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“An opportunity to do things differently in Cornwall”

Steve Turner of medicinegov.org, which organises MedLearn, an online event that promotes shared learning and engagement between senior health and care stakeholders and patients and carers to share insight, experiences and knowledge,  shares his personal views on the potential changes to how services are commissioned and delivered in Cornwall.

“There’s a huge amount going on with health and social care in Cornwall. Including the exciting prospect of devolution of health and care services through Shaping Our Future.

Although I have worked in health and care for more than 30 years, I struggle to keep up with the issues, and struggle to understand how services are organised.  This isn’t helped by the current polarisation of views.

On the one hand we have a big dose of NHS and Council ‘spin’ and some ‘engagement exercises’. On the other hand we have public concern, often expressed around specific issues, and sometimes based on unfounded rumours.

Neither of these positions are helpful, and neither represent the vast majority of people (public, staff and patients) who just want good services delivered by kind people who are open, accountable and transparent.

We have a great opportunity now with the devolution of health and care services. This will be realised if we all build bridges, and transcend the usual hierarchical boundaries. We all need to listen and learn. Everyone, to coin an overused phrase, needs to step out of their comfort zones.

Why we need to think differently?

Stories about community hospitals being under threat of closure lead to anger and have been dominating the headlines. Less attention is given to identifying and measuring the benefits, and any disadvantages of community hospitals. For example, can they be staffed adequately, bearing in mind this means doctors, nurses, physiotherapists, radiographers, dieticians, speech and language therapists, social workers etc.? Is home care a viable option for patients and carers?  Are there any creative options such as bringing back the old style ‘convalescence’? Is rural isolation and lack of public transport the major issue?

It’s becoming increasingly difficult to book a timely GP appointment. This has led to several scare stories in the press about ‘cuts’ to face-to-face GP contact. This needs deep thought as there are times when easy access to a GP on the phone, or online, may actually be a better option. Access to health information from community pharmacies or in NHS run clinics in shopping centres, or better health information and advice available locally, may be a more effective approach – leaving GPs free to spend more time with those who need their help and expertise most.

There has been talk of relocating some specialised services out of the county. Here, I believe, it’s too easy to jump on the bandwagon, especially for politicians. What we need to consider is whether some highly specialised services will be safer delivered in larger centres. It’s not just the availability of equipment and consultants that matters, we also have to consider the skills of the whole team. If things go wrong, is the relevant expertise available 24 hours a day, are the relevant investigations available 24/7, will a bed on a specialist unit be available? If treatment is shown to be safer carried out in another area, and no alternatives are possible, then the issue becomes one of transport and accommodation, or accepting a risk of a delay to treatment whilst a move takes place.

It’s now widely accepted that the NHS and Social Care is underfunded. Despite this there is still a great deal of duplication and waste in the system. How many times have you been asked to repeat information to health professionals which others already have? Do some services overlap, and are there gaps? Do different organisations link seamlessly with other organisations? Are all services accessible to all? Many people have important stories to tell on these areas of inefficiency.

Now’s the time to talk about this, find out what’s planned, and take action together. ‘Patient engagement’ is a key component of shaping our future.

Patients and public need to take the lead on this. It’s not the NHS or Cornwall Council’s plan, it’s ours.”