We were on the Road – Aintree University Hospital, in Liverpool. 170 people in the auditorium. Wow.
The panel? Sir Ian Gilmore (Renal Czar; Advocate of minimum unit pricing for alcohol; holistic thinker) (sorry, health warning – my views of the event, as ever, not checked with organisers or speakers – sorry!). Simon Bowers. GP and Clinical Vice Chair of Liverpool CCG.(Clinical Commissioning Group). Famous for a Panorama programme – “A day in the life of a Clinical Commissioner”. Patient advocate. Roz Gladden. Local councillor. Soon to be Lord Mayor of Liverpool. Housing Officer originally. And a bit into the joined up thinking that will be needed with Devo Liverpool coming along (probably). Making sure the holistic approach will actually happen.
We were there the day after the Junior Doctors second strike. Made some of Roy Lilley’s lines of questioning and provocations easy. They all felt that Trusts – who will after all pick up the pieces that any of the negotiators agree upon, are really caught in the crossfire. We are in danger of risking care to the patients by taking our eye off the ball, they argued. What people want at the front line is the freedom to drive up quality and safety. Through the day we had attended exhibitions of The Academy of Fabulous NHS Stuff ideas, under the auspices of Healthy Liverpool. As Sir Ian said, Liverpool has made substantial progress – from a very low base. But the number and quality of simple actionable programmes being showcased here is what is driving the successes, I think.
Some other quotes and highlights? As ever, Mr Lilley was provocation personified. “This is barmy – you haven’t put Healthcare into Devo Liverpool” (it will be in the next phase…). “The CCG’s can’t agree – so places like Aintree Hospital don’t know which pathways to use for discharging – because it depends where the patient lives” (This does sound daft to me. The locals call it “What colour is your wheelie bin?” Each authority has different coloured bins dependant on geography. Roy lost some of the localism. “The 3 CCGs go from out near the Woolly Backs in the south to posh Southport” Woolly backs are the non city dwellers – who can see sheep from their gardens….).
Is it time to amalgamate the CCGs to be co-terminus with Local Authority boundaries served by the local hospitals? Fewer meetings, less administration, and simplification?
There was a lot of discussion about the interface between medical and social care. The Buurtzorg model of nursing (and cleaning, shopping, cooking, bathing and more) from Holland was mentioned again (Google it). We do seem in a ‘full bed occupation’ stranglehold because of the interface between health and social care becoming a barrier rather than an enabler. The panel all agreed though that multi disciplinary teams residing in the Primary Care surgery improved communication and effectiveness. And, an absolute truism, borne out of bad experiences, was never to cut Public Health budgets when money is tight. It is a false economy.
Sir Ian remained optimistic. Yes, we could see a time of working better together. There is a lot of passion to make things continue to improve. Perhaps the horrors of squeezed budgets and austerity at least foster innovation? There does feel like there is both a vision for a healthier Liverpool, and opportunity to turn talk into action.
Saddest moment? One of the contributors would not want their kids to follow them into medicine. If you keep kicking people (from our Press to the Government) eventually people will give up.
I didn’t feel that after this meeting. The place crackles with energy and positivity. And much of the force of nature up in the north west is very copy-able.
I suggest you all check it out via the Fab NHS Stuff portal – and steal with pride from the Scousers!