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Wednesday, 29 July 2015
I have had a series of meetings on the future of our local NHS, and Charing Cross Hospital in particular, in the last two weeks. These have ranged from seeing the management of Imperial Healthcare Trust, who run Charing Cross, Hammersmith and St Mary’s, to the long-awaited meeting with the Department of Health on the whole ‘Shaping a Healthier Future Programme’ – the blueprint for A&E and other acute service closures across west London.
Jeremy Hunt still refused to meet us as he has for two years – despite there now being 12 MPs anxious to lobby him on the effect of the closure programme. But we did see the hospitals minister, Jane Ellison, and all the leading NHS bureaucrats in charge of the project. This is what I learned.
• They are still intending to go ahead with the demolition of Charing Cross and its replacement with a small primary care/ elective surgery ‘local hospital’.
• The timetable is slipping. The business case – ie funding for the scheme -may not be agreed until 2018. Hence their decision to move all stroke services from St Mary’s to Charing Cross for at least five years – so no demolition until at least 2020.
• The business case, in fact the whole project, looks increasingly rocky. It will require at least £1 billion in capital and £250m in implementation costs. £500m is for St Mary’s rebuilding alone, and another £150m for Charing Cross.
Frankly, I can’t see this ever happening. It is another white elephant scheme like Paddington Basin. The difference here is that for all the public money and input of time and effort (much of the cash going to management consultants) the end result would be a smaller, less comprehensive NHS. The whole thing is quite mad.
If I am right, Charing Cross will still be there for them to attempt to close again in 20 years’ time (remember the last attempt was in 1992). The logic of keeping it (and Ealing Hospital) is remorseless. Population is spiralling in west London with 50,000 new homes planned just in H&F. Our health needs grow more complex, especially as the population ages. The primary and community care services that are supposed to reduce demand for acute hospital services are vestigial and will never replace the need for A&E services (not my view but that of the College of Emergency Medicine).
But this doesn’t mean I’m optimistic for the future of the NHS – just like the reorganisation that the Coalition Government inflicted on it, this rebuilding programme, even if it never happens, is a huge distraction and opportunity cost and staff are voting with their feet to go elsewhere.
Meanwhile, there was still no sign of the report into the effects of the Hammersmith and Central Middlesex A&E closures on waiting times at Charing Cross and elsewhere, six months after it was supposed to be published.
A Parliamentary Question from me [http://www.theyworkforyou.com/wrans/…] elicited the response that it had been quietly slipped onto the NHS England website [http://www.healthiernorthwestlondon.nhs.uk/…/gb-14-july-ite…] a few weeks ago – hidden in plain sight.
No one was told about it, indeed Imperial denied they knew anything about it.
You can understand why – it showed even a small change in demand threw the remaining A&Es into chaos before Christmas [http://www.standard.co.uk/…/revealed-northwick-park-hospita…].
These were two small part-time or under-resourced A&Es. What would happen if they did close the major services at Charing Cross?
Saturday, 11 July 2015
Imperial NHS Trust are consulting on their plans to transfer the stroke unit at St Mary's to Charing Cross Hospital
'The deadline for submitting comments has been extended from the original date of Friday 10 July to Wednesday 22 July 2015.'
Don't miss the chance to tell Imperial Trust management what you think about the Stroke Services...
Photo: GETTY IMAGES
It is hard to decide which is the most disturbing fact that has come to light about the NHS 111 service as a consequence of The Daily Telegraph’s recent investigations. Our undercover reporter revealed that the service 111 provides to patients can be alarmingly poor: some were deliberately denied ambulances, despite clear medical need.
That was disturbing enough, but also alarming is the tacit admission made in an internal letter to NHS bodies from Dame Barbara Halkin, NHS England’s chief operating officer. Ordering the immediate suspension of all negotiations over new contracts for local 111 services, Dame Barbara says that such contracts should not be agreed until the NHS has put in place “a functionally integrated urgent care access, treatment and clinical advice service”. In other words, until the health service has worked out how 111 should relate to hospital accident and emergency departments and GPs. The implication of that, of course, is that such fundamental decisions, on which an efficient and effective health service depends, have not yet been taken. That is troubling indeed.
But perhaps more worrying still is that it took the determined efforts of journalists to bring these things into the public domain. No large organisation can ever avoid errors or weaknesses, but the successful ones deal with their mistakes quickly and openly. The NHS is often too slow and too secretive about its own failings, a closed culture that has contributed to a number of scandals in recent years. The challenge for the health service following our investigation is not just to address failures of care and organisation, but to adopt a truly open culture where such shortcomings cannot be concealed.
Yael originally posted a version of this letter on her Facebook page, but after being inundated with likes and comments, decided to actually send it to the hospital.
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