Local Stroke Services - Chair of Berkshire West PCT Responds

Today I have received a response from Penny Henrion, the Chair of Berkshire West PCT, five months after my original letter raising concerns about local Stroke Services in Reading which had been heavily criticised by the independent Care Quality Commission.

In it she claims that her office never received it which is possible so I am prepared to give them the benefit of the doubt although I have a copy of the letter that was sent out by Cllr services at the Council.

Penny Henrion writes:

"The CQC report was published in January 2011 and was based on data relating to April 2009-March 2010. It therefore accurately reflects the situation during that period. However, ealy in 2010 the PCT itself undertook an analysis of local stroke services which identified the gaps in the service and led us to initiate several work streams to deal with these gaps in provision.'

The she goes on to point out 3 key projects that started by the PCT in 2010 to address deficiencies with the service:-

• Stroke Patient Information Project - completed in March 2011 and delivered through consultation with stroke survivors and their carers, a comprehensive range of accessible information about stroke and the services and the resources available to improve quality of life.
• The PCT has produced a simple guide for stroke survivors and their families, which is also available on the PCT's new website: http://www.berkshirestrokeservices.nhs.uk/
• South Central Cardiovascular Network Stroke Project - this project due to complete in March 2012 is aimed at enhancing patient and public involvement in shaping all aspects of stroke care.
• The Network which the PCT is part of, is aiming to establish at least one patient/carer user group for each Acute Hospital Trust in the region to create a forum for patients and carers to influence the provision of stroke services in their area.
• Stroke Reviews: work is underway to identify the appropriate local service model for the provision of reviews for stroke survivors in the community.

Ms Henrion finishes the letter by stating her commitment to 'continued joint working to improve health and welbeing in Berkshire West' and offering a meeting.

This is very welcome.

I am really pleased to that the PCT are taking a series of steps to improve services for local residents who are victims of Stroke.

However, I make no apology for raising concerns both in January and again this month.

I believe it is vital that unelected PCTs are held to account for the health services they provide.

Post-Stroke NHS services in Berkshire West

Back in January I called for action to be taken to improve local post-Stroke services for patients after the publication of a highly-critical report by the Care Quality Commission.

In that report, Berkshire West PCT (which serves Reading) was rated 127 out of 151 PCTs in England. Services in neighbouring Berkshire East were found to be even worse.

The report was circulated to members of the Council's Community Care, Housing & Health Panel but as far as I'm aware the then Labour Chair of the Committee, Cllr Mike Orton did not investigate the issue further.

I wrote to the Chair of the PCT, Penny Henrion in my capacity as then Lead Member for Health expressing my concerns and asking her what steps were being taken to improve patient care in a number of key areas:

• Providing a range of information for patients who have suffered a stroke (score – 1 out of a possible 5)
• Involving stroke survivors and carers in planning and developing stroke services (score – 1 out of a possible 5)
• Helping people to participate in community life (score 1 out of a possible 5)
• Helping people to choose services they want (score 1 out of a possible 5)
• Reviewing progress after people have left hospital (score 2).

I waited for a response from Ms Henrion but am sorry to say I did not recieve one.

So much for accountability in our local health services!

I have emailed Ms Henrion again today asking for a response and an update on this important issue which impacts on thousands of Reading residents.

Team work between Royal Berkshire NHS Foundation Trust and Council helps patients

Yesterday evening I attended a meeting of the Royal Berkshire NHS Foundation Trust Council of Governors. I  am a Partner Governor of the Trust as part of my role as Lead Member for Health on Reading Borough Council and since I became Lead Member last May I have worked hard to build up a good relationships with our local NHS hospital to ensure Reading residents get the best possible care and services.
We are very lucky in Reading to have an excellent local hospital on our doorstep. However, the Trust serves a large population beyond our area so it is important the views of Reading patients are represented and officers held to account for the services they provide - hence the important role Trust governors, particularly Public Governors (who are elected) play.
Like local councils the Trust has some substantial savings to make over the coming years. Senior Trust staff acknowledge that the £20 billion pounds efficiency savings the NHS has been asked to make by Sir David Nicholson, Chief Executive of the NHS (started under the previous Labour Government and continued by the Coalition) is going to be one of the Trust's biggest challenges - even bigger than the proposed NHS reforms they reckon.
One of the ways the Trust will be saving money is by investing in an Electronic Patient Record system which is set to save over £29 million pounds over seven years. This innovation should also benefit patients by reducing problems caused by lost paperwork and missed appointments. Work is also ongoing to save money in the back office by sharing services with other NHS bodies.
Despite the savings the Trust has to make I was reassured to hear that senior officers and staff at the Trust are still totally focussed on improving patient care. The number of formal complaints by patients relating to care they had received at the Trust has fallen substantially compared to last year and patient satisfaction is very high - with over 90% of patients saying they would recommend the Trust to their family or friends.
There were a number of interesting issues on the agenda at the meeting across a range of subjects relating to the performance of the Trust.
I was particularly interested to hear how the Trust coped with the recent flu outbreak.The Chief Executive reported that there had been a significant increase in flu-related illness during the Christmas and New Year period across the local NHS.
There was a big spike in the number of emergency admissions between 28 December and 12 January.
This put local health and social care services under immense pressure - and life was made more difficult due to the poor weather and the fact it was during the holiday period.
The number of GP admissions to the Trust was 27 % higher than the same period in 2010. As a result the Trust increased the number of beds in line with its agreed Winter Escalation Plan. We heard that this was implemented successfully and the number of beds opened was 20 beds less than last year.
The Chief Executive of the Trust, Ed Donald publicly acknowledged in the meeting that Reading Borough Council social care staff had played an absolutely critical role during this difficult period helping NHS staff at the Trust free up beds for those that needed them by helping manage discharges and care in the hospital and out in community. For any elderly or vulnerable residents admitted to hospital with flu at this time this must have been a very stressful experience. Having social workers on hand must have made a real difference to them and their families. I was aware of the work staff did  from conversations I had with RBC staff a few weeks ago but it was fantastic to hear a local partner thank Council staff publicly in this way. taff in our social care teams are a credit to the Council and to the people of Reading.
I was also pleased to hear in the meeting Ed Donald mention the recent highly critical Care Quality Commission report about stroke care for patients in our area. This report said that inpatient care was excellent but that rehabilitation services in our area are lacking.
I was pleased to secure reassurances from Ed that the Trust would work with the Council and the PCT to improve stroke care services in the community. This follows the letter I have written to the Berkshire West Primary Care Trust calling on them to make urgent improvements to stroke care services.
Lots of other interesting and important issues were discussed at the meeting including recruiting more members of the Trust. Membership is open to all members of the public with an interest in the running of the Trust. If you would like to find out more about the workings of our local NHS Foundation Trust Hospital why not become a member? It is free to join and you find out more details here.

Local stroke services must improve

Today saw the publication of a national report by the Care Quality Commission into the quality of stroke services. Stroke is the biggest single cause of adult disability with an estimated 50,000 people per year left with disabilities following a stroke.  The report published today found that many stroke rehabilitation services across the country were lacking. I downloaded the local report assessing stroke care in Berkshire West PCT area (which covers Reading) and was shocked to find that services in our area have been rated among the worst in England. Berkshire West PCT was rated 127 out of 151 PCTs in England. Services in Berkshire East were found to be even worse.

This is disappointing news for patients and carers of people with stroke - people in living in Reading should have access to high-quality services and therapies offered to people living in other parts of the Country.

As Lead Member for Health on Reading Borough Council I am responsible for representing the interests of patients and working to improve local health services. With this in mind I penned a letter to Penny Henrion, Chair of Berkshire West - the text of which is below:

As Lead Member for Health on Reading Borough Council the wellbeing of stroke patients and their carers in Reading is of utmost importance to me. I am committed to representing the local patient voice and also ensuring there is accountability in our local health system. For this reason I have copied this letter to Cllr Mike Orton, Chair of the Health Scrutiny Panel on Reading Borough Council so he is aware of my concerns.



I am aware of the difference timely, high quality care can make to individuals and families. Recent innovations in rehabilitation and stroke treatment locally and nationally have led to better outcomes for patients and this is to be welcomed.

However, I am concerned that stroke services in Berkshire West are not as good as those offered to patients in other areas and I look forward to hearing how you plan to address these issues. It is important not to overlook the positives, however.

Firstly, I would like to congratulate you for the work you are doing with local agencies including Reading Borough Council, GPs and the Royal Berkshire Hospital Foundation Trust around early supported discharge.

This is very important work which benefits many residents in Reading and the surrounding area and it is good to see the efforts of NHS and Council staff recognised in this way by the Care Quality Commission.

However, I am very concerned about the areas highlighted in the report where weak performance has been identified:

• Providing a range of information for patients who have suffered a stroke (score – 1 out of a possible 5)


• Involving stroke survivors and carers in planning and developing stroke services (score – 1 out of a possible 5)


• Helping people to participate in community life (score 1 out of a possible 5)


• Helping people to choose services they want (score 1 out of a possible 5)


• Reviewing progress after people have left hospital (score 2).


I was also concerned to read in the report that the PCT has scored only 2 out of 5 in relation to working together across health and social care services. Reading Borough Council is committed to working with local health partners to improve the care pathway for patients.

If you have any thoughts about ways joint working could be improved please let me know and I will do my best to make this happen.

I would be grateful if you could respond to me as soon as possible about how you plan to address the issues raised in the report for the benefit of stroke sufferers and their carers.

I look forward to hearing what the PCT's response is. Meanwhile if you or anyone you know in Reading has experienced local stroke services please do get in touch with any feedback.