Most of Ealing’s Healthcare Services Will be Managed by NHS General Practitioners: Just How is this Going to Work?
In six months’ time, a committee dominated by Ealing General Practioner (GP) doctors in the maelstrom of the expiring Ealing Primary Care Trust (PCT) will be running much of Ealing’s NHS healthcare provision.
NHS Ealing Clinical Commissioning Group (ECCG) is primarily a group of Ealing GPs who will be responsible for designing and provisioning local health services in Ealing. They will do this by commissioning or buying health services and care services including:
+ Mental health and learning disability services
+ Urgent and emergency care
+ Most community health services
+ Rehabilitation care
+ Elective hospital care
Any qualified provider can bid to provide these services. Allegedly at least three Ealing community health services were required to be handed over to any qualified provider in September 2012. I have yet to discover which services they were.
There are 217 doctors practicing at 84 GP surgeries in Ealing. The largest GP surgery is Queens Walk Surgery, Pitshanger with nine doctors. There are 18 surgeries with a single doctor, and six of these are in Southall. Southall has by far the most GP surgeries with 25, followed by Acton with 12. The complete geographic distribution is as follows:
9: Ealing W5
I have been unable to discover just how these the ECCG doctors intend to organise themselves individually or collectively to ‘provide’ the healthcare services listed above. No doubt with just a few months to go their plans will be well advanced. I have attended two recent public meetings (26 September and 11 October) at which the ECCG Chair was billed to speak and answer questions on this topic, but she failed to show up at either meeting. What has Dr Mohini Parmar got to hide?
We are led to believe that as many as 55,500 residents throughout NW London have expressed doubts in writing about a radical restructuring of NHS services and facilities throughout the region.
However in Ealing we have not been consulted or even informed on how our GPs intend to manage the delivery of healthcare to us in just 6 months’ time. Will it be outsourced – like the still floundering CircleHealth-managed Hinchinbrook Hospital– to a private contractor or contractors? If it will, who is the company or companies? To whom will this company/companies be accountable? Do the private companies lined up or signed up for this outsourced management work include Serco, Virgin Healthcare, Circle Health, Spire, General Healthcare Group and BMI Healthcare?
Will the CCG engage a private healthcare management company to provide some or all of these healthcare services? Alternatively will GP practices group together and perhaps fund and form (or are forming) new local healthcare administration and management companies? Finally will some GP practices hire in staff and elect to administer and manage their own post PCT operations themselves?
After seven years’ medical study and training doctors can become GPs. GP practices are probably run by the lead GP partner/ owner GP with possible administrative support from a GP partner or non-medical administrator. GPs always seem very busy when I consult one. One wonders how GPs will find the time to serve effectively and work with peers to manage the £90 million + annual Ealing healthcare budget. If Ealing CCG were to outsource, for example, its £10 million annual mental health disorders services budget would CCG members have the experience and skills to manage this? It’s unlikely that many Ealing GPs will have any private sector large company procurement experience.
For something as important as life and death and good health and poor health, we need to research and evaluate how our local healthcare is to be organised and provided. And as National Insurance payers and the NHS pay masters, we need to be happy with the arrangements we discover.
‘Public Health Ealing’: What is it and How Might it Work by April 2013?
Public Health is about helping people to stay healthy and avoid becoming ill, so it includes work on a whole range of policy areas such as immunisation, nutrition, tobacco, drugs recovery, sexual health, pregnancy and children’s health. As part of the restructuring of the NHS, Public Health England is being established as part of the Department of Health. ‘Public Health Ealing’ will be part of this and be operational by April 2013. Jackie Chin is now Director of Public Health at the London Borough of Ealing (LBE).
£18 million is apparently the 2013/4 annual spend for Public Health Ealing and LBE has already announced that 50% of it will be spent on sexual health services and drug and alcohol services.
Who Will Represent Patients’ and Carers’ Interests in Ealing?
Of course this is also changing. Over the last four years Ealing Local Involvement Network (LINk), under the stewardship of Beth Hales, and the administration of Hestia has performed statutory patient representation in Ealing. In the shiny new world of the Lansley/Hunt NHS, these two will be replaced in April 2013 by Ealing Local HealthWatch to be run by Carmel Cahill and Ealing Community Voluntary Services (based at Lido House,West Ealing). The new organisation will:
+ Represent the views of patients, carers and the public on the LBE Ealing Health and Wellbeing Board
+ Provide a complaints advocacy service to support people who make a complaint about services.
+ Report concerns about the quality of healthcare to HealthWatchEnglandwho can then recommend that the Ealing CCG take action.
2 November 2012