Hands up everyone who knows how many “Calls to Action” NHS England has unleashed since the dog days of summer? OK, hands up anyone who has even heard of at least one of the Calls to Action? To get you up to speed, here they all are:
July – aimed at the whole of the English NHS
August – aimed at general practice across England
October – aimed at London’s NHS
So to recap: we now have the 3 calls to action (CTAs) from NHSEngland + what Ruth Carnall (former CEO of NHS London) is doing with the Mayor’s Office about London health + what Dr Clare Gerada (past chair of Royal College of General Practitioners) is doing with NHSEngland to transform London’s GP care + the implications of Francis and Berwick to contend with in London. And I suspect most Londoners – and even most of our GP practices – are blithely unaware of any of it.
Here’s the Big Question: Assuming that all of this is honestly done and well-intended (I do not share in conspiracy theories), how are we to avoid confusion and indifference and actually do something constructive that has public support for change? And it would be helpful to know what’s the alignment between these three CTAs and also with Francis and Berwick?
Answers on a postcard. Please write very small.
Trying to make sense of it at practice level
There is a way forward. That is to get general practices talking about all of this. Here’s a recent example I was involved in that worked.
The patient participation group Balham Park Surgery Patients Liaison Group (BPSPLG) at Balham Park Surgery London SW17 asked me to come and talk to them about the general practice CTA at their September meeting. About 20 patients attended plus some members of the clinical and management team.
We went through the slide pack provided by NHS England – and very helpful it is. The most interesting thing was the list below which summarises the discussion about the Call to Action. These are the topics which the patient group at this biggish practice, about 13,000 patients, in urban South West London said they were most interested in and want to take forward jointly with the practice team:
(a) Access 7 days a week to GPs and hospitals (both appointments and walk in/urgent care)
(b) A named GP for all elderly patients (or other clinician – someone who knows what’s going on)
(c) Same day appointments for routine and urgent matters at the surgery, not necessarily with named GP or nurse
(d) Exploring alternatives to individual face to face appointments to free up time for people really needing them (even Skype!)
(e) Thinking about patient expectations if federations of practices deliver wider services outside of hospital.
The patient group was quite clear that the expectations of public and service users would have to move with the times along with the attitudes and behviours of clinical staff and managers. We really were all in this together – not to re-coin an overused phrase.
Leadership needed locally
We look to the Wandsworth CCG to provide some leadership across the patch to discuss these key changes. All the Calls to Action impact locally.
The CTAs, especially the most recent one for London, are a perfect opportunity to demonstrate leadership and community education, but so far our CCG has been silent and invisible about any of this, which is concerning.
There is a big danger that essential changes in primary and community health care could get caught up in a political firestorm about acute sector reconfigurations (read “local hospital closures”) as the approaching London Council elections in May 2014 raise the political heat. If that happens and politicians start marching with placards, then the rest of the Call to Action will get ignored.
It has happened before when change was needed. If it happens again, London may not get another chance before it all hits the wall.
The Millar Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations. Feel free to contact us to discuss the opportunities. Follow MAC on Twitter @publicinvolve