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Showing posts from 2016

The NWL Sustainability and Transformation Plan (STP)

Sustainability and transformation plans (STPs) have just been submitted by  NHS organisations in different parts of the country outlining the future of health and care services in their area. Ours involves the whole of North West London and involves the NHS services and the Local Authorities planning ways in which they hope to come together to deliver health and care in a more intelligent and integrated way, bridging the gap between social care and health services.  One of the principle themes now is cooperation rather than competition, which has  driven the way we work over the last 4 years (in, some would say, a very destructive and dysfunctional way). The other themes are, of course, diminishing resources - both money and people - and rising and changing patterns of demand and how to provide good quality care under these circumstances.  There will be a lot of re-balancing budgets and reshaping the types of services offered. There is simply no possibility of carrying on in the cu

A new model for Urgent Care for NW London?

If you want urgent (unplanned) medical help where do you turn to – your GP, A&E,   a Walk In Centre , an Urgent Care Centre,   Minor Injuries Unit, or Out of Hours GP service, ring 999 or 111 ? In hours and Out of Hours the choices are rather different. This multiplicity of choices and the different options in each area makes for a very confusing picture and it is no wonder people often go to less appropriate places. There is a lot of duplication and very poor communication so that you have to repeat your story and there no access to your complete medical record held at your GP practice and the information about your urgent care contact may not filter back to the GP or other people involved in your ongoing care. You may be seen by a doctor or a nurse or another type of professional. And the cost is high; attendance at A&E is rising inexorably and you’ll have seen the headlines showing that the system is breaking and unsustainable in its present form. We need a syst

Sharing information to improve care

Information Processing We in Brent CCG are part of the  North West London Collaboration of Clinical Commissioning Groups which is engaged on a huge project to integrate health and social care across the 8 boroughs of North West London ( Whole Systems Integration Pilot ).  A fundamental part of this is to link the information systems so if you are seen in A&E, General Practice, Hospital Outpatients, Community clinic, wherever, that appropriate levels of information flow across to enable safe, efficient care. Some of this information also needs to tell Social Services what you need to have in place when you are discharged from hospital, the Ambulance crew to understand your essential medical history in an emergency, the Palliative Care team to help give the most appropriate care and all the Community teams to coordinate their care properly. Surprisingly, most of the IT systems do not speak to each other and so there is duplication of information, big gaps and things done by fax and

How to deal with your sick child

It's that time of the year when all children get ill with coughs, colds and other viral infections often accompanied by fevers, vomiting and rashes and they can feel really miserable and distressed.  As adults we've all been through these infections and  as a result  our immune systems now give us resistance, so even if we get ill we usually don't feel so bad. And we can understand and know we'll feel better in a few days but a young child doesn't know this. When we see a sick child with a high fever it can be extremely worrying for a parent to know if it is part of a more serious illness and what should be done to make your child better. The NHS 111 service has produced a very useful booklet to help:                                                When should I worry? Signs of potentially more serious illness: Your child is drowsy or irritable . (Although children with a temperature are often more sleepy, irritable and lacking interest than usual, they usuall