Dartford, Gravesham and Swanley Clinical Commissioning Group chairman answers key questions
PUBLISHED: 09:00 26 April 2013
April 1 brought about significant changes in the NHS that mean hospital, community and mental health services in Dartford, Gravesham and Swanley are now run by a clinical commissioning group (CCG), led by working GPs.
The group oversees a budget of around £285million and replaces Primary Care Trusts.
The CCG board is made up of 15 voting members, including six elected GPs, a chief nurse, a hospital medical specialist, two members of the public and health managers, who will hold public meetings where residents can ask questions.
Dr Bhaskar Bora, 37, is the chairman of Dartford, Gravesham and Swanley CCG and has been a GP in his Elmdene Surgery in Greenhithe for four years, having retrained from a surgeon.
Here, he answers questions about what the changes will mean, in an interview with Robin Cottle.
What are the main priorities for Dartford, Gravesham and Swanley?
This area has one of the highest rates of population growth in the country and that puts strain on our healthcare. We want to reduce health inequalities which I believe are happening across the area.
There is a large undiagnosed population – people who won’t go to their GP, often because of social and economic deprivation. Many will only go in an emergency and by then it could be too late and what they have will be more difficult to treat.
The specific problems we need to tackle are cardiovascular diseases and respiratory conditions.
Also, diabetes in very young people is always difficult to treat, and we need to try and catch it early or prevent it altogether in as many cases as possible. Early diagnosis will help us delay the progression of the disease.
As well as having higher than average deprivation, there is a rising birth rate and growing elderly population.
So our other immediate priorities include children and maternity services, mental health and managing long-term conditions.
How have the problems with South London Healthcare Trust affected healthcare in the area, and how will they in the future?
The closure of the A&E department at Queen Mary’s Hospital in Sidcup had a profound effect on us because more patients who would have gone there are now referred to Darent Valley Hospital in Dartford.
The proposed closure of the department at Lewisham Hospital could exacerbate this problem further.
We try to encourage people to not go to Darent Valley unless it’s an emergency and will refer them to their local GP – but if they’re Bexley patients, it becomes a little more difficult because Bexley GPs are not under our umbrella.
We are trying to develop a relationship with Bexley CCG to encourage co-operation.
Will patients face longer waiting times as GPs deal with bigger workloads?
I work four sessions for the CCG over three days but I don’t let that affect my patient times.
I always make sure I provide the same number of appointments and quality and do my job in the practice, although this may sometimes mean I end up staying back for longer hours in the practice after work.
In case I have to spend more than that time on CCG business, the session is covered by locums and that’s the same across the board. Basically, patients shouldn’t be affected.
With GPs in charge of the budget, could there be a conflict of interest?
It’s true £285 million is a lot of money to be in charge of. But there are constraints about how we spend it – it’s not like we have a blank cheque written for whatever we want.
GPs know what is good for their patients and what is not. I’ve taken up this position because I knew I could influence decisions across Dartford, Gravesham and Swanley.
It’s an advantage to see things from both sides.
We have to save at least one per cent of the budget for potential unforeseen circumstances and if that is remaining at the end of the financial year it is carried on to the next.
If we save money from the budget, it does not mean we get paid more. The savings will also be carried over and the governance of our action is robust.
We have regular public meetings so patients can see how we make decisions. I would like to take this opportunity to invite members of the public to the first meeting on Tuesday (April 30) at the White Oak Indoor Bowls Centre, Garrolds Close in Swanley from 1pm to 3pm.
n Are you a doctor or patient affected by the changes? Let us know your views, email firstname.lastname@example.org