Issue: 27
August 2015
This occasional newsletter is researched, written and edited by a group of concerned residents in Ealing, West London who want to preserve our NHS. We view the wholesale engagement of private, for-profit healthcare service suppliers as unnecessary, profligate and dangerous. Process improvement is what is needed in our NHS – not revolution.
No More Babies Born at Ealing Hospital
Around 100 demonstrators turned up outside Ealing Hospital on 1 July 2015 to protest about the closure of the Maternity Unit there on that day. In fact the last baby born there was on 25 June 2015. Given this was the hottest day of the year, the size of the demonstration was remarkable. The core of the protest group were members of Ealing Save Our NHS (www.facebook.com/ealingsaveournhs).
Midwives still working at the hospital came out to greet the protestors. They were cheered. But tears were to follow shed by both staff and protestors. Drivers in car after car hooted their support as they drove past the demonstration. Protestors from Charing Cross, Hammersmith and Lewisham Hospitals were welcomed at the event.
I can’t help but think that this closure is of historic significance. Will it prove to be a dreadful mistake – a tragic error of judgement? Will we ever know? As has been stated so many times before, the people most likely to suffer most from this closure are impoverished, pregnant women in Southall with complex needs.
ITV ‘Exposure’ Documentary Reveals Failings at Care UK’s Urgent Care Centre at Ealing Hospital
On Wednesday evening 22 July 2015 an ITV investigative programme featured covert filming of the workings of Ealing Hospital’s Urgent Care Centre (UCC). The UCC is run by Care UK, a private healthcare company.
The programme highlighted multiple failings whose causes hinged around meeting targets and making profits rather than meeting patient needs.
Failings exposed included:
+ Doctors not fully trained
+ Record keeping ‘fudged’ in order to meet targets
+ Under-staffing
+ Inadequate stocks of drugs
+ Patients discharged too early
+ Triage carried out in public at the UCC reception instead of being carried out by a nurse in private.
For those who missed the programme, it can be viewed until 22 August 2015 at:
www.itv.com/itvplayer/exposure-out-of-hours-undercover
Care UK has responded to the programme and their rebuttal can be found at www.ealingtoday.co.uk. Southall’s MP Vivendra Sharma has called for an investigation. He doesn’t (for some reason) identify Ealing Commissioning Group (ECCG) as having any responsibilities for these failures. The Evening Standard quotes the ECCG Chair. She said ‘…an urgent clinical visit found no immediate cause for concern’. Her statement is very much at odds with the programme content and places ECCG in the category of ‘cause for concern’. After all ECCG chose Care UK to run the UCC and it is the ECCG which is responsible for ensuring that Care UK delivers a first class service.
NHS England (London) has announced it will, along with ECCG, commission an independent clinical and lay review of any patient safety concerns at Ealing Hospital UCC. However the Director of NHS England (London) in an email to colleagues refers to ‘allegations’ made in the ITV documentary. This clearly is misleading as the film/video footage is clearly evidence and not allegations.
AgeUK Ealing’s Survival at Risk as Ealing Council Withdraws Funding for 2016 – 2019
Ealing Council is planning to allocate the entire voluntary sector older peoples budget to just one organisation – Southall Neighbourly Care. This will total £1 million over the next three and a half years.
The impact of this decision will be severe and immediate. AgeUK Ealing – a well established charity serving the needs of many older people – is now severely under threat. Also under threat is the AgeUK Ealing supported Southall Day Centre. Hundreds of centre users demonstrated against these proposals outside Ealing Town Hall on the evening of 28 July 2015.
Doubts are being expressed as to the suitability of Southall Neighbourhood Care to receive all this grant money. It’s a consortium of 21 organisations not all of which are charities, some of which don’t offer services to the elderly and some which don’t even operate in Ealing. Charity Commission records show consistent annual overspend by the organisation over the last five years.
Charing Cross Hospital
Andy Slaughter MP met with Hospitals Minister Jane Ellison in July 2015. He says the SaHF timetable is slipping and SaHF funding may not be agreed till 2018. With £1 billion now needed in capital costs and £250 million required in implementation costs, SaHF looks increasingly rocky. She did however say the intention was still to demolish Charing Cross Hospital and replace it with a new ‘Local Hospital’. She also confirmed that there would be no new Keogh Report, which supposedly was to be the document which would define the nature of a ‘Local Hospital’.
The Save Our Hospitals (SOH) group in Hammersmith have, surprisingly, received an invitation from Hammersmith & Fulham CCG (H&FCCG). The CCG wants to ‘…establish a more constructive dialogue…’. SOH has yet to decide whether to agree to a meeting.
NHS Announce Eight New ‘Vanguards’ Aimed Towards Transforming Urgent and Emergency Care
On 24 July 2015, NHS England Chief Executive Simon Steven said:
‘Urgent care will be delivered , not just in hospitals but also by GPs, pharmacists, community teams, ambulance services, NHS 111, social care and others, and through patients being given support and education to manage their own conditions’.
These are no doubt laudable aspirations for ‘joined-up’ urgent care operations. Current Vanguard projects around England are trumpeting successful initiatives including mobile treatment services, street triage services and acute home-visiting.
Currently these Vanguards are funded from a £200 million transformation fund. No inner London Vanguards are referenced in the announcement. There is one in outer London at Barking, Dagenham, Havering and Redbridge. One does wonder what the cost would be to run these joined-up urgent care services nationwide.
It is of course ironic that this NHS urgent care announcement came just two days after the ITV documentary portraying Ealing Hospital Urgent Care Centre (UCC) as a shambles. Under the NHS ‘Shaping a Healthier Future’ strategy Ealing Hospital’s A&E unit will close and all we will be left with in Ealing for emergency and urgent care will be Care UK’s UCC. Never mind joined-up urgent care throughout Ealing we, seemingly, can’t even deliver urgent care adequately at Ealing Hospital’s UCC.
McKinsey’s NHS NW London A&E Post Closure Performance Whitewash is Finally ‘Sort of’ Placed in the Public Domain
After disastrous local A&E performance following the September 2014 A&E closures at Central Middlesex and Hammersmith Hospitals, NHS NW London/Shaping a Healthier Future (SaHF) commissioned management consultants McKinsey to research the failure. Ironic really as one suspects that the A&E closure strategy originated within McKinsey themselves!
Sometime in July 2015 a document was quietly published on the NHS England web site entitled ‘Review of the Implementation of North West London A&E Changes’. The document is not the McKinsey review itself, but NHS England London Region’s ‘report’ on it.
The report contains the expected nonsense about ‘…increase in acuity’. In normal speak this means more ‘iller’ people turned up at A&E than expected. However there is no supporting qualitative or quantitative data to support this alleged increased severity of illnesses.
The old chestnut of ‘…a national increase in (A&E) demand’ is trotted out in the report. Colin Standfield of Save Our Hospitals has repeatedly refuted this lie. In fact the NHS’s own data shows no increase in the numbers of patients visiting our local A&Es. In North West London over the last four years A&E attendance fell by 26.2%.
Another quote is ‘…the underlying cause for this increase in acuity could not have been linked to the A&E changes’. This really is a totally meaningless statement.
And let’s not forget how disastrous the A&E performance was. For example in the week ending 30 November 2014 NHS NW London was the worse performing NHS region in England for Type-1 A&E patients – with only 65.7% of patients being seen within four hours. For the week of 15 December 2014 at Ealing Hospital A&E 62.6 % of patients were seen within four hours – making it the worst performing hospital in England.
The report pats SaHF on the back for getting its post-closure A&E patient modelling correct. It then claims that unfortunately patient demand was not as predicted. How truly pathetic this is.
Over the last two years NHS North West London has spent £33 million on management consultancy help in strategies and programmes to cut and privatise local hospital services. One has to ask whether this really was a good use of public money.
Independent Healthcare Commission to Publish its Final Report in September 2015
This commission – also referred to as the Mansfield Commission – was launched in December 2014. It is examining the progress, success and impact of the NHS North West London ‘Shaping a Healthier Future’ (SaHF) strategy. SaHF, announced in 2012, aims to save money by reducing the number of major hospitals, A&E units, Maternity units, and hospital beds. SaHF envisions better, cheaper healthcare being delivered outside of hospitals. The commission was set up by four Local Authorities – Brent, Ealing, Hammersmith & Fulham and Hounslow.
It will be interesting to see what the four authorities decide to do with the evidence collected. The commission’s Interim Report, published in March 2015, was very damning about SaHF in many aspects, which included access to care, quality of care, the business case and the whole SaHF process. It’s quite clear that the body of evidence collected about the operation of SaHF is enormous and unique. I suspect the only external attack which could dent or perhaps ‘sink’ the SaHF supertanker would be one carried out in the Law Courts. The commission’s evidence base would be a crucial weapon to be used in any legal challenge.
Tories Move Towards Inquiry on Whether NHS Should be Funded by User Charges and Insurance
On 9 July 2015 in a debate on NHS sustainability in the House of Lords, Lord Prior announced a move towards setting up an inquiry into ‘Pay NHS’. Lord Prior is an ex CQC boss and an ex deputy Conservative Party Chair.
Not a hint of this came out running up to the General Election. Also the Kings Fund recently carried out an inquiry into the topic and rejected the user charging approach.
Hammersmith & Fulham Council Challenge the Financial and Operational Viability of the Planned Merger of NHS Chelsea & Westminster and NHS West Middlesex Hospitals
On 7 July 2015 Hammersmith & Fulham Council (H&FC) for a second time publicly slated the NHS Chelsea & Westminster Hospital Foundation Trust (CWHFT) for its failure to reveal the business case supporting the merger of the two hospitals. H&FC also expressed concerns on the impact of the merger on local services, particularly the potential effects on A&E and paediatric services. CWHFT says it expects the Secretary of State to sign-off the merger in August 2015.
CWHFT says that its Board members have all signed confidentially agreements which prevent them disclosing the financial details of the merger. This clandestine approach seems entirely inappropriate where public money is involved.
Mental Health Risks Top Head Teachers’ Concerns
67% of 1,180 school head teachers surveyed by The Key stated that the risk of children developing mental health problems was their biggest concern. The survey included responses from Primary school and Secondary school heads. Given the budget cuts to mental health spending this widespread concern by head teachers is extremely worrying.
The Key (www.thekeysupport.com) is an independent company providing leadership and management support to 47,000 school leaders and governors.
GP Groups All Highlight that Government Funding for 7 Day GP Working is Inadequate
Dr Morton’s – an online medical helpline staffed by GPs – estimates that 7 day working by GPs will cost over £3 billion/year.
The Royal College of GPs estimates that if 50% of GP practices operate 7 days a week it will cost the NHS £1.2 billion /year.
The BMA GP Committee say that 7 day working by GPs will require more investment by the NHS than what has been promised.
So far the Government has invested just £175 million to facilitate the evening and weekend opening of GP surgeries.
