Monday 7 November 2016

Public meeting on Tuesday 29th November, 7pm, at Town Hall: H&F rejects NHS "STP" plans to downgrade Charing Cross and Ealing


Please come to a public meeting at 7pm at Hammersmith Town Hall on Tuesday 29th November to hear and discuss the response of H&F Council to the latest proposals for cuts in health services in NW London called the "Sustainability and Transformation Plan" or STP.

The plan involves a complete upheaval of every service, from community care to mental health services to GPs to A&E departments to acute beds in the major hospitals, in NW London. The central aim of the plan is, we are told, to save money: a staggering £1.3 billion over the period to April 2021.
Hammersmith and Fulham Council strongly opposes the STP and has voiced its opposition to the NHS bodies concerned.

The plan has many major faults: the most obvious is that no precise details are given about exactly how the services are to be kept going to provide essential care to a growing and increasingly older population in NW London through a period of transition to "new models of care". The plan is so sketchy that it seems more like a "wish list" than an NHS-backed plan for our health services. In addition independent experts have cast doubt about whether the financial savings are possible, because new forms of service delivery always throw up problems and it is not clear that these have been really thought through. With a well-planned transition savings could come in time, but not immediately.

Most of the proposed "new models of care" have never been tested in the UK except in a few well-funded trial areas, where they have produced mixed results.

The plan, which is part of NHS "Five Year Forward View", has been rushed through with the help of management consultants from start in October 2014 to draft plan in June 2016. While the FYFV includes desirable aims like improving public health through better education and better use of IT, it offers an unrealistic time scale for achieving a general improvement in health such that A&E departments and acute beds can be stripped out. The latter are, of course, the expensive parts of the NHS. No country has ever achieved such a dramatic improvement in health in the time scale proposed.

A key part of the STP is the closure of Ealing Hospital to be followed by Charing Cross Hospital after 2021. They will be either lost completely or downgraded to a "local hospital" - whatever that means. It is clear that the STP demands the loss of 500 acute beds, about 12% of existing capacity (4272 in 4th quarter of 2015/16).

There is also a privatization agenda. The "new models of care" will be provided by US-style "Accountable Care Partnerships" merging private and public providers - and over 100,000 unpaid carers! - to offer all the services listed above, apart from A&Es, to be funded by capitation payments. The collection of GP medical records enables costing of services for use by ACPs.

Cuts to A&Es and reductions in acute services were first proposed in summer 2012 in a NHS NW London document called "Shaping a Healthier Future" which was published with little fuss, and hardly anyone noticed. The Consultation proposed a very restricted range of options, to which 17,000 people (out of a population of 2 millions) replied, mostly calling for the retention of A&E capacity.

NB: the link to the Response by H&F: please go to page 197 of the Public Reports pack for the Cabinet meeting of 7th November 2016. A report prepared for the Council by Dr Roger Steer, Dr John Lister and Sean Boyle, "Health and Social Care in NW London, a review of 'Shaping a Healthier Future' and the NW London STP", is at page 203.



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