My Vision for improved Healthcare on the Island

The pressures on our healthcare are shared by many other parts of Britain.  The NHS is moving to delivering services from larger centres, putting pressure on district general hospitals.  Serving an increasingly elderly population puts immense pressure on the health system, especially when it is insufficiently integrated with adult social care. Financial pressures are sadly commonplace.  The Isle of Wight Clinical Commissioning Group is estimated to be spending £19m (10%) above its target funding allocation and the Isle of Wight Council is also under financial pressure.

In addition, we need to add the Island factor.  We have St Mary’s Hospital because we are an Island. Our population is half the size of that which is normally served by a district general hospital.  As with other public services, we suffer ‘diseconomies of scale’; maintaining acute services is more difficult on the Island because we cannot share resources.  In particular, we have found it difficult to retain staff.  The NHS on the Island is looking to overcome staffing issues by sharing roles with the mainland.  This is absolutely vital and is connected not only to the NHS on the Island but also how we present ourselves to the rest of Britain and the many other factors that people look at when they move here, such as education and quality of life. The latest figures produced by the Trust show that the extra cost of providing healthcare on the Island is more than £5 million per year.


The Future of the NHS on the Island

Above all, it will feature integrated working, flexibility, as much home care as possible and the use of technology to overcome physical barriers caused by the Solent.

First, healthcare is becoming increasingly specialist. General surgeons are becoming rarer. Due to our size it will make sense to share some expertise with mainland trusts.  So, flexibility and joint working with NHS Trusts on the mainland in vital.

Second, we need to support as much home treatment and GP treatment as possible in the three local centres in Ryde, Sandown and Newport. These are the bases for our district nurses and community work and are based around groups of five to six GP practices.  These centres conduct minor but important operations. 

In general, we need to fight the NHS tendency to centralise. We need to provide national-standard healthcare whilst decentralising, bringing services down to the home or the GP surgery, wherever possible.

Third, we need to use technology to overcome the physical barriers of the Solent.  It may be that for slightly more complex medical procedures, Islanders will still need to travel to the mainland, but why do they need to go to mainland hospitals for all their pre and post-operation appointments?  A consultant available on tele-medicine and specialist nurses in situ can give a better patient experience.  I wonder if, when the Trust has put itself onto a firmer footing, it can become a national champion of telemedicine, working with the Department of Health and other organisations to use modern technology to find novel and creative ways of providing healthcare.  Ditto health data, which has been poorly used nationally, but used correctly, can play a major role in preventive medicine.

Fourth, the Island should aim to develop national and international experience in certain types of specialisations, such as elderly care and dementia.

Combining Health and Adult Social Care

Much of our ability to deliver quality healthcare will be to integrate health and adult social care for older Islanders.  One in four Islanders is over the age of 65 (27 percent to precise), and this will increase to 30 percent by 2025, with a current rise in the numbers of very elderly - 80 plus - residents too.  In terms of our demographic and in terms of people living longer, we are now where the rest of Britain will be in twenty years. Therefore, we need to get aging ‘right’, both for ourselves, now, and for the rest of the country in the future. It is clear that the Council, voluntary sector, health sector and MP need to work more closely together to make good the My Life A Full Lifeprogramme, which was meant to ensure that health and adult social care work closely together.  There are some immediate things that need to be done. 

Building extra-care housing to give older residents a choice. 

The Council team is ensuring that we these homes.  They give our older residents the option of moving into specialist accommodation.  It means they have a choice between staying in their own homes (which they perhaps find difficult to look after) and going into a nursing / residential care home (which could impact on their savings and capital).  Extra care homes could in turn allow housing associations to buy bungalows and other properties, and repurpose them for one or two younger families who need housing.

Supporting the elderly to leave hospital on time. 

Getting older people out of hospital and into their homes is not primarily about saving money.  It is about saving life.  The damage to an elderly person overstaying in hospital is startling.  A 2016 National Audit report noted that older patients lose five percent of muscle strength per day. It also highlighted a study which reported that 10 days of bed rest led to a 14% reduction in leg and hip muscle strength and a 12% reduction in aerobic capacity: the equivalent of 10 years of life.  Every day in hospital for an elderly person risks catching illness from others, and muscle wastage.  Getting older residents out of hospital on time and safely, extends life itself as well as quality of life.  Again, excellent work is being done by the Council to deliver social care packages to ensure that older residents are properly supported when they go home: effectively the hospital moves to the home with the person.  It is better for the person - and better value for money - than keeping that lady or gentleman in hospital.