I am now enjoying a short break between jobs. Fortunately (and I know there are many in a less fortunate position) it is a planned break. Originally intended to include the Paris marathon and a lengthy break with the family my plans have changed to pretty much just staying at home. Even the things I can still do are affected. I no longer run in a straight line as I curve around people mutually maximising our social distance. My plans to make up for lost time as a school governor have transformed from lesson walks and observations to video meetings and a focus on health and safety and safeguarding.

If it was a badly timed break it is also a badly timed job start. I am, after a brief dalliance in the private sector, returning to the NHS. I cannot pretend it’s a noble move: it was not COVID-19 motivated and by the time I’ve got to grips with my role, new organisation and relationships we may well be past the pandemic peak but the virus will still make starting a job in any organisation an unusual experience.

But the pandemic does highlight why I am going back to the NHS. I was a late and accidental joiner but felt a strong sense of purpose from my very first day. Part of the reason I’m returning is because, even though remained in healthcare, I never felt that same sense of purpose after I left. The NHS is a huge and complex organisation and my contribution was, and will be, small. But the NHS is the sum of those small contributions and each one is worthwhile.

As I stood at my front door joining in the last night I was reminded of the Nigel Lawson comment that the NHS was the nearest thing this country has to a national religion. He, of course, made that comment with the sneering contempt you would expect him to have for a public sector institution. It was clear last night, though, the public attitude would be very different.

The NHS, despite its imperfections (often introduced, I would argue, in the attempts to ‘improve’ by introducing the market) and years of underfunding, remains one of this country’s greatest assets. I’m very much looking forward to having some time with my family but incredibly proud and excited and just a little impatient to be back in the NHS.

Lots of these have sprung up around me in the past few days. Without commenting on the campaign itself, there’s something very comforting about the place the NHS has in the nations heart.

I’m really not that sure how interesting it is for me to write about meetings. They certainly aren’t interesting enough for people to turn up and listen. Having said all that, there were a few interesting items on the agenda of last night’s Adult Care Services and Health OSC.

I was only there for part of it, my council role is a bit of an experiment in ‘cross-cutting’ (which seems to be causing undue confusion, I have to say) so I attended only for the ‘health’ and not the ‘adult care services’ elements. To give some select highlights:

10-627 Patient records
Despite my predilection for civil liberties and occasional concerns about the expansion of the state into private life I find it hard to get excited about these things! But given the appalling track record of the state on data security in recent years it possibly isn’t surprising that the local NHS were questioned heavily about how access will be controlled and the audit trials that will be put in place to ensure record safety. I think most of the committee members were satisfied.

From my point of view the question is of balancing risk. No system will be 100% secure and, I have no doubt, whatever safeguards are introduced someone will have enough malice or incompetence to circumvent them sooner or later. However, what we need to assess is whether or not the benefits a system that means different parts of the NHS can see your relevant medical history is worth the risk of potential security breaches.

Personally, I feel happier about having an electronic medical record than old paper copies that can get lost, burnt, mixed-up, misplaced or even burgled. But not everyone would share that view, it struck me that the NHS were putting a lot of effort into creating a system that could reassure most people their information is safe.

10-628 National Patient Survey
I posted about the results from this recently. The committee members were interested in exactly why some surgeries are performing so badly when compared to some of the excellent results that other practices got.

The local NHS stated that they needed to better understand exactly why there was severe dissatisfaction with some surgeries and what they needed to do to encourage choice. They were asked to return to the committee with details of what they were doing to improve those weaker surgeries.

10-629 NHS White Paper – Response to consultation
This was an interesting discussion. I’ve not posted much about the NHS White Paper, but it represents a superb opportunity. The council has long held a policy that it should be responsible for health commission. While the white paper doesn’t suggest that it goes someway towards it.

For a start the council would take on responsibility for public health (as it did until 1974), and for establishing a ‘Health and Wellbeing Board’ however, there are opportunities to work with the GP consortia providing, for example, support on things like procurement or analytical services. In turn, this will enable a better, more joined-up set of services to residents.

There seemed to be good support for the council’s position of moving rapidly to set up the Health and Wellbeing Board here and working with GPs to establish how it could all be implement. The local NHS said they were “fully supportive”. The opposition members also expressed their support for the council’s position, but couldn’t vote for it, citing issues like the government’s naming of the white paper as a bone of contention.

10-632 Local Involvement Network – Annual report
This was an interesting report, mainly because of the thought processes that it set me on. The Local Involvement Network (or LINk) (or @WandsworthLINk on Twitter) was established a few years ago, there is basically one per borough, and is a free membership organisation that exists to formally scrutinise health and social care services in the borough. The council provides support to it.

In the white paper they continue, except they will be re-named HealthWatch and given a significant proportion of the seats on the Health and Wellbeing Board.

I am half-planning a fuller post on them because it struck me that they are, basically, an unnamed part of the Big Society. I’ve posited before that the Big Society exists, but we just don’t recognise it as such. Yet. LINks are, to me, probably in exactly the same category. They are there scrutinising local health services on behalf of residents and patients and, I would contend, in a better way than many other statutory bodies (by focusing very much on the ground level experience, than management level statistical outputs).

Maybe the first thing we should be doing in the Big Society is identifying and renaming all those parts that already exist.

There were several other health related items on the agenda. You can see the full agenda with linked reports on the council’s website.

I seem to have stopped taking photos this year – so the cup of tea is getting a few outings – not that photos of meetings or a fairly damp and dreary London are any more exciting.

Councillor Awards
I started the week off acting as a judge for the Local Government Information Unit’s first national councillor awards. While I’ve judged a few things in Wandsworth (most recenty the SNT award) this is the first time I’ve been part of a national award’s judging panel.

It was certainly a fascinating, and humbling, experience – and a real privilege to be asked. Seeing what councillors and local government around the country are achieving was an inspiration.

While the winners aren’t announced for a few weeks (they all find out at a conference at the Emirates next month) I can, of course, start acting on that inspiration.

Wandsworth LSP
The Local Strategic Partnership is one of those bodies that exist in every local authority that no-one actually knows about.

The name gives away what it is (or should be) it’s a high level partnership of everyone involved in the local area – the council is an obvious member, but they are joined by the police, local health service, local businesses and charities to help set the overall direction of the area. The partnership in Wandsworth works remarkably well, and has certainly improved enormously since I first joined (that is a function of a change in the partners around the table, rather than my joining).

One interesting point that came up (I think from one of the health service representatives) was the amount of work we can create for local businesses when tendering contracts.

Until fairly recently it would have been illegal to consider bids on anything but price and quality, though this has relaxed recently, but is an issue that I’ve been looking at over the years. One thing I wouldn’t want to do is start putting a price on location. Is being Wandsworth based worth a £1,000 or £10,000? And what happens if a company moved mid-contract?

The key problem, though, is that Wandsworth is predominantly a small business economy and the public sector is forced to be quite restrictive. For example, we require significant financial guarantees and will look through a company’s accounts to ensure the public money we are spending is at as little risk as possible. These have certainly deterred businesses in the past and often a small company just won’t have been in existence long enough to meet these requirements.

But we can improve access for local businesses by advertising the opportunities and providing advice on how to bid and this is something we are starting to improve. We have long been accessible to local businesses (through things like the Wandsworth Business Forum, the next one being on Monday) and are always willing to advise and help a business compete for our contracts.

Nine Elms Opportunity Board
My last meeting of the week was the Nine Elms Opportunity Board. Now that the area is finally starting to develop this is becoming an exciting meeting again (for years its meetings seemed to be just to discuss what wasn’t happening).

The body was initially formed to try and maximise the benefits to local residents of the development of the Power Station site and the report from Job Centre Plus was interesting. Yesterday I highlighted the small drop in Wandsworth’s JSA claims, but apparently the movement in the market is considerably higher than this time last year. So while there were only a few job vacancies being reported at the beginning to 2009 there are plenty being reported and filled this year. Perhaps we can start being a little more confident about the end of the recession.

I’m very proud of the work the council does in support of Neighbourhood Watch (unlike most other areas the council, rather than the police, provide support Neighbourhood Watch in Wandsworth) and particularly proud of the opportunities we’ve given for co-ordinators to take on enhanced roles.

Much of this is provided through extra training for volunteers on how they might assist authorities, like the council, police or fire brigade in the event of an emergency.  For example, one of the first training sessions was on flooding – large parts of Wandsworth are in flood risk areas.  The training taught volunteers some basics which would help them safely tackle floods – meaning they could help out their neighbours and take some of the pressure off emergency services.

Pandemic training has already been offered, but in light of the small outbreak of swine flu, and potential for it to resurface later in the year, the primary care trust – NHS Wandsworth – are offering another couple of sessions on pandemics.  This time they are open to any Neighbourhood Watch co-ordinator, and not just those who have previously volunteered for the additional training.

The first session is next Thursday, 14 May at the Salvation Army Citadel on Ram Street, Wandsworth SW18 starting at 7pm.  A further meeting will be organised in June.  Any Neighbourhood Watch co-ordinator is welcome to attend.