‘A HEALTHY OUTLOOK’
Guest speaker at the Harpenden Society’s April meeting (following the AGM) was Simon Linnett, chairman since 2014 of Luton & Dunstable University Hospital Trust. He spoke about the future of NHS provision in the area served by the hospital, which includes Harpenden and surrounding Hertfordshire villages. He pointed out that 10% of L&D’s income from the NHS was in respect of its service to the population of that Hertfordshire ‘enclave’.
By way of introduction he explained that the word ‘university’ in the hospital’s title, derived from its vital courses of consultant training. It underlined the quality of the service provided by 4000 members of staff for a population of some 330,000 in the Luton and Dunstable area of Bedfordshire, as well as Harpenden and surrounding villages across the border in Hertfordshire.
With due modesty Mr Linnett said he reckoned the L&D was ‘reasonably successful’ compared with many other NHS hospitals across the country, a number of which had suffered negative publicity in recent times. The yardstick often applied in judging a hospital’s performance was the time patients coming into the Accident and Emergency department had to wait for attention. Over 90% of those arriving at the L&D’s A&E department were seen within four hours.
Like other hospitals the L&D was waiting for a further injection of NHS funding pledged by the government. But he feared the imminent General Election could well interfere with the timetable.
That money would make more beds available. As things stood, there was typically a shortfall of some 80 beds; in other words that number of beds were occupied by patients who had been medically discharged but had no post-discharge care in place, either at home or through social care facilities.
Mr Linnett conceded that some of L&D’s secondary care facilities were ‘tired’ and even ‘decrepit’, while nevertheless well run. But the existing site had a negative effect on patient, visitor and staff wellbeing.
However, a more modern hospital was evolving. He referred to the five-year £150 million site redevelopment plan approved in 2014 which would include a new five-storey acute services block, a major expansion of the existing A&E department and a suite of additional operating theatres (able to perform some 1500 types of operation), as well as an integrated critical care floor with isolation rooms. Away from the project’s vital clinical objectives, many would also welcome the inclusion of plans for improved car parking for patients, staff and, not least, visitors.
Mr Linnett said that, as in the world of private business, where he had worked earlier in his career, a hospital had to be run as cost effectively as possible. But a key difference was that the commercial law of supply and demand could not be
readily applied. Sudden demand for medical services was not predictable. He cited the instance of a TV documentary on breast cancer which had triggered a surge in the requirement for breast screening services.
Nevertheless, L&D had in recent years remained profitable, in contrast to Milton Keynes and Bedford trust hospitals, with which it was now grouped in one of 44 areas as parts of an NHS England reorganisation, and which continued to be loss making.
There was a recognition, said Mr Linnett, that the pressure on hospitals had to be addressed in ways other than on-site expansion. Accordingly, L&D had set itself a number of objectives which, crucially, included establishing a more integrated relationship with GPs and social care services in its catchment area.
He also alluded to the broader issue of encouraging would-be hospital patients to lead healthier lifestyles, where facilities like the ‘Health and Wellbeing Campus’ planned for the Red House site in Harpenden would play a vital role. As an aside he suggested that those covered by private health insurance tended to stay more healthy, if only to keep down their premiums.
He reminded his audience that private health services had both good and bad aspects. Obviously they allowed those who could afford it often to receive faster, though not necessarily better, treatment. But, importantly they took pressure off the invariably stretched NHS.
Patients from Harpenden attending L&D were, he said (to some laughter), ‘good patients’. They invariably turned up for their appointments, unlike some from elsewhere on the hospital’s ‘patch’. Perhaps, suggested Mr Linnett, a nominal charge (possibly refundable) should be made for routine hospital or GP appointments.