Firstly, I’d like to thank Healthwatch Camden for the opportunity to share some of my personal reflections; I am very honoured to be invited to do so. I have lived and worked as a GP in Camden for more than 25 years; in addition, I am a patient, a parent and a carer of elderly relatives in Camden. I love the vibrancy and vitality of Camden and its people, the open spaces, the huge international railway stations, the buildings, the academic institutes, the street life and the communities, all of which define Camden. But Camden is also a place of stark inequalities, especially in health. I see the impact of key determinants such as education, employment, income and housing on the health and well-being of the patients attending my surgery, but as an individual practitioner I have limited ability to change it rather than managing its consequences.
I have always enjoyed my work as a GP and the opportunity to meet and support individual patients. My current role as chair of the CCG enables me to apply what I have learned from patients’ experiences over the years to the wider population of Camden for whom the CCG commissions or ‘buys’ health services. We know that in Camden some of the key challenges we face include very high levels of serious mental illness; high levels of vulnerable children; particularly poor health outcomes for the homeless and those with learning disabilities; and an increasing demand on services from an ageing population. All of these challenges need to be addressed despite serious financial pressures on public services. I know that while Camden’s services are of high quality, access to all parts of the system (especially general practice and urgent care) can be difficult, particularly for those with complex needs. To address this, we have been working closely with patients and users of services to ensure that how services are designed and delivered is informed by ‘patient-defined’ outcomes.
Each year at this time we create a ‘Key Achievements’ document to share with the public and seek their feedback. We hope this helps us all internally and externally to celebrate success and see where we still have gaps. The latest version highlights a number of 2015/16 initiatives focused on children and young people, mental health, older people, long term conditions and cancer, and primary care.
Extracts from 2015/16 Key Achievements
Children and young people
- Worked with over 100 families to manage obesity by funding special School Nursing Health and Lifestyle Practitioners.
- Helped over 220 young people by offering counselling and psychotherapy services at the Brandon Centre.
- Improved asthma care and the management of respiratory issues in children, by training GPs and improving access to specialist support.
- Launched ‘Minding the gap’ which has improved the lives of young people struggling with the transition into adulthood.
- Improved the care available to those with serious alcohol problems by launching the ‘Integrated Camden Alcohol Service’.
- Launched ‘Team Around the Practice’ (TAP), where mental health specialists work across GP surgeries.
- Launched the Big White Wall, an online community providing mental health support.
- Recruited more than 30 peer mentors who now support others within the community to achieve their wellness goals.
- Improved dementia care by setting up the ‘Dementia Action Alliance’ with partners.
- Reduced social isolation by supporting a number of initiatives, including a Memory Service, dementia cafes and appointing 41 befriending volunteers who worked with socially isolated people.
- Introduced a ‘Care Navigation Service’ which has already helped to improve the lives of over 700 older people, 83% of whom would recommend this service to others.
Long term conditions and cancer
- Worked closely with GPs to improve the detection, diagnosis and management of long term conditions such as heart failure, kidney disease, diabetes and more.
- Aimed to increase the early diagnosis of cancer by improving people’s awareness.
- Introduced a new community epilepsy service which has helped to improve the lives of over 100 people.
- Launched Saturday GP and nurse appointments at 14 GP practices in South Camden.
- Funded 14,000 extra GP appointments throughout winter.
- Increased the number of nurse appointments in general practices in Camden.
Through these initiatives, we have been able to demonstrate positive outcomes. For example, childhood obesity is lower than the London average; more cancers are detected at an early stage, improving survival statistics; more of the frail and elderly are supported to stay at home; and a higher percentage of people feel supported to manage their long-term condition than across the rest of London.
On a personal level, the role of CCG Chair is enormously varied and often challenging, but I have always felt privileged to work with a range of passionate people to improve Camden’s health and wellbeing. Perhaps my most rewarding experiences have been meeting service users, listening to their experiences, and visiting the services we developed together. Some time ago I visited the fantastic integrated services for children based at Swiss Cottage School, the Regents Park Children’s Centre, and the Netley campus. Simultaneously the CQC were reviewing the frail and elderly services, and shared their findings with me. There was significant synergy between what I saw visiting the children’s services, and what I heard from the CQC inspectors. Both identified some key building blocks to success: the importance of leadership; organisations working together around people’s needs; and those involved in delivering the service feeling proud of their work. As the CQC inspector himself said “I‘d like to grow old in Camden”; what an outcome that would be! I realise that these are green shoots rather than mature trees, and there is a long way to go in an uncertain environment. But I do believe if we can build on the above and learn from what we have done well, then together with all our partners we will see real progress at speed.