This month we have stories of the Governments latest manoeuvres, this time it’s to blame managers for not dealing with the waiting list crisis and not spending the money effectively – you really couldn’t make it up.

They haven’t got off completely scot free as there have been some damaging headlines on Covid failings but as you will read they got off fairly lightly!

There is a bit of good news about Ealing Hospital and some very good reading too.

Our Guest Speaker this month is Malcolm Alexander, Chair of the Patients Forum for the London Ambulance Service telling us more about our ailing ambulance service.

CAMPAIGN MEETING TUESDAY 19TH OCTOBER AT 7.30PM

‘CUTS & CHALLENGES FACING THE LONDON AMBULANCE SERVICE’

Our next Meeting with be on ZOOM from 7.30pm – all welcome.

Our Guest Speaker is Malcolm Alexander, Chair of the ‘Patients Forum for the LAS’ and a long time campaigner.

As many of you will have read the London Ambulance Service (LAS) has been in crisis for some time with Government cuts and underfunding leading to increasingly poor performance. More recently plans were revealed to close 68 ambulance stations, to be replaced with 18 ‘hubs’. Thanks to campaigning these dangerous plans are now on hold.

Malcom Alexander was very instrumental in the campaign against the threatened closures and appeared in the national media – we are delighted he can join us for what should be a very interesting discussion – please tune in!

Also on the Agenda will be the latest news on what’s happening at Ealing Hospital and LNWH Trust, mental health, upcoming meeting with Tim Orchard, CEO of Imperial Trust, future street stalls & the campaign for fair pay in the NHS.

To join the ZOOM Meeting here at 7.30pm please contact us. 

GOOD TO BE OUT ON THE STREETS AGAIN!:

It was great to be out on the streets of West Ealing last Saturday with our Stall after such a long time. There was lots of interest especially in our Mental Health leaflet. Clearly many people and their families are experiencing problems and some are having difficulties accessing services. It certainly doesn’t help having no beds in Ealing for children or adults under 65** Thanks to everyone who came to help. 

**Please do have a read of our latest research on beds in Ealing on our website produced by members of our Mental Health Working Group.

A SHORT UPDATE ON EALING HOSPITAL:

The Trust who runs Ealing Hospital meets in Public every two months, so it is an opportunity for us to ask questions. Recently Ealing Hospital has been  getting more resources and some attention.  At the meeting last month a clear statement was made that Ealing Hospital will remain a District General Hospital with a fully operational A&E, so they have to resource all the services that are needed to support that. There are plans to increase surgical activity but these are not yet defined. In the pipeline is plans to build a new multi-story car park, but that means the current car park will be sold, no doubt for more housing!  

GOVERNMENT FAILINGS ON COVID EXPOSED OR LET OFF THE HOOK?

Media headlines on the Parliamentary Health & Social Care Committee’s Coronavirus – lessons learnt to date’ report, gives the impression that the Government failings on Covid, leading to thousands of unnecessary deaths has finally been exposed. But has it? 

Reading more closely and looking at the response from national campaigners and bereaved families is seems the Government has got off lightly and the real lessons not learnt.

Perhaps this is not surprising given that it was chaired by Jeremy Hunt (Health Secretary from 2012-18) keen not to be too implicated for his own role, and Greg Clark Conservative MP.

‘Keep Our NHS Public’ who recently concluded their excellent ‘Peoples Covid Inquiry’ which took evidence from bereaved families, front line staff and expert scientists and clinicians (unlike the parliamentary committee) said –

‘Despite outlining some mistakes in the Government’s early response, which will surprise next to no one, the report and the spin on it rests most of the blame on public health bodies rather than the Government, and of course Prime Minister Boris Johnson gets off almost scot-free’

Hannah Brady, Spokesperson for the ‘Covid 19 Bereaved Families for Justice Campaign’, said the report was a slap in the face for the families which is not surprising given that the Committee explicitly refused to speak to them or any bereaved families.

‘The report … is laughable and more interested in political arguments about whether you can bring laptops to Cobra meetings than it is in the experiences of those who tragically lost parents, partners or children to Covid-19. This is an attempt to ignore and gaslight bereaved families, who will see it as a slap in the face.’

You can read more on this story here –

MASSIVE WAITING LISTS – BLAME IT ON THE MANAGERS!

Yet again the Government is shifting blame for its failures, this time it’s the waiting list crisis. According to Health Secretary, Sajid Javid, “throwing money at the problem is not the answer”, it’s down to health managers to manage the money much more efficiently and make it go much further! Just how the current (or indeed proposed) amount of funding can go further with over 100,000 NHS vacancies and lack of at least 17,000 beds, he doesn’t explain.

The Health Secretary’s plans to ‘fix the crisis’ include an independent management review which is to be led by recently retired Vice-Chief of the Defence Staff, General Sir Gordon Messenger (military training for NHS bosses?) Javid also proposes changes that would allow him to take control of hospitals considered to be performing poorly, possibly replacing the whole leadership team with higher performing neighbours or business leaders. This obviously isn’t going down well with health service managers who rightly see it as a ‘slap in the face’ and, many of them are reported as thinking about leaving the NHS.

You can read more on this story here –

OCTOBER ISSUE OF HEALTH CAMPAIGNS TOGETHER BULLETIN – A MUST READ!

The latest issue is packed with great stories and analysis as usual including; the Health & Care Bill summed up patients paying privately for hip and knee operations; fantasy hospital plans, pharmacists to cash in on GP crisis.You can read it here online – 

A easy to read set of leaflets has been produced by Health Campaigns Together which summarise the key threat of the Health & Care Bill 

You can read them here  

A report from online research journal “the Lowdown” highlights the current situation for our mental health services 

“There are around 8 million people in England that are denied access to mental health services because they do not have severe enough symptoms to get put onto a waiting list, according to NHS leaders.”

Read more here….

There’s a national crisis in mental health – and any failure to address children’s needs is especially dreadful.  Rates of depression and suicides are rising.  NHS Child and Adolescent Mental Health Services (CAMHS) have been targeted for austerity cuts since 2010. Even the NHS Confederation says the system is at “tipping point”.  (See the Lowdown on Mental Health Services)

What’s happening in Ealing?  Our campaign research puts a spotlight on the situation. 

Healthy Child Programme – Public Health England

First point of contact NHS services Midwifery & Health Visiting & GP services

Pathways 0-5 year element – health visiting service preventive & universal services; Identifying health needs which include physical, social and emotional for child and family  

5 -19 Service led by school nursing service preventive universal services, and referral to GP for medical need and onward to other services as necessary including voluntary sector.

CAMHS Mental Health Tiers 

Health visiting and school nursing services link into the Ealing Tier 1 Universal services – early 

intervention. CAMHS will have children of all ages referred to their services but less likely to be under-fives but some developmental and behaviour problem can be identified in those early years.  

School children may be referred into Tier 2 services, counselling, YOTs etc

Tier 3 Specialist services will have children and adolescents with moderate to severe mental health problems.

Community Nursing Staff  

Specialist Public health Nurse qualification (Nursing & Midwifery Council Register)

In 2015 the health visitor and school nurse budgets were transferred to LA Public Health Department from the NHS. Both services are now managed by Central London Community Healthcare NHS Trust from 2018 

London Borough of Ealing

Staff Whole Time Equivalent (Agenda for Change Pay Banding )

Health Visitors

Grade 2018 2019 2020 

Band 6 33.21 30.2 22.93 

Band 7 4.88 3.80 5.0  Team Leaders and Practice Teachers

Totals 38.09 34.00 27.93

Band 5 6.22 3.63 5.63 Skill mix registered support nurses 

School Nurses

2018 2019 2020

Band 6 2.00 3.88 5.68

Band 7 1.80 1.00 1.00 Team leaders

Totals 3.80 4.88 6.6

There is DFE has also funded for Ealing pilot project (SWIS) for social workers in 8 secondary schools

Potential Workload

Total Population 2020 352,000

2020 – 5,250  births in Ealing Low birth weight 138 

0-19 Population  2020 – 67,000

0-4 population 2020 – 23,615

Ealing has 91 state-funded schools and nurseries. 

16 Secondary Schools

69 Primary Schools

8 Special & alternative schools 

25 children’s centres 

Special Educational Needs Primary 764

Secondary 389

Special School 824

Total Workforce  England

It would appear that since the transfer of funding to Local Authority in 2015  the England workforce numbers appear to have declined. 

Health visitors

2015 12,094 Increase in HV workforce – government investment. 

2017 8497

2020 6672

School Nurses

2017 2400

2020 925

There was an increase in skill mix with registered staff nurses and nursery nurses for the school nurse service. 

Access to services 

There is no maternity unit in Ealing Hospital, so mothers can choose to go to the hospital of their choice. As soon as baby is born then a notification will be sent to Ealing for mothers with Ealing addresses 

Access to services for Children and Families in Ealing is via Central London Community Health Trust website but parents should have contact information at the new birth assessment visit which include all the child health checks, health advice information and immunisation schedule.

Concerns

Workforce deployment during Covid-19 lockdowns 

Large workloads if following the mandated Healthy Child Programme – recommended caseload per health visitor is 250 families, but caseloads now can be 500-1000 families (iHV 2020)

Reducing numbers of staff over time since 2015 – council grants reduced

Staff leaving from stress of job – unmanageable workloads

Devastating toll of the pandemic. Are we abandoning children and young people?

Not enough nurses going into training for Specialist Qualification in Public Health Nursing – having to take out education loans

COVID-19 has made it very difficult for community nurses to carry the normal programme of visiting and child health clinics due to lockdown. Many of the contacts are now telephone or on line. These might exclude those families who don’t have access to IT. In some areas, health visitors can visit if they have adequate PPE. Almost 20% of heath visitors reported that 50% or more of their team were redeployed during the first year of pandemic.

Redeployment significantly reduced the workforce in some areas, leaving the remaining health visitors to manage increased caseloads, reducing the amount of time available to support individual families.  (Institute of Health Visiting  2020)

Review of Mandation of Health Visiting Services Gov. UK 2017 states that they have started to decline due to uncertainty during that year and reduced investment to LAs and possible delays in recruitment and training 

 Local authorities are responsible for commissioning public health services for children aged 0-19. Regulation requires all families with babies to receive five health visitor checks before their child reaches 2 and a half years old as described in the Healthy Child Programme 0-5 years. 

Public health services for children aged 0-19 are predominantly led and delivered by health visitors and school nursing teams with input from other partners as appropriate. 

Local commissioners should also consider the links and interface with screening programmes, mental health, sexual health, smoking, substance misuse and dental health. The core public health offer for all children includes: 

• This guidance is based on a public health pathway for children and young child health surveillance (including infant physical examination) and development reviews 
• €child health protection and screening 
• €information, advice and support for children, young people and families 
• early intervention and targeted support for families with additional needs 
• €health promotion and prevention by the multi-disciplinary team 
• defined support in early years and education settings for children with additional and complex health needs 
• additional or targeted public health nursing support as identified in the Joint Strategic Needs Assessment, for example, support for looked after children, young carers, or children of military families 

Best start in life and beyond: Improving public health outcomes for children, young people and families Public Health England 2020

In this short article our campaign researchers take us through the story of how, Step by step, mental health beds have closed in Ealing as the NHS funding crisis unfolded.  

We must not forget what has been taken away and we continue to campaign for vital services..  

A Summary of Mental Health Ward Closures in Ealing

Photo: © Copyright J Taylor and licensed for reuse under this Creative Commons Licence.

St Bernard’s Hospital has been providing mental health care to the people of Ealing since it first opened in 1931. Based on the same site as Ealing Hospital, it includes beds for male and female adults with mental health conditions, as well as specialist services for older people.

Over the past ten years, St Bernard’s has lost approximately 70 beds through closures, meaning that more Ealing residents and carers are having to travel out of the borough for mental health care and treatment. 

In 2013, the John Conolly Wing (JCW) was closed and demolished to make way for a new Forensic Medium Secure Unit (catering for patients who require a higher level of security). As a result, patients from acute services were relocated to four wards at Wolsey Wing on the Ealing site (Hope, Horizon, Starlight and Discovery), and others to wards at Lakeside and Charing Cross. 

As part of the closure of JCW, two older people’s wards (Windemere and Coniston), which had 16 beds each, closed and the 18-bedded Jubilee ward opened (leading to a net loss of 14 beds).

Following the move to the Wolsey Wing, Starlight ward (8 female beds) and Discovery ward (17 male beds) also subsequently closed. Both wards were noted to be doing well in 2013 as you can read here. 

In 2019/2020, two rehab wards (Mott House and Glyn ward) moved from the Ealing site to Lakeside, where they were amalgamated and renamed Robin ward. Mott House was a Highly accredited Adult Rehab service. 

The Wolsey Wing (Hope and Horizon) closed to inpatients due to the COVID pandemic in March 2020. There is no information available at present about if/when those wards will reopen. This means that since the closure of these wards, patients from the borough of Ealing who need inpatient psychiatry admissions are being admitted in either Hammersmith or Hounslow. A freedom of information response is pending on admission of Ealing patients to private psychiatry wards. 

Hope was a female admissions ward with 17 beds, and Horizon a male admission ward of 14 beds. In 2016, the CQC report mentioned that both wards could be noisy, unsettled and that the long narrow layout of the wards did not provide adequate communal space, including access to quiet areas.

Ref: https://www.cqc.org.uk/sites/default/files/new_reports/AAAF9938.pdf

In the last 5 years (11/06/16 – 11/06/21), 16 and 17 year old adolescent patients with acute mental health problems were admitted to adult wards on 37 occasions across areas covered by West London NHS Trust. The Ealing Hospital site has no mental health wards dedicated to 16 and 17 year old patients, and it is unclear whether the Trust has any standard operating procedure to ensure that such young people are appropriately supported when admitted in adult mental health wards.

Once again the organisers of Hanwell Carnival did the community proud. Despite rain in the morning,  thousands of local people turned up and we talked to lots of them. Dozens of small people became skeletal! 

Obviously it is not a quiet time for our NHS, which is experiencing a huge rise in patients attending A&Es along with significant staff shortages thus placing even greater demand on our overstretched and exhausted staff. At the very least they deserve a decent pay rise not a measly 3%!

Instead of responding to the pressures on the NHS the Government is going ahead with a major re –organisation, which you can read about in this month’s newsletter.

You can also read about the latest news on the GP Data Grab, our recent visit to Ealing Hospital, New prescription charges for 60 +, sign the latest Petition and more….. 

IT’S CARNIVAL TIME IN HANWELL – JOIN US ON SATURDAY 21 AUGUST

Once again Ealing Save Our NHS is joining in the festivities with our colourful Stall and some fun for the kids. We have some great new leaflets on the mental health crisis and the dangers of the Governments new Health & Care Bill, balloons and stickers too.

It has become a tradition to have a photo opportunity and this year ‘Love the NHS, dont let it be a skeleton service‘ is our theme with our ‘skeleton face in the hole’ – as you can see from the photo above.

If you are visiting Hanwell Carnival please come and say a hello, take a photo and a leaflet or have a look at our new leaflets here and here 

INVITE TO VISIT TO EALING HOSPITAL – A GOOD NEWS STORY:

At the end of last month ESON was invited to a walk around at Ealing Hospital to see the investment and improvements in services and meet Joanna Paul the Director of Operations at the Hospital, who was accompanied by Simon Crawford, Deputy Chief Executive, London North West Trust who run Ealing Hospital. A few photos are above.

It is once again a busy time at Ealing for Covid patients as wards have had to be reopened to see new cases but thankfully not the numbers previously seen.

Big changes have had to be made to minimise the spread of Covid so services have been be re-located, which is working well, and at the same time have been much upgraded. In particular there has been considerable investment in improving Older Peoples in-patient wards and clinics, which are very welcoming and the Paediatric Outpatient and Day Surgery Unit is frankly delightful.

Diagnostic services have been reinstated with 3 MRI scans now operating on the site and Endoscopy is set to expand. There has also been digital investment making it easier for doctors to monitor patients and access patient data.

It is very welcome to see Ealing Hospital getting some much needed investment and we hope this will continue. Thanks to the Trust for inviting us.

OTHER LOCAL NEWS:

Ealing Hospital suspended services to be restored:

The Review of the Trust’s suspension of Emergency Overnight Surgery and the Trauma & Orthopedic Service at Ealing has recommended that both services be fully restored. We are told this won’t be instant as they have to sort out extra staffing, but it’s still good news.

Ealing Breast Care Clinic:

Ealing currently has 2 Breast Clinics (pre Covid it had 4) whereas Central Middx has 7 and Northwick Park has 5 – quite a disparity! We have been lobbying hard for the restoration of the 2 Breast Clinics that were cut due to Covid. The Trust has now told us they intend to restore these Clinics – but no date yet. We also want to see a return of surgery so that Ealing women can get a full one stop service.

Northwick Park Maternity:

Following the recent CQC inspectors report which downgraded the maternity service to ‘inadequate’ (not the service we were promised when they closed Ealing’ s Maternity) we have been pressing hard for re-assurances that Ealing mums will be safe and get a caring service. The Trust and the North West London ICS, who are now monitoring the Trust, both say the changes they have made mean it’s now safe. A huge amount of work needs to be done to improve the service and they say it will take time. We will do our best to monitor it too.

3% WONT PAY THE RENT OR HELP RETAIN NHS STAFF:

NHS workers and their unions have been protesting against the dismal 3% pay award, this Summer. In July ‘NHS Workers SAY NO’ handed in an 800,000 strong petition to Downing Street calling for 15% now and demonstrations have been taking place around the country.

Since 2010, NHS pay has failed to keep pace with inflation so staff have experienced a real terms cut of at least 15% and the 3% doesn’t even cover inflation, currently at 3.9%.

Unite, GMB, the RCN and Unison are balloting members on whether they support the 3% and considering the next steps of their pay campaigns, including possible strike action. Junior doctors, who have not been awarded 3%, and Consultants are also being consulted about industrial action by the BMA.

With demoralisation and exhaustion at an all-time high the 3% award, which in non-negotiable, will do nothing to stem the escalating recruitment and retention crisis.

ESON is supporting our NHS staff all the way in their fight for pay justice as can be seen by the photo above at our July 3rd NHS Birthday celebration.

HEALTH & CARE BILL – A REAL DANGER FOR THE NHS:

Loss of local accountability and control, centralisation of decision making and budgets, more lucrative contracts for the private sector without competition and wide sweeping powers for the Secretary of State are key dangers facing our NHS from this Bill.

Well known national campaigner JOHN LISTER has written an analysis of the dangers in the Bill in the latest edition of Health Campaigns Together.

And we have summarised his article with some local examples in the latest article on our website, which you can READ HERE

SIGN THE PETITION: SCRAP THE HEALTH & CARE BILL!

ESON will be joining with other campaigners around the country to raise awareness about the threat to the NHS of this Bill and do our best to oppose it.

You can help by signing this Petition headed up by Dr Louise Irvine from Keep Our NHS Public and help spread the word.

Please also keep up to date by reading our Newsletter and following us on Facebook and Twitter.

YOU CAN SIGN THE PETITION HERE

DATA GRAB POSTPONED AGAIN!

The Government’s plan to take the patient records which GPs hold on everyone in England and enter them all into one massive database has been postponed again.

Government Minister Jo Churchill, has told GPs that the uploading of patient data will not take place until –

• The ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded;
• The backlog of opt-outs has been fully cleared;
• A Trusted Research Environment has been developed and implemented in NHS Digital and;
• Patients have been made more aware of the scheme through a campaign of engagement and communication

This a significant backdown brought about by pressure from GPs, like those in East London refusing to comply, campaign groups, professional bodies and of course patients who opted out in droves!

Leading Data Grab campaigners, Foxglove and Med Confidential are not convinced that all the Governments promises will happen. In the meantime we think if you have concerns the best thing is to opt out – you can always opt back in again!

HOW TO OPT OUT 

Latest News from MedConfidential

HAVE YOUR SAY – OPPOSE NEW PRESCRIPTION CHARGES FOR OVER 60s!

The Government is trying to sneak through a so- called ‘consultation’ this Summer on its plan to introduce prescription charges for people aged 60-66.

It is all being done under the guise that as State Pension Age has now moved to 66 so should the right to free prescriptions.

All in all its pretty nasty when so many older people are struggling and women in particular were hard hit by the rising of state pension age.

The Consultation closes on 2nd September and its short and easy to complete

More information can be found here and a link to the online consultation questionnaire HERE

THE SUMMER ISSUE OF ‘HEALTH CAMPAIGNS TOGETHER’ BULLETIN – A GREAT READ

Written in newspaper format, with lots of well-presented and easy to read information on the NHS Bill; the Covid crisis; Maternity Safety issues; the £10bn private sector contract and much more….

You can read it online here –

As a time when our understaffed and underpaid NHS staff struggle to cope with Covid and a massive backlog of people waiting for surgery, you might well wonder why the Government is pushing ahead with a major NHS re-organisation.

The main features of the Bill are a huge loss of local accountability and control, greater centralisation of decision-making and budgets and more lucrative contracts for the private sector without any competition.

The Secretary of State, Sajid Javid is to be given wide sweeping powers including the right to impose reconfigurations that can merge and close services as happened here in Ealing with the loss of our Maternity and Children’s Ward and the threat to close our A&E.

Well known campaigner and analyst JOHN LISTER unfolds the story in the latest copy of Health Campaigns Together in his article – ‘Listing key dangers in the Health & Care Bill’

Here are is a short summary of the key dangers from his article:-

No end to privatisation:

Although the legal requirement for Clinical Commissioning Groups to have to put services out to tender is to be scrapped there is plenty of scope in the new Bill for privatisation too.

“Scrapping Section 75 also raises the question of what new system will apply to regulate the awarding of contracts. On this issue the Bill is a pig in a poke: there is no clear mechanism or commitment to prevent more of the scandalous behaviour that became normalised during the pandemic – awarding contracts worth tens of millions to Tory donors and cronies without competition”

Fewer local bodies, even less local voice:

Over the last year, decision-making about local services has been become even more inaccessible as Clinical Commissioning Groups (CCGs), who commission our local NHS services, have merged across huge geographical areas. In North West London all 8 Borough based CCGs, including Ealing, have become a single NWL CCG meeting only 5 times in the year, with less then an hour for public questions.

This is the first step in the radical change that will further reduce decision-making and concentrate power into the hands of 42 ‘Integrated Care Systems’ (ICSs) which will cover populations of up to 3.2 million. The North West London ICS will continue to cover the 8 Boroughs with a population of over 2 million people.

“To make matters worse the new ICSs would each be collectively tied to a tightly limited single pot of allocated funding after a decade of austerity and falling real terms funding – and at a time when NHS England has already begun cracking the whip for tighter financial controls, and therefore looking for cuts to balance the books”

These new ICS bodies will have a Board with the Chair appointed by NHS England but Health Secretary Sajid Javid will have a veto over appointments and removals!

Charter for Cronyism

Given that the Chair has the power to make appointments – “On recent form, a rampant expansion of cronyism into the new bodies seems inevitable”.

This is further born out by the lack of any criteria or guidance for the appointments to the Board or their role or responsibilities.

“Nor is there any explicit requirement that the Boards must meet in public or publish their board papers, although NHS England has stated their preference for this: nor is there any commitment, given the wide geographical spread of some ICSs, for meetings to be made accessible online”

“And while local authorities have been weakened by a decade of brutal cuts in spending, and get just one seat on each ICS, the private sector could find itself gaining a stronger voice”.

Powers on reconfiguration:

New powers are to be given to the Secretary of State to intervene directly to either block local plans or enforce reconfigurations such as the dreadful ‘Shaping a Healthier Future’ here in North West London which would have closed our A&Es and beds at both Ealing & Charing Cross Hospitals.

But these powers are but a few of the 138 new powers in the Bill that are to be given to the Secretary of State.

Discharge to Assess:

Despite the title of the Bill including ‘Care’ and all the talk of integration there are hardly any concrete proposals for addressing the Social Care crisis. Instead we have increased CQC inspections of local authority services and the removal of the legal requirement for local authorities to assess the care needs of vulnerable patients before they are discharged!

With reported backlogs of more than 75,000 disabled and older people waiting for help with their care and support from overstretched Social services this is pretty disastrous and will place huge burdens on families and carers, for those who have them.

There is lots more in the Bill including the potential down grading of professional standards in pursuit of ‘financial and efficiency savings’

You can read the full story by John Lister here

Along with campaigns around the country we will be campaigning against the Bill over the next few months. Please read our Newsletter for latest news and sign the Petition.