 Genomes Project

The West of England Genomic Medicine Centre (WEGMC) is helping the NHS build a new genomic medicine service by providing NHS patients with the opportunity  to take part in the 100,000 Genomes Project.

Last month, the WEGMC achieved the major landmark of enrolling the first patients in the West of England region.

The project, a ground-breaking initiative launched by former Prime Minister David Cameron in 2012 and the largest national genome sequencing project of its kind in the world, aims to sequence 100,000 genomes from around 70,000 people with a rare disease, and their families, and from people with cancer. The West of England region was successfully awarded the status of being a national Genomic Medicine Centre at the end of 2015.

Adrian Shipp, 39 and from Bristol, is a haematology patient at University Hospitals Bristol NHS Foundation Trust and is one of the first people to join the 100,000 genomes project at the WEGMC.

Adrian said:
“I’ve had a haematological condition since birth and I think this important genomics research could provide some answers around it. I also hope the research could lead to improved diagnosis and treatments for people with rare conditions.”
Professor Ruth Newbury-Ecob, WEGMC rare disease clinical lead, said:
“At the moment many patients with rare conditions go through a ‘diagnostic odyssey’ of tests. Genomics has the potential to provide prompt and accurate diagnoses. As a result of this project, genomics may also provide screening and targeted treatments for common conditions such as diabetes, cancer and heart disease in the future.”
Dr Andrew Mumford, clinical director of the WEGMC, said:
“Patients, like Adrian, are absolutely at the heart of this project. We are thrilled to see that patients in the West of England region are supporting this very important initiative that will shape the future of healthcare and personalised medicine in the NHS.”
Professor Sue Hill, Chief Scientific Officer for NHS England, said:
“Genomics is vital to the future of healthcare and this is another great step in keeping NHS care at the cutting edge of science. The contributions of people like Adrian as well as families of people with rare disease are helping to build the future of healthcare across the country.

“We’ve been particularly impressed by the strength of the partnerships that the West of England Genomic Medicine Centre has brought together between the NHS and other key players which will help them to ensure a strong and effective service for the region.

“The UK is already a leader in genomic technologies and the unique structure of the NHS allows us to deliver these advances at scale and pace for patient benefit. This is another step towards building the knowledge and skills to improve care for generations to come.”

Clinicians from the hospitals involved will recruit potentially eligible patients. Patients choosing to be involved will then take part in a test which will then be processed in a lab at Southmead Hospital in Bristol, before being sent to a national centre for sequencing.

Some of the patients involved could benefit from a quicker conclusive diagnosis for a rare and inherited disease. Cancer patients may benefit because a treatment might be suggested based on a particular genetic change in their tumour.

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New campaign launches to encourage those with a persistent cough or breathlessness to go to their doctor

On Thursday 14th July, a new Be Clear on Cancer campaign is launching across England. The campaign highlights that a cough for three weeks or more could be a sign of lung disease, including cancer and that if you get out of breath doing everyday things that you used to be able to do, like mowing the lawn, it could be sign of lung or heart disease, or even cancer.

While it may well be nothing serious, the campaign makes it clear that if you have either of these symptoms you should go to your doctor. Finding these conditions early makes them more treatable.

The campaign will be live until 16th October and will see adverts running on TV and radio, in magazines and online. Click here to find out more.

People asked to be mindful of drinking too much this summer

With the holiday and festival season upon us, local residents are being asked not to drink excessive amounts of alcohol and risk damaging their health this summer.

As part of their Stay Well this Summer campaign, Wiltshire Council and NHS Wiltshire Clinical Commissioning Group are reminding people that excessive drinking in a short space of time can have lasting damaging effects.

Unit guidelines are now the same for men and women with both advised not to regularly drink more than 14 units a week, the equivalent of six pints of four percent beer or six glasses of 13 percent wine. People are encouraged not to save up their 14 units for one occasion and try to spread evenly across the week and have regular drink-free days.

People are also advised to limit the total amount of alcohol in one session, drinking more slowly and alternating with food and/or water.

The Stay Well this Summer campaign will also highlight a number of other summer-related issues over the coming months including water safety for children, safe outdoor eating and protecting yourself from excessively high temperatures.

Frances Chinemana, Wiltshire Council associate director for public health said:
“We want people to have a safe, happy and healthy summer and we hope our campaign will help with that.

“People will no doubt have a few drinks over the summer, especially if they go on holiday or attend one of the many festivals that take place, but we just want to gently remind people that drinking too much in a short space of time can have a negative knock-on effect to their health.”

Dr Peter Jenkins, Chair of NHS Wiltshire CCG, said:
“Most people enjoy a sensible social drink without it having any negative effect but at times lots of people will go out for a good time and have a few more drinks than they’re used to.

“Drinking more than the recommended limit is a habit that we can all fall into easily but drinking just a little too much alcohol puts people at greater risk of developing serious illnesses including heart disease, stroke and cancer.

“That’s why we’re urging everyone to take a sober look at their drinking over the summer and resolve to drink sensibly.” 

For more information, people should visit www.wiltshire.gov.uk//drugalcoholmisuse

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The Change4Life 10 Minute Shake Up with Disney campaign is back

The Change4Life 10 Minute Shake Up with Disney campaign is back and encouraging families to ‘Just Keep Moving’ as they kick off a summer of activity, inspired by this year’s Disney·Pixar film, Finding Dory.

Families can once again take part in the 10 Minute Shake Ups as well as enjoying Finding Dory inspired family swim sessions at local pools across the UK, all approved by the Amateur Swimming Association (ASA). The swim sessions provide an interactive hour of storytelling fun and activity for the whole family.

Too much inactive time is bad for a child’s physical, social and mental wellbeing, yet just 21% of boys and 16% of girls currently meet the daily national recommended level of activity of 60 minutes Being active helps children to build social skills, boost self-confidence, improve bone and heart health and maintain a healthy weight. Every 10 minute burst of exercise can make a real difference in helping children reach the 60 minutes they need each day.

Make this a non-stop summer of fun activity and search Change4Life online now for Disney and Finding Dory inspired 10 Minute Shake Ups and don’t forget to book your swim session at www.disney.co.uk/justkeepmoving.