Health Matters – May 2019

Four Issues in this month’s Health Matters post:

  • Where to go if you need a hospital appointment
  • GP Appointments
  • Number of GPs per 10,000 Patients
  • 21 st Century Hospital – should you pay?

1. 21 st Century Hospital

We talked about Hospital reconfiguration in last month’s podcast; but we need to update it! There has been a significant leaflet dropping campaign across St Albans by a group calling themselves the 21 st Century Hospital Group – https://westherts21chospital.com/. They’re asking for money through crowd funding to “help raise money for the new hospital we deserve”; they want £38K and when I looked they were just short of a third of the way towards it. There’s a meeting at St Mary’s Church Hall in Marshalswick on May 15 to state the case.

Should you pay? Well by all means go long to the meeting and hear what they have to say, but whether you should pay up really depends on how you assess the probability of success. And that comes down to some fairly simple arithmetic

  • West Herts Hospital Trust – who are responsible for the hospitals in our area – have been told that their proposal for updating our hospitals should not exceed £350m – their annual budget. If they come in at this level it should go into the Treasury’s Spending Review in the Autumn.
  • But they also say they need a minimum of £700m to fund a completely new hospital.

So, coming back to that probability of success in the crowd funding, what it actually comes down to is this:

  • Could the 21 st Century Hospital Group show that WHHT has got its sums wrong and they could actually do it for £350m? Or
  • Could WHHT still get it into the Spending Review if they put in a budget that’s twice what they’ve been told they should be able to get?

So, what would you do?

2. Is there a GP Shortage?

The Nuffield Trust has just published figures showing the number of GPs per 100,000 people has fallen by over 8% over the last five years – https://www.nuffieldtrust.org.uk/news-item/is-the-number-of-gps-falling-across-the-uk

The core findings are:

  • Across the UK, the number of GPs relative to the size of the population has fallen in a sustained way for the first time since the 1960s.
  • The fall in number of GPs has been particularly marked in certain regions of England such as North West London and the East of England. These regions also have the lowest total number of GPs per 100,000 people, whereas Scotland has the highest.
  • The fall in GPs per person reflects insufficient numbers previously being trained and going on to join the NHS; failure to recruit enough from abroad; and more practitioners leaving for early retirement.

So I’ve been diving through the NHS data to see what the situation is locally – this is what I found for our local Surgeries; the number of GPs per 10,000 patients in the Practice. So, to give you a benchmark figure first – the overall average in England is 5.5 and the average for Herts Valleys area (Watford, Hemel, and St Albans) is 5.4

  • Hatfield Road Surgery – 4.8
  • Lattimore & Village Surgery – 4.9
  • Parkbury House – 5.2
  • Grange Street – 5.9
  • Maltings – 6.1
  • Harvey Group – 6.8
  • Midway – 7.0

So there’s a significant variation among St Albans Practices – but these figures do need to treated with a degree of caution – they don’t take into account situations like maternity, sickness, and the fact that some Practices have patients with greater health needs, whilst some are teaching practices; in other words, not all Practices are equal, so, to an extent, we’re comparing apples with pears!

3. GP Appointments

And on the subject of GPs, one of the biggest complaints that we have as patients is not being able to get an appointment. There’s a lot that’s been done lately, such as weekend and late appointments, but overall appointment availability can be a challenge. So let’s think about this for a moment. Isn’t it a bit archaic to think that whenever we believe we can see a doctor we can make an appointment?

There’s evidence that between 20 and 30% of doctors’ appointments aren’t necessary – we may have believed we needed to see the doctor but, in reality, someone else would have been more appropriate (e.g. a nurse, a pharmacist, a social worker etc.).

So would it be better if doctor’s appointments were triaged – i.e. assessed as to what’s necessary?  And if it’s urgent we could be seen by a doctor that specialises in that condition as opposed to whoever’s available!

One surgery in St Albans – Parkbury House – already uses this approach to a significant extent. So, the solution may be one of triage (even given the unsavoury nature of the word triage and its origin in the Napoleonic Wars (dead, nearly dead, and could be saved).

4. Where To Go?

Do you have a medical procedure coming up? If so there’s a great web site that tells you the waiting times at all the hospitals within an area that you define – go to http://mywaitingtime.com/

Alan Bellinger Written by:

Alan is chair of the Maltings Surgery Patients Participation Group, and is also a member of the Executive Committee of the St Albans and Harpenden Patients Group. After retirement from a successful career in the private sector (working in both training and Information Technology), Alan wanted to get involved in supporting local health issues and has an excellent understanding of the patient’s view of health matters, Alan has lived in St Albans for well over 60 years; he and his wife Wendy have two children and they especially enjoy the company of their four grandchildren – all of whom live in the local area.