Graeme Kendall: Why Barlborough can still play a role

The following article by Graeme Kendall, general manager at Barlborough NHS Treatment Centre recently appeared in the Nottingham Evening Post. In it Graeme reflects on what has been achieved at the hospital over the past 5 years as well as what the future holds.

Until recently, patients had very little choice of hospital if they needed an operation, and we all know of a friend or family member who waited anything up to two years to have a painful hip replaced or knee repaired, or someone who in the end "went private" as they couldn't take the agony any longer.

They can ask about waiting times, the track record of surgeons or the incidence of hospital-acquired infections and make an informed and real choice.

The waiting time can be significantly shorter. Even the Government's target waiting time of 18 weeks for an operation is now the maximum wait you should have to expect. One of the ways in which the Department of Health helped achieve the 18-week target was with the establishment of specialist NHS hospitals such as the one at Barlborough, purpose-built to undertake routine, planned operations in a modern, safe environment.

I'm proud to work at the Barlborough NHS hospital and I believe that it is a perfect example of patient choice in action.

I talk to our patients every day and I know that a lot of them choose us because a friend, neighbour or family member has been delighted with the care they received here.

They find that they are seen and have their operation significantly faster than the Government's target waiting time of 18 weeks, and they are greatly reassured that we've never had a case of hospital-acquired MRSA or clostridium difficile and that the clinical outcomes are of the highest standards.

For those that require it, free transport is provided, so location doesn't need to be a problem.

Even in the snowy weather, our team has been getting out to patients, running outpatient clinics in local towns.

Community outreach is a big part of what we do. We visit people's homes for pre-assessments, ensure their home is well adapted to help their rehabilitation post operation and we always follow up with them afterwards.

As you might have read in a recent edition of this paper, the NHS contract for Barlborough is just coming up for renewal.

It was not expected that the contract would be renewed on the same terms and we have been keen to talk to our colleagues in the NHS about what happens next for Barlborough hospital.

One option is simply to close Barlborough, which we feel would make a mockery of the notion of patient choice. Why close an NHS hospital that has one of the highest levels of patient satisfaction in the country, zero cases of hospital acquired MRSA and excellent clinical outcomes?

Over the past few months, discussions have been in progress about Barlborough's future.

We are so confident of its excellent local reputation that we have asked the NHS whether we can lease the existing building in order to continue offering operations to NHS patients without the volume guarantees that we recognise have proved contentious in the past.

We appreciate that it has been difficult in the past for PCTs to estimate future demand for specific procedures, so an arrangement whereby the hospital operator takes that risk and is remunerated on a like-for-like basis with other NHS hospitals for each operation is a fair deal for all. Last year, in a number of local PCTs, around one in five of the hip and knee replacements were carried out by Barlborough – 19% in Nottingham City, 12% in Notts County.

No one has yet been able to demonstrate how this extra capacity could be delivered elsewhere without waiting times returning to 18 weeks at the very least and probably more. Even four-and-a-half months is a long time if you are in so much pain that you can barely get out of the chair.

Some 98% of former patients have said that they would recommend Barlborough hospital to family or friends.

We are enormously proud of that endorsement and NHS commissioners should be too.