Doctors and nurses in Luton will be given the power to make decisions about how health services in Luton are run when the local primary care trust NHS Luton ceases to exist in April 2013.
It’s the result of the Health and Social Care Bill, which means all areas of the country now have a clinical commissioning group (CCG), to plan, buy and design local services for local people according to local need, as determined by clinicians.
Dr Manraj Barhey met the Luton News to explain how this will affect patients in Luton and what impact it will have on services.
He has worked at the Woodland Avenue Surgery since 1995, and is one of the clinicians who will be taking time away from his GP duties to work on the new clinical commissioning group.
Dr Barhey said: “We see patients day in, day out, we get a feel for the things that matter most and what services they require from the feedback they give us, so we are in a good position to make a difference.
“Improving quality of care is going to be at the forefront of it all for us. Another major aim is to improve efficiency within the system and reduce the number of steps it takes to be treated for something.
“For example, someone needing a cataracts operation at the moment is referred by their optician to the doctor, then to hospital to be seen by a consultant, then for a pre-surgery check and then finally for the operation. In the future they could be referred by the optician straight to the hospital where they will have the pre-surgery check the same day as their operation.”
Simplifying processes like these will save time and of course money, which is a big concern for the CCG.
Dr Barhey (pictured above)said: “The big worry is the financial constraints on the CCG. If we had the money like we had a few years ago then we would think great but unfortunately the way of the world and the economy at the moment we have to do this in a budget that’s saving 20 per cent over the next five years. That’s going to be a challenge.”
Dr Barhey said although the CCG will be saving money by reducing wastage and improving efficiency, once you’ve taken into account ‘medical inflation’, the budget will still be tight.
He said: “More people are living longer, getting more illnesses like obesity, diabetes, heart disease and high blood pressure which are all increasing, and the new drugs, operations and equipment which always cost more than the old ones. Even though we will be saving money, once you take into account all of those increases, we will have to save somewhere along the lines of 20 per cent.”
The Luton CCG is a shadow group at the moment, and has not yet formally taken over its new duties, but in October it will apply for authorisation and will be officially approved to become a legal entity in its own right.
Dr Barhey said: “We [clinicians] are not meant to be managers but we are going to have to learn, and learn pretty quick. I don’t think we are trained to do the job and we still need the other managers. However, it’s something we have always wanted to do and now we have been given the chance to make a real difference to quality of care.”
Dr Barhey also acknowledged Luton’s many health problems.
He said: “The situation in Luton is very complex. There are a number of issues and health inequalities where we are not as good as other surrounding areas. There is a lot of work we can try to do. Things like helping people quit smoking and reduce their blood pressure –they are things we can influence.”
He said a key part of the CCG strategy is educating people, so they can use services sensibly – for example only calling 999 or going to hospital in emergencies – and take responsibility for their own health.
The CCG will be working closely with Luton Borough Council, the Luton and Dunstable Hospital and community mental health services.
Dr Barhey said: “It’s all about integrated working and combining services to improve efficiency. It’s not been done in Luton before. We want it done in such a seamless way so there’s no waiting and going through three or four different people to get what you need. With all the other stakeholders we realised we are all in this together.
“I am passionate, I am enthusiastic and I want to make a difference to the quality of care in Luton for local people.”
Patients can have their say in the CCG through patient groups at their surgeries and during public meetings.