Wow – what a week!

Lots of policy changes announced by the new government this week; scrapping of some key health targets, reduction in NHS management costs, GPs to be ‘lynch pins’ of NHS and some of these policy changes are having an impact locally. And there was the sport!

Health Secretary Andrew Lansley has stated that "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes. Doctors will be free to focus on the outcomes that matter - providing quality patient care."

Nationally it has been reported that the government is to scrap the 4 hour waiting target in A&E, the 18 week treatment target and the right to see a GP for a routine matter within 48 hours. But when you drill down a little bit into the detail then they are not actually scrapping the 4 hour wait target in A&E – just reducing the target from 98% to 95%. And announcing that the NHS locally can have more input in deciding what targets are important locally.

The new Health Secretary, has made it clear he sees GPs as the lynchpins of his vision for the NHS. He wants us to take responsibility for local budgets, believing they know more about what works than managers working for local primary care trusts. The previous government had a similar plan called Practice Based Commissioning – but it never really go off the ground. Mainly because it was overly bureaucratic, there was no proper incentives to change pathways of care and there was no administrative support to practice to undertake some of the management work of these budgets. I am interested in seeing what these new changes will mean.

The new government has told PCTs to reduce their management costs by 43% and locally Wakefield PCT has agreed to reduced their management costs by just over 12% this year compared to last year. The PCT has identified 42 senior management posts that could be removed.

Other local changes that have been announced are about who runs services provided by the PCT. The PCT provides a variety of community services – things like district nurses and health visitors. The PCT has been trying to get other organisations to take over the day to day running of these services – and currently it looks likely that either the Mid Yorkshire NHS Trust or South West Yorkshire Mental Health Trust will take other some or all of them. If the aim of this is to make services more cost effective as a whole then this is not necessarily a good idea as there is a risk that any pathways for community care will go directly to secondary care and avoid coming to primary care and GPs – thus increasing costs!

And of course there was THE weekend of sport – England beat Australia at cricket in the one day series, Lewis Hamilton tops the F1 drivers championship, Andy Murray is through to the second week of Wimbledon but England were humiliated in a four, one thrashing by Germany in the World Cup. But it was a lovely sunny weekend!