Hammersmith Council U-turn: "Expensive consultation could lead to hospital closure" Tuesday October 30, 2012

From Hammersmith Council's website: 

"Expensive consultation could lead to hospital closure"

Tuesday October 30, no rx 2012

A multi-million pound consultation on the future of healthcare in north west London could lead to the closure of one of the capital’s most world renowned hospitals says a local council.

Instead of spending £7 million on its Shaping a Healthier Future consultation, click NHS North West London (NHS NWL) should have ploughed the money into securing the future of Charing Cross Hospital – which is now threatened with closure, help claims Hammersmith & Fulham (H&F) Council.

The sky-high consultation costs, which were discovered through a Freedom of Information response, include £3m in fees to management consultancy firm McKinsey – ironically to work out the financial case for the closures – and £650,000 to public relations firm The London Communications Agency.

The NHS NWL consultation on proposals to close four out of nine A&E units in the area has again stirred up fears that, if Charing Cross’ A&E is closed, it would signal the death knell for the entire hospital.

An independent review found the NHS plans to be ‘fundamentally flawed’ and the council is warning that if Charing Cross A&E is shut parts of the building will be sold off piecemeal eventually leading to the closure of the whole hospital.

NHS bosses have admitted that the Charing Cross site has been valued at £80million but that this cautious estimate would be likely to ‘run into hundreds of millions.’

Councillor Marcus Ginn, cabinet member for community care, says: “Instead of wasting huge amounts of taxpayers’ cash on management consultants and spin doctors the NHS should have spent the money keeping front-line services going. I could have told them for free that H&F residents want Charing Cross to remain a major hospital and the money could have kept the casualty unit open for a whole year!

“This consultation is not only flawed but is primarily designed to help Imperial sell off their most expensive asset – Charing Cross Hospital. We all know the huge value of the land and that once a hospital loses its A&E it is only a matter of time before the inevitable happens and the whole hospital shuts down permanently.”

H&F Council has been warning for years that Charing Cross is being systematically downgraded. In December 2010 the vascular surgery ward at Charing Cross was closed, apparently because of a severe infection outbreak. All vascular surgery was moved to St Mary’s where it remains, apparently permanently. There was no public consultation on the move and no clinical evidence presented to support the permanent move.

In 2009 Charing Cross was overlooked as the major trauma centre for the area and all six of Charing Cross’ world famous neurosurgeons were forced to provide an on call service at both St Mary’s, in Paddington, and Charing Cross without consultation.

Cllr Ginn says: “We need to keep fighting against the proposals and keep up the pressure on NHS NWL so that they see what they are doing is not only unsafe for local people but is also ultimately wrong. We need to protect our local hospital.”

The consultation asked residents in Brent, Ealing, H&F, Harrow, Hillingdon, Hounslow, Kensington and Chelsea and Westminster to choose from several options – each of which involved closing local services – yet never offered them the opportunity to say ‘no’ to the proposals.

As one of only two London boroughs set to lose all of its A&Es – the other borough is Ealing – local people will have to travel much further and longer for emergency services, and the council says that decisions are being made with no guarantee that alternative community services will be able to cope.

The council’s official response to the Shaping a Healthier Future consultation states: “The council considers that there are several key flaws in the proposals. The proposals are consequently seen as unsafe from the council’s perspective.”

It says the proposals fail on three of the four key tests for all health reforms and would put people’s lives at risk:

  • There are fundamental problems with the consultation process
  • The proposals are not based on adequate clinical evidence; and
  • There is a lack of due regard for the impact on the people who live and work in Hammersmith & Fulham.

At a public meeting in September at Hammersmith Town Hall hundreds of people heard that GPs are not ready to take up the strain of A&E closures, ambulance journey times to overstretched out-of-borough A&Es will increase and, if four out of the nine A&Es close (at Charing Cross, Hammersmith, Central Middlesex and Ealing hospitals), a population equivalent to the size of Sheffield will be left without a single local A&E. The council’s response to the consultation also echoed these concerns.

The Shaping a Healthier Future consultation ended on October 8 and a cross-party, joint Save Our Hospitals campaign led by H&F Council and community organisers collected more than 22,000 signatures calling for Charing Cross and Hammersmith hospitals to be saved from the axe. A decision on the future of the hospitals will be made early next year (2013).

» Send us your comments now

We NEED our Charing Cross A&E. It serves a huge and densely populated area of West London. It is a TEACHING hospital and we need training in A&E too.. It would not only be mad but absolutely bad for patients needing immediate emmergency treatment. The distance from Hammersmith areas to Chelsea & Westminster hospital is fraught with traffic problems. Ambulances would take longer, lives would be lost and crews exhausted. More ambulances would become essential or more lives would be lost in waiting for them to turn up. At best sick people needing attention would be left to suffer because of lack of professional care. It is outrageous to consider we could do without Charing Cross and a gross misuse of the Council''s power in the decision making process. Times are hard enough on the sick and the elderly without Council fat cats making it worse. Why? And don''t forget Council members, you live in this borough. You or one of your loved ones will get sick one day. You or yours might need fast, life saving medical attention when you least expect it. But you will have condemned yourselves to the same fate as your fellow residents. And it will be YOUR own fault.
From Lewis on 24/02/2013 at 23:37
It would be absolutely scandalous if Charing Cross Hospital were to be closed. Does no-one listen to the local people. The service CCH offers is second to none. They saved the life of three members of my family. If we had had to travel any further the result would have been fatal.
From Judy Wright on 03/11/2012 at 19:47
The NHS NWL is a mess peoples lives are not important to them only statistics and money-saving. If hospitals worked more efficently in the management area and sensible budgetting and all the non-jobs went that would be a great help financially. But they would rather selloff the hospital buildings instead to fill their bottomless cash pots!
Charing Cross Hospital if sold off would join the rest of the luxury buildings in Fulham and Hammersmith and the money they would get for it would just disappear and
From StellaMary on 03/11/2012 at 11:48
it's time to stop lining peoples pockets
stop putting pressure on us nursing staff to meet unrealistic targets
and look at how we can make our patients safe during their hour of need
From valerie falzon on 03/11/2012 at 08:36
I have lived in the borough for over 70 years and have been treated at both Hammersmith and Charing X hospitals. I was born in Hammersmith hospital, as were both my children.
I think it is disgraceful that we are to be left without an A&E department and most probably without Charing X hospital.
When people start dying because they cannot get to an A&E quickly enough will we just get regretful remarks from the NHS? We really must put a stop to this now!
From Romai on 02/11/2012 at 21:24
The problem is that no one can actually see this working. The guys proposing the cuts seem to think it'll work but what if it doesn't? What about those that this inconveniences? They won't give a rats bottom - then we'll have lost a facility just because of some political skulduggery when someone else gets promoted / makes ??? and the entire community loses. All I can see is that the community loses a hospital but we gain increased inconvenience and *supposedly* better treatment, which hasn't been proven. It's like a turkey voting for Christmas, except we don't get to vote. I don't buy it.
From J Ellis on 02/11/2012 at 19:52
All I can say is, I hope those responsible for the 'Sham' have been put inside for theft. Or like bankers have they got away with our money and those responsible walk free to rob us all yet again with the sale of the hospital ? It should be easy enough to identify them.
From Louise on 02/11/2012 at 18:12
This latest missive is mendacious scaremongering. Charing Cross hospital is not yet "facing closure"; The site is far from the "most expensive asset" of Imperial - selling off small chunks of South Kensington campus or St Mary's hospital would raise far more, though Imperial would not get any money from a hospital site sale. Fewer larger A&E departments are safer and more efficient, with less risk of peak time bottlenecks so reducing overall time to treatment even with an increased travel time IF funding is available to make the necessary improvements to the departments and ambulance services. The preferred option of closure is intended to allow this. Misinformation and uninformed tinkering with the plans by media-hungry councillers helps no-one.
I am an H&F resident and I have worked at Hammersmith Hospital since 1990 -I've seen all this before- and, yes, my job could be at risk (I and my colleagues have had a 20-25% fall in pay last year and several have been demoted to save money) but I support the NHS in the need for closures.
From Dr John Morris on 02/11/2012 at 16:07
I am shocked, distressed and most concerned for all who need our CXH to be fully functioning in our community, especially the frail & elderly. I feel & fear that the decision for the ultimate closure has already been made. eg I need a full body bone scan and have now been asked to attend St Mary's in Paddington; extremely difficult for me.
From Wilma Leroy on 02/11/2012 at 14:54
It seems absolutely inconceivable that anyone should even consider closing Charing Cross Hospital. What is more laudable in the long term, people's health care, or the quick profits made by developers? This hospital is one of the pre-eminent hospitals in London and simply has to be protected. I speak as someone who has lived in the borough for more than fifty years and whose family have benefitted enormously from the skilled doctors and staff at Charing Cross. We simply cannot allow the profiteers to dictate our lives.
From Lawrence Moore on 02/11/2012 at 14:44
I am totally against closure of A&E units in fulham
Closing another hospital as well is crazy.
From Df on 02/11/2012 at 14:33
Unbelievable and truly disgusting.
From Maria Miles on 02/11/2012 at 14:33
For Cllr Marcus Ginn please:

Suzanne & Robert Leather fully support Cllr Ginn's concerns about Charing Cross Hospital. Quite apart from the present pressures, what plans are being made re attending to the future needs of all the additional people who will be living in the vast proposed development at Earl's Court, not to mention the additional people who would live in a redeveloped Charing Cross Hospital site? The pressures on Chelsea & Westminster Hospital would be immense.
Robert & Suzanne Leather
From Leather on 02/11/2012 at 14:16
We should close maybe half the A&E departments in London, although that should have happened ten years ago, in the Blair boom. Larger A&E departments save lives and give better outcomes - that is the worldwide experience.
It still means we have to fund those large A&Es and the ambulance service (which nowadays are mobile A&Es) properly.
From J_Anderson on 30/10/2012 at 19:47


FOI response from the London Ambulance Service

We have recently received a response to a Freedom of Information request made to the London Ambulance Service. The information provided gives us a glimpse into the impact of cuts to emergency services. 

Amongst other important points, shop the response contains proof that there has been a reduction in the number of Ambulance Crews operating within the trust from 2009 to 2012.

We can also see a substantial increase in the Average Handover time from personnel having patient to handing over the patient to medical staff at the nearest facility.

The response, clinic including the questions asked, can be found directly below.  




Further to your enquiry made under the provisions of the Freedom of Information Act 2000, which we received on 14th October 2012, you requested the following information:


1 I would like to know how many 999 Ambulance Crews the Trust has/had in 2010,2011 & 2012 ?

2 I would like to know how many ambulances are sent out with just 1 Crew Member on average 2010,2011, & 2012 on a month by month basis until August for 2012 ?

3 How Many times Has London Ambulance service needed to use Private Ambulances ? in 2010,2011 & 2012 on a month by month basis until August for 2012


Hours and Working


4 How Many members of Staff of London ambulance service have zero hour contracts ?

5 How many Have zero hour contracts in 2010,2011 & 2012 upto August 2012 ?

6 Will the Service have to make reductions in staffing iuf so how many ? And will any of these be due to the MARS (Mutually Agreed Resignation Scheme)


Travel & Patient Handover


7 Whats the Average travel time to the nearest emergency medical facility ?in 2010, 2011 & 2012 upto August

8 Whats the Average Handover Time from personnel having patient to handing over the patient to medical staff at the nearest facility 2010,2011 & 2012 upto august

9 Whats the longest time ambulance staff have had to wait before they have been able to handover a patient in 2010,2011, & 2012 upto August Consultations

10 Has London Ambulance service been consulted as to the possible closure to Hammersmith and charring cross hospitals

11 Has the London Ambulance Service done any calculations as to the effect of the proposed closure of Charring Cross and Hammersmith Hospital.

11a The Increase in distances travelled before the ambulance gets to a medical facility in aprticular A&

11b Has the London Ambulance service done any calculations as to the number of extra fatalities this may create.

11c Will London Ambulance service need extra crews to counteract the increases in travel time and the increases in handover when the remaining A&E units are swamped




Our response is as follows:

1.    FY 09/10 (April-March) - 3260 as at Month 12 wte in post. 

FY 10/11(April-March)  - 3233 as at Month 12 wte in post.

FY 11/12 (April-March) - 3028 as at Month 12 wte in post.  

FY 12/13 (April-March) - 3009 as at Month 7 wte in post.                                                   

Staff grades are from Team Leader to A&E Support.

2.    The LAS has not sent out any single-crewed ambulances in any of the above years. We do not operate that as part of our response system.

3.    Please see the attached spreadsheet for details of LAS use of private ambulance services.

4.    We do not use zero hour contracts. We run a bank but there is no mutuality of obligation and those on the bank are not employees.

5.    N/A

6.    Reduction in staffing is being managed by turnover, redeployment and restrictions on recruitment activity (see attached News Release). We do not operate a MARS scheme.

7.    The average time, in minutes, from scene to hospital is as follows:

Year       AVG to Hospital

2010       13.03

2011       12.74

2012       13.32     (to August)


It is not possible to state that a patient was taken to the nearest medical facility, only that they were taken to a medical facility.


8.    Average Arrive Hospital to Patient Handover (mins):

            2009/10 (April/March)            12.7

            2010/11 (April/March)            14.2

            2011/12 (April/March)            16.6

            2012/13                                   17.4


9.    The longest Arrive hospital to patient handover time was 171 minutes on 11th December 2010.

10.  The LAS is aware of the North West London Shaping a Healthier Future consultation document and attended the JHOSC held at Ealing Town Hall on 6th September 2012 when travel arrangements were discussed.


11.  The LAS has completed modelling around the proposals set out in the consultation.


11a The modelling includes the potential impact on travelling times needed to get to the          nearest E/D.


11b The London Ambulance Service has modelled the extra resources needed to mitigate the effects of the response times in relation to the consultation.


11c            An increase in resources will be needed to balance the impact in travelling times.

There has been no modelling completed on increase in handover times. This would be best answered by the Acute Trust.





Save Our Hospitals Rebuttal Guide to "Shaping a Healthier Future" consultation

The unelected commissioners behind the ‘Shaping a Healthier Future’ consultation say they are keen to canvass public opinion but nowhere in their questionnaire is there a place to register a simple ‘yes’ or ‘no’ to the proposed closures of the A&E departments at Hammersmith and Charing Cross hospitals.

Instead, sovaldi the brochure and accompanying questions invites you to choose between three different packages or ‘options’ which the commissioners – drawing on their clinical ‘wisdom’ – believe represent the best deal for patients.

Their ‘preferred’ option – option A – would see the closure of A&Es at four of the nine hospitals serving northwest London – Hammersmith, Charing Cross, Central Middlesex and Ealing – and their replacement with Urgent Care Centres staffed by GPs and nurses and able to treat only a limited number of minor conditions.

Although the commissioners claim that both Hammersmith and Charing Cross would continue to operate as ‘local hospitals’, offering maternity and other specialist services, we believe the A&E closures would fatally erode clinical expertise at those sites, paving the way for the closure of other departments and the sale of valuable hospital buildings. Indeed, this process already appears to be underway at Charing Cross – hence the recent announcement by Imperial NHS Trust that the hospital’s hyper-acute stroke is to migrate to St Mary’s, one of the five preferred hospital sites selected by the commissioners.

What follows is a common list of claims made in the consultation document and other documents issued by NHS North West London (NHS NWL) and our responses to them:

Claim and Response

Read more ...

Emergency Departments in the UK

A major part of NHS North West London’s case for removing our A&E departments is that we have too many of them. As they have said themselves:

“We have more A&E departments per head of population than other parts of the country and this makes it harder to ensure enough senior staff are available. (Pre-Consultation Business Case Vol 1, thumb p51)”

“NW London has more A&E departments per head of population than other parts of the country and this makes it harder to ensure enough senior staff are available to provide adequate cover. (Pre-Consultation Business Case Vol 2, p91)”

However, this is not true.


Read more ...