Wiltshire GPs examine ways to make savings

This Is Wiltshire: Dr Simon Burrell Dr Simon Burrell

Minor injury services and hip and knee replacements in Wiltshire are being reviewed by GPs who will be taking over the responsibility of organising and buying local health services.

Details of the reviews emerged at a public meeting in Devizes on Saturday, held to explain the changes in the NHS that begin to take effect in April.

The main change will be that NHS Wiltshire (the Primary Care Trust) will be abolished and replaced by Wiltshire Clinical Commiss-ioning Group (CCG), comprising mainly GPs, which will have a budget of about £500million.

The CCG is examining all aspects of health care including referrals to acute hospitals in Swindon, Bath and Salisbury, and aims to prioritise care in the community.

At the public meeting held in the Corn Exchange Dr Simon Burrell, a GP in Corsham, said hip and knee replacements in the county seemed “very high” and were being looked at.

In the CCG’s strategic plan, which is available online, GPs in West Wiltshire, Devizes, North and East Wiltshire intend no growth in the number of hip and knee replacements in 2013/14 and for a reduction in such outpatient appointments.

In its proposed budget for 2013/14, the CCG wants to save £1.3 million by reducing planned orthopaedic surgery.

The same GP practices are also planning for a reduction in attendances at minor injury units in Chippenham and Trowbridge Community Hospitals, according to the CCG’s strategic plan.

The CCG’s proposed savings show £300,000 is allocated for reducing inappropriate activity at minor injury units.

At the public meeting Judy Rose, a health campaigner in Devizes, asked Dr Burrell what was being done to provide a minor injury service, particularly in Devizes and East Wiltshire where there is none.

Dr Burrell said: “We are looking at it very closely. We are looking at minor injury in Chippenham.

“The cost of treating a minor injury in Chippenham is staggeringly high, not many people use the service.

“Why have discreet minor injury units? Why not locate a little service in each surgery?

“Is building a large building to provide a minor injury service for a few people a week really worthwhile?

“We have to think outside the box. Doing the same that we have always done isn’t going to work.

“Services in community hospitals have to be looked at again, we have been doing it over the years. We have to think what is best for the future and not what is best for the past.”

Comments (17)

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5:04pm Wed 6 Feb 13

Aran Oatan says...

So hip and knee replacements are high in Wiltshire are they? Must be all those people having them for the fun of it. People will have to hang on, in pain and immobile for longer because some tosser of a GP decides they're spending too much and its affecting their profits. What happened to NHS spending being protected?
So hip and knee replacements are high in Wiltshire are they? Must be all those people having them for the fun of it. People will have to hang on, in pain and immobile for longer because some tosser of a GP decides they're spending too much and its affecting their profits. What happened to NHS spending being protected? Aran Oatan
  • Score: 2

5:10pm Wed 6 Feb 13

goateatingtroll says...

"We have to think outside the box".

I think it is time we stopped spending money on childbirth. We should make people give birth in the wilds with no specialist medical facilities (or nurses). It worked okay historically and any mothers/children that fail to make it simply represent a long-term saving.
"We have to think outside the box". I think it is time we stopped spending money on childbirth. We should make people give birth in the wilds with no specialist medical facilities (or nurses). It worked okay historically and any mothers/children that fail to make it simply represent a long-term saving. goateatingtroll
  • Score: 0

7:03pm Wed 6 Feb 13

Clarwilt says...

The NHS has cut back dramatically on knee and hip replacement operations so for this doctor to state that these type of operations in the county are high is scandalous. You don't even get referred to see a specialist in most cases. You are now sent to pain management clinics, given the loan of a tens machine for a short period with the option to buy. Exercise classes at physiotherapy units where elderly people can hardly walk leave alone do exercises. The pain is etched on their faces, many in tears. I was told that at 67, I am considered to young for a knee operation!
The NHS is perilously close to collapse and this Dr. Is a disgrace to the profession.
The NHS has cut back dramatically on knee and hip replacement operations so for this doctor to state that these type of operations in the county are high is scandalous. You don't even get referred to see a specialist in most cases. You are now sent to pain management clinics, given the loan of a tens machine for a short period with the option to buy. Exercise classes at physiotherapy units where elderly people can hardly walk leave alone do exercises. The pain is etched on their faces, many in tears. I was told that at 67, I am considered to young for a knee operation! The NHS is perilously close to collapse and this Dr. Is a disgrace to the profession. Clarwilt
  • Score: 3

9:59pm Wed 6 Feb 13

toryexitpole says...

More thinking "outside the box":

We should stop treating cancer as we could save shed loads of cash. We should start looking at cancer as God's way of saving the NHS money.
More thinking "outside the box": We should stop treating cancer as we could save shed loads of cash. We should start looking at cancer as God's way of saving the NHS money. toryexitpole
  • Score: 0

10:04pm Wed 6 Feb 13

derekfatwah says...

We could simply shut all the hospitals and GP surgeries and let luck heal (or not) the ill. That would save the NHS money.
We could simply shut all the hospitals and GP surgeries and let luck heal (or not) the ill. That would save the NHS money. derekfatwah
  • Score: 0

4:50am Thu 7 Feb 13

zednotzee says...

Perhaps the doctors should pay themselves less?
Perhaps the doctors should pay themselves less? zednotzee
  • Score: 2

7:30am Thu 7 Feb 13

notscot says...

I'd like to see the NHS cut the deadweight, too. I would like to see ALL addicts left to stew in their own choices. I am so sick of seeing these people given benefits and homes. Benefits that they use to buy more crap. Homes that they don't just abuse - homes that they wreck. Homes that become a blight in the immediate community because of the dregs that are attracted to the properties. One drug addicted scummer in a block of flats blights the entire property. They are supported, housed, re-housed and continually bite the hand that feeds them.
And as for the 3rd-generation chavs bringing up 4 kids in a 3-bed house with 2 dogs a cat and a 4x4 on the drive - having NEVER held down a job/paid taxes - time to cut the chaff. You want a family? A home? A car? Then YOU support them. You can't? THEN YOU CAN'T HAVE WHAT YOU CAN'T AFFORD.. Books balanced. End of sermon/rant.
I'd like to see the NHS cut the deadweight, too. I would like to see ALL addicts left to stew in their own choices. I am so sick of seeing these people given benefits and homes. Benefits that they use to buy more crap. Homes that they don't just abuse - homes that they wreck. Homes that become a blight in the immediate community because of the dregs that are attracted to the properties. One drug addicted scummer in a block of flats blights the entire property. They are supported, housed, re-housed and continually bite the hand that feeds them. And as for the 3rd-generation chavs bringing up 4 kids in a 3-bed house with 2 dogs a cat and a 4x4 on the drive - having NEVER held down a job/paid taxes - time to cut the chaff. You want a family? A home? A car? Then YOU support them. You can't? THEN YOU CAN'T HAVE WHAT YOU CAN'T AFFORD.. Books balanced. End of sermon/rant. notscot
  • Score: 2

8:39am Thu 7 Feb 13

Aran Oatan says...

Notscot - a little off topic perhaps but obviously heartfelt. What do you think about cutting hip replacements?
Notscot - a little off topic perhaps but obviously heartfelt. What do you think about cutting hip replacements? Aran Oatan
  • Score: 2

8:43am Thu 7 Feb 13

notscot says...

Aran Oatan wrote:
Notscot - a little off topic perhaps but obviously heartfelt. What do you think about cutting hip replacements?
Hmmm - let's see.
If you're overweight - remove legs - purchase wheelchair. Optimum use of funds.
If you're not - hip replacement to be carried out immediately - before the deterioration of the person's ability to move independantly prevents them from working/living - and before the other hip is so overworked that it too requires replacement.
[quote][p][bold]Aran Oatan[/bold] wrote: Notscot - a little off topic perhaps but obviously heartfelt. What do you think about cutting hip replacements?[/p][/quote]Hmmm - let's see. If you're overweight - remove legs - purchase wheelchair. Optimum use of funds. If you're not - hip replacement to be carried out immediately - before the deterioration of the person's ability to move independantly prevents them from working/living - and before the other hip is so overworked that it too requires replacement. notscot
  • Score: 0

11:38am Thu 7 Feb 13

merulius says...

Clarwilt wrote:
The NHS has cut back dramatically on knee and hip replacement operations so for this doctor to state that these type of operations in the county are high is scandalous. You don't even get referred to see a specialist in most cases. You are now sent to pain management clinics, given the loan of a tens machine for a short period with the option to buy. Exercise classes at physiotherapy units where elderly people can hardly walk leave alone do exercises. The pain is etched on their faces, many in tears. I was told that at 67, I am considered to young for a knee operation!
The NHS is perilously close to collapse and this Dr. Is a disgrace to the profession.
Dr Burrell has been a dedicated GP in Corsham for as long as I can remember, so the very opposite of a "disgrace".

The replacement of the PCT with the CCG is a political decision that Burrell and his colleagues must live with - or retire. He has re-dedicated himself to this at a time of life when many would throw in the towel (that photo should be carbon-dated, by the way.)

Are there too many hip and knee replacements? I have no idea, but please don't knock a guy who's trying to make it work within the budgets that this awful government are setting.
[quote][p][bold]Clarwilt[/bold] wrote: The NHS has cut back dramatically on knee and hip replacement operations so for this doctor to state that these type of operations in the county are high is scandalous. You don't even get referred to see a specialist in most cases. You are now sent to pain management clinics, given the loan of a tens machine for a short period with the option to buy. Exercise classes at physiotherapy units where elderly people can hardly walk leave alone do exercises. The pain is etched on their faces, many in tears. I was told that at 67, I am considered to young for a knee operation! The NHS is perilously close to collapse and this Dr. Is a disgrace to the profession.[/p][/quote]Dr Burrell has been a dedicated GP in Corsham for as long as I can remember, so the very opposite of a "disgrace". The replacement of the PCT with the CCG is a political decision that Burrell and his colleagues must live with - or retire. He has re-dedicated himself to this at a time of life when many would throw in the towel (that photo should be carbon-dated, by the way.) Are there too many hip and knee replacements? I have no idea, but please don't knock a guy who's trying to make it work within the budgets that this awful government are setting. merulius
  • Score: 2

11:45am Thu 7 Feb 13

merulius says...

"The main change will be that NHS Wiltshire (the Primary Care Trust) will be abolished and replaced by Wiltshire Clinical Commiss-ioning Group (CCG), comprising mainly GPs, which will have a budget of about £500million."

This is stupid, misguided change. GPs should do what they are best at: caring for the sick. What they not good at (why should they be?) is managing a £500m budget. So what does the government do? Take their attention away from caring and make them budget managers! Dumb, dumb, dumb.

And all the PCT staff who were made redundant are re-hired to support the CCG (because the work has not gone away, just moved).

And through all this disruption, the same bunch of people struggle on to do their best.
"The main change will be that NHS Wiltshire (the Primary Care Trust) will be abolished and replaced by Wiltshire Clinical Commiss-ioning Group (CCG), comprising mainly GPs, which will have a budget of about £500million." This is stupid, misguided change. GPs should do what they are best at: caring for the sick. What they not good at (why should they be?) is managing a £500m budget. So what does the government do? Take their attention away from caring and make them budget managers! Dumb, dumb, dumb. And all the PCT staff who were made redundant are re-hired to support the CCG (because the work has not gone away, just moved). And through all this disruption, the same bunch of people struggle on to do their best. merulius
  • Score: 0

12:12pm Thu 7 Feb 13

notscot says...

And by the way, Aran O. - if you can't have a family unless you can afford it - that WILL save the NHS a small fortune.
And Merulius is right - Doctors' help and advise sick people - it's what they've been trained to do. They have not been trained as accountants. But the ensuing mess will ensure we're looking at the doc tors when it all goes wrong. Not the govt.
Until the moment they announce they've discovered the NHS doesn't work and we'll all have to buy into medical insurance.......
And by the way, Aran O. - if you can't have a family unless you can afford it - that WILL save the NHS a small fortune. And Merulius is right - Doctors' help and advise sick people - it's what they've been trained to do. They have not been trained as accountants. But the ensuing mess will ensure we're looking at the doc tors when it all goes wrong. Not the govt. Until the moment they announce they've discovered the NHS doesn't work and we'll all have to buy into medical insurance....... notscot
  • Score: 0

2:41pm Thu 7 Feb 13

Clarwilt says...

Dr. Burrell may well be a dedicated GP in Corsham for as long as you can remember (merulius) and clearly has his fans..but that doesn't mean to protect his job and huge salary that a GP earns he has to go along with this governments devastating cuts to the NHS. In his profession especially, he should be supporting patients who are suffering from these cuts and speak out and if he can't do that, perhaps he should consider throwing in the towel.
Dr. Burrell may well be a dedicated GP in Corsham for as long as you can remember (merulius) and clearly has his fans..but that doesn't mean to protect his job and huge salary that a GP earns he has to go along with this governments devastating cuts to the NHS. In his profession especially, he should be supporting patients who are suffering from these cuts and speak out and if he can't do that, perhaps he should consider throwing in the towel. Clarwilt
  • Score: 1

5:44pm Thu 7 Feb 13

goateatingtroll says...

Clarwilt wrote:
Dr. Burrell may well be a dedicated GP in Corsham for as long as you can remember (merulius) and clearly has his fans..but that doesn't mean to protect his job and huge salary that a GP earns he has to go along with this governments devastating cuts to the NHS. In his profession especially, he should be supporting patients who are suffering from these cuts and speak out and if he can't do that, perhaps he should consider throwing in the towel.
+1
[quote][p][bold]Clarwilt[/bold] wrote: Dr. Burrell may well be a dedicated GP in Corsham for as long as you can remember (merulius) and clearly has his fans..but that doesn't mean to protect his job and huge salary that a GP earns he has to go along with this governments devastating cuts to the NHS. In his profession especially, he should be supporting patients who are suffering from these cuts and speak out and if he can't do that, perhaps he should consider throwing in the towel.[/p][/quote]+1 goateatingtroll
  • Score: 1

5:49pm Thu 7 Feb 13

goateatingtroll says...

merulius wrote:
Clarwilt wrote:
The NHS has cut back dramatically on knee and hip replacement operations so for this doctor to state that these type of operations in the county are high is scandalous. You don't even get referred to see a specialist in most cases. You are now sent to pain management clinics, given the loan of a tens machine for a short period with the option to buy. Exercise classes at physiotherapy units where elderly people can hardly walk leave alone do exercises. The pain is etched on their faces, many in tears. I was told that at 67, I am considered to young for a knee operation!
The NHS is perilously close to collapse and this Dr. Is a disgrace to the profession.
Dr Burrell has been a dedicated GP in Corsham for as long as I can remember, so the very opposite of a "disgrace".

The replacement of the PCT with the CCG is a political decision that Burrell and his colleagues must live with - or retire. He has re-dedicated himself to this at a time of life when many would throw in the towel (that photo should be carbon-dated, by the way.)

Are there too many hip and knee replacements? I have no idea, but please don't knock a guy who's trying to make it work within the budgets that this awful government are setting.
You are aware that the majority of Dr Harold Shipman's patients thought he was an excellent doctor?

Talking of which; more "thinking outside the box":

Morphine is dirt-cheap. Why not kill-off all the elderly patients with morphine. That would save the NHS loads of money.
[quote][p][bold]merulius[/bold] wrote: [quote][p][bold]Clarwilt[/bold] wrote: The NHS has cut back dramatically on knee and hip replacement operations so for this doctor to state that these type of operations in the county are high is scandalous. You don't even get referred to see a specialist in most cases. You are now sent to pain management clinics, given the loan of a tens machine for a short period with the option to buy. Exercise classes at physiotherapy units where elderly people can hardly walk leave alone do exercises. The pain is etched on their faces, many in tears. I was told that at 67, I am considered to young for a knee operation! The NHS is perilously close to collapse and this Dr. Is a disgrace to the profession.[/p][/quote]Dr Burrell has been a dedicated GP in Corsham for as long as I can remember, so the very opposite of a "disgrace". The replacement of the PCT with the CCG is a political decision that Burrell and his colleagues must live with - or retire. He has re-dedicated himself to this at a time of life when many would throw in the towel (that photo should be carbon-dated, by the way.) Are there too many hip and knee replacements? I have no idea, but please don't knock a guy who's trying to make it work within the budgets that this awful government are setting.[/p][/quote]You are aware that the majority of Dr Harold Shipman's patients thought he was an excellent doctor? Talking of which; more "thinking outside the box": Morphine is dirt-cheap. Why not kill-off all the elderly patients with morphine. That would save the NHS loads of money. goateatingtroll
  • Score: 1

9:32pm Thu 7 Feb 13

Clarwilt says...

They are ahead of you on that one, have you not heard of the Liverpool pathway??
They are ahead of you on that one, have you not heard of the Liverpool pathway?? Clarwilt
  • Score: 1

9:23am Fri 8 Feb 13

moonrakin wurzel says...

Well - to start with they can save the money that Wiltshire PCT was handing over to Smoke Free Southwest to put up advertising hoardings, buy Google advertising and generally maintain a bunch of parasitic penpushers in Bristol in the considerable style to which they have become accustomed... to the tune of £600K over the last couple of years.

This was frontline NHS funding handed over - when the AIr Ambulance is run with voluntary contributions - this is criminal.

Whoever runs the funding - there should be FULL PUBLIC ACCOUNTS up to date and on line. This is trivial to achieve these days.
Well - to start with they can save the money that Wiltshire PCT was handing over to Smoke Free Southwest to put up advertising hoardings, buy Google advertising and generally maintain a bunch of parasitic penpushers in Bristol in the considerable style to which they have become accustomed... to the tune of £600K over the last couple of years. This was frontline NHS funding handed over - when the AIr Ambulance is run with voluntary contributions - this is criminal. Whoever runs the funding - there should be FULL PUBLIC ACCOUNTS up to date and on line. This is trivial to achieve these days. moonrakin wurzel
  • Score: 2

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