Health Matters – November

Four subjects this month –

  • Integrated Care Board
  • GP Practices
  • Patient Choice
  • SEND Report
  1. ICB Achievements & Challenges – If you remember I am the chair of the Patient Engagement Forum and last night (Tuesday 14th NOV) we had an hour with Paul Burstow who is the chair of the Herts & West Essex Integrated Care Board. The key successes are:

1.1, New Hospitals – in our patch both Watford General and Princess Alexandra in Harlow are high up on the new hospitals list. Amanda Pritchard visited Watford a couple of weeks ago and endorsed the plans. But all of the hospitals have to follow the New Hospital 2.0 model – and that’s creating some challenges which wouldn’t have been there in the New Hospital model. And the reduction of the toal number of hospital beds does need to be challenged

1.2 Virtual Wards – a huge success; Watford started this approach during Covid to get people out of hospital sooner; and the new model of virtual wards in the East & North of the county has been a real success.

1.3 GP Practices – finally turned a corner – we’ll corner in more detail in a moment; and

1.4 Dentistry – we are finally seeing access to NHS Dentistry becoming a reality; the National system is not fit for purpose but the ICB has commissioned additional services – contact through 111

And the areas that require improvement are:

1.5 Elective Care Backlog – the backlog is still growing and this is largely down to strikes; there have been improvements in waiting well and people on the backlog are offered choice.

1.6 CQC Ratings for Acute Hospitals – we have three hospitals in the Herts & west Essex area and all three are in the CQC area of requires improvement!

1.7 Mental Health long running problem since pandemic with increased numbers being treated out of area and while still not out of the woods we have seen, a downward trend in this thanks to hard work.

1,8 The SEND Report – Special Educational Needs that we’ll talk about in a minute

2. GP Practices

I have just compiled a report that shows a significant improvement in patient experience of Primary Care Services and wanted to drill down into some of the key points – there were six areas that we reviewed:-

  • Access to Services – great improvement in most Surgeries; improved triage processes have meant that urgent cases are seen on the day and greater use of digital access methods, plus additional staff at PCN level have led to an improvement in the handling of no-urgent requests
  • Winter Pressures – the vaccination programs have gone well locally and there is a reasonable level of confidence; the main determinant of how they will cope is going to be the severity of the winter weather!
  • Digital or Telephone Access to Services – whilst some surgeries have gone down the route of improving telephone access through upgraded switchboards, others have gone down the digital only route. But there’s a huge issue here – whilst digital only lead to bug improvements in productivity, there still needs to be a way for people who are not comfortable with digital devices to be able to get access to services; so telephone access is needed, and once people know it’s there will there will people use it out of preference rather than need?!!!
  • PCNs – Primary Care Networks are the groupings of 2 to 3 Surgeries into a joint working approach – in many ways the additional staff at PCN level, referred to as Integrated Neighbourhood Teams, are the drivers behind the improvements in patient experience; but the big caveat is that not all PCNs are at the same level of maturity
  • Triage – we need to get used to it. Here’s the issue;
    • Good GPs are rare and their time needs to be prioritized – so they get to see the most urgent cases, hopefully on the day
    • Less urgent cases can be directed at Junior GPs< Nurses, Paramedics and the Neighbourhood teams.
    • Routine appointments can now be scheduled in and
    • Repeat Prescription requests can be turned around faster.
  • Equality of Access – there is a lot of work being done to ensure that everyone has equal access to service, and this especially extends to people who don’t have English as their first language.

So, for the first time since the Covid pandemic we can report that things are improving.

3. Patient Choice – on the 1st November NHS England took significant steps to re-enforce patient choice at three levels:

  • People on the Waiting List – in cohorts, but already started people are being asked how far they are prepared to travel, and then offered the earliest appointments within that range with the ability to make an informed choice;
  • People referred to Secondary Care if your GP needs to refer you for an appointment at an acute hospital they will be required to give you five Providers from which you can choose your preference. You’ll have full information on each of them and can choose based on quality, availability, and access. And that’s quite a game-changer.
  • Your GP Practice – you are guaranteed a choice of Surgery and can switch if you wish. This has always been there but is rarely publicized. I have heard of stories where people have switched Surgeries believing the “grass is greener”, and then found it wasn’t!! When they tried to switch back, they were refused! This is wrong! But Practices do have a right to refuse to take on new patients if they are at capacity; and with the current shortage of healthcare professionals that’s quite probable.

If you have any concerns about the way your right to choose has been handles in any of these three scenarios contact the Herts & West Essex Patient Experience team

  • by email to or
    • telephone 01992 566122. 

4.SEND Report – a report was published last week on special educational needs in Hertfordshire; this is the first sentence of that report

There are widespread and/or systemic failings leading to significant concerns about the experiences and outcomes of children and young people with special educational needs and/or disabilities (SEND), which the local area partnership must address urgently.

It’s tough reading – you can see it here

Alan Bellinger

15th November 2023

Alan Bellinger Written by:

Alan is a Trustee of Healthwatch Hertfordshire and very well engaged with all things related to Health & Social Care within the Community. 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 what it takes to ensure a great patient experience, Alan has lived in St Albans for well over 65 years; he is a widower with two children and he especially enjoys the company of his five grandchildren – four of whom live in the local area.