Changes to heart attack care, mental health and community health services

Notes on Health Scrutiny meeting 17th January 2013

 Emergency heart attack care

In 2009 a new specialised service was set up in the region for patients who suffer certain types of heart attack. These are known as STEMI heart attacks. The treatment centres are in Basildon, Norwich and Cambridge.

At these centres a Stent is inserted to reinflate the collapsed artery. Prior to that ambulance staff could administer thrombolysis, or clot-busting drugs. However these only worked in 50% of patients, whereas Stents are suitable for the vast majority and have better survival rates.

From the start there were major concerns about the length of time it would take to transfer a patient from rural East Suffolk. Results have been monitored since the change and, whilst survival rates were greater than 95%, the target transfer time of 150 minutes was exceeded for a quarter of patients. This could affect the longer term survival of patients.

The report to the Health Scrutiny committee recommended:

  • A programme of continuing education for ambulance staff in the management of cardiac emergencies.
  • National and regional campaigns to educate the public about the need to dial 999 as soon as possible if someone experiences chest pain. The sooner treatment is given the better.

New Heart Treatment centre at Ipswich hospital

A new £5m centre is being built at IpswichHospital for routine heart operations, including the insertion of Stents. There will be nurse specialists, a cardiac rehabilitation service and intermediate care clinics.

Concern over “Radical redesign” of Mental Health services

The combined Norfolk and Suffolk Mental Health Trust are having to make savings of 20% to their budget over the next 4 years. They are proposing a “radical pathway redesign” of their services. This seems to involve getting rid of a third of their doctors, including senior consultants! Instead nurses are to bear far more responsibility. Hospital bed numbers will also be reduced and there was mention in the report about using “bed and breakfast places”.

Representatives of the doctors and patients are extremely worried about the effect on patient care.

Some of the changes are to be welcomed – like closer working at local level with social services and other health colleagues as well as greater support for people in their own homes. However no risk assessment was included in the report.

A joint health scrutiny committee is to be set up with Norfolk to examine the Trust’s proposals in more detail.

Job cuts by new Community Healthcare provider?

Serco took over as the provider of Suffolk Community Healthcare on October 1st 2012. This contract was let by NHS Suffolk. Services which Serco now provide include community hospitals, community nurses, physiotherapists and occupational therapists.

Anecdotal information suggested that Serco were intending to reduce the number of physiotherapists and occupational therapists. They were reluctant to give any answers on this at the Health Scrutiny committee. They did hint, however, that they were looking again at their decisions! We wait to see what changes come out of this – if any.

Future items for the committee:

  • A task and finish group is to be set up to look into patient transport to Ipswich Hospital. A shortage of parking spaces and changes to the concessionary fare scheme have led to problems getting to appointments.
  • We have asked that the committee look into the provision of Epilepsy Services in Suffolk. Press reports indicate that this is far from satisfactory.
  • East of England Ambulance Service – the committee will look at performance and other issues.

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