Hospitals downgrade plan fatally flawed

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Hospitals downgrade plan ‘fatally flawed’

Wednesday September 12, 2012

NHS plans to downgrade west London hospitals are fatally flawed and will compromise local health services, according to a damning independent report released today (September 12).

Former NHS chief executive, Timothy Rideout, says there are fundamental flaws in NHS North West London’s controversial plans to scrap the A&E departments at Hammersmith and Charing Cross Hospitals, as well as the hyper acute stroke unit at Charing Cross.

In a scathing report, Mr Rideout - who is a specialist in change management, financial strategy and organisational turnaround within the health service, spells out a series of major concerns in the NHS business case. These include:

  • A failure to explore genuine alternatives to A&E closures.
  • Evidence that the “over-provision” of A&E departments, that NHS North West London claims to justify the closure of four units in the area, is not as marked as claimed. Nationally an average A&E department caters for 259,425 people. In North West London around 247,150 people are currently served per A&E (just 5% less than the national average). But, if the current NHS proposals go ahead, the remaining A&E’s would each need to cater for 395,440 people - meaning the area would have 52% less capacity than the national average.
  • Using location as the main factor to decide downgrade options, rather than more relevant issues such as: the needs of local people or the current performance of local hospitals. For example, Charing Cross has the lowest mortality rate in North West London and the highest satisfaction score from patients, but this was not one of the criteria considered.
  • Failure to independently verify the financial modelling used to determine the level of savings that the NHS needs to make.
  • The ‘funnel effect’ of the chosen methodology in knocking out viable alternatives before they had a chance to be fairly compared.
  • Lack of regard for the 40 per cent of inpatient admissions and 23 per cent of A&E admissions - people who will be dramatically affected by downgrading local hospitals.

Mr Rideout says the process that NHS North West London chose to decide that the borough’s two hospitals should be downgraded is ‘unsafe’ - and that, therefore, so are the proposals.

“There are fundamental problems with the whole business case used by NHS North West London,” says Mr Rideout. “There is a complete failure to take account of current clinical outcomes and a lack of regard for the scale of impact these radical changes will have on Hammersmith & Fulham residents.”

The excellence of current services will be put at risk as residents will be faced with increased travel times and delayed access to emergency care, according to the report. All this is combined with an inadequate public consultation earlier this year while the proposals were being drawn up - with just one in every 5,000 residents consulted.

Despite receiving MORE funding from central government, NHS North West London is ploughing ahead with budget savings of 4 per cent per year.

Cllr Nicholas Botterill, Hammersmith & Fulham (H&F) Council Leader, says: “The Rideout Report is a devastating critique of the failure of NHS bureaucrats to spend the extra cash that they are getting from Government to improve and protect front line health services.

“Instead, this detailed review shows how the unaccountable NHS bureaucrats have attempted to justify the downgrading of two local hospitals in the face of massive opposition from patients with no firm evidence that nurses or GPs agree with their wild conclusions."

The report also warns that the removal of 1,000 adult beds should not go ahead before new NHS structures come in to effect in April 2013, as it would be ‘highly inappropriate for formal decisions to be taken by Primary Care Trust on the eve of their abolition’. The report goes on to argue that major changes should not even be considered until the capacity of primary and community care, under the 'Out of Hospitals' strategy, has been significantly beefed up.

Cllr Botterill continues: “NHS North West London has failed to adequately consult the council, GPs or patients and their so call preferred option of downgrading Charing Cross and Hammersmith Hospitals is fatally flawed.

“To add insult to injury, under the current timetable, a dying organisation in the form of the current PCT is scheduled to make a major decision on the future health and wellbeing of thousands of residents as its last act before being dismantled. If this is allowed to continue there will be no accountability and no one to blame when lives are lost.

“We will now re-double our efforts to persuade the NHS North West London to think again.”

Timothy Rideout was brought in to help scrutinise NHS plans to downgrade local hospitals by H&F Council. Mr Rideout has more than 20 years experience in senior roles within the health service and was formally appointed to assist by the council’s Housing Health and Adult Social Care Select Committee in July.

To read the full report click here (pdf 534KB) or come to the public meeting and have your say!

» Send us your comments now

Hi all i live in bridgend s/wales where we are at present is in a engagement process of downgrading 2 out of 3 local hospitals.
Is there a nationwide campaign to save our services if not why not?
Also i beleive the the nhs trust will hide the fact that it will cost lives not save them Fact every minute that a stroke patient spends in an ambulance in transit the patient loses more brain cells which they will not get back and will slow down the recovery process. Also for every 10km spent in transit for a major injury increases loss of life(doa)by 1% the trust would not like you to know these facts.If you have any ideas and any more facts please email me thanks
a concerned member of the public phil
From phil on 12/11/2012 at 12:43
Every hospital should have provision for the treatment of accidents and emergencies. Hospitals are the place where doctors work. Doctors strive to save life and limb for the unfortunate victims of accidents... you can have an accident, your child can have an accident, your Mother can fall down the stairs, your friend your lover... other peoples friends and lovers. Truth be told in the National Health Service this is about cutting budgets and saving money to give tax cuts to those who need them least of all. Closing an A&E department is the first step in the planned closure of a hospital. Anyone who tries to tell you different is a liar.
From Douglas Miller on 22/09/2012 at 19:34
We have to have an A&E department at either Charing Cross or Hammersmith otherwise there is nothing close for Shepherds Bush/Hammersmith or Fulham and it has to be obvious that one of these departments is essential for emergencies for this highly populated area of London.
From Valerie Aikin on 16/09/2012 at 12:58
Save our hospitals!!!
From Lina on 16/09/2012 at 07:50
Can we know addresses of the people who concluded that Hammersmith and Charing Cross A&E should close? Why choose to keep Chelsea open when for most of the Health region it is the least accessible - no tube, expensive and scarce parking etc? On the basis of the independent report you quote, it is a rotten and I''ll-conceived proposal
From GC on 15/09/2012 at 20:39
We need a local a and e. Chelsea is too far away
Delena Raymond
resident 51 years in Hammersmith
From delena raymond on 14/09/2012 at 12:53
I am diabetic. I work full time and always have therefore I have paid all taxes and national insurance all my life. Unfortunately, I have had to be rushed to hospital because of my diabetes. On average any individual can wait avbout 4 hours to be seen in A & E how long will we have to wait now. People with an illness will just not disappear, where do we go now, and how long will we have to wait to be seen. The plan to close these A & E departmets is disgusting, and does not give a hoot about the local residents.
From JOSEPH BATT on 14/09/2012 at 10:01
No, A&E is actually one of the cheapest bits of the NHS. It is about 2.65% of the total London NHS budget, and only 5.1% of all London's hospital spending. That's why it is so barmy to think about trimming A&E to save money, as you can't save that much. UNLESS, of course, you know that once A&E has gone, the rest of the services that depend on it have to go: maternity, paediatrics, general surgery. THEN, of course (and this is night-follows-day stuff), you declare your hospital 'non-viable' or 'unsafe' and then you can close it and sell the land to - who might it be? - oh yes, a private developer. A hospital without an A&E is not a 'local hospital', it is a polyclinic with too much empty space and no future. Trust me, I'm not a doctor.
From Colin Standfield on 13/09/2012 at 21:52
The world is coming to and end, all the facilities that were available to the public is now being shut/close down! I'm a tax payer who was born in this hospital and I dont want to see it go..

So, stop this rubbish and understand us!

From SAVE OUR HOSPITALS on 12/09/2012 at 23:08
It seems to me that all the NHS boards want to close their A@E departments. I have just had an email on proposals to shut the A&E at Chelsea and Westminster as well. It is not hard to see why, I am sure that they are far more expensive to run than other services. However, it is getting to the stage that there will be almost nowhere for west londoners to go in an emergency, yet surely this is the most basic service that hospitals should provide.
From anna Cheveley on 12/09/2012 at 12:46


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