Wednesday, 28 January 2015

Nurses calling to halt west London NHS changes over lack of out-of-hospital care

The Royal College of Nursing is concerned a lack of focus on out-of-hospital care while A&Es are closing will result in an even worse healthcare crisis

Nurses are concerned patients are not getting the right out-of-hospital care for the NHS to justify closing A&Es in west London

Frontline nurses today (January 27) called for the suspension of the west London hospital reorganisation programme until further guarantees can be given about out-of-hospital care.
The Royal College of Nursing (RCN) is asking Imperial College Healthcare NHS Trust and the government to suspend its Shaping a Healthier Future programme which has seen Hammersmith Hospital’s A&E being closed and more changes are to come.
Members are worried patients are suffering from a lack of investment in out-of-hospital care to make up for the closures as they believe it is currently not at a safe level.
The RCN, which focuses on patient needs, today submitted evidence based on local frontline members’ feedback to a review being held by Michael Mansfield QCon behalf of Hammersmith and Fulham, Brent, Ealing and Hounslow Councils.
Local nurses told getwestlondon there were increased waits for ambulances outside hospitals in the area and dangerous diversions were being made due to capacity problems
They also said patients and carers do not understand the new Urgent Care Units which have replaced A&Es at Hammersmith and Central Middlesex Hospitals. One member said: “Patients and particularly their carers are frightened and confused about the A&E closures.”
Members added that pressure on GP services means practice nurses cannot carry out preventative health interventions meaning people are going to A&E who should have been kept well earlier in the system.
Under the Shaping a Healthier Future programme it was argued fewer A&Es were needed if people could be kept out of hospital by preventative health measure.
As well as patients becoming frustrated nurses themselves said they are ‘burnt out, tired and frequently unable to get their time for the next study days'.
RCN London regional director Bernell Bussue, said: “The RCN will always support service reorganisation which delivers improvements in the quality of patient care. However it is just not clear that patients have seen any benefit from these changes so far.
“The positive case for the Shaping a Healthier Future programme was based on an increase in out of hospital care to enable more patients to be kept well or treated at home to reduce hospital admissions. In practice, little seems to have been done to boost capacity elsewhere in the system to make up for the closures. Proper replacement services, transition arrangements, funding and a workforce plan should have been in place before the existing units were cut.
“Nursing staff working in the area have told us the closures have damaged patient care. The remainder of the Shaping a Healthier Future closures should be suspended until out of hospital capacity is properly expanded.”
The RCN has also cited health secretary Jeremy Hunt as saying Shaping a Healthier Future would give north west London ‘probably the best out-of-hospital care anywhere in the country’ but this winter west London’s remaining A&E units have experienced some of the longest waiting times in the country.

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