Yesterday the BBC reported that ambulance crews would have to call ahead to the control room before taking patients to A&E at Northwick Park Hospital because of the pressures on the hospital. Local GPs are being asked to refer patients to other hospitals. It also reported that in September 179 patients had to wait for more than 30 minutes for an ambulance and 30 patients have to wait for more than an hour.
Yesterday at Scrutiny Committee councillors put the NW London NHS Trust under pressure regarding these issues. In often emollient replies to tough questioning councillors were assured that there was no danger to patients.
Problems were ascribed to an increase in acuity of patients arriving at the hospital with a sustained rise in medical emergency admissions. In other words more Brent people are becoming sicker.
Although the planned increased bed capacity at Northwick Park would not take place until Autumn 2015 the Trust were taking steps to increase 'in year' capacity at Northwick Park by 32 beds and 20 at Ealing Hospital. Ealing had not shown a marked rise in admissions but there had been an increased length of stay for patients.
Measures to cope with the problem included quicker discharge and less DTOC (delayed termination of care).
In a rather chilling statement an NHS officer said that there was no evidence that the problems were having an impact on mortality rates. 'Yet...' was what I said to myself.
Summing up the Committee's view, last night's Chair, Cllr Reg Colwill, said they were concerned about the timescale of the implementation of improvements to Northwick Park and the danger this posed to Brent residents.
The discussion of the repercussions of the closure of Ealing Hospital Maternity ward also centred on capacity.
Councillors were told that the facility was no longer viable and an earlier closure than the two years initially planned was necessary to maintain safe services. Northwick Park and Imperial had the capacity to expand maternity provision without infrastructure work and a maternity booking service would be introduced. 41% of Brent mothers already attend Imperial which includes Queen Charlotte's in Hammersmith. Ealing staff would be transferred to other facilities over a transitional period.
Officers said that current activity in the hospitals was less than the previous maximum and the expected rise in numbers would be within that maximum. there was an expectation that 95% of women would get their first choice of maternity care. The only cap was at Queen Charlotte's Hospital.
Cllr Mary Daly challenged this in the light of the area's rising birthrate. In summing up Cllr Colwill said that the Committee was not convinced that the rise in birthrate had been sufficiently taken into account and remained concerned about whether alternative provision would be in place in time.
The main discussion on the future use of the Central Middlesex Hospital site following the closure of the A&E, was the transfer of rehabilitation beds from the Willesden Centre to Central Middlesex. This raises the question of the future use of the vacated space at Willesden.
The plans for moving Park Royal mental health facilities to Central Middlesex are not going ahead. This was because the costs arising from the 'enhancements for mental health service would not be economically appropriate'.
Yesterday at Scrutiny Committee councillors put the NW London NHS Trust under pressure regarding these issues. In often emollient replies to tough questioning councillors were assured that there was no danger to patients.
Problems were ascribed to an increase in acuity of patients arriving at the hospital with a sustained rise in medical emergency admissions. In other words more Brent people are becoming sicker.
Although the planned increased bed capacity at Northwick Park would not take place until Autumn 2015 the Trust were taking steps to increase 'in year' capacity at Northwick Park by 32 beds and 20 at Ealing Hospital. Ealing had not shown a marked rise in admissions but there had been an increased length of stay for patients.
Measures to cope with the problem included quicker discharge and less DTOC (delayed termination of care).
In a rather chilling statement an NHS officer said that there was no evidence that the problems were having an impact on mortality rates. 'Yet...' was what I said to myself.
Summing up the Committee's view, last night's Chair, Cllr Reg Colwill, said they were concerned about the timescale of the implementation of improvements to Northwick Park and the danger this posed to Brent residents.
The discussion of the repercussions of the closure of Ealing Hospital Maternity ward also centred on capacity.
Councillors were told that the facility was no longer viable and an earlier closure than the two years initially planned was necessary to maintain safe services. Northwick Park and Imperial had the capacity to expand maternity provision without infrastructure work and a maternity booking service would be introduced. 41% of Brent mothers already attend Imperial which includes Queen Charlotte's in Hammersmith. Ealing staff would be transferred to other facilities over a transitional period.
Officers said that current activity in the hospitals was less than the previous maximum and the expected rise in numbers would be within that maximum. there was an expectation that 95% of women would get their first choice of maternity care. The only cap was at Queen Charlotte's Hospital.
Cllr Mary Daly challenged this in the light of the area's rising birthrate. In summing up Cllr Colwill said that the Committee was not convinced that the rise in birthrate had been sufficiently taken into account and remained concerned about whether alternative provision would be in place in time.
The main discussion on the future use of the Central Middlesex Hospital site following the closure of the A&E, was the transfer of rehabilitation beds from the Willesden Centre to Central Middlesex. This raises the question of the future use of the vacated space at Willesden.
The plans for moving Park Royal mental health facilities to Central Middlesex are not going ahead. This was because the costs arising from the 'enhancements for mental health service would not be economically appropriate'.
4 comments:
The NHS officer slightly mislead the committee with his statement if he said there was no evidence on mortality as there has been a 'death spike' of such a degree that on the weekend Dr Mark Spencer announced that he was ordering an inquiry.
See here for more: http://www.dailymail.co.uk/news/article-2845731/NHS-bosses-finally-order-investigation-E-closure-chaos-two-year-campaign-MoS-exposed-deaths-delays.html
Scott Bartle,
@mapesburygreen
Just to say, elected patient reps raised the Northwick Park A & E performance and have asked much more searching questions than is possible for councillors to do at Scrutiny. We find ourselves being fed data from which it is virtually impossible to extract the salient numbers, so it is very difficult to arrive at informed conclusions as to what has gone wrong and why.
It certainly does not help that the NHS powers that be never admit that cost is what drives their actions. At least if they made this admission up front we would all have a firm basis for working out a strategy for handling the problem. Instead, what we have is fragmented, short-termism dressed up as better care, closer to home and other such meaningless, patronising twaddle.
With reference to the Ealing Hospital gynae closure, the critical question is not how many births there have been at the hospital but how many births have taken place in the catchment area of Ealing Hospital. As with CMH, when the NHS powers that be decide they want to close things down, they start really early to undermine the facility in question by cutting its resources and letting it be known that it might be closing down. Candidates then don't apply for jobs there and so the NHS can (and does) claim the place is not clinically safe and must be closed down in the interests of patient safety.
Another further consideration would be to look at the socio-economic circumstances of the women who would attend the facility if it were properly resourced, and the degree to which they and their families might be adversely affected by having to travel further afield. The problem is that we never hear these kinds of issues being discussed and I rather suspect they are not taken into consideration (although I do live in the constant hope and expectation of being pleasantly surprised). All is obfudgescation.
Of course, what we NHS watchers know is that Northwick Park Hospital and Ealing Hospital were each financially embarrassed. The NHS dating agency decided they would be a good match, after all two could live as comfortably in the red as one. So it does not take the old neuro-surgery practitioner to work out that there may be a necessity for some parts of the newly paired organism to be eviscerated (cuts in services to you and me).
Enter stage left: Suitably caped and with underwear on display, the now ubiquitous Private Sector, swoops down to rescue us. The question is whether we will all live happily ever after.
Nan. info@brentppg.org.uk
Just to say, elected patient reps raised the Northwick Park A & E performance and have asked much more searching questions than is possible for councillors to do at Scrutiny. We find ourselves being fed data from which it is virtually impossible to extract the salient numbers, so it is very difficult to arrive at informed conclusions as to what has gone wrong and why.
It certainly does not help that the NHS powers that be never admit that cost is what drives their actions. At least if they made this admission up front we would all have a firm basis for working out a strategy for handling the problem. Instead, what we have is fragmented, short-termism dressed up as better care, closer to home and other such meaningless, patronising twaddle.
With reference to the Ealing Hospital gynae closure, the critical question is not how many births there have been at the hospital but how many births have taken place in the catchment area of Ealing Hospital. As with CMH, when the NHS powers that be decide they want to close things down, they start really early to undermine the facility in question by cutting its resources and letting it be known that it might be closing down. Candidates then don't apply for jobs there and so the NHS can (and does) claim the place is not clinically safe and must be closed down in the interests of patient safety.
Another further consideration would be to look at the socio-economic circumstances of the women who would attend the facility if it were properly resourced, and the degree to which they and their families might be adversely affected by having to travel further afield. The problem is that we never hear these kinds of issues being discussed and I rather suspect they are not taken into consideration (although I do live in the constant hope and expectation of being pleasantly surprised). All is obfudgescation.
Of course, what we NHS watchers know is that Northwick Park Hospital and Ealing Hospital were each financially embarrassed. The NHS dating agency decided they would be a good match, after all two could live as comfortably in the red as one. So it does not take the old neuro-surgery practitioner to work out that there may be a necessity for some parts of the newly paired organism to be eviscerated (cuts in services to you and me).
Enter stage left: Suitably caped and with underwear on display, the now ubiquitous Private Sector, swoops down to rescue us. The question is whether we will all live happily ever after.
Nan. info@brentppg.org.uk
If these councillors had been a little more vociferous when they were actually closing Central Middx A&E we might not be in this position. As it was it took them 2 full years to decide this wasn't a good idea and initially partially endorsed the Shaping A Healthier Future proposals.
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