Judy Terry is a marketing professional and a former local councillor in Suffolk.
What difference do local authority Health and Wellbeing Boards actually make? Where is the evidence that they hold local health services – and especially the Clinical Commissioning Groups – to account when they are restricting cataract treatments and hip/knee replacements, inevitably impacting patients’ independence?
In the Eastern region, there are a number of significant issues to be addressed. The Norfolk and Norwich emergency and teaching hospital trust remains in special measures, ‘requiring improvement’ following another CQC (Care Quality Commission) assessment, after being branded ‘inadequate’ a year ago. The May 2019 report notes ‘targets for mandatory training in medical care not met, and governance process not embedded, with inconsistencies in how risks are resolved.’
It goes on to add there is a “need to improve culture, openness and transparency across the organisation”. In response, the Chief Executive admits that there is more to do.
One is tempted to suggest a degree of complacency, with no evidence that the local Health & Wellbeing Board has sustained oversight; putting a councillor on the Trust board to monitor progress and report back would be a good start.
Meanwhile, the Norfolk & Suffolk NHS Foundation Trust continues to face criticism for serious failings in caring for the mentally ill, including suicides. Having lost its Chief Executive after about a year, it also remains in special measures, although external advisers are working hard to make a difference. At least the service now appears on the Health and Wellbeing Boards’ agendas, but without a joint Norfolk & Suffolk Committee focusing on the issues, and helping to contribute to solutions.
Questions could also be asked about how the East of England Ambulance service can justify spending £700,000 in 2018-19 on posh leased cars, including Audis, BMWs and Jaguars “for managers and top executives”, as well as ‘blue light workers’.
Challenging is uncomfortable, but surely that is the Health and Wellbeing Boards job, as taxpayers’ representatives. Perhaps they can earn some brownie points by taking positive action to raise awareness of the little known NHS plans for a new national rehabilitation centre in the East Midlands, alongside the recently opened Stanford Hall, run by the Ministry of Defence (MoD), which provides specialist care for our courageous servicemen and women.
Sadly, it is conflicts like the Iraq war, and all those years in Afghanistan, which revolutionised surgical and medical care for victims of explosions and weaponry, which would previously have taken lives. Thanks to the latest treatments, they can survive losing limbs, and vision, or serious brain damage.
Whilst Help for Heroes raised millions from the general public, as well as businesses, to support rehabilitation, it soon became apparent that Headley Court, the specialist centre in Sussex founded in 1899, which helped 20,000 patients annually, required upgrading to cope with the range and severity of injuries.
Alongside the latest technology required to develop prosthetics for lost limbs, today’s specialist care also means having the right facilities, and people, to restore confidence and mental health, as well as to provide permanent long term care for those who can never live independently.
This was recognised by the Ministry of Defence (MoD) and the 6th Duke of Westminster, Gerald Grosvenor, a Territorial Army Major General and passionate advocate for the Services. He understood life on the front line, funding a detailed review by specialists in the MoD and NHS and establishing The Black Stork charity with the sole objective to deliver world class facilities to meet current and future need.
In 2011, he spent £50 million of his own money to acquire Stanford Hall in the East Midlands, to create the new £300m Defence and National Rehabilitation Centre (DNRC). Located close to the Royal Centre for Defence Medicine at Queen Elizabeth Hospital in Birmingham, it strengthens the region’s reputation for medical excellence, and high level training opportunities.
Unfortunately, the 6th Duke died at just 64 in 2016, before the new centre became a reality, but his son, the 7th Duke, Hugh Grosvenor, took up the mission and recently donated a further £55 million. The Duke is evidently a private young man, but his family charity deserves credit, as does Help for Heroes, which directed its funds to this vital project, alongside major businesses, banks, entrepreneurs and philanthropists.
Fully operational from January this year, and four times larger than Headley Court, the Defence and National Rehabilitation Centre at Stanford Hall stands in 360 acres with a state of the art swimming pool, sports facilities as well as areas to simply relax and enjoy the extensive gardens and wildlife.
Recognising the value of concentrating expertise to speed up recovery and rehabilitation, the NHS proposed a separate facility on the site for the wider public, including the police or fire service personnel, suffering major injuries in, for example, car accidents or terrorist events.
However, at present, there doesn’t appear to be a budget or delivery plan. So this is an opportunity for local authorities to use their Health and Wellbeing Boards to demand information and a timescale, in the knowledge that their own residents would benefit, saving money by enabling patients, and their families, to rebuild their lives more quickly, reducing pressure on local health services
The MoD has created a successful model, which could be adapted, perhaps sharing the swimming pool and sports facilities, and specialist personnel, subject to appropriate security clearance. Working with their contractors to design, build and equip the new NHS centre would speed up the process, and reduce costs.
The public are generous in raising money for such good causes, but this can’t happen without a plan – and targeted publicity, to attract investment.
By championing it across their communities, Health and Wellbeing Boards could capture the imagination, taking credit for making it happen.