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Local healthcare 'will change for the better', says Grantham GP




The future of local health services has been a contentious issue for some years now, but a Grantham GP says changes in the way our services are run in the community and in hospitals will benefit everyone.

Dr David Baker, a partner in Vine House Surgery in Grantham and chair of the South West Lincolnshire Clinical Commissioning Group (SWCCG), is leading the way in bringing in changes to local healthcare.

He says people’s health is affected most by changes to community care so the focus needs to be on these services rather than on hospitals.

“People always focus on what we are going to do in the hospital but, actually, how often do people get admitted to hospital? This should only happen when it is absolutely necessary.

Journal news editor Graham Newton talks to Grantham GP David Baker, chair of South West Lincolnshire Clinical Commissioning Group. (8806094)
Journal news editor Graham Newton talks to Grantham GP David Baker, chair of South West Lincolnshire Clinical Commissioning Group. (8806094)

“For most people, their contact is with their GP, the district nursing service or with the nursing team in their local practice, so I think the way we devel0p community services is as important, if not more important, than hospital services.

“The driver going forward is to deliver as much as we possibly can in the community, which is where most people want their healthcare. They don’t want to go to hospital, particularly if they have to go to Nottingham or Lincoln. They would rather get most of their treatment as close to where they live as possible.

“Over the next five years the idea is that a bigger proportion of investment will go to community services. General practice needs to change. At the moment we have 17 practices in our CCG and they all operate pretty independently, but if we want to offer more services in the community, those practices will need to work together.

“So from June/July the practices will be coming together to form what we call primary care networks. For example, there will be one network which covers Grantham and Grantham rural, there will be a primary care network which covers the Sleaford area. So currently a lot of people may go to Lincoln to see somebody in outpatients, but we will be able to deliver quite a lot of that care either in general practices or other community settings so people will not have to travel.

“We want to keep as many people out of hospital as we can, but if people do go to hospital they don’t want to be in there very long. You want to be pulling people out at a much earlier stage and that takes the pressure off our hospital services as well.

“Our secondary care colleagues are quite cautious people so they will monitor bloods every day and if something doesn’t quite look right they will keep them in, but if a GP went in to see that patient they would be saying, ‘why is this patient still in hospital?’. So we need to get GPs working closer with our hospital colleagues and that will cut the amount of time people spend in hospital.

“I always say this, but hospitals are quite dangerous places because everybody is ill in hospital and there is always the risk you will acquire an infection, which is a huge problem in our hospitals.”

Dr Baker admits that a proposal to transform Grantham A&E into a urgent treatment centre (UTC) is causing the most concern among local people.

He said: “Grantham A&E hasn’t really been an A&E for years. I think perhaps for 15 years it has really operated as an urgent treatment centre for. In Grantham we haven’t got all the back-up services. We haven’t got acute surgery, we haven’t got obstretrics, we haven’t got paediatrics. I could go on. To have an A&E you have to have those back-up services in the same hospital.

“If you haven’t got those services then it’s difficult to justify calling it an A&E. So I think it really is an urgent treatment centre.”

Dr Baker said the plan is that the UTC will provide 24-hour care which A&E no longer does, meaning more people can be treated locally.

Asked why Grantham can’t have a hospital providing all services for a growing population in the town, he said: “I think we have a top-notch hospital, but it needs to know what it can deliver and what it can’t deliver. We can’t put back the surgeons or the obstetricians because there is a shortage of all these different skilled people. And actually doctors don’t want to work in a hospital where they are only going to see three people a day.

“When they were doing acute surgery at Grantham Hospital 15 years ago they were doing two or three operations a week. Even if your population doubles they may only do five or six operations a week. It’s not realistic. It’s not going to happen.

“Let’s get Grantham to focus on what it is really, really good at and I think it will be really good at delivering urgent care services.

“The big positive for me is the elective centre for Lincolnshire is now going to be at Grantham. So where Grantham currently does 1,000 operations a year, they could be doing between 2,000 and 3,000 a year.

“The Grantham population is often going to other providers in the private sector, or sometimes to Nottingham or Lincoln or Boston to have their surgery. Many more of those people are going to be seen in Grantham now to have their surgery.

“So for me what we are proposing for Grantham is an enhancement on what we’ve currently got.

“Unfortunately, there has always been something taken away from Grantham, but this is putting something back into Grantham. So we are going to extend the hours of the UTC , we are going to do lots more elective care, we are going to retain the other services we have got at Grantham and we are going to improve those services.”

Dr Baker believes GPs in Lincoln and Boston will be jealous of services in Grantham because there will be one service provider bringing all local health services together.

He added: “I would like to think there are going to be people coming from other parts of the country to Grantham Hospital to learn from us and try to copy it.”

Dr Baker said changes to local healthcare will go out to consultation before the end of the

year, adding: “Assuming we get a positive response from that formal consultation, then we want to be bringing some of this in as soon as we can.

“If we can get some of this in place by next year, then why not?”

One proposal which failed to get a great deal of support in the recent Healthy Conversation consultation was the use of 111 to gain access to a Grantham UTC overnight. The 111 service has been controversial with some users saying it has not worked properly. Dr Baker says this is being reassessed and will be part of the consultation process.

This year, a petition was launched by hospital campaigner Jody Clark, calling for a new hospital on the edge of town.

Dr Baker says he is fully in favour of this and talk of a brand new hospital is not pie in the sky. But he insists that any new facility would not provide any more services than are being proposed in the consultation.



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