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Charing Cross threat

February 12, 2009

A new consultation document, published by Healthcare for London, identifies St Mary’s hospital in Paddington as its preferred location for one of four major trauma centres for the capital. Charing Cross did not pass the independent expert clinical assessment which was used to identify potential sites for the trauma centre.

Charing Cross is identified as the site for one of a network of specialist units for stroke patients, but the consultation also refers to plans to re-locate these services to St Mary’s hospital in Paddington.

The consultation document says; “Should Charing Cross Hospital be designated as a hyper-acute stroke unit and St Mary's Hospital be designated as a major trauma centre, a plan to realise the benefits of future co-location on the St Mary’s site would be developed.“

Healthcare for London spokesman, Robert Williams, confirmed there was a real possibility that Charing Cross’s proposed hyper-acute stroke services could later be transferred to St Mary’s Hospital. “If Charing Cross gets the hyper-acute stroke unit and if St Mary’s gets the major trauma centre, then at some point in the future it’s possible there will be a move from one site to the other,” he said. “But it’s all hypothetical at this stage and it’s part of what we are consulting on at the moment.

H&F Council leaders have warned that moving the specialist stroke unit could lead to the loss of related neurology and neurosurgery expertise from the borough. “Over the years, many departments, such as renal, obstetrics, and gynaecology, have been moved from Charing Cross, says Council Leader, Councillor Stephen Greenhalgh. “I have been concerned that other specialisms would be lost at Charing Cross, and that is exactly what this document suggests. I will be making urgent representations to Imperial College Trust when I meet them at the end of this month.

 “We have been asking for many months for some reassurance that other specialisms will not be moved to St Mary’s, but this proposal, made in a footnote in a 50-page report, seems to confirm that the plans to further downsize Charing Cross are very real.

"We have made progress in persuading Healthcare for London to listen to our arguments on the need for a fourth trauma centre to serve west London, but we believe that the case for locating this at Charing Cross needs to be made in the strongest possible terms. Charing Cross Hospital has the best located A&E department in west London with many of the wide range of back-up specialist services required for a trauma centre."

There are three options in the consultation: four trauma centres with either St Mary’s or the Royal Free serving north west London or three centres with nothing in north west London.

The council fears that a further downgrade of Charing Cross would mean the west of London will be less able to deal with the major injuries following a disaster at Heathrow or 7/7 style terrorist attacks. Charing Cross is the largest and busiest hospital in the west of London. Around 65,000 accident and emergency (A&E) attendances and 12,000 emergency admissions take place at Charing Cross each year.

The council is also questioning why all four proposed trauma centers are bunched together in central London making journey times, particularly from the west of the capital, dangerously lengthy.

Claire Perry, managing director of Imperial College Healthcare NHS Trust which runs both St Mary’s and Charing Cross hospitals, said: " We are confident our bid will provide West Londoners with access to the highest quality specialist care. The naming of the Trust as a preferred option for the provision of major trauma comes at a time of significant investment at Charing Cross, Hammersmith and St Mary's Hospitals. By way of example, Charing Cross is in the process of creating a new state-of-the-art super surgery to complement it’s A&E provision and has recently been fitted with a £1.5million PET/CT scanner. The hospital has a bright future and will continue to provide services for our local people. The same is true of Hammersmith and St Mary's Hospitals - we will continue to run three very busy hospitals, each with their own A&E department."

Healthcare for London has promised that, under the new proposals, all Londoners will be within 45 minutes’ journey from a major trauma centre.

Professor Matt Thompson, clinical director of the project, said it aimed to improve the UK’s survival rates in major trauma cases. “The case for change is that if you look at complex surgical interventions in the UK, the death rates are 30 to 40 percent higher than they should be, compared to Europe, the US or Australia,” he said. “It’s easy to write big scary headlines about travel times, but the time of absolute importance is the time from when someone is injured to when they receive definitive care.”

If St Mary’s is confirmed as a major trauma centre it will begin operating in 2012, two years later than the other three trauma centres at Royal London, King’s College and St George’s hospitals, due to open in April 2010. Healthcare for London is yet to confirm its interim plan for handling trauma cases in west London, but expects patients will continue to be stabilised at their nearest hospital and then transferred to one of the other three trauma centres.

Hammersmith & Fulham NHS will hold the first of a series of meetings to discuss the proposals and gather feedback in White City on February 25. Consultation on the proposals will end in early May.