Thursday, 19 January 2017

Decision on prescribing proposals and the decommissioning of Foxley Lane following NHS engagement

 Today, Croydon Clinical Commissioning Group (CCG) approved recommendations to stop the prescribing of gluten-free products, vitamin D for maintenance, self-care medications and baby milk, and to decommission Foxley Lane women’s service, an eight-bedded mental health stand-alone unit in Purley.  Foxley Lane women’s service is run by South London and Maudsley NHS Foundation Trust (The Trust).



These decisions have been made in the context of the financial pressures the local NHS is facing. Croydon CCG needs to make savings of over £30 million next financial year, which is around 6% of the commissioning budget for local health services of £482.3 million.

Today’s decisions follow two engagement periods run from early November last year to Friday 6 January 2017 when the proposals were put to the public to give the local NHS their views.

Foxley Lane

Throughout the engagement process for Foxley Lane, Croydon CCG engaged face to face with almost 150 Croydon residents, patients and professionals and received a total of 57 written responses through the online and paper survey. A petition opposing the closure of Foxley Lane was created on the 38 Degrees website which, when delivered to Croydon CCG, had received 737 verified signatures.

The CCG’s decision has been clinically based and reflects the borough’s mental health strategy and commitment to treat more patients in the community closer to their own home.  Instead of being admitted to Foxley Lane patients will be provided with individual care packages in their homes where appropriate.  Patients that require more intensive support could be admitted to inpatient services including a new 14 bedded women’s ward on the Bethlem site which will open in the spring. These community services will be provided by a range of community mental health services including Croydon Home Treatment Team and the Community Liaison Team.  Last year 55 women were treated at Foxley Lane. By treating patients in the community rather than at Foxley Lane the local NHS could save over £500,000 a year.

Dr Tony Brzezicki, Clinical Chair of NHS Croydon CCG said:

“We want to thank all of those people who took the time to give us their views on our proposals. This insight has meant we have been able to amend and adapt our commissioning intentions to prioritise what is most important for our patients.

“We have heard first hand at public and community meetings, as well as in the written responses and petition, the passion people feel for Foxley Lane women’s service.  Those who responded, felt overwhelmingly that they did not agree with this proposal and they raised a number of concerns that we will continue to work closely with the Trust to address and to make sure those women who are affected will be supported.

“We know that the community mental health services in Croydon can offer patient centred packages of care to support women previously treated at Foxley Lane within their own homes.  We will work with the Trust to embed the Foxley Lane ethos within the community mental health services, which also receive positive feedback from their current patients.”

Dr Hugh Jones, Clinical Director, South London and Maudsley NHS Foundation Trust said:

“We have developed a treatment model based around the individual which we are confident will allow us to make sure every patient receives the best quality care.  The number of patients who are referred to Foxley Lane is very small, and we believe we can support all of them appropriately within the range of community mental health services we have in place following £9 million investment in Croydon over the last two years.

“We would also like to reassure people who raised concerns about mental health inpatient capacity in the local area that the Trust is opening a new 14 bed inpatient ward for women in the spring this year at Bethlem Hospital.”

Prescribing

Throughout the engagement process for the prescribing proposals, Croydon CCG engaged face to face with over 300 individual Croydon residents, patients and professionals at over 30 events, groups or locations.  The CCG received a total of 346 written responses through the online and paper survey.

Dr Tony Brzezicki, Clinical Chair of NHS Croydon CCG said:

“These are very difficult decisions but we need to focus our limited resources where we can have the biggest impact on people’s health and well-being.

“Although the response we received to our prescribing proposals was predominantly positive with over 70% of respondents agreeing that the CCG should stop providing self-care medications, we know these changes will cause some people who currently receive these products on prescription difficulty.  We want to work with local communities, Croydon pharmacists and GPs to help make sure we support people to find affordable alternatives and a phased approach to implementation over the coming weeks.

“As we heard during the engagement period, we share the public’s concerns and want to do what we can to prevent these changes impacting on the most vulnerable in our communities.  We are committed to working with local health professionals, community groups and the public to make sure everyone has access to good information to help them find appropriate alternatives to meet their needs.

The full Patient and Public Engagement reports for both engagement processes are published on the CCG’s website at www.croydonccg.nhs.uk

Croydon CCG is currently asking local people about their proposal to stop the routine prescribing of IVF.  To find out more and respond to the consultation, which ends on Wednesday 1 March 2017, go to www.croydonccg.nhs.uk

Tuesday, 17 January 2017

Talking Healthcare: Local NHS launches new ‘conversation’ with people in south west London

People in Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth are being asked for their input as the local NHS continues to plan for the future of healthcare in south west London.

Pressures on the NHS are making national headlines, as the service struggles to cope with rising demand in hospitals during the winter period. Local services in south west London are under increasing pressure and local clinicians and managers agree that a long term plan is needed to address the serious issues we face.


Some of the biggest challenges are:


·         Our population is increasing and ageing. More people than ever before are living with complex physical and/or mental health problems, sometimes needing new treatments which can be expensive. We want to help them live healthy, independent lives for as long as possible, but our current services are just not set up to do this.

·         Too often, people end up in hospital in an emergency when we could have treated them earlier or closer to home. Our systems are not set up in the right way: we do not do enough to keep people well, treat them as soon as possible or help them to monitor and manage their health on a day-to-day basis.

·         Due to increased demand, there are not enough senior doctors to provide the round the clock care patients need at all our acute hospitals – and this is made worse by the fact that too many people end up in hospital when they really do not need to be there. There is also a national shortage of other qualified staff such as GPs, nurses and specialist children’s doctors which makes it difficult to deliver consistently high quality care.

·         There are some excellent health services in south west London, but not all services meet the standard we want for our patients. The service you receive depends too much on where and when you seek help from the NHS. Too often, people end up giving the same information to lots of different professionals – this is what we mean when we say services are not ‘joined up’ enough and we need them to be.

·         Not all of our buildings are suitable for 21st century healthcare. They need to be brought up to scratch so that the NHS can provide the best possible setting for patients in a modern and safe setting. We need to upgrade facilities in primary care, mental health and some of our hospitals.

·         These pressures on the NHS are made worse by reductions to local council budgets, especially social care. When services such as day centres, home help, residential care and support for people leaving hospital are being reduced, there is knock-on effect on what people look for from the NHS.

·         As a result of all these pressures, the costs of providing our services are rising far more quickly than the money we get from central government each year. This means that there is a growing ‘financial gap’. If we do not address this by changing the way services are delivered, we will not be able to afford the services we now provide in five years’ time.

All parts of the local NHS – hospital doctors, GPs, nurses, therapists, hospitals, mental health trusts, pharmacists and commissioners - have worked together and with local authority colleagues and members of the public on a draft Five Year Forward Plan to improve local health services and make them sustainable for the long term.

During 2017, the NHS wants to build on many years of dialogue with local people in a new and wide-ranging ‘conversation’ across south west London, which is being called ‘Talking Healthcare’.

Over the next two months, public Talking Healthcare Forums will be held in each of the six local boroughs. The local NHS and local authorities will be encouraging local people to have their say in a variety of ways – at local meetings, via social media or by responding directly in writing to the ideas being put forward. The NHS will also be carrying out an online survey to gather people’s views on what matters to them about their NHS

Dr Andrew Murray, GP Chair of Merton CCG, said:  “We’ve been talking with local people for many years about the significant challenges local health services are facing. We’ve taken their feedback into account in developing a Five Year Forward Plan for south west London.

“The Five Year Forward Plan is not a detailed blueprint – it’s a series of emerging plans for how we might improve different areas of healthcare. We have published the document for discussion, and we now want to go back to local people and organisations and see what they think of the ideas.

“There are a whole range of ideas we are putting forward. The central aim is to tackle the challenges we have been talking about for many years, making sure people can get high quality care wherever they access our services and that the whole system works together, rather than different parts of it competing against each other.”

Dr Naz Jivani, GP Chair of Kingston CCG,  added:  “We need to deliver services differently to how we do now. If we help people sooner – and if we invest more money in primary care services, community care and support for people at home – we can improve the quality of care simply by spending our money more wisely. This will mean changes to the way in which health services support you and what is expected of you. But we believe that our plan will improve and also protect your local health services for future generations.

“We need to look carefully at what services are provided where, making sure more care is available closer to home for those who need it. We know we have some excellent services in south west London, but we also know that some of them are very stretched and we do not always meet the standards we want for our patients. We know, for example, that too many people end up in hospital when they do not need to be there. We also need to do much more work across the NHS and with our local authority colleagues to prevent illness and keep people well.

“Taken together, we think the ideas we are proposing will reduce the pressure on our hospitals and strengthen the care available to patients in the community – for example, making it easier to see a GP or another primary care clinician such as a nurse or pharmacist.

“This is the start of what we hope will be an on-going conversation with patients and the public about our NHS. It is precious to all of us and we want it to work the best way it possibly can for local people. We will of course share the feedback we receive across south west London and make sure that it continues to inform our thinking.”

The key ideas set out in the Five Year Forward Plan – and set to be discussed at local Health and Care Forums in each borough over the next two months – are set out in a summary of the plan which is available here The full plan is also available online

Unlike previous plans for the area, which were led by local commissioners,  the Five Year Forward Plan is the product of unprecedented collaboration between all parts of the local NHS, working with colleagues in local councils and with members of the public represented on all clinical groups.

How to get involved in ‘Talking Healthcare’


·         Go along to a Health and Care Forum in your area – dates listed below and on www.eventbrite.co.uk

·         Follow @SWLNHS on Twitter, using the hashtag #talkinghealthcare

·         Invite NHS spokespeople to your meetings to talk about the Five Year Forward Plan

·         Write to South West London NHS, 5th floor, 120 The Broadway, Wimbledon SW19 1RH

Health and care forums in south-west London


·         1 February 2017   Sutton Borough Event, The Trinity Centre, Holy Trinity Church, Maldon Road, Wallington SM6 8BL

·         7 February 2017  Croydon Borough Event, Croydon and District Masonic Halls, 73 Oakfield Road, Croydon CR0 2UX

·         8 February 2017  Kingston Borough Event, Kingsmeadow Function Rooms, Jack Goodchild Way, 422a Kingston Road, Kingston KT1 3PB

(The dates for the Health and care forums in Merton, Richmond and Wandsworth are to be confirmed.)

If you would like to attend a forum in your borough, please register your interest at Eventbrite (see above), or email us at SWLCCGs@swlondon.nhs.uk or phone 020 8251 0591 / 020 8544 6180.





The Case for the 20MpH Speed Limit in the South of Croydon

Further to the mailings that all Coulsdon West residents should have received this week (use this link if you haven't got yours yet) .  Please find a great website that advocates for the 20MpH speed limits in built up areas.

http://www.20splenty.org/briefings



There seems to be plenty of public debate and CWRA has not taken an official position on either side of the debate for this reason.  If you look through previous posts you can also see the counter position summarised.


Monday, 9 January 2017

A letter from Cllr Bashford re: the 20Mph Limit in the South of the Borough


Dear Resident

The Council have a policy to introduce 20 MPH roads across the borough, these will cover the majority of roads, with the exception of a few arterial roads, such as Brighton Road and Addington Road

Different people have different views as to the need for these 20 MPH zones, but if implemented will operate 365 days a years and 24 hours a day.

Two zones in the north have marginally voted in favour of the scheme and now it is our turn to tell the Council what we want. The Council will start its consultation on the 18th January and it will run until the 15th February. They will deliver a leaflet with the full details to each household. The details will also be on the Council’s website. The consultation is not a simple yes or no vote, you will be asked to explain why you object, if you do, to the consultation and it will relate to all roads in the zone you live in to be 20MPH. This is a departure from how the previous two zones were consulted on so it is very important for you to respond giving your reasons. In summary the first two zones in the north of the borough had an opportunity to vote yes or no in an opinion survey, but the two zones covering the south and parts of the centre of the borough won’t have that opportunity.

This is an all or nothing approach so you will be expressing your view for the whole zone you live in. For example, Zone 4 covers Croham, Fairfield, Fieldway, Heathfield, New Addington, Sanderstead (part), Selsdon and Ballards and Shirley (part). Zone 5 covers Coulsdon East. Coulsdon West, Kenley, Purely, Sanderstead (part) and Waddon. Each Zone is consulted on separately, so if you have an objection you will need to submit it.

As your local councillors we have a number of concerns raised with us about this blanket approach scheme. We asked the Council to consider problem hot-spots and areas of specific need such as outside schools, medical facilities and elderly care homes. They refused.
Whilst we all realise that accidents at low speeds cause less injury and damage there are a number of reasons why a scheme across the whole zone has raised concerns too. The concerns that have been raised with us are:-

• At low speed pollution is greater
• The police at the first scrutiny meeting on 20MPH zones said they would not enforce it.
• If there is no (or minimal) enforcement pedestrians have a false sense of security.
• This does not cover the main roads where the higher number/ most serious accidents are.
• Each Zone costs £300K to implement (£1.5M for the whole scheme) and only targeting specific hot spots is better value for money.
• Every road in the zone, at all times, eg 2am will be 20 MPH
• That this scheme will not prevent inconsiderate / bad drivers who are the cause of many accidents.
• That current 20MPH zones outside schools will lose their significance and become more dangerous.

If you do not receive the information from the Council by the 25th January please do let us know, so we can ensure you have the opportunity to make your views known.

Please do contact us if you have any questions.

Yours sincerely

Cllr Sara Bashford

Sunday, 8 January 2017

Consultation on the future of IVF and ICSI in Croydon


Croydon CCG has launched a consultation to ask local people what they think of there proposal to stop the routine provision of some elements of the assisted conception service: IVF and ICSI*.

As you know, this proposal is in the context of the increasing financial challenges we face.  Croydon CCG needs to make savings of almost £30 million next financial year, which is around 6% of the commissioning budget for local health services of £482.3 million.

Now more than ever we need to spend the money we have to commission local healthcare wisely as there is not enough money to keep funding everything we fund now.  We need to focus our limited resources where we can have the biggest impact on people’s health and well-being.

Typically, the CCG funds 150 cycles of IVF each year at a cost of over £800,000 to the local NHS.   Croydon CCG currently offers one cycle of IVF to couples who meet the national criteria, whilst national guidance is to offer three cycles.  Croydon CCG is now in a financial position where we are proposing that we stop routine IVF.  Where there are exceptional clinical circumstances a GP or consultant could still make an application on behalf of a couple to the Individual Funding Request Panel.

We know that these proposals will affect a limited number of couples, but that impact to those couples has the potential to be great.  We need to make sure that we understand and consider the views and needs of the people who may need these services in the future, and we will be working with local community and voluntary groups over the coming weeks to gather views to help us make this decision.

The consultation period starts today and will close on Wednesday 1 March 2017.  We are holding a public meeting to discuss these proposals at 6pm to 8pm on Tuesday 24 January 2017, and you can register here.

To read the full details of our proposal and to have your say please go to our website at www.croydonccg.nhs.uk

Kind regards,

Dr Tony Brzezicki

Clinical Chair, Croydon Clinical Commissioning Group


*In Vitro Fertilisation (IVF) is a technique by which eggs are collected from a woman and fertilised with a man’s sperm outside the body. Usually one or two resulting embryos are then transferred to the womb. If one of them attaches successfully, it results in a pregnancy. One full cycle of IVF with or without ICSI, should comprise of one episode of ovarian

stimulation, egg retrieval, fertilisation and the transfer of any resultant fresh or frozen embryo(s). Intracytoplasmic sperm injection (ICSI) is a variation of IVF in which a single sperm is injected into an egg.

Saturday, 7 January 2017

Coulsdon and Purley Debating Society

Next debate for Coulsdon & Purley Debating Society has been moved from the usual first Monday of the month to Thursday 12th January.

Coulsdon and Purley Debating Society

The Government’s Brexit strategy will damage London

Councillor Andrew Pelling, Labour Member for Waddon Ward

vs

Chris Philp, Conservative Member of Parliament for Croydon South


Thursday January 12th. at 8 p.m., Old Coulsdon Day Centre, Grange Park, Old Coulsdon.

Visitors welcome; for further details,

contact Angela Applin, 020 8668 8558.