We should learn lessons from the huge victory won by Ealing and Charing Cross hospital campaigners

Hammersmith and Fulham Council's campaigning video

Amidst the distraction of the Brexit farrago a statement was slipped out in the House of Commons last Tuesday of great significance for everyone campaigning to save the NHS and against austerity cuts to public services.

The Secretary of State announced the decision with many a swipe at the local MPs (starts with Karen Buck's question):

A key factor in  the campaign was how Hammersmith and Fulham Council got behind the local community and hopsital campaigners and devoted resources to savinf their local hospital A&E. Unfortunately the Shaping the Healthier Future plans that led to the closure of the A&E  at Central Middlesex Hospital, although well fought.,were implemented and the A&E is still missed today, particuarly by residents in the Park Royal, Harlesden and Stonebridge areas.

Save our Hospitals Hammersmith and Fulham said:

The Secretary of Health Matt Hancock announced on March 26^th that the closure plans for both Charing Cross and Ealing hospitals contained in the cuts & closures plan known as Shaping A Healthier Future have been withdrawn.  We’ve won. It’s not been easy taking on a well funded posse of spin doctors, management consultants and political ideologues but many thousands of people have done just that and after a 7 year fight we’ve stopped a closure plan that was downright dangerous. Everyone has done their bit whether that’s signing petitions, challenging bureaucrats in meetings, running street stalls, demonstrating, fundraising or delivering & displaying posters. We should feel really proud of ourselves and celebrate our collective achievement.

Of course there are still huge problems: The £30m primary & community cuts planned for H&F, the state of disrepair in our hospitals, on going understaffing & under resourcing coupled with the threat of privatisation by the likes of Babylon and Virgin. Some may have seen the laughable attempts of local conservative MPs and councillors to claim responsibility for a victory they have consistently done their best to sabotage  It’s also true that the government could change it’s mind and come back with new closure plans in the future.

So we’ll have to keep campaigning - we’ve proven today that campaigning works. But for now let’s just celebrate a victory won by lots of different people (including you) working together to Save Charing Cross Hospital.

Kind Regards AD(SOH chair)

Ealing Save Our NHS said:

Finally, the Government has admitted the horrible ‘Shaping a Healthier Future Plan’ (SAHF) is not workable!

Former NHS England chief executive Sir David Nicholson had called these plans “the most significant reconfiguration project in the country”. But since they first announced SAHF plans to cut nine major hospitals in North West London down to five, Ealing Save Our NHS has been campaigning against it side by side with many others including Save Our Hospitals Charing Cross and the Councils in Ealing and Hammersmith & Fulham. SAHF spent tens of millions of pounds of NHS cash on management consultants. All for nothing. 

Now Secretary of State for Health, Matt Hancock, has announced the Department of Health no longer supports it. Ealing Save Our NHS has distributed a quarter of a million leaflets, held protests, attended carnivals, organised parties, lobbies, petitions, car convoys and much more to spell out the truth. On the other side huge amounts of NHS money was spent on public relations staff and glossy leaflets to pretend that our health would mysteriously be improved if they closed A&E’s and hundreds of beds. It didn’t work.

So what will happen now? Ealing Save Our NHS will keep on campaigning. This disastrous SAHF plan has seen the closure of two local A&Es, Central Middlesex and Hammersmith, as well as the closure of Ealing A&E to children. As a direct consequence, waiting times for Type 1 urgent A&E visits increased greatly. Ealing Hospital’s excellent maternity department was also closed, forcing Ealing mothers to travel long distances and negatively effecting continuity of care for many.

But health bosses appear to have learned nothing and continue to defend the indefensible. Mark Easton, the head of the North West London Clinical Commissioning Groups, in announcing the death of SAHF has just made the mind-boggling claim that maternity care and emergency paediatric care have improved. This is certainly not the view of local parents whose local services have closed. Ealing Hospital remains seriously underfunded and in crisis. But at least there is a ray of sunshine, the horrible plan underlying all these cuts has gone and we can focus on calling for proper funding and restoration of local health services.

Dr Tony O’Sullivan, Co-Chair of Keep Our NHS Public added,

This is a very important victory for the people of Ealing and Hammersmith & Fulham. Campaigners must be proud of themselves for standing up for the NHS and their local communities for 7 long years – with integrity, skill and huge impact. Elections unseated the council backing closure of Charing Cross and the Ealing MP backing government attacks on the local NHS and public services. Campaigners won the local councils to their side and refused to give in to the irresponsible plans of ‘Shaping A Healthier Future’ in North West London. Well done and thank you. The battles are not over. We are with you in your fight to restore the damage done and win back maternity and children’s services in Ealing Hospital.

Hammersmith and Fulham Council said:

We did it together! The government has finally been forced to retreat on closing Charing Cross Hospital.

Thanks to Save Our Hospitals campaigners, Michael Mansfield QC (who ran the independent commission that provided such unchallengable evidence against the plans) and to the many, many residents who have fought with us so hard and for so long.

Council Leader, Cllr Stephen Cowan says: “This is a huge validation of Michael Mansfield QC’s findings and a huge victory for the Save Our Hospitals campaign. Thank you to all the residents who worked with us to save Charing Cross Hospital.”

Statement from North West London CCG (26 March 2019): “We will not be taking forward the plans as set out in SaHF for changes to Ealing and Charing Cross hospitals.”

What was planned?

We’ve won the battle to save Charing Cross Hospital from proposals to demolish most of it and replace its A&E with an urgent care clinic – leaving just 13 per cent the size of the original hospital.

·      We joined forces with local residents and with Ealing Council, who have been fighting the closure of Ealing Hospital

·      We commissioned a public inquiry led by Michael Mansfield QC that has provided a strong evidence base for why the proposals are wrong. Read the full report here.

·      We’ve refused to sign the ‘North West London STP’ – because it restates the plan to reduce acute services from nine major hospitals to five.

·      We commissioned a review of the NHS proposals and the STP – Read the review (pdf 4MB).

·      We’ve held scrutiny meetings to publicly quiz NHS managers on their plans

·      We’ve invited local people to public meetings, rallies and demonstrations

·      We’ve presented petitions and published individual residents’ own experiences and stories

·      We’ve kept local people updated on the campaign through letters, leaflets, posters and social media.

The current much-loved Charing Cross Hospital was to be replaced with an urgent care centre, diagnostics and out-patients only.

The NHS plan included:

·      Demolishing the current Charing Cross Hospital and selling off most the site

·      Replacing the current Charing Cross Hospital with a series of clinics on a site no more than 13 per cent the size of the current hospital

·      Replacing the current A&E with an urgent care clinic

·      Losing more than 300 and possibly all the acute care beds

·      The detail on the proposals is in the NHS Case for Change.

CONGRATULATIONS TO EVERYONE INVOLVED

Bid for £513m for NW London CCGs to be submitted to implement STP

Just after the Kilburn Times LINK published a story about the potential impact of the Sustainability and Transformation Plan (STP) on Brent, the NHS Brent Clinical Commissioning Group held an extraordinary Governing Body meeting at lunchtime today. The Times story pointed to a difference in emphasis on the STP from Cllr Krupesh Hirani, lead member for community wellbeing who said he would sign up to the STP, and Carolyn Downs, Brent CEO who has led on the STP, who repeated the caveats made at Brent's October Cabinet meeting*. The STP got very little detailed mention at today's meeting.  Ealing and Hammersmith and Fulham boroughs have refused to sign the STP at present.

The chair said that in seeking £513m investment the area CCGs were following through the controversial Shaping a Healthier Future  (SaHF) and the Sustainability and Transformation Plan . The investment was necessary to deliver these plans and the meeting considered the Strategic Outline Case (Soc 1) for the investment. 

The majority of the funding (£304)  would go to acute hospitals, most of it to Ealing Hospital. £69m to improving GP practices, and £141m to out of hospital hubs.

 

The £304m hospital share would:

• support Ealing's changes to become an excellent local hospital
• expand A& E and provide more beds at West Middlesex Hospital
• expand A & E and maternity at Hillingdon Hospital
• provide more primary and community care services at Central Middlesex Hospital
• provide more post-op recovery and critical care beds at Northwick Park Hospital and improve some existing buildings

The £69m GP practices share would:

• make it easier for patients to physically get in and out of practices
• make better waiting rooms and more consulting rooms across all 8 boroughs

The £141m allocated to Out of Hospital Hubs would:

• modernise 11 existing community hubs
• build 7 new ones
• increase capacity and enable people who have multiple health and care needs to have those dealt with in one place 

The overall aim was better health care and preventing unnecessary hospitalisation.

At the public question time Robin Sharp speaking for Brent Patient Voice said:

I thank the Governing Body for making 30 minutes available for public comments or questions during this session. I am afraid that the rest of what I have to say will be more critical.

Sadly we are presented with yet another example of flawed procedure and a flawed case for change on the part of our NHS.

To begin with procedures, it is farcical that the Governing Body are set to approve a complex 250-page submission only 8 days after it was put into the public domain. Doctors on the Governing Body are very busy people with important clinical jobs. How can they have had time to read and understand these proposals?

It is also disgraceful that 7 out of the 8 NW London Healthwatches which make up the PPRG (Patient and Public Representative Group) for SaHF have offered quasi-endorsement for the document even though they admit that the public they are supposed to represent have not seen it.

We are told there will be public engagement in future, but is not this the wrong way round? Engagement should have been before the document goes to the Treasury.

Turning to the clinical case for change, it has been over 3 years since the “Better Care Closer to Home” strategy set out in SaHF was launched. It was supposed to be all in place by 2015. Where is the assessment to show that more care in the community has stopped people being admitted to hospital and reduced the need for acute beds?  It is certainly not in the NW London STP (Sustainability and Transformation Plan). “If Better Care Closer to Home” works why are our A&Es among the most challenged in England. Why are Referral to Treatment (RTT) times on a downward trend?

We were told in the slide presentation that 27 Hubs across NW London are at the heart of this Business Case and that St Charles off Ladbroke Grove is an example of a fully functioning “Hub”. Can we please see a paper giving details of how this is working? As a patient of a nearby Brent practice who uses the Urgent Care Centre at St Charles I have to say that the existence of a Hub is a well kept secret. No-one has told me or my Practice PPG about it.

Maurice Hoffman asked if only a limited amount of the monies claimed was available how would it be distributed?  He asked if  a 'local A & E' would meet London standards. He was told that the CCG had made it clear to the NHS that all the proposals were inter-connected and they were pitching for the full amount.  He was told that a Charing Cross A & E would not take 'blue light' case and NW London CCGs were looking at what services for the frail and elderly could be best placed there.  He was assured that 'until we have the capacity we will not change anything.'

As the presentation had mentioned voluntary organisations as providing services in the hubs, I asked how this would work when NHS England and NHS Estates were saying that market rents had to be paid. There was a momentary silence while the governing body members looked at each other and then Sarah Mansurali replied that they were looking at giving grants to voluntary sector organisations so they could afford the rent, offering sessional space or try to integrate voluntary organisations into new models of care.

The Governing Body noted the scope of the SOC and approved Part 1 for submission to NHSE and NHSI for approval and asked for the following points to be considered prior to approving subsequent related Outline Business cases (OBCs):

• further public involvement is undertaken where appropriate
• the OBCs continue to justify the capital requirement set out in SOC part 1
• opportunities to accelerate the delivery of the benefits are explored
• opportunities to further improve the income and expenditure position of proposals are explored

It is worth noting that this meeting took place during the day on a weekday so opportunities for the public to attend were clearly limited.  

*Cabinet Minutes October 24th 2016:

1.     Cabinet noted the STP submission for North West London. 


2.     Cabinet welcomed the principles adopted within the STP of prevention, out  of hospital care, dealing with the social care funding gap and the need to work across the public sector to maximise benefits from changes to the NHS and other public sector estate. 


3.     Cabinet noted that the STP will need formal sign off by the end of December and that between October and December the following issues need to be clarified both within the submission and through other NHS processes, in 
 order for the council to give full support for the plan:

a.     That the IMBC on which delivery area 5 is based is released, debated and understood; 


b.     That the flow of monies from acute to out of hospital settings are clarified; 


c.      That the specification for out of hospital settings, in particular social care, are clarified
based on an agreed model of out of hospital care; 


d.     That a full risk assessment for the plan and relevant mitigations are included.

Ealing and Hammersmith & Fulham Councils show Brent how to campaign on the STP

 It is just not possible for me to go to every vital meeting that I advertise on Wembley Matters so I am posting this account from the Hammersmith and Fulham website of their public meeting on the NW London Sustainability and Transformation Plan.

How about a similar meeting in Brent, Brent Council?


The decision by Hammersmith & Fulham and Ealing councils to refuse ‘secretive’ hospital closure plans was backed by hundreds at a packed town hall meeting this week.

Nearly 700 cheered and applauded the leaders of the councils as they explained why they have refused to sign up to the local NHS Sustainability and Transformation Plan (STP). Councils across the UK have been asked to endorse similar plans for each region of the NHS, before they are submitted to government for approval.

“The STP is a deeply cynical re-hash of the earlier flawed plans which now proposes to close Charing Cross Hospital in 2021,” said Cllr Stephen Cowan, Leader of Hammersmith & Fulham Council.

“There are no good arguments for demolishing Charing Cross or for selling off much of the land and replacing it with an urgent care clinic just 13 per cent the size of the hospital. That’s why this administration will continue its fierce defence of Charing Cross and the vital local NHS services people rely on.”

The meeting drew campaigners from across the region who have been fighting plans to close or downgrade services at five out of the nine hospitals in north west London.

Despite the published plans, an NHS spokesman has said: “We want to reassure our staff, patients, local residents and partners that Charing Cross is not closing and that there will be no reduction in the hospital’s A&E and wider services during the lifetime of the STP, which runs until April 2021.”
Anne Drinkell, of the Save our Hospitals campaign, said: “This is a cuts and closures programme. We’re not saying we want no change. But objectively there’s already not enough capacity in our local hospital so closing more services would be unsafe.”

Campaigners were united in condemning the tactics being used to force through drastic reductions in local health services secretively and without public consultation.

The NHS has pressured councils to approve STPs by linking it to the release of vital government cash needed to keep councils’ social care services from collapsing under ever-rising demand.

But Cllr Julian Bell, Leader of Ealing Council, said: “The NHS tried to bounce us into signing the STP. They tried to get us to agree to the STP on the basis of a two-page summary and they told us we didn’t need to see the full document. We insisted, but it didn’t arrive until they day before we were meant to sign it. And once we finally saw what was in it, we understood why. There was no way on earth I was going to sign up to those plans.”

Dr David Wingfield, chairman of the Hammersmith and Fulham GP Federation, suggested the STP was not equipped to tackle the health and social care problems facing the borough. He offered to form a ‘grand alliance’ between GPs, councillors and members of the community to confront local healthcare challenges.

 

Save Charing Cross Hospital meeting audience

 

Save Charing Cross Hospital campaigners

Mansfied Report report says Shaping a Healthier Future programme threaten fundamental principles of the NHS and provide “no realistic prospect of achieving good quality accessible healthcare for all.”

Hammersmith and Fulham Council have issued this release on the Mansfied Report

One of the country’s biggest hospital shake-ups is deeply flawed, likely to exacerbate a deteriorating situation, a threat to the fundamental principles of a universal NHS and should be halted immediately, according to a landmark report from the Independent Healthcare Commission chaired by Michael Mansfield QC.

NHS North West London’s Shaping a Healthier Future (SaHF) programme has already seen the hugely controversial closures of two A&E departments, at Hammersmith and Central Middlesex hospitals and the closure of Ealing maternity unit. Further downgrading of Ealing hospital is planned, along with the closure and sale of the majority of Charing Cross hospital site.

The Independent Commission also uncovered shocking details of spiralling management and consultancy costs. At the same time, a crisis is developing in emergency services, with GP services clearly failing to meet demand across the region, contributing to a crisis in A&E performance.
Independent Healthcare Commission Chair Michael Mansfield QC said:

“The findings of the Independent Healthcare Commission for North West London are stark - the reforms, both proposed and implemented thus far, are deeply flawed. There is no realistic prospect of achieving good quality accessible healthcare for all, and any further implementation is likely to exacerbate a deteriorating situation.

“Our recommendations are equally stark. It is the view of the Commission that the Shaping a Healthier Future programme should be halted immediately, and that the affected councils should consider a legal challenge if it is taken forward in the current circumstances.”

“At the very core of any decent civil society is the imperative to ensure that the individuals and communities who make up that society have sustainable access to good quality healthcare. The response from North West London NHS, flowing top down from central government, has singularly failed to deliver on this imperative, with all indications pointing to a further deterioration in the future.

“It is crystal clear that the impact of fragmentation through privatisation is slowly eroding what was a National Health Service, a development that ran like a thread through much of the evidence given at our public hearings. In so many ways, the catalogue of failings, missed opportunities and profligacy we have seen in North West London act as a microcosm of a wider malaise across the English NHS. As such, though this report focuses on the NHS in North West London, it should act as a warning call to the top of government.”

Leader of Hammersmith & Fulham Council Cllr Stephen Cowan said:

“People across west London have been horrified to see their treasured NHS deteriorating so quickly – and so unnecessarily. They have protested, sent in petitions and begged local health chiefs to stop this madness, and are furious that local NHS bosses have ignored them for so long. My council colleagues shared this anger, commissioning the Independent Healthcare Commission, and in doing so keeping our pledge to fight for local health services.

“Today’s report from Michael Mansfield QC is a watershed moment. Rigorous, thorough, detailed and rightly independent, the review provides indisputable evidence that these changes to local health services are badly planned, hugely costly and causing life-threatening failures in local healthcare. The only sane decision is to put a halt to them right now.”

The reports key recommendations are:

• The Shaping a Healthier Future programme must be halted immediately
• North West London local authorities should consider their options for launching a legal challenge if a decision is taken to press ahead with the programme in the current circumstances.
• The report’s key findings are:
• Cutbacks are being targeted on the most deprived communities
• The public consultation was inadequate and flawed
• The escalating cost of the programme (£1bn) does not represent value for money and is a waste of precious public resources
• There is no business plan to show the reconfiguration is affordable or deliverable
• NHS facilities have been closed without adequate alternative provision being put in place
• The plans seriously underestimate the increasing size of the population in North West London and fail to address the increasing need for services

In today’s landmark commission report, Michael Mansfield QC also recommends that:

• Ealing and Charing Cross hospitals must retain full ‘blue light’ A&E services for the foreseeable future
• The decision to close Ealing maternity unit should be reversed with immediate effect
• The A&E department at Central Middlesex Hospital should be re-opened
• The National Audit Office should undertake a review of the value for money of the programme
• A new public consultation is needed as the proposals have changed significantly
• Substantial investment should be made in GP and out-of-hospital services, which are clearly overwhelmed and inconsistent.

Read the Independent Healthcare Commission for North West London's final report» (pdf 819KB)

Protest against Hunt's attempt to curb legal challenges to hospital closures

There was a protest today by campaigners fighting Jeremy Hunt's attempt to add a clause to the Social Care bill which would prevent communities taking legal action, such as that of the Lewisham Hospitals Campaign,  against hospital closure plans.

Brent, Hammersmith and Ealing march together to save hospitals

Refusing to be divided from one another with localist claims of one hospital against another, campaigners from Brent, Ealing and Hammersmith and Fulham marched to gather on Saturday calling for ALL the hospital A&E departments in the area to be saved, thus preventing the eventual running down of the main hospitals.

Speakers included the Leader of Ealing Council and a Conservative councillor from Hammersmith. Muhammed Butt, leader of Brent Council, joined the march briefly before going off  another official engagement.

However it was the speeches from hospital workers, patients, trade unionists (including Christine Blower, General Secretary of the NUT) and a mother of 5 children which really galvanised the crowd.  Pete Firmin, secretary of Brent Trade Union Council, was applauded when he emphasised the need for unity and outlined how the closures were an attack on the most vulnerable in Stonebridge and Harlesden.

The following comments from the public on the Hammersmith and Fulham Council website about Charing Cross A&E  echo many that have been made about Central Middlesex A&E:

Closing this A&E would mean over-burdening others in West London - the people of Hammersmith need this facility. NHS efficiency drives are to do with saving money, not with saving lives.
Jane Thurston-Hoskins
 
Has anyone tried getting to the Chelsea and Westminster hospital in a hurry, especially during a Chelsea football match?!!
S Jenner
 
What are planners thinking of!! Have they ever been to C&W Hospital from almost any direction and any time. Fulham Road is permanently gridlocked even for busses and there is no near by underground.I suppose it is a convenient way of having a quiet A&E. And where do patient go when they have to be admitted. ?To ChX. And why was ChX's A&E department been given an overhaul only recently. I do speak out of experience with both hospitals. ChX is by far the more caring hospital And what if there is an accident on the A4 The so called planners are an absolute disgrace. I could go on!!
Dina Harris
 
Keep Charing Cross Hospital with a full range of departments. I am disabled; it is my nearest hospital and the most accessible one. I have been well looked after in dealing with my cataracts, hammer toes and mastectomy. I remember it being built, serving a great need.
Patricia Owen
 
Absolutely agree. Charing Cross is a fantastic hospital with very high standard of care, at the forefront of medical technology and life saving equipment. My son was saved there at 3.5 years old after falling under a car. I have just had a laparoscopy on my gall bladder. I cannot believe what a high standard it is. It is clean, friendly and has super nursing and consultant staff.
Ewa Sylwestrowicz