Issue: 32

January 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.

EALING HOSPITAL NEWS

Ealing Save Our NHS (ESON) Meets Some of the Ealing Hospital ‘Bosses’

Representatives of ESON (www.ealingsaveournhs.org.uk) met with Ealing Hospital bosses on 23 December 2015. We originally arranged to meet Dame Jacqueline Docherty, the CEO of the Trust which runs the hospital, on 11 December 2015 but she cancelled. She never turned up on 23 December either but Peter Worthington (Trust Chair) and Simon Crawford (Trust Director of Strategy) did. None of the three BTW work at Ealing Hospital – they all work in Harrow.

It became very clear fairly quickly in the meeting that the fate and future ‘shape’of Ealing Hospital is not in the hands of Ealing Hospital officers or Trust officers but in the hands of Ealing CCG, the eight North West London CCGs and the ‘Shaping a Healthier Future’ (SaHF) cabal. When we asked who, employed on the Ealing Hospital site, runs the hospital, they both said there was someone but neither of them could remember his name. I asked whether there was a Clinical Director based on site and the answer was no.

We talked about the potential public relations disaster when the parents of the 64,000 children in Ealing realise that there would be no paediatric A&E at the hospital as from June 2016. We told them we felt cheated that an MP and a minister had lied to us all about the fate of A&E at the hospital. We had been lied to in connection with the impact of the two September 2014 A&E closures. None of this elicited any comment or response.

Mr Crawford suggested a new completion date for SaHF of  2020/2021. (Interesting this as the 2012 SaHF documents stated the SaHF rollout would take at least three years).

I showed them both the NHS 28 page colour ‘Stay Well’ – guide to Ealing local health brochure, which is currently being delivered to all 100,000+ Ealing households. As the document has some inappropriate content, I asked if Ealing Hospital or its ‘owner’ Trust had reviewed/approved the document. They astonished us by admitting that they had never seen it before.

We asked about much needed new transport services to take patients and family to remote hospitals outside Ealing’s borders. They said they were researching their own shuttle bus service to link Ealing Hospital with Northwick Park Hospital in Harrow – for staff. Room might be found for patients who could prove they had hospital appointments.

Ealing’s 64,000 Children Will Be Excluded from Local Accident and Emergency Services at Ealing Hospital as from June 2016

Ealing Clinical Commissioning Group (ECCG) voted unanimously at a meeting held in public on 9 December 2015 to delete Children’s A&E services at Ealing Hospital as from June 2016. As from then nowhere across Ealing’s 21 square miles will a chronically physically or mentally ill or seriously injured Ealing child be found life saving treatment, surgery and intensive care in Ealing. Ealing children are being sacrificed for the greater good of children in other parts of North West London.

So much for Tory ministers’ and Tory MPs’ promises in May 2015 of ‘A&E saved at  Ealing Hospital’ and ‘no more changes to Ealing Hospital A&E for three years’.

As a replacement for A&E paediatric services in Ealing, more beds, consultants and nurses will be added to five ‘remote’ hospital A&Es outside the London Borough of Ealing. These remote hospitals are Hillingdon, Northwick Park, Chelsea & Westminster, St Mary’s and West Middlesex.

In future paramedics in ambulances and parents in cars in Ealing will have to decide themselves how ill or injured a child is before taking the child to the poorly rated Ealing Hospital Urgent Care Centre – to be seen by a GP – or to one of the five remote hospital A&E units.

There appears to be no strategy in place for providing additional mental health A&E facilities in the five remote hospitals for Ealing children. The number of children presenting with mental health problems at A&E in England in 2015 has doubled to 20,000 in just four years. West London Mental Health Trust out-of-hours services are virtually non-existent.

A new ill-named facility has been opened at Ealing Hospital called ‘Rapid Access Clinic’ (RAC). This is for children. It’s not rapid access for children and their parents as it’s not walk-in and attendance is only by GP referral. We all know that access to GPs is not rapid. Another limiting factor is that the RAC is only open for four hours each weekday.

Ealing residents in attendance at the meeting voiced their concerns about the legality of and risks inherent in the changes. Residents also pointed out that the Mansfield Commission had recently discredited the NHS NW London ‘Shaping a Healthier Future’ (SaHF) strategy and programme. Dr Mark Spencer – a SaHF lead – said that the NHS had pronounced the changes ‘legal’ and that it was 100% certain that no child would die as a result of the changes.

ECCG/SaHF executives became somewhat tetchy about the Mansfield Report. They said they knew about it but it did not come up with any alternative approaches. This comment was a red herring as the Local Authorities who commissioned the report asked the Commission to review the implementation of SaHF. When an activist suggested that SaHF costs had ballooned to £1.3 billion, ECCG/SaHF said that this figure was inaccurate. I then asked them to tell us what is the current cost for SaHF. Complete silence followed. Maybe the cost has now risen beyond £1.3 billion.

ECCG/SaHF is still clearly in denial about the 12 months of awful A&E performance in NW London being directly related to the closure of two hospital A&Es in September 2014. They quoted the £150,000 ‘independent’ report (by McKinsey & Co) on the subject in their defence. This was just plain silly as the report actually provides no hard evidence to dispute the reason being the closures. In fact pages 45 and 72 of the McKinsey report identify extra loading at St Mary’s and Northwick Park Hospital A&Es due to ‘sector changes’ and ‘additional pressure from A&E changes’. See:

https://www.england.nhs.uk/london/2015/11/09/healthier-future/

For the children of Southall these paediatric A&E changes are a tragedy. The closure of Ealing Hospital maternity in June 2015 was also a tragedy for Southall mothers. Parts of  Southall are some of the most deprived areas in the whole of England. Just what has Southall done to deserve such a tragic downgrade in its local healthcare services?

Ealing Hospital Told to Only Use  2nd Class Stamps as ‘Planned’ £88 Million Deficit by Parent Trust Might be Exceeded

‘The Independent’ newspaper has reported on a letter sent to staff employed by the London North West Healthcare Trust NHS Trust (LNWHT). Ealing Hospital is one of four hospitals in LNWHT. The letter orders them to cut down on their expenses. Austerity measures introduced include:

+ only 2nd Class stamps to be used

+ computer upgrades have to be agreed with senior management

+ fewer taxis to be used

+ old furniture to be recycled instead of thrown away

+ nursing managers to ‘have a day on the ward roster every two weeks’

+ overtime only in exceptional circumstances.

With a new cap on using agency staff, permanent staff are being asked to work longer hours. Is this any way to run a national health service?

As 95% of all NHS Trusts are in so-called deficit then none of them are in deficit. They are just simply underfunded.

London Healthcare and Social Care Devolution Could Lead to the Destruction of Our NHS

On 15 December 2015 the government announced – somewhat out of the blue – that healthcare and social care is to be devolved in London. Agreements have been signed with all London CCGs and Local Authorities. London GPs were apparently not invited to join in with discussions on devolution and no-one seems to know how GPs will be affected by the plans. Apparently Parliament, local MPs and the GLA were not consulted. The London Ambulance Service is not included in the devolution deal.

Five new devolution pilot schemes were announced. They are all concerned with integrating services. None of them are in West London. The largest is in Barking & Dagenham, Havering and Redbridge. Here a new Accountable Care Organisation (ACO) is to be created. This ACO will ultimately control the healthcare and social care spend for the combined authorities of £1.2 billion. One assumes this will be the first of many ACOs. Very worrying is the fact that ‘partner’ organisations involved in these pilots have agreed to look at local flexibilities in payment and tariff mechanisms. Make of that what you will.

No budget was announced for London care devolution. However the Manchester care devolution announced in May 2015 carried a budget of £6 billion. With just over three times as many residents in London compared with Manchester a budget of at least £18 billion might be expected for London. However Boris Johnson at the launch pegged the figure at £15 billion.

The London devolution agreement needs to be read in conjunction with the draft Cities and Local Government Devolution Bill 2015/16 currently at committee stage in Parliament. Clauses 8 and 17 in this Bill provide for the dissolution of NHS bodies and the transfer of their functions and assets to Local Authorities or combined authorities.

If local government effectively takes over procuring healthcare services will the healthcare budget be ring fenced? Will local/regional care priorities hold sway over national priorities? Who will hold the whip hand in an ACO? Will it be the (NHS) healthcare folks or the (Local Authority) social care executives?

Just how might this London devolution impact NHS North West London’s ‘Shaping a Healthier Future’ (SaHF) vision/strategy/programme? Well SaHF prescribes changes to  healthcare and not social care and does not address integrating primary healthcare, secondary healthcare and social care. SaHF is already unproven, late, over budget and unfunded. Maybe it will soon become a dinosaur because it does not address integrated care.

One thing is for sure and this is that yet more future upheaval in managing and delivering healthcare and social care in Ealing is on its way.

There hasn’t been a referendum in London on the issue. It should be no surprise that activists in Manchester have been clamouring for months for a referendum on Manchester care devolution.

One can see a future of a patchwork quilt of devolved ‘care’ regions – Manchester, London, Cornwall, Birmingham, etc. There will be no mandated consistency of approach to care in these devolved regions. Our national healthcare body (our NHS) could well disappear and our national social care body – which never existed – will stay unborn.

NHS England Decides to Ban the Publication of Regular Performance Updates this Winter

As an indication of how desperate NHS England is about its inability to maintain, or improve, NHS performance – it’s now blocking the publication of key waiting-time figures. As of 15 December 2015 no Winter figures will be published on:

+  A&E waiting times

+  ambulance waiting times

+  last minute cancellations of operations

+  patients on hospital trolleys waiting more than four hours.

One of the major concerns about the Winter NHS service is shortage of staff. Feeding this shortage are disgruntled doctors and nurses leaving the NHS, permanent staff vacancies at the many major hospitals threatened with closure and the Government clampdown on hiring agency staff.

The degraded hospital performance figures will now be published monthly (not weekly as before). Also the NHS England has ‘re-sized’ Winter. Previously the NHS England Winter ran from the beginning of November to the end of March. Now the new NHS England Winter runs from the beginning of November to the end of  February – ie a month shorter!

It’s clear that the Government and NHS England fear that NHS performance over this Winter will be the worst for years. However they do not want citizens to be updated on a regular basis with statistics informing them of just how bad it is.

To make matters worse the Government chose to release this degeneration on the day Parliament debated bombing Syria – surely a device to ‘hide’ bad news.

Mansfield Commission Final Report Calls for a Halt to NHS NW London’s ‘Shaping a Healthier Future’ (SaHF). Calls on Local Authorities to Seek a Judicial Review if it is Not Halted

On Wednesday 2 December 2015 on London’s South Bank Michael Mansfield QC launched the final report of the Independent Healthcare Commission for North West London. The 87 page document presents a devastating critique of NHS North West London’s abortive attempts over the last three years to implement change and reduce running costs by £1 billion.

All written evidence and witness statements along with the final report can be viewed at:

www.lbhf.gov.uk/healthcarecommission

There are 12 recommendations:

1. The current Business Case is immediately made available for proper public scrutiny. This is the only way to ensure that the SaHF programme has taken full account of the current and projected population changes in North West London since 2012 and is soundly based on an up-to-date assessment of needs. The need for this is reinforced by the Finance and Economics section of the report.

1. The National Audit Office undertakes a review of the value for money of the SaHF programme.

1. A fresh consultation on the Business Case (referred to as the Investment Business Case in official guidance but as the Implementation Business Case by SaHF programme leads) as the programme has changed significantly since the Pre-consultation and Decision Making Business Cases were published. There should be extensive and uniform publicity across the region and a clear consultation document with appropriate translations made available in areas of high concentrations of BME communities.

1. No further implementation of SaHF in two principal respects:

1. There must be no further closures of any A&E departments in North West London. Ealing and Charing Cross hospitals must retain full ‘blue light’ A&E services for the foreseeable future;

1. An equalities impact assessment to be carried out into the whole SaHF programme, with particular focus on the communities that will be deprived of services at Ealing and Charing Cross hospitals, as it is clear to the Commission that the selection of these hospitals for service closures will adversely affect the more deprived BME communities in the region.

1. The UCCs in North West London should be co-located with A&E departments.    Where this is no longer the case there should be an immediate and extensive publicity campaign mounted to raise awareness as to what such centres can provide and who should be referred or self-refer there.

1. The decision to close Ealing Maternity unit should be reversed with immediate effect.

1. The A&E departments at Central Middlesex Hospital should be re-opened to alleviate the burden on other A&Es, especially Northwick Park.

1. A substantial investment in GP services, which are clearly overwhelmed and inconsistent, to meet the additional demands of more vulnerable patients, and a recruitment drive for additional GPs and primary care staff.

1. A sub-regional out-of-hospital strategy to be produced, with clear metrics and targets setting out what level such services will be considered sufficiently successful to allow for further reconfiguration.

1. The levels of spending on social care in North West London and elsewhere have been hit by ill-conceived central government policies, but the Commission recommends that social care budgets are increased and protected to maintain patient flows from hospital to domiciliary and residential care.

1. Elected local authority representatives be invited to attend SaHF Programme Board meetings to give greater public accountability and transparency.

1. NHS issues up to date guidance to CCGs and Healthwatch England as to the exact scrutiny role of Healthwatch bodies and Patient Participation Groups in all matters of commissioning and service reconfiguration.

Of the five local authorities who sponsored the Commission Hammersmith & Fulham and Ealing have both stated publicly that they will actively consider mounting a legal challenge against SaHF based upon the Commission’s findings and recommendations.

Last week Ealing Clinical Commissioning Group agreed to continue with plans to close the Paediatric Ward at Ealing Hospital, despite high local birth rates. The closure is scheduled for June 2016 and would mean that blue light ambulances carrying children would no longer attend Ealing hospital.

Local health campaigners denounced the decision.  Sarah Boston, from Ealing Save Our NHS
said that Hospital A&Es should have paediatric consultants. “The fact is that most children are taken to A&Es by their parents not by an ambulance.” she said.  “If they close our much needed paediatric ward, children needing emergency treatment would have to wait for assessment at Ealing, then wait to be taken elsewhere, then finally treated by paediatric consultants.”

Campaigner Oliver New added “Health chiefs are simply in denial about Ealing Hospital.  The truth is they are ignoring local needs to prepare the ground for closure of Ealing A&E, as laid out in the so-called Shaping a Healthier Future Plan.  The Independent Healthcare Commission has just concluded that this Plan will cost £3.2 billion pounds for a far worse service.  But the Clinical Commissioning Group is refusing to discuss it, the policy seems to be head down, carry on regardless and don’t discuss the Commission report.”

The CCG say that after the children’s’ ward is closed, 73% of children’s treatment will remain at Ealing.  However, campaigners point out this would consist of less serious services.  “They are playing with statistics”, said Mr New, “The specialist paediatric treatment that the CCG wants to take away from Ealing isn’t really comparable with the outpatient treatments that would be left.  They need to stop what they are doing and review the whole programme of cuts.”

On 15 December 2015 the government announced – somewhat out of the blue – that healthcare and social care is to be devolved in London. Agreements have been signed with all London CCGs and Local Authorities. However bizarrely the London Ambulance Service is not included in the devolution deal.

Five new devolution pilot schemes were announced. They are all concerned with integrating services. None of them are in West London. The largest is in Barking & Dagenham, Havering and Redbridge. Here a new Accountable Care Organisation (ACO) is to be created. This ACO will ultimately control the healthcare and social care spend for the combined authorities of £1.2 billion. One assumes this will be the first of many ACOs. Very worrying is the fact that ‘partner’ organisations involved in these pilots have agreed to look at local flexibilities in payment and tariff mechanisms. Make of that what you will.

No budget was announced for London care devolution. However the Manchester care devolution announced in May 2015 carried a budget of £6 billion. With just over three times as many residents in London compared with Manchester a budget of at least £18 billion can be expected for London.

The London devolution agreement needs to be read in conjunction with the draft Cities and Local Government Devolution Bill 2015/16 currently at committee stage in Parliament. Clauses 8 and 17 in this Bill provide for the dissolution of NHS bodies and the transfer of their functions and assets to Local Authorities or combined authorities.

If local government effectively takes over procuring healthcare services will the healthcare budget be ring fenced? Will local/regional care priorities hold sway over national priorities? Who will hold the whip hand in an ACO? Will it be the (NHS) healthcare folks or the (Local Authority) social care executives?

Just how might this London devolution impact NHS North West London’s ‘Shaping a Healthier Future’ (SaHF) vision/strategy/programme? Well SaHF prescribes changes to  healthcare and not social care and does not address integrating primary healthcare, secondary healthcare and social care. SaHF is already unproven, late, over budget and unfunded. Maybe soon it will become a dinosaur because it does not address integrated care.

One thing is for sure and this is that yet more future upheaval in managing and delivering healthcare and social care in Ealing is on its way.
One can see a future of a patchwork quilt of devolved ‘care’ regions – Manchester, London, Cornwall, Birmingham, etc. There will be no mandated consistency of approach to care in these devolved regions. Our national healthcare body (our NHS) could well disappear and our national social care body – which never existed – will stay unborn.

Ealing’s 68,000 Children Will Be Excluded from Local Accident and Emergency Services as from June 2016

Ealing Clinical Commissioning Group (ECCG) voted unanimously at a meeting held in public on 9 December 2015 to delete Children’s A&E services at Ealing Hospital as from June 2016. As from then nowhere across Ealing’s 21 square miles will a chronically ill or seriously injured Ealing child be found life saving treatment, surgery and intensive care. Ealing children are being sacrificed for the greater good of children in other parts of North West London.

So much for Tory ministers’ and Tory MPs’ promises in May 2015 of ‘A&E saved at Ealing Hospital’ and ‘no more changes to Ealing Hospital A&E for three years’.

As a replacement for A&E paediatric services in Ealing, more beds, consultants and nurses will be added to five ‘remote’ hospital A&Es outside the London Borough of Ealing. These remote hospitals are Hillingdon, Northwick Park, Chelsea & Westminster, St Mary’s and West Middlesex.

In future paramedics in ambulances and parents in cars in Ealing will have to decide themselves how ill or injured a child is before taking the child to the poorly rated Ealing Hospital Urgent Care Centre or to one of the five remote hospital A&E units.

There appears to be no strategy in place for providing additional mental health A&E facilities in the five remote hospitals for Ealing children.

A new ill-named facility has been opened at Ealing Hospital called ‘Rapid Access Clinic’ (RAC). It’s for children. It’s not rapid access for children and their parents as it’s not walk-in and attendance is only by GP referral. We all know that access to GPs is not rapid. Another limiting factor is that the RAC is only open for four hours each weekday.

Ealing residents in attendance at the meeting voiced their concerns about the legality of and risks inherent in the changes and the viability of the recently Mansfield Commission discredited NHS NW London ‘Shaping a Healthier Future’ (SaHF) strategy and programme. Dr Mark Spencer – a SaHF lead – said that the NHS had pronounced the changes ‘legal’ and that it was 100% certain that no child would die as a result of the changes.

ECCG/SaHF executives became somewhat tetchy about the Mansfield Report. They said they knew about it but it did not come up with any alternative approaches. This comment was a red herring as the five Local Authorities who commissioned the report asked the Commission to review the implementation of SaHF. When an activist suggested that SaHF costs had ballooned to £1.3 billion ECCG/SaHF said that this figure was inaccurate. I then asked for them to tell us what is the current cost for SaHF. Complete silence followed. Maybe the cost has now risen beyond £1.3 billion.

ECCG/SaHF is still clearly in denial about the 12 months of awful A&E performance in NW London being directly related to the closure of two hospital A&Es in September 2014. They quoted the ‘independent’ report (£150,000 McKinsey &Co) report on the subject in their defence. This was just plain silly as the report actually provides no hard evidence to dispute the reason being the closures. In fact of pages 45 and 72 the McKinsey report identifies extra loading at St Mary’s and Northwick Park Hospital A&Es due to ‘sector changes’ and ‘additional pressure from A&E changes’. See here.

For the children of Southall these paediatric A&E changes are a tragedy. The closure of Ealing Hospital maternity in June 2015 was also a tragedy for Southall mothers. Parts of  Southall are some of the most deprived areas in the whole of England. Just what has Southall done to deserve such a tragic downgrade in its local healthcare services?

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Issue: 31

December 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.

IS SHAPING A HEALTHIER FUTURE (SaHF) ON ITS LAST LEGS?

SaHF was/is a June 2012 plan for NHS NW London. Its intentions were/are to include:

+ cost savings of £1 billion by 2015

+ improving care both in hospitals and in the community and saving many lives each year

+ eliminating 5,600 jobs

+ closing 979 beds

+ closing 4 of the 9 hospital A&E units

+ switching outpatient appointments away from acute hospitals to ‘community settings’ – so called Out-Of-Hospital (OOH) care

+ demolishing the major hospitals at Ealing and Charing Cross and building new much smaller ‘Local Hospitals’ on the heritage sites.

Through the miasma of the eight Clinical Commissioning Groups (CCGs) that spend the NHS NW London budget goodness knows to what extent these intentions has been realised. However:

+ NHS London’s loss for 2014/15 was £110.8 million – so it’s really challenging to envision any significant cost savings accrued last year by NHS NW London  

+ Clearly only two of the A&Es have closed and demolition has not yet started on the Ealing and Charing Cross sites

+ There is still no clear budget for SaHF. The OOH budget for example has fluctuated widely over three years – from as low as £72 to £86 million over three years to over £190 million each year!

It was made clear in June 2012 that some of the proposed SaHF services were already being put in place. It was also stated that the SaHF changes would ‘take at least three years to put in place’. Three years have now passed but I can find no public statements as to when the SaHF changes will be completed.

Data on NHS NW London job and bed losses is hard to find. No-one, currently, seems to want to talk about how many lives have been/are being saved. As for improving care in hospitals, the consistently poor A&E performance at all but one of the NHS NW London acute hospitals makes this a nonsense. In fact the region has the worst performing Type-1 A&E in England. Ironically the only acute hospital A&E which is consistently performing well in the region is Ealing Hospital’s A&E. This unit, of course perversely, is on the SaHF closure list.

By any reasonable measure SaHF must be viewed as a failure.

It’s unproven, late, over budget and unfunded. Surely it is just a matter of time before everyone notices that the (SaHF) emperor has no clothes.

(Some of the above data has been extracted from John Lister’s excellent June 2012 TUC paper- ‘North West London’s NHS Under The Knife’) – and also from the many research efforts of Save Our Hospitals’ Colin Standfield)

Creating New SaHF Out Of Hospital Services in Ealing : Still in the Slow Lane

The SaHF programme in 2012 promised Out-Of- Hospital (OOH) services which would reduce admissions to hospitals. But OOH services have been a long time coming in Ealing.

At the North West London Joint Health Overview and Scrutiny Committee meeting on 16 October 2015 it was stated that the OOH ‘Hubs’ in North Ealing and East Ealing are expected to be delivered in 2017/2018. They will cost £34 million to set up. As to what services a hub will provide – this is still not crystal clear. A third hub will exist in the new Ealing (‘Local’) Hospital. No date is suggested for this but a £90 million price tag for creating this hospital is quoted.

However all of the above capital spend requires approval up to HM Treasury level. Such approvals are unlikely to be obtained before summer 2016. The relevant Business Cases are apparently still not finalised.

McKinsey &Co Management Consultants Still Riding the SaHF Gravy Train

Colin Standfield of Save Our Hospitals has revealed that McKinsey & Co received £549,828 from SaHF in August 2015. And the nature of the work, apparently, was ‘Delivery Architecture’.

Given that SaHF was conceived by 2012 one might have thought that the architecture to deliver SaHF (whether ‘soft’ or ‘hard’) should certainly have been in place way before 2015.

Since 2013 NHS NW London has paid external advisors over £33 million in fees. McKinsey &Co alone received £27,000 every day last year!

NHS NW London Pays McKinsey & Co £150,000 to ‘Mark Its Own SaHF Homework’

In 2009 McKinsey & Co were employed by NHS London to extol the virtues – with little supporting evidence – of reducing expensive A&E services and replacing them with cheaper ‘Out-Of-Hospital’ services. This ‘efficiency’ mantra was much in evidence in the 2012 NHS NW London SaHF strategy and programme. Part of the SaHF programme was the closure of four of the nine hospital A&E units.

In September 2014, two of these units were closed – at Central Middlesex and Hammersmith Hospitals. Immediately after the closures A&E performance figures for the region plummeted. They fell so far that the region was, and is still often, the poorest performing A&E region in England. Most damning was the region’s being England’s worst for Type-1 A&E patients.

Activists were understandably up in arms. NHS NW London responded by saying (incredibly) that the poor performance had nothing to do with closing two of the nine hospital A&E units. To bolster their position they announced they would commission an independent review of why the poor performance came about and what lessons could be learnt.

This ‘independent’ report never reached the public domain. On 27 October 2015 Save Our Hospitals submitted a FOI request for sight of the report and supporting details. NHS England replied on 26 November 2015. The report said the drop in performance had nothing to do with the closure of the two A&E units. It cited a long list of unconsidered factors the main one of which was unexpected increase in local demand. I call this very poor capacity and contingency planning.

But just as mind boggling was the identity of the ‘independent’ report’s author. No other than McKinsey & Co. NHS NW London paid McKinsey & Co £150,000 to report on the performance of McKinsey & Co’s A&E closures’ strategy and programme. This is truly shocking and clearly corrupt.

Solace Mental Health Drop-in Centre to be Rebuilt with No Loss of Space or Capacity

Some good news at last for 80+ users of the Solace mental health drop-in centre in Bowman’s Close West Ealing. Last year it was threatened with closure. A complicated deal was put together which would have rebuilt the centre as a much smaller facility.

However, in November 2015 however Ealing Council announced a better deal which would rebuild the centre with no reduction of space or capacity. Existing staff will be retained and a larger kitchen built. Three new mental health residential units will also be built. This is going to cost £640,000 and the work will begin in summer 2016. There is still a capital bid to be won in early December but service users are now confident that Solace has been saved.

Jeremy Hunt MP Ducks His Southall Appearance on the Day 27,741 Junior Doctors Voted for Strike Action

Over 100 demonstrators assembled outside Southall Conservative Party HQ on the evening of 19 November 2015 to ‘welcome’ the Secretary of State for Health. The demonstration was organised by the Ealing Save Our NHS group (www.ealingsaveournhs.org.uk). Hunt’s visit to the Tories in Southall had been planned weeks ago. But he never turned up. His non-appearance was rather pathetic.

On the same day Sir Bruce Keogh, England’s top doctor, suggested Junior Doctors might not help on strike days during which there was a terrorist attack in England. What a crass suggestion this was. Understandably Juniors Doctors reacted to it with fury.

And on the day after – 20 November – the Health Secretary failed to turn up in the House of Commons to answer a question on the Junior Doctors’ strike. Maybe Hunt is on the way out.

By the way, a previous time a senior figure cancelled his attendance at a meeting in Ealing was on 19 April 2007. West London Tram (WLT) boss Christopher Dean was the no-show. On 2 August 2007 the WLT was cancelled. Let’s hope history repeats itself in some way and the Health and Social Care Act 2012, Hunt, SaHF, and Junior Doctors’ contract changes are all ‘cancelled’.

Private Care Homes Crisis Looming

Nine out of ten elderly and disabled people who are living in care homes are now in privately owned facilities. Many of these residents’ fees are paid for by Local Authorities. However with Local Authority budgets being squeezed the amounts being paid have gone down in recent years. This has lead to reduction in care home beds and care home closures.

A major alarm bell rang in July 2011 when Southern Cross, the then largest private care home group with 750 homes, went out of business. Now the current private care home leader, Four Seasons with 350 care homes, is having difficulties. In February 2015 it closed seven care homes in Northern Ireland. It is apparently struggling to pay its annual £26 million interest payment on its considerable borrowings.

Four Seasons, Bupa UK, HC-One and Care UK lobbied the Government for £3 billion to head off care home closures. However in November 2015 Chancellor Osborne promised less than £0.5 billion.

Care homes are also now dreading the implementation of the National Living Wage in April 2016 which will increase their operating costs and could well lead to bed and home closures.

Care home closures and bed reductions will directly impact the occupancy of NHS hospital beds. Bed blocking will increase and occupying hospital beds maybe the only available solution to care home closure.

How this all may impact NHS NW London and SaHF is hard to gauge. No doubt NHS London will pay a six figure sum to McKinsey & Co to write a report on how SaHF will handle this and the ‘lessons there are to be learned’……..

NHS WLMHT Whistle-blower Finally Vindicated as ‘Having Acted in Good Faith’

Dr Hayley Dare, a 20 year NHS veteran clinician, had concerns about bullying and harassment of staff at the West London Mental Health Trust (WLMHT). She voiced these concerns to WLMHT’s CEO Steve Shrubb in March 2013. WLMHT spent £130,000 fighting Dr Dare’s claims, even though NHS staff surveys supported her allegations. She was dismissed from her role as consultant clinical psychologist by means of a three line email.

In September 2014, Dr Dare lost her employment tribunal on a technicality. WLMHT pursued her for £100,000 in costs. Dr Dare appealed and on 6 November 2015 WLMHT conceded that she had acted in the public interest and in good faith. She received £10,000 back from the Trust. Both parties will now bear their own costs of the case.

WLMHT’S Chairman Nigel McCorkell resigned in July 2014 and its CEO Steve Shrubb took retirement in November 2015.

GP Conflicts of Interest

The front page lead of ‘The Times’ on 11 November 2015 detailed routine conflicts of interest by GPs who sit on Clinical Commissioning Groups (CCGs). The scale of such conflicts is staggering – estimated at £2.4 billion in over 400 contracts.

I was not the only one to complain when Ealing CCG signed an agreement with Care UK’s Harmoni out of hours GP service. Some of the ECCG Governing Body GP members owned shares in Care UK. However they clearly felt no conflict. As they had declared the share ownership they seemed to feel that there were no corporate governance issues to be considered!

Inadequate Mental Health Spending by Local Authorities

The charity Mind has calculated that just 1% of public health budgets are spent on tackling mental health problems. Mind estimates that in 2015/2016 Local Authorities will spend just £40 million on mental health problems. £93 million will be spent on promoting physical activity; £111 million spent on tackling obesity; £160 million on anti-smoking measures; and £664 million on sexual health.

In fact some Local Authorities do not intend to spend any money at all on mental health services. It’s an accepted fact that one in five adults are suffering from a mental health problem. Those Local Authorities spending nothing on mental health problems ought to be ashamed of themselves.

Health bosses have already closed the much loved and needed Maternity Unit in Ealing Hospital. They want to close the Paediatrics Ward next summer – a disaster for sick children in our area. This is all part of the horrendous plans for North West London called (believe it or not) Shaping a Healthier Future.

They have already closed Accident and Emergency Departments at Central Middlesex and Hammersmith Hospitals and next to be axed is the blue light A&E at Ealing Hospital. The final aim is to cut 300 beds in Ealing, and sell most of the site
for flats. Charing Cross Hospital is to get the same treatment. When questioned, local health bosses claim all these services will be replaced by as yet undisclosed facilities ‘in the community’.

Support Our Doctors and Health Staff

“Junior doctors” (i.e. hospital doctors) were forced to vote for strike action to stop the Government increasing their hours and cutting pay. The Royal College of Nurses may be forced to take strike action for the first time in their history. Meanwhile GPs get constant increases in their workload as other health services are cutback.

NHS staff are working under tremendous pressure, only to be rewarded with pay freezes, staff shortages, re-organisations and cuts.

Defend our NHS – Support our NHS staff!

A Winter Crisis is Coming…

Here in North West London expensive Management consultants have been paid £33 million pounds for advice on
cutting and restructuring local services.  That money has come from our health budgets.
The NHS deficit is approaching £2 billion pounds after a 5 year freeze on NHS spending and paying management consultants. Private companies and agency staff makes it worse, not better.

The NHS is already at full capacity and  the winter season will push it into crisis.

What should the Government do? If you’re in a hole stop digging! That means stop cutting and privatising now!

[color-box color=” customcolorpicker=” rounded=true dropshadow=true]NHS Privatisation and Break up

In West London and across the country health services are being put on the market. Private companies can pick which services to run and profit from – usually by cutting costs. They even get to keep the NHS logo. Last year over £3.5 billion pounds worth of NHS services was awarded to these privateers, undermining the whole idea of a single united NHS with low overheads.

To make it worse, the Government is now giving entire chunks of the NHS to local councils, breaking it up into areas so that underfunded Councils get the blame for cuts rather than the Government. [/color-box]

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The long awaited Independent Healthcare Commission report on North West London was launched on 02/12/2015 at a press conference in the Royal Festival Hall.  Campaigners from Ealing and Hammersmith were delighted to hear the report endorsing everything we have been saying.  It was covered by the BBC, ITN, London and local press. Will Hunt listen?  We need to make him! We need to take every opportunity to use the report and expose the truth.

Key recommendations of the report include:

• The decision to close Ealing maternity unit should be reversed immediately
• Reopen the A&E department at Central Middlesex Hospital
• The National Audit Office should undertake a review of the programme’s value for money
• A new public consultation is needed as the proposals have changed significantly
• •Substantial investment should be made in GP and out-of-hospital services
• •Ealing and Charing Cross hospitals must retain full ‘blue light’ A&E services for the foreseeable future

The report can be read here

BBC coverage here

Ealing Save our NHS’s vice chair Oliver New  explains in this video what has been happening to Ealing Hospital and other NHS services in North West London.

While Ealing Save our NHS’s secretary Eve Turner describes how we have been campaigning against closures and privatisation in the borough.

Ealing Save Our NHS from Martin Woodford on Vimeo.

Brilliant – we frightened off Head NHS wrecker Jeremy Hunt!

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London North West London Hospitals NHS Trust in October 2015 boasted that Ealing Hospital has, ” a nationwide reputation as the largest British centre providing high-calibre training for junior paediatricians.” Yet that same Hospital Trust plans to close the in-patient children’s ward and cut back paediatric specialists (nurses , junior doctors and consultants) working at Ealing Hospital.

The closure of the ward means that:

• Blue light ambulances will not take children to Ealing A&E . They will be routed to other hospitals.
• Parents taking their children to Ealing A&E or the Urgent Care Centre will, if their child cannot receive the treatment it needs the child will be, stabilised, assessed and transferred to another hospital.
• Paediatric specialists will no longer be available on-site at Ealing Hospital to treat critically ill children.