The new Care Quality Commission report for the London North West Healthcare NHS Trust is out.

Link to the report

Eric Leach, a researcher and campaigner for Ealing Save Our NHS, added:  ‘It’s sad that overall ‘Requires Improvement’ is a common theme. However we do note that CQC states that Northwick Park Hospital (NPH) requires more improvement than Ealing Hospital (EH).

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Issue: 37

June 2016

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.

500 Acute NHS Beds To Be Axed in North West London Over the Next Four Years

It took an article in the 10 May 2016 issue of the ‘Evening Standard’ to inform us all about the projected butchering of our local hospitals. The so called debt of £1 billion in NHS NW London is apparently to be dealt with by axing 500 Acute beds in our local hospitals by 2020. The beds to be lost would have been for use by both the physically and the mentally ill.

The trio who told the newspaper are the bosses of the NHS Ealing Clinical Commissioning Group, Brent Council and the NHS Imperial Healthcare Trust.

Digging deeper into this bombshell we find that the figures came from the draft  NHS NW London Sustainability and Transformation Plan (STP). This draft STP has been hatched in secret by representatives of 31 public bodies including eight NHS CCGs, eight Local Authorities and all the NW London NHS Trusts. The failing 2012 cost cutting ‘Shaping a Healthier Future’ (SaHF) programme does not get any mention whatsoever. Obviously SaHF as a cost cutting vehicle has now been replaced by STP.

The body which created this STP calls itself the NWL Strategic Planning Group (SPG). The SPG has no statutory authority and is not the creation of any Act of Parliament. No public consultation was carried out on the STP or the SPG. I can’t find any evidence of SPG meeting minutes or the draft STP. You might have thought that these documents might exist on the Ealing CCG web site, the Ealing Council web site or the web site of the ‘North West London Collaboration of Clinical Commissioning Groups’,  but you would be wrong.

Of course the ‘Evening Standard’ quotes some anonymous NHS spokesperson shoveling out the usual claptrap about not axing beds before alternative services are in place. Well, this never happened when Acute beds were axed from Central Middlesex and Hammersmith Hospitals in September 2014. And I don’t expect it will happen with the new ‘Axe 500 beds’ project.

Are Clinicians the Best People to Make Decisions That Could Put in Danger  the Lives and Health of Our Children?

On 25 April 2016 eight senior NW London Paediatricians wrote a letter in support of closing Ealing Hospital’s Acute care for children. On 18 May 2016 Ealing CCG duly endorsed the experts’ view and confirmed closure of all Acute services for children at Ealing Hospital on 30 June 2016.

The first glaring omission in the experts’ letter is the complete lack of any reference to caring for mentally ill children. So much for the parity of esteem for physical and mental health. This unforgivable slight on emergency care for seriously mentally ill children almost invalidates the letter completely. A second glaring omission is that the authors don’t even have the guts to explicitly endorse the closure of A&E facilities for children at Ealing Hospital.

No doubt senior clinicians endorsed or even mandated the closure of the A&E units at Central Middlesex and Hammersmith Hospitals in September 2014. These closures led to an immediate, unprecedented and massive drop in A&E performance across the whole of north west London. And even now, some 18 months since the A&E closures, the A&E waiting times at Charing Cross and St Mary’s Hospitals are amongst the worst in England.

The reality of better clinical care for children in Ealing is rapid access to appropriate physical and mental health competencies for seriously ill children. 4,500 seriously ill children are brought to Ealing Hospital A&E each year. Last year 4,185 of these arrived in the arms of a parent, carer or loved one and not by ambulance. Under the new July 2016 regime these sick children will be triaged by the Urgent Care Centre at Ealing Hospital and then subject to an up to one hour wait for Patient Transport Services (PTS) to take them to a remote hospital A&E outside Ealing. The other option being proposed is the Children’s Acute Transport Service (CATS). CATS median response time is 75 minutes. Only when the child reaches this out of borough hospital will the possibility of expert treatment become a reality. It’s not clear how the parent/carer/loved one will get to the remote hospital, especially if it’s 4am for example. None of this is clear in the letter from the senior medics or any NHS patient literature in print or in draft.

No doubt the senior medics who admit to designing these new children’s Acute services  and who signed the letter are experts in their fields and have impeccable motives. However do we as a society allow nuclear scientists to push the nuclear weapon button? To use another analogy – from my own career – when you are designing a computer system you start off with discovering the users’ requirements. The users’ requirements in this case are quite clear. The 68,000 Ealing children and their parents/carers/loved ones require a complete children’s care service in Ealing providing 24 hour A&E, in-patient beds and specialist Peadiatric and mental health services. The obvious location for this across the 21 square miles of the borough is within the existing facility at Ealing Hospital in Southall.

Dr Anne Davies, Dr Michele Cruwys, Dr John Hutchins, Dr Hermione Lyall, Dr Kingi Aminu, Kay Larkin, Katrina Warkcup and Nathan Askew – I do hope all your service design efforts for our local children work out well. I do realise it would have been very difficult for you all to say explicitly ‘…we had to save money and what we’ve come up with is the least worst option’. However you didn’t. No doubt you might have gained citizens’ respect if you had said that. If children’s Acute services for Ealing children take a turn for the worse at least we’ll know at whose doors to lay the blame.

‘A Hospital is Not Always the Best Place to Treat People’

We have heard and read this somewhat asinine assertion a number of times emanating from some anonymous NHS spokesperson. In response to this a few questions come to mind. They include:

+ So what?

+ What has it to do with the number of hospital beds we need?

+ Is the statement in actual fact a gutless replacement statement for ‘hospital beds are very expensive and we have to close 100s/1,000s of them because the Government refuses to pay for them’?

Allied to the ‘not always the best place’ assertion is another claim that hospital beds can be replaced by out-of-hospital treatment at home or close to home in the community. However there is little or no evidence that this out-of-hospital approach provides significant cost savings. For example the 2012 ‘Shaping a Healthier Future’ (SaHF) programme has apparently been implementing this bed loss/out-of-hospital replacement approach for over three years in NW London. However the SaHF mavens have yet to claim anywhere, anytime that there have been any resultant cost savings.

With people living longer more elderly people will need treatment/care/surgery that only hospitals can provide.

The number of people in England detained under the 1983 Mental Health Act is rising. It has risen by 30% over 10 years. 58,400 Sectioned patients needed hospital beds in 2014/15 – up 10% on 2013/14.

Government figures in September 2015 stated that 68,560 households in England were living in bed and breakfast, hostels, refuges, supported lodgings and self-contained annexes. The number of families with children in bed and breakfast accommodation has risen by 45% in just one year. Secondary/hospital-type care and treatment for all these people is impossible ‘at home’.

The number of care home beds declined by 1,500 in the year ending September 2015.

Ealing Council’s 2012 plans for building new homes will add 12,407 new homes and 30,000 new residents in Ealing by 2026. Residential development at one site alone in Southall will house some 9,000 new residents.

In conclusion, England lags behind many countries in the number of hospital beds per head of population. Locally the population continues to grow. The number of people requiring hospital beds is rising. The number of care home beds is declining and this will do nothing to reduce bed blocking levels in hospitals. There is no convincing evidence that there are any significant cost savings achieved by replacing hospital care with home care or care in the community (whatever that might be).

‘Home is Not Always the Best Place to Treat People.’

Exploring NHS Myths

+  Priority of esteem for the physically ill and the mentally ill.

NOT  TRUE

13% of the NHS annual national budget is spent on mental health treatment. Mental health needs make up 28% of the NHS burden of illness.

+  There are increased attendance levels at hospital A&Es.

NOT  TRUE

NHS figure show that nationally in the 119 week up to 31 July 2015 all hospital A&E attendance levels variously varied from the median by 13.5% below to 7.1% above.

+  The best way to measure A&E performance is to lump together all A&E patient treatment performance data and Urgent Care Centre treatment performance data.

NOT  TRUE

Of greatest interest and relevance to all of us is the treatment of those who are rushed to hospital with serious injuries or illnesses. The NHS labels these patients as A&E Type1s.

In north west London although Type1 attendance levels have remained the same for over three years, rapid treatment has been elusive. Waiting times for Type1s extended dramatically immediately following the closure of two A&Es in September 2014. It has never really improved since then. In January 2016 attempts to treat  95% of Type1s within four hours (the national target) failed miserably. At Hillingdon, Northwick Park and Charing Cross hospital A&E Type1 performance was below 70%.

Colin Standfield of Save Our Hospitals digs out this Type1 data which is collected but not trumpeted by the NHS. What the NHS trumpets is treatment performance figures for A&E Type1, Type2, Type3 and Urgent Care Centre patients – all lumped together. The implication is that the NHS has the same interest in how fast patients with indigestion are treated as it has with patients with life threatening injuries or illnesses. However a cynic or realist might observe that NHS bosses just don’t want us all to know how it is failing the seriously ill in the provision of hospital A&E services.

This letter was sent to all the Doctors sitting on the Ealing Clinical Commissioning Group (CCG) board. They all appeared to have agreed to close Maternity & the Children’s ward as well as accepting that there will be no paediatrically trained staff in the Urgent Care Centre (UCC) or A&E at Ealing hospital. A Rapid Access Clinic has been set up but this is only available to GPs not the staff of either the UCC or A&E.

1.6.2016.

Dear Dr.

I am writing to you as you are on the Ealing CCG representing our profession as well as determining the Health services available to the Ealing community.

The Ealing CCG voted last year to close the maternity department of Ealing Hospital unanimously. I assume therefore you agreed with the received wisdom that as 24 hour in patient consultant cover was not available, the care was therefore not safe. This was the reason given for closing the department. Dr Parmar said that this was evidence based. The evidence was not available as no unit in England had at that time 24 hour cover.

Birmingham tested this employing additional consultants at a cost of ¾ of a £ million and found after one year there was no change in outcome. A further review published in the BMJ (copy enclosed) came to the same conclusion. The out of Borough hospital maternity units do not provide 168 hour Consultant in patient cover and on evidence & the shortage of funds employing the extra staff will not contribute to Shaping a Healthier Future and is a waste of money

Although the Independent Healthcare Commission lead by Michael Mansfield QC recommended the reopening the Ealing Hospital maternity department, this is no longer a possibility because the real reason for closing maternity was to save money.

You are about to close the in patient paediatric beds. Children admitted to the out of Borough Hospitals will be given a choice for their follow up. Most will probably wish to have continuity of care thus reducing slowly out patient numbers at Ealing.

In summary you are strangling Ealing hospital by degrees in order to close it as outlined in the original consultation document, ‘Shaping a Healthier Future’.

You are all working GPs do you really think that the Ealing community will receive a better NHS as a result of your past unanimous actions? May I suggest you vote to postpone the closure of the IP paediatric beds at Ealing Hospital?

Yours sincerely,

Clara Lowy MD, MSc, FRCP

Arthur Breens wrote  this letter that was published in the Ealing Gazette on 27/05/2016.

Well done the Gazette for reporting last week’s meeting at which NHS managers decided to close the children’s ward and children’s A&E at Ealing Hospital on 30 June 2016. Minor injuries only will be treated at the Urgent Care Centre. A&E child specialist staff will work at other sites.

The story around Samantha Phelps Schmidt (same issue) confirmed the doubts from the floor expressed by Ealing Healthwatch and Ealing Save Our NHS. Otherwise this meeting was tightly orchestrated by the chair and these 50 NHS managers (Ealing Clinical Commissioning Group) looked both uncomfortable and sheep-like.

Don’t trust this organisation to honestly and publicly monitor its own performance. Its level of self-interest and self-importance is high and its record poor. Remember it took a TV documentary to expose the inadequate monitoring of Ealing’s Urgent Care Centre by the CCG. The poor performance of A&E in our wider area after the closure of A&E s at Hammersmith and Central Middlesex has been well documented by Mansfield and a Hanwell resident but denied and spun by the chair of this group.

If whistleblowers still face problems in the NHS then we must demand rigorous independent performance monitoring of these major changes to Ealing children’s services and the promise to reverse these “bridge too far” cuts if required.  

Arthur Breens

Watch the video to hear reactions from local parents in Greenford, outside Ealing CCG’s meeting where it was decided to close the Charlie Chaplin Children’s Ward at Ealing Hospital.

Ealing Save Our NHS Childrens Ward Closes

“It would be difficult for people like us who live locally and if they centralised everything to another hospital it would cause big havoc”

“She was born in Ealing Hospital, brilliant service, my midwives are absolutely brilliant and it is such a shame it is not there anymore”

“Why are they closing it anyway?”

“We might have to travel a long time to Northwick Park, plus parking…”

“I think it’s disgusting as well”

Around 80 angry protesters gathered outside Greenford Town Hall as the Ealing CCG decided to close the Charlie Chaplin Children’s Ward which means that children will no longer be accepted at Ealing A&E. You can read here what the consequences of the closure will be for sick or injured children in Ealing, according to an experienced Consultant Paediatrician.

The crowd was addressed by Greenford councillor Aysha Raza and newly re-elected GLA member Onkar Sahota as well as health campaigners.

[dropshadowbox align=”none” effect=”curled” width=”auto” height=”” background_color=”#f5d387″ border_width=”1″ border_color=”#dddddd” ]If you oppose the closure but were unable to join our protest, you can still write to your GP and/or local councilloers. You will find template letters here. [/dropshadowbox]

Below downloadable photos of the protest.

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Issue: 36

May 2016

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.

RIP: Children’s Services at Ealing Hospital

In just a few weeks time acute care for very sick Ealing children will no longer be available at Ealing Hospital. This will be the end of A&E services for children at the hospital after 36 years. As of 1 July 2016 there will be no specialist A&E Paediatric consultants and no beds for children. The Charlie Chaplin Ward for children will be closed.

93% of all sick children who arrive at Ealing Hospital do so in the arms of a parent and not by ambulance. 24,000 children self-presented at the hospital in 2014/15 and of these 4,500 needed A&E treatment. If you have a seriously physically or mentally ill child on 1 July 2016 or after do not take him or her to Ealing Hospital. Figure out which of the following hospital A&E units you can get to most quickly and take the child there:

West Middlesex, Hillingdon, Northwick Park, Chelsea and Westminster or St Mary’s.

Taking your very sick child to Ealing Hospital will delay the onset of treatment as there will be no Paediatric consultants there to diagnose and treat the child. The Urgent Care Centre (UCC) at Ealing Hospital will request transportation to one of the above remote hospital A&Es and you will have to wait for NHS Patient Transport Service (PTS) to take your child for treatment. Contractually, apparently, PTS will collect your sick child within one hour of being telephoned by the UCC. Apparently also your child will not be accompanied on the trip by a medically qualified paramedic/nurse/doctor.

The NHS North West London Collaboration of Clinical Commissioning Groups is producing a booklet called ‘Changes to Children’s Services at Ealing Hospital’. Draft  version 20 of this booklet shamefully tells parents and carers to continue to take sick Ealing children to Ealing Hospital after 1 July 2016. This cannot be in the best interests of the child. There’s no reference to PTS in the leaflet which will lead parents and carers to presume that NHS ambulances will transfer their child to a remote hospital A&E. I’m certain that this will prove an erroneous presumption. The booklet doesn’t even define the NHS upper age of a ‘child’. 16, 17, 18 years old maybe? Surely the adresses and postal codes of the remote hospital A&Es should be included in this booklet.

You might have thought that A&E waiting times will clearly increase significantly because of the waiting time for the PTS service and the travel time to the remote hospital A&E. But, oh no……NHS bosses say that the ‘clock’ will stop when the UCC calls the PTS. The clock will only re-start when the sick child arrives at the remote hospital A&E. This amounts to despicable manipulation of a performance metric. It is unethical and completely against the spirit of the 4 hour wait as a measurement of treatment performance. Why won’t the SaHF gurus have the guts to be honest about the fact that the closure of children’s A&E at Ealing Hospital will result in degraded treatment performance?

Finally as you can read in the next newsletter item, two of the remote hospital A&Es – Hilllingdon and Northwick Park – are performing dreadfully in treating very sick patients (so called Type 1 A&E patients) in a timely manner. Imagine how much worse the performance figures at these two A&Es will be when significant numbers of very sick Ealing Type 1 A&E children start arriving in July 2016.

Northwick Park Hospital’s A&E Service for the Seriously Ill Still Performing Poorly: Even Though A&E Attendance Levels  for the Seriously Ill are Unchanged for Three Years

Only 66.90% of Type 1 A&E patients (those most ill) were seen in four hours at Northwick Park Hospital at the end of January 2016. This is a disastrous performance as the target is 95%. The Type 1 A&E collapse is also evident at Hillingdon Hospital (61.3%) and at Charing Cross Hospital (69.1%) At Ealing Hospital the figure was substantially better at 87.49%. Type 1 A&E attendance figures for all north west London hospitals have remained the same since April 2013. The Northwick Park Hospital’s poor performance is in spite of a new A&E unit being installed there and repeated reports of ambulances being diverted away from the hospital.

NHS bosses refuse to acknowledge the Type1 A&E crisis in north west London.

However in the topsy-turvy world in which we live, it’s Ealing Hospital’s A&E that will close. And this closure begins in just a few weeks time when Ealing’s children will be deprived of A&E services at Ealing Hospital. Let’s hope none of them die because of this.

Ealing Hospital Bosses Try to Schedule the Hospital’s Future in the Context of Healthcare and Social Care Integration

The LNWH NHS Trust, which runs Ealing and Northwick Park Hospitals, has published details of the Sustainability and Transformation Plan (STP) for the North West London ‘footprint’. STP is the latest of a number of State initiatives to cuts care costs whilst miraculously and simultaneously integrating healthcare and social care. The Trust is one of 11 Trusts, eight Local Authorities and eight CCGs who have been thrown together in this footprint to save money. A new body has been formed to run this footprint – the NWL Strategic Planning Group (SPG).

The SPG must produce an STP which must specify how:

+ existing local NHS debts are eliminated

+ 7-day NHS working is implemented

+ hospital beds will be replaced by care at home

+ A&E units will be replaced by Urgent Care Centres

+ healthcare and social care provision will be integrated.

The first worrying thing about the LNWH Trust document is that the phrase ‘social care’ does not appear anywhere. What this suggests to me is that the senior NHS folks see STP   as being exclusively about healthcare.

By April 2017, the Trust expects the ‘Shaping a Healthier Future’ project (SaHF) Ealing Hospital Implementation Business Case to actually exist. SaHF is a 2012 NHS healthcare cost cutting initiative which, amongst other things, aspires to demolish Ealing Hospital. By April 2018 the Trust expects the existence of an ‘Ealing Hospital A&E/UCC model’. This little gem is all about post demolition creation of a First Aid post on the site staffed by GPs and nurses.

‘It is anticipated that much of this work will be overseen by (Local Authority) Health and Wellbeing Boards’. How this marking of its own homework will be accomplished is unclear – given that the eight Local Authorities will be jointly authoring and jointly implementing the STP in the SPG.

A new bureaucratic layer will be added in 2018/19. This will be the Accountable Care Partnership (ACP). The ACP is apparently all about mental health as its constituents will be Local Authorities, mental health service providers and the voluntary sector.

Finally it’s stated that ‘…the aim is for the eight CCGs in North West London to work within a single financial control total with the NHS service providers’. Surely what this means is that there will exist, in effect, a regional health authority. It also means that GP led control of local NHS spending will disappear completely – given that it ever existed since CCGs were forced upon us in 2012.

Ealing One of Just Eight Local Authorities in England Not to Raise Council Tax to Help Pay for Social Care

Chancellor George Osborne announced a precept in November 2015 which would allow Local Authorities to raise Council Taxes by 2% without facing any punishment or the need for a local referendum. 144 Local Authorities in England took advantage of this. Ealing Council was not one of them. Had Ealing followed the vast majority of other authorities it would have raised at least an extra £2 million for social care.

I for one would have supported this Council Tax rise, and I suspect so would many other local tax payers. Ealing Council’s reasons for not raising Council Tax seem to be purely political. I know of one single unemployed mother with a four year old child who upon being evicted in April 2016 could not be re-housed in Ealing. The best Ealing Council could do was put her and her daughter in a B&B room with a single bed and a fridge outside the borough of Ealing.

To compound Ealing Council’s hubris, they decided that even the registered disabled would pay something towards their Council Tax this year. In previous years the disabled were exempt from paying Council Tax. Who would have thought a Labour administration would favour taxing the poor instead of taxing the rich?

Healthcare and Social Care Integration: A Muddle of Mutually Exclusive Initiatives?

First we had the NHS Better Care Fund. Then we had NHS Vanguard projects. We also now have devolved integrated healthcare and social care eg Manchester. And recently we have had the NHS Sustainability and Transformation Plan.

All these four initiatives variously throw Local Authorities, NHS CCGs and NHS Trusts together and effectively say to them ‘sort this integration stuff out between you and at the same time make major cost savings’.

Of course the Emperor’s New Clothes factor here is that we have an ever decreasing number of hospital and care home beds. Between 2010 and 2015, 10,000 hospital beds in England were lost. For the year up to September 2015, 1,500 care home beds in England were lost. In March 2016 AgeUK estimated that three million hospital bed days were lost between June 2010 and January 2016, due to lack of social care provision.

All this is about money – of course:

+  If you are in a hospital bed the State pays for it. The average weekly cost per bed is £2,121

+ If you are in a care home bed in most cases you will pay something towards the average weekly cost of £563. Only 37% of care home beds receive Local Authority funding. 90% of all care homes in England are privately owned.

+  For social care at home you will be means tested. If you receive three hours care each day the average weekly cost is £356.58.

Looking logically at the integration of healthcare and social care we clearly need more care home beds. However the private care home sector is failing to expand care homes or build new ones. Reasons quoted include:

+ The April 2017 introduction of the National Living Wage will threaten the viability of their businesses

+ Local Authorities are receiving less money for social care from national government. In response they have reduced the rates of remuneration paid to private care homes.

It’s obvious that the only way to increase the number of social care beds is for the State to build new care homes and run them.

Devo-Manc Health Up and Running With Only £6 Billion Each Year to Improve on the Current £10 Billion Spent on Healthcare and Social Care Across Greater Manchester

I spent the first 19 years of my life living in North Manchester. I have visited friends in Manchester regularly since 1992. The healthcare/social care experiment taking place there is of more than just a passing interest for me. It’s also probably the clue to what’s going to happen in London.

I have read the 60 page December 2015 ‘Taking charge of our health and social care in Greater Manchester’ plan published jointly by the NHS and the Greater Manchester Combined Authority (GMCA).

Greater Manchester (GM) is the pioneer in England for attempting integrated healthcare and social care services on a grand scale. Here are some relevant dates and numbers on this bold (or reckless) initiative:

+ GMCA and National Government agreement signed on 3 November 2014

+  Formal start date of the project was 1 April 2016

+  2.8 million people’s lives will be affected

+  By 2021 £2 billion saving must be achieved

+  37 statutory bodies are attempting to work together – 10 Local Authorities, 12 NHS CCGs and 15 NHS Trusts

+  Current official figures for the current annual spend on healthcare and social care in GM is £7.7 billion. Oldham and Saddleworth (Greater Manchester) MP Debbie Abrahams calculates it to be £10 billion

+  Currently paid healthcare and social care staff in GM number 100,000

+  563 care homes (the vast majority of all care homes) not owned by Local Authorities in GM – none of them are represented on the GM Board which decides how the annual £6 billion budget is spent.

Themes very similar to those in the ailing 2012 NHS NW London ‘Shaping a Healthier Future’ project can be found in the plan. Although the plan contains admirable aspirations and laudable goals it is also riddled with cost cutting initiatives. These include reducing the number of acute beds, fewer visits to hospitals, more out-of–hospital/community care, increased use of technology to reduce face-to-face transaction times, more home care and more self care.

A new raft of bureaucracy is planned. New ‘models’ will be created. These include:

+  LCOs (Local Care Organisations)

+  MSCPs (Multi-Speciality Community Providers)

+  PACs (Primary and Acute Care Systems)

+  ICAs (Integrated Care Organisations)

+  ACOs (Accountable Care Organisations)

+ AHMOs (Accountable Healthcare Management Organisations)

The so called Financial Plan is absurd. Instead of detailing just how the £6 billion will be spent it lists savings to be made. There’s no overview on projected income and expenditure. This leads me to believe that those leading this experiment are unsure of its costs and its income. This is very worrying.

Given £billions will be spent over the next 11 months it’s odd that there are no stated integration performance goals and consequently no details on how integration performance will be measured. So there will be no way of making quantitative or probably qualitative assessments of services’ success – or failure.

It’s also not encouraging that the boss of the project has just left a year into his job. On 31 March 2016 a new Chief Officer was appointed. He’s Jon Rouse. At least he does have relevant senior management experience in local government, healthcare and social care. However I suspect he’s never run a three ring circus before.

It took an article in the 10 May 2016 issue of the ‘Evening Standard’ to inform us all about the projected butchering of our local hospitals. The so called debt of £1 billion in NHS NW London is apparently to be dealt with by axing 500 Acute beds in our local hospitals by 2020. The beds to be lost would have been for use by the physically ill and the mentally ill.

The trio who told the newspaper are the bosses of the NHS Ealing Clinical Commissioning Group, Brent Council and the NHS Imperial Healthcare Trust.

Digging deeper into this bombshell we find that the figures came from the draft 2016/2017 NHS NW London Sustainability and Transformation Plan (STP). This draft STP has been hatched in secret by representatives of 31 public bodies which include eight NHS CCGs, eight Local Authorities and all the NW London NHS Trusts. The failing 2012 cost cutting ‘Shaping a Healthier Future’ (SaHF) programme does not get any mention whatsoever. Obviously SaHF as a cost cutting vehicle has now been replaced by STP.

The body which created this STP calls itself the NWL Strategic Planning Group (SPG). The SPG has no statutory authority and is not the creation of any Act of Parliament. No public consultation was carried out on the STP or the SPG. I can’t find any evidence of SPG meeting minutes or the draft STP. You might have thought that these documents might exist on the Ealing CCG web site, the Ealing Council website or the web site of the ‘North West London Collaboration of Clinical Commissioning Groups’. But you would be wrong.  

Of course the ‘Evening Standard’ quotes some anonymous NHS spokesperson shoveling out the usual claptrap about not axing beds before alternative services are in place. Well this never happened when Acute beds were axed from Central Middlesex and Hammersmith Hospitals in September 2014. And I don’t expect it will happen with the new ‘Axe 500 beds’ project.

A fantastic turnout at Ealing Hospital on both days!
More doctors than ever kept turning up and consultants popped along to show their support.
Car horns were going all the time – there’s clearly massive public support for the docs and the NHS.

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