Currently patients have to live in a GP practice’s catchment area before they can register. This system dates back to 1948 when the NHS was created and one of the reasons was to help GPs manage their workload, especially home visits.

The Government is now looking at options to change this so people can choose a GP Practice that suits them. Most people want a practice that is near their home but some find it difficult to see a GP – for example, people who work fulltime and cant get to their GP during opening hours. Other people may want a practice with longer opening hours or different services.

There is more information on www.gpchoice.dh.gov.uk – responses can be done online or in writing to Your Choice of GP Practice, Room 2E42, Quarry House, Quarry Hill, Leeds, LS2 7UE.

The following note has been sent to the District Council by the PCTs:

Urgent Care Centres

The boards of NHS East and North Hertfordshire and NHS West Hertfordshire have reviewed progress on the development of urgent care centres for Bishop’s Stortford and St Albans.

There are existing minor injury units in both towns with 14,000 annual attendances at St Albans and 7,000 annual attendances at Bishops Stortford so they already treat a considerable number of patients locally.

Formal tendering process to develop new urgent care centres for St Albans and Bishop’s Stortford were halted at the end of 2009 because insufficient competitive bids were received. The current service providers were subsequently asked to draw up proposals to enhance the existing minor injury units in the two areas within existing resources.

This comes at a time when there are significant financial pressures in the NHS nationally and locally and the Hertfordshire PCTs are working hard to bring down a financial overspend primarily due to an increased level of activity in acute hospitals. The PCTs also face extremely challenging years ahead.

Having considered carefully, the boards felt there were risks that the new proposals, involving significant additional PCT expenditure, would not reduce patient attendances at A&E departments. Board members also felt there was a considerable risk of increasing numbers of patients choosing to use the urgent care services instead of their general practitioner therefore creating duplicate capacity and incurring duplicate costs.

The proposals would not therefore provide best value for money, be sustainable and maximise the use of resources in the current climate.

For these reasons, board members did not support the proposals. They asked the Urgent Care Working group to look again at how enhanced services could be provided in Bishops Stortford and St Albans and to report back to the new NHS Hertfordshire Board in the summer.

The Herts County Health Scrutiny Committee heard with astonishment that the PCTs are planning on cuts in excess of £28 million in order to manage an expected deficit this year of £24 million.

County and district councillors were already suspicious that there were major problems when the PCTs failed to deliver a financial update paper in time for the beginning of the meeting.

Documents handed out during the meeting showed that the PCTs were already well off budget and are planning major cuts next year including:
– ‘acute trusts validation of activity and pathways’: £8 million
– clinical effectiveness, including treatments of limited clinical value: £3 million
– reduced payments to ambulance service: £3.5 million
– ‘reductions in secondary care activity’: £5 million

Chris White comments; ‘Clearly they had something to hide. They were keen to make sure that elected members on the Health Scrutiny Committee had the minimum chance to analyse and penetrate the jargon and ask searching questions.

‘It beggars belief that there won’t be front line cuts: when I asked whether any operations would be cancelled this year as a result they failed to answer.’

Nick Hollinghurst, Liberal Democrat Health Spokesperson, commented during the meeting: ‘It is very disappointing indeed that we are back again in financial difficulties even before the new financial situation starts to bite.
‘You gave reasons: some is due to work being brought forward. But there is another factor: the increase in emergency admissions. I find this disturbing. This is the poor management of chronic disease processes in the primary sector. If we could just get the primary sector to give better treatment to people with basic illnesses we would avoid stress and suffering – and costs.

‘The PCT must manage the process in the primary sector.’

Chris White also commented: ‘The cuts in payments to the ambulance service are disturbing. So is the evidence of current mismanagement – why are the PCTs paying for treatments of limited clinical value?’

As of Friday 11 December 2009

The drop in the number of flu cases is thought to show that we have passed the peak of the second wave. However, there is significant variation across the age groups. There has been a marked decrease in flu cases amongst young adults and older children but the under 5s continue to suffer high levels of respiratory illness and are being hospitalised in greater numbers than other age groups.

Hertfordshire GP practices and community staff continue to vaccinate those in the priority groups. Nationally, decisions on how the second wave of the swine flu vaccination programme (for children aged between 6 months and 5 years) will be delivered have yet to be confirmed. In the meantime, detailed information and answers to commonly asked questions can be found at www.nhs.uk

As of Friday 4 December 2009

The Council continues to monitor the situation.

Swine flu is continuing to spread throughout the UK. So far, most swine flu cases have been mild, with symptoms similar to those of seasonal flu. Only a small number of people have had more serious symptoms.

Numbers of people using the National Pandemic Flu Service and collecting anti-virals has been fairly level over the past month.

Seasonal flu is now also circulating in the community. It is important that eligible people take up the swine flu vaccine when offered, even if they think they may have already had swine flu. These symptoms may have been caused by a seasonal flu virus and those individuals may remain at risk of infection from swine flu.

Swine Flu Symptoms can include a temperature of 38°C or above, plus two or more of the following:

Widespread muscle and joint aches
A cough
Headache
Blocked or runny nose
Sore throat
Vomiting
Watery diarrhoea
Cannot stop crying (only children)

People who think they may have swine flu should contact the National Pandemic Flu Service for assessment on 0800 1 513 100, or at www.direct.gov.uk/pandemicflu
Anti viral medication will be made available where required.

People should contact their GP if:
they have a serious underlying illness
they are pregnant
they have a sick child under one year old
their condition suddenly gets much worse
their condition is still getting worse after seven days (or five days for a child)

As of Friday 27 November 2009

The next stage of the swine flu vaccination programme has now been confirmed by the Chief Medical Officer. Once patients in the initial priority groups have been vaccinated, GPs will be writing to parents of children between 6 months and 5 years inviting them to attend a clinic for their child to receive a vaccination. We are told that the under 5s are particularly prone to catching flu and other similar viruses and so it is important that parents take up the opportunity to have their child vaccinated when it is offered.

More information will soon be made available through local press and schools explaining how the next stage of the vaccination programme will work.

As of Friday 13 November 2009

The Council continues to monitor the situation. There has been a slight dip in the number of people contacting the National Pandemic Flu Service, both nationally and at a local level here in Hertfordshire. This may be due to the October half-term holiday and should not necessarily be seen as the start of a downward trend.

The PCT reminds us that treatment with antivirals remains a key part of the strategy to manage swine flu as antivirals can prevent complications developing in otherwise healthy people. Whilst the spread of swine flu remains at a lower level than first thought, there is still a proportion of the population who are developing a very severe illness after contracting swine flu.

It is therefore very important that those in the priority groups take up their invitation to have the vaccination at the earliest opportunity. GP practices will be calling patients into clinics being held over the next few weeks.

A useful leaflet explaining who is in the priority groups for the vaccination and why it is important they have the jab can be found at Swine flu vaccination, what you need to know.

As of Friday 6 November 2009

The Council continues to assess the position on a regular basis.

For the first time in the second wave, the East of England region has seen a significant increase in flu activity and now is the region with the second highest rate for antiviral collection in the country.

There are now two hotspot areas in the region (Cambridgeshire and Peterborough) where numbers of people showing flu-like symptoms has risen above the regional and national average.

Hertfordshire figures are still relatively low in comparison. The number of antivirals collected last week ranged between 100 and 240 each day.

The vaccination programme has begun in Hertfordshire with acute trusts vaccinating their front line staff and patients.

A great deal of work has been going on behind the scenes to prepare for this programme and the PCT now has more than 320 clinicians who have received full training on administering swine flu vaccines. This group of staff will work alongside other staff such as district nurses, to ensure that all patients in the priority groups receive their vaccination as soon as practically possible.

There is a range of useful information available on the Department of Health and NHS Choices websites, including:

Swine flu vaccination, what you need to know – a public leaflet to explain who is in the priority groups for the vaccination and why it is important they have the jab.

Swine flu campaign resources – including downloads of the new respiratory and hand hygiene campaign materials.

As of Friday 30 October 2009

The Director of Public Health has advised that swine flu numbers in Hertfordshire remain steady, with no sharp increase in cases such as those in the North of England. The steep rises in other parts of the country have contributed to a near doubling of cases nationally over the past week.

The Chief Medical Officer, Liam Donaldson issued revised planning assumptions for the next six weeks. These assumptions are based on epidemiological information about how the swine flu virus is behaving and in general, show a more optimistic worst case scenario. Of course, in Hertfordshire our resilience planning has been based on far greater numbers of hospitalisations and deaths, so we continue to be well prepared for flu as it progresses this winter.

He also spoke about the increased demand that swine flu, plus the usual winter pressures will place on the NHS during the next few months. In the areas of the country seeing rapidly increasing swine flu numbers, NHS organisations are now starting to see signs of growing pressure. At the moment this isn’t the case in Hertfordshire, but as winter draws near and the use of NHS services grows, this may change. However he feels that the NHS winter planning processes will be adequate.

Detailed planning for the local swine flu vaccination programme continues. Acute trusts in Hertfordshire expect to have taken delivery of their first supplies of vaccine, and to vaccinate those patients in the priority groups, plus staff starting this week.

GP practices will be receiving their first vaccine supplies this week. The delivery is being managed nationally over a 3 week period. Practices will begin to invite patients when stocks arrive in their practice. This means that most clinics will be running between mid-November and mid-December. Information will be issued through local media to explain to patients in the priority groups that they will receive an invitation letter from their GP and encouraging them to respond.

Antivirals can be obtained locally from:

Boots in St Peter’s Street, St Albans provided you have phoned the flu line and have been given a reference number
Morrisons in Hatfield Road, St Albans provided you have a voucher from your GP

As of Friday 23 October 2009
 
The Chief Medical Officer has confirmed that he believes the second wave of swine flu is well underway. The rise in cases continues but is slow and steady, rather than the sharp peak seen in the first wave back in the summer.
 
In Hertfordshire, numbers remain steady with approximately 100 people collecting antiviral medication each day. Around 100 schools in Hertfordshire have reported some pupils with swine flu symptoms but no Hertfordshire school has what is classified as an ‘outbreak’ ( i.e. 15% absenteeism or marked increase in absentee rates due to flu-like illness).
 
In the past few days, important elements of the vaccination programme have been confirmed:
 
Each GP surgery will receive an initial 500 doses from 26 October. Following receipt of their vaccine supply, practices will be writing out to patients in the priority groups inviting them to attend a clinic as soon as possible. This means that practices are likely to be vaccinating their patients during both November and December.
A press release is to be issued by the PCTs this week to inform local people about the vaccination programme, explain why the vaccine is needed and how those in the priority groups will be invited to receive their vaccination.