NW London STP

  • Can we afford to close any more A&E departments ? Evidence from North West London

    Research paper by Dr Gurjinder Singh Sandhu, published by the Centre for Health and the Public Interest on 19th April 2017. You can read it here (14 pages).

    The following graph shows that the closure of Hammersmith and Central Middlesex A&E departments in Sept 2014 caused a very serious decline in the performance of the remaining A&E departments, that they recovered only a little in the summer months and that the trend is downwards.

     

    Dr Sandhu has provided unequivocal evidence using statistics from NHS and other public bodies (Jan 2012- Jan 2017) for the Mansfield Commission findings that SaHF, and by extension the NW London STP, can be shown to fall foul of (1) equalities (BME) legislation and (2) discrimination on grounds of age. 

     

    "Conclusions

    Since the closure of Emergency Departments in North West London in September 2014, each successive winter has seen deterioration in Type 1 A&E Performance. For some hospitals there has been no recovery over the summer months and emergency care has been in perpetual state of crisis. Ambulance response times are deteriorating, A&E units are unable to offload ambulances, and patients are waiting longer on emergency department trolleys to be assessed, treated and bedded where necessary. For time- sensitive conditions such as sepsis, respiratory failure, kidney failure and the unconscious patient, all this lost time equates to cellular death and eventually patient deaths. A lack of critical care and high dependency unit beds for the sickest patients is the greatest cause for concern.

    In North West London A&E closures have also had significant effects on the performance of neighbouring A&E departments. STP footprints are not isolated: the STP for South West London also proposes to downgrade one of five A&Es, which will have a knock-on effect on North West London, and vice versa.

    There has been a lack of equality impact assessment on the effects on deprived communities and the elderly in the NW London STP plan. Poverty is shifting from the centre of London to the outskirts, yet across London it is in these areas that clinical networks between a hospital, GPs and social care are being dismantled.

    Whilst isolated deaths due to pressures on the emergency system have been reported by the media, disinvestment in NHS and social care services has been explored in one recent study as a factor contributing to nearly 30,000 extra annual deaths in 2015. The authors* expressed significant concerns that a pattern of rising mortality each year is emerging and called for further in-depth scrutiny of what caused this marked increase in mortality. Despite a dangerous deterioration in A&E performance since the closure of two local A&E Departments, the North West London STP still envisages closing a further two A&E units at some point in the future. Future planning needs to learn lessons from the reconfigurations that have already taken place and not continue with A&E closures based on assumptions which have not been borne out in reality."

     

    * Prof Martin McKee, Lucinda Hiam, Prof Danny Dorling and Dominic Harrison.

     

     

  • STP finance figures in spreadsheets and Delivery Plan "incorrect" - or not?

    At a presentation to Kensington and Chelsea Healthwatch members and residents on Tuesday 31st January, the STP team were challenged by Merril Hammer, Chair of Save Our Hospitals, about the figures revealed recently by a FOI request to NW London CCGs. The finance figures were contained in a "workbook", a set of spreadsheeets submitted with the Oct 2016 STP. Merril referred to the plans for the loss of 3,658 NHS jobs in NW London next year 17/18, rising to 7,753 job losses by 20/21.

    When NHSE, an executive body of the Dept of Health, publishes information, especially as a result of a Freedom of Information request, the public has a right to be able to rely on its contents.

    But in the question and answer session Christian Cubbitt, Director of Communications for NHS NW London Collaboration of CCGs, publicly retracted the figures. He said that they were "incorrect" and that there would not be nearly 8,000 job losses. He said that the "correct" figures would be produced, but did not give any deadline.

    Given that the objective of the STP is to find £1.3Bn of savings and that the template of the STP is set by the Dept of Health, it is impossible that the final numbers will be very different from the ones just published, using the same categories. SOH and its advisers have looked closely at all the pages in the workbook, including the "solutions" which are the balancing figures between the "Do Nothing" and the "Do Something" scenarios. Most of the solutions include words like "these costs have not been finalised". For Solution 4 (NHSE Specialised Commissioning) it says: "We have not yet developed the "solution" for closing the gap, however it is assumed that this gap will be closed. This is a placeholder".

    The Delivery Plan is obviously nearly right too.

    The denial by NW London CCGs is a clumsy attempt to limit the harm after the release of highly damaging information which should not have been disclosed on the grounds that its release would prejudice incomplete development of the plans. But then the FOI request would probably have been forwarded to the Information Commissioner and SOH would have made a big fuss about the refusal and about the fact that the figures were still being worked on three months after submission to NHSE on 21st October as a "final" version.

    That is why the current dispute about the status of the information produced by the NHS's NW London Collaboration of Clinical Commissioning Groups reveals even more than the figures themselves

    Brent Patient Voice have discussed the huge cuts in "Losing the power to shock".

  • Councils and residents close ranks to fight 'new ploy' to close Ealing and Charing Cross Hospitals

     

     

    Four hundred people came to Hammersmith Town Hall on a cold Tuesday night (29th November) to hear about the fight against NHS proposals which will force the closure of Ealing and Charing Cross Hospitals.

    Health services in the north west of London are already stretched after "Shaping a Healthier Future" (SaHF) plans (2012) resulted in the closure of Hammersmith and Central Middlesex Hospitals’ A&E departments in September 2014. Ealing lost its maternity unit in 2015 and its children's ward last June.

    In June 2016 local authorities in England were being asked to sign up to Sustainability and Transformation Plans ("STPs") but Ealing and Hammersmith and Fulham Councils have refused to do so, saying that this would see the end of their hospitals as major providers of vitally needed blue-light A&Es and acute beds.

    The meeting was chaired by Hammersmith and Fulham Council’s Vivienne Lukey, cabinet member for health and adult social care.

  • Plan to 'transform' NHS could lead to downgrade of major London hospitals

    Council leaders refuse to back proposal amid fears Ealing and Charing Cross hospitals could lose A&E and other services as focus shifts to ‘virtual’ care

     

     

  • Join the protest at Imperial NHS Trust AGM 14th Sept 2016