Annual members meeting 2014

We held our Annual Members Meeting on Wednesday 17 September 2014 in the Oak Room at Woodlands Conference Centre, Chorley.  

Here is a list of questions that were asked at the Annual Members Meeting, September 2014:

Are there any recognised side effects when taking statins?

It is difficult to be specific in answering this question as the term “statins” relates to a group of medicines.  There are also several different generations of statins but, generally speaking, they are regarded as low risk medications.  In some prescriptions, initial muscle aches have been associated with statin use, but this has rarely required patients to transfer to different drug regimes.  Statins are generally administered to reduce long-term risk for patients and are therefore seen as beneficial to overall health.

Are the hospitals still doing minor operations on toes?

In general terms, our hospitals still provide a full range of operations required on toes (otherwise known as the metatarsal bones).  You explain in your question that when the surgeon reviewed your particular case it was felt that an operation would not improve your symptoms and therefore the operation was cancelled.  It is difficult to comment on individual cases, but if there are recurrent symptoms then it would be best to discuss this with your GP in the first instance.

Could you please confirm/give any information regarding recent articles in the papers about major healthcare contracts in Lancashire going into private hands?

The Government introduced a policy some years ago to require commissioners to tender many services every 3 years.  Private companies are entitled to bid for these services and are now providing many of them across the country.  The service remains an NHS-commissioned service as it is free at the point of delivery to all patients.  In addition, all GPs are required to offer a choice of provider to patients when making referrals to secondary care.  These providers often include a private sector option.  Again these remain NHS-commissioned services as they are free at point of delivery to patients.

Any measures in place to ensure the quality of information shared between LTHTR, other NHS services and private healthcare providers? Bearing in mind the CQC and RCGPs expressed concerns.

Please be assured that we have data sharing agreements in place with any other organisation that we share data with, alongside protocols which govern the format, content and use of such data.  These agreements are detailed, and provide the following as a minimum:

  • The purpose of sharing the information
  • Clarity on who will access and use the information
  • What information will be shared
  • What access controls are in place to govern access to the information
  • What information data and quality standards should be adhered to
  • An escalation process in the case of non-compliance with the agreement

With regard to the quality of the data, we have numerous checks and balances and data quality assurance processes that govern the documentation, collection and reporting of data; both within and outside the organisation.

Why, for a non-urgent outpatient appointment, can’t the choose and book service offer appointments more than a month ahead?

The “choose and book” system works on what are referred to as maximum waiting times; that is to say the range of dates for which appointments can be offered.  This depends on a number of factors, such as the capacity within the departments, and therefore for some specialties we are able to offer appointments more than a month in advance whereas in others we are not.

I have perused the latest magazine, finding it very interesting, especially the bit about the 3D bone scanner.  Regrettably I will not be able to attend the meeting as I have a prior engagement on that evening but I do have a point I would like to raise however.  “In view of all the persistent unsolicited phone calls which seem to be increasing daily, I suggest it would be very helpful, especially for elderly patients, if staff phoning from the hospital(s) said who they were at the outset – i.e. “this is XXX Department at Chorley/Preston Hospital calling” rather than “can I speak to Mrs/Mrs/Ms etc.”.  The latter is the approach from unsolicited callers, even sometimes using Christian names at the outset.  Being on the telephone preference service list makes no difference, you can still get several calls per day.

The reason our staff ask for individual patients when telephoning is to ensure confidentiality.  It is important that we identify and confirm who we are speaking to before introducing ourselves, so that we don’t inadvertently breach confidentiality or cause unnecessary upset to the patient or their family.  As you will appreciate, there are sometimes occasions when patients choose not to tell their family that they will be attending an appointment, or where such an appointment is of a personal nature.

If Euxton emergency out of hours service was incorporated at our hospital, what potential effect could this have on 24-hour A&E services?

The urgent care centre at Chorley and South Ribble Hospital will offer primary care facilities to people requiring an urgent response to their care needs.  It will complement the in-hours GP services, and provide an out-of-hours centre for when GP practices are closed.  A number of people will attend an A&E every day when their needs would be more appropriately met by their GP.  If A&E and out-of-hours services are located closely together, patients can be seen by the most appropriate service in a convenient manner.

Will the urgent care unit at Chorley replace the A&E facility?  And if so, how will RPH A&E cope with the extra demand?

The urgent care centre at Chorley and South Ribble Hospital will offer primary care facilities to people requiring an urgent response to their care needs.  It will complement the in-hours GP services, and provide an out-of-hours centre for when GP practices are closed.  A&E is designed to care for people with emergency care requirements and, as such, each department is designed to meet different needs.

I understand from the LEP that orthopaedic care is to be passed out to a private concern.  How will this be funded for NHS patients?  Elderly people are prone to hip and knee ops and replacements more than most.  What will it entail for them?  How will they be affected from diagnosis to recovery?

Although some orthopaedic care will soon be provided by a private company, patients will not be expected to pay for any treatment. All NHS treatment is funded by local clinical commissioning groups, and is free at the point of care regardless of where the treatment is provided.  The clinical commissioning groups currently make payments to us for the patients we treat, and these payments will transfer to the new provider.  The only difference patients should see is the location of their treatment.

What extra help is available for my fibromyalgia and why do some doctors not recognise it as a serious problem?

Many patients suffer from chronic widespread pain and the exact cause of the pain is often unclear.  Different diagnostic labels are used, such as “fibromyalgia”, “ME”, “fibrositis” “CFS” or “Chronic Pain Syndrome” although such terms do not contribute to determining an appropriate treatment.  “Fibromyalgia” is not recognised as a distinct disease entity in the way you describe in your question.

It is suggested that patients with chronic widespread pain may have abnormal pain perception and may process neural impulses in an unusual manner.  Such patients may exhibit a degree of somatisation where psychological conflict and distress is experienced as a physical symptom. There are, unfortunately, no conventional medical treatments for these phenomena.

The mainstays of treatment are (i) to treat any associated depressive illness according to current guidelines (ii) to encourage gentle, paced exercise and (iii) to reassure and encourage self-help.  Doctors do recognise chronic widespread pain to be a very serious problem, both for sufferers as individuals and for society as a whole.  Recognition of the magnitude of the problem does not mean that there is, or necessarily will ever be, a medical cure.

Some patients are able to derive benefit from programmes organised by suitably-qualified clinical psychologists and physiotherapists.  We run an excellent pain management programme called “IMPACT” and we also offer group sessions to help our patients to learn relaxation and mindfulness techniques.

If you would like to learn how to manage your life more effectively despite chronic pain, then please ask your doctor to refer you to the pain clinic for assessment.

When in-patients stay in hospital, is the food and services provided free of charge, or is the cost of their stay deducted from their tax allowance?  If the answer is yes, then the follow-up question is “how would the DWP be informed about the duration of their stay in hospital”. Surely a person who is being treated for an illness and is an in-patient should not be gaining a financial advantage by being ill.

When patients stay in hospital, no charge is made for the food and services provided to them.  We do not inform the Department of Work and Pensions that an individual is an in-patient.

What services and support do we provide for people with sleep problems?

Our ear, nose and throat (ENT) department provides a comprehensive service for sleep-related breathing disorders, ranging from simple snoring to upper airway resistance and the diagnosis of obstructive sleep apnoea.  We have the capacity to see at least ten patients per week and to provide domiciliary cardiorespiratory monitoring.  The team also works closely with colleagues in other areas of the Trust to provide continuous positive airway pressure (CPAP) treatments.

Has work with the clinical commissioning groups resulted in any major changes to the provision of services; if so which areas are affected or likely to be affected in the coming year?

We have been working with health and social care organisations to review the urgent care system, to make sure the right services are available when people need them, in the right setting, to help them stay well and retain independence.

The Lancashire Area Team (the local department of NHS England) has recently launched a new programme called Healthier Lancashire which will review what is available in the community and what needs to be developed to meet the changing needs of our local population, so that hospitals do what only hospitals can do.

Why in the Cardiorespiratory Department is the clinic being referred to as ‘Dr Roger Moore’s Clinic’ when he had left some considerable time ago?

The names of our clinics were largely historical and reflect how the appointment system was originally established.  As you rightly point out, consultants can change and often patients will actually be attending an appointment with one of the consultant’s team, which we know creates unnecessary confusion.  We have reviewed how we produce letters to make it clearer what appointment the patient is being invited to.  We have also reviewed the letters to make sure they are written in plain English, and only provide the detail the patient needs to know so they are not overloaded with extraneous information.

Why do my husband and I get appointments at Preston Hospital when we live in Chorley when neither of us drive and have to use patient transport which is costing the hospital money?

Some services are only available at one or other of our hospitals; for example, most of our planned orthopaedic procedures and breast care is provided at Chorley whereas radiotherapy and neurosurgery is only provided at Preston.  Waiting times can also differ so we might invite patients to a hospital a bit further away so they can be seen quicker.

Where services are provided at both hospitals we need to provide patients with a choice and are currently looking at our booking system to improve this.

I have recently read in the national press that some NHS staff are encouraging people to jump queues for treatment by paying or contributing for it themselves. This would seem to me to have the effect that those who do not pay, or are unable to pay, will be pushed farther down the queue. Also, being at odds with the principles of the NHS. Can you clarify whether or not this is happening in our hospital trust and if not will clinical need and fairness continue to be the sole criteria for treatment.

NHS patients are usually given a choice as to where they can receive their treatment, but we certainly don’t accept payments to fast-track NHS patients to receive quicker treatment.

 

Our next annual members’ meeting will be held on 23 September 2015, 6.00pm for 6.30pm, at Wellington Park Hotel, Leyland, PR25 3AB

 

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