A&E closure will affect schools' capacity to deal with child illness and accidents

The UCC can deal with broken arms but not broken legs

My submission to the Shaping A Healthier Future had a particular focus on the impact of the Central Middlesex A&E closure on children and schools, as well as the role schools could play in preventative medicine.

This is an extract:
   
PROCESS

1. Dr Mark Spencer, leading on the Shaping a Healthier Future consultation, told a TV news programme before the consultation had begun that A&Es would close. This suggests that the consultation is a sham as decisions had been prior to the public having a say.
2. Despite claiming that ‘nothing had been decided’ the continuation of Central Middlesex A&E was not included as an option in the proposals. The statement is thus untrue and misleads the public.
3. No risk assessment was carried out on the proposals prior to the consultation so the public have had insufficient evidence on which to base their responses.
4. Throughout the consultation meetings it has been claimed that the proposals are not ‘cuts’. However flat funding at a time of population increase and increased demand does amount to a cut in real terms even before we take into account the financial plight of the Trust and the subsequent need to make ‘savings’. This again amounts to misleading the public.
5. Headteachers and school governing bodies, responsible for the health, safety and well-being of children in their care, were not consulted about Sustaining a Healthier Future.. Key stakeholders have thus had no say about the impact of the closures on a particularly vulnerable section of the community.

CENTRAL MIDDLESEX A&E

1. The department has been run down over several years, including overnight closure, pre-empting the closure proposals.
2. The department serves two of the most deprived wards in the capital (Stonebridge and Harlesden) with low life expectancy and high incidence of illness including a specialism in sickle cell anaemia affecting the African Caribbean population.
3. Car ownership at only 22% is low and public transport links poor making the journey to Northwick Park A&E difficult with potential dangers to patients of long and delayed journeys in emergencies.
4. The area has a significant number of sites where major incidents could occur which necessitate an easily accessible fully functioning A&E in the vicinity:
1. Railway lines including Euston-Birmingham mainline, Chiltern line, London Overground, Bakerloo, Jubilee, Metropolitan and in the future possibly HS2
2. The North Circular Road, Harrow Road, Edgware Road.
3. The industrial area around Wembley Stadium and Neasden, and the Park Royal Industrial estate (one of the largest in Europe)
4. Major venues including Wembley Stadium, Wembley Arena and Fountain Studios
5. The area has a rapidly growing child population so has increasing demand for A&E services associated with  childhood illnesses such as meningitis, asthma, allergic reactions and the increasing incidence of TB; as well as the usual head injuries and fractures associated with childhood accidents.
6. Many recent immigrants in the area are not registered with GPs which leads to increased use of A&E by their parents for childhood illnesses.
7. The assumption is that Urgent Care Centres and A&Es are complementary provision, operating on the same site. This will not be the case if Central Middlesex A&E is closed and instead cases that cannot be treated by the UGC will have to be transferred to Northwick Park A&E. This will necessitate an additional journey by ambulance, private transport, cab or public transport increasing the risk to the patient.
8. Concerns about first aiders in schools and work places having to make decisions about whether to send patients to the UGC or Northwick Park A&E were not answered convincingly during the consultation. We were told that they would soon get to know which was appropriate or could ring a new telephone service for advice. I remain concerned that this could put patients in danger and puts far too much responsibility on the first aiders concerned.
9. School first-aiders and support staff taking children to Northwick Park A&E act in locus parentis until parents get to the hospital. The distance and transport issues mean that parents will take longer to get to Northwick Park hospital with resultant distress for children, and school staff will have to stay at the hospital for longer periods.
10. Similar arguments can be made for other A&E facilities threatened with closure in the NW London NHS area.

URGENT CARE CENTRE

1. The demarcation lines between UCCs and A&E are unclear and without an A&E at Central Middlesex could cause dangerous delays to treatment.
2. The UGC is privatised and therefore less accountable to the local community and susceptible to market pressures.
3. The Central Middlesex UCC, run by Care UK.  having lost 6,000 x-rays does not have the confidence of the local community.

SCHOOLS

1. Schools and Children’s Centres have not been included in the section about care outside hospitals and preventative care in these settings could be of vital importance.
2. As mentioned above newly arrived families are often not registered with GPs and schools could play a role in campaigns over registration, immunisation and be a site for health checks on new arrivals.
3. The health service could also deliver support to groups of  parents in school on health, sexual health and other related issues in an environment in which they already feel at ease.
4. As well as health screening for new arrivals dental, eyesight, allergy and weight checks for all pupils could be reintroduced as a form of preventative care.

 

Hirani and Spencer to debate hospital changes on Tuesday

There is to be a 'Question Time' style debate  between Dr Mark Spencer, Clinical lead, NW London NHS and exponent of Shaping A Healthier Future's proposals which  include the closure of Central Middlesex A&E,  and Cllr Krupesh Hirani, Brent Council lead member for Health and Adult Social Care,

The debate takes place on Tuesday October 9th, the day after the Shaping A Healthier Future consultation closes.

It will be part of the agenda for the Harlesden Connect forum at 7pm, All Souls Church, Station Road, Harlesden (next to Lloyds Bank)

Is Central Middlesex A&E safe for patients to use?

Saturday's consultation meeting on Shaping a Healthier Future produced some passionate debate and full video coverage can be seen on the Brent Green Party blog HERE

What concerned me most, was the implication that Central Middlesex A&E as it now exists, is so devoid of staff and expertise that it is not safe for patients. Dr Mark Spencer listed a number of services that it could not provide and Dr Kong at one stage seemed to be saying that it was being closed because it was not  safe. When I questioned this  she retreated somewhat, saying it was just the overnight A&E that was unsafe.

Dr Spencer did not retract and later, asked about whether, despite not being in the options, it could remain open, said that if there was sufficient demand via the consultation and it could be done 'safely' then there was a possibility it could remain.

I immediately raised the point that there seemed to be a possibility that patients, individually, referred by schools or by workplaces; could be attending a facility that doctors themselves deemed unsafe. If this was the case it should not be open at all - patients are being put at risk.

I am strongly in favour of a full A&E service at Central Middlesex Hospital and restoration of a 24 hour service. An A&E is essential in an area of great deprivation, criss-crossed by major railway lines and roads and with one of the largest industrial estates in the capital.  It is a major concern if the A&E has already been run down to such an extent that doctors do not consider it safe for patients.

There is till time to comment on Shaping a Healthier Future but you need to act quickly as it closes on Monday October 8th.

Follow this LINK to the document and consulation form

Brent LINk vote against Central Middlesex A&E Closure

After a debate between Dr Mark Spencer of NW London NHS and Graham Durham of the Brent Patients Campaign, Brent LINk members and any public attending, voted to oppose the closure of Central Middlesex A&E. There were two abstentions and no votes against.

In the course of the debate Dr Spencer repeatedly failed to answer Graham Durham's request for him to explain why he had stated in a BBC interview before the consultation began that four Accident and Emergency units would have to close in NW London.  Dr Spencer also admitted that despite the rise in the number of children in Brent schools and the importance of child health, that schools, headteachers and governing bodies had not been consulted.

There will be another chance for the public to make their views known when the 'Shaping a Healthier Future' roadshow comes to Harlesden Methodist Church on Saturday September 29th. The Q&A session will be from 11am until 12 noon.

Will Sarah Teather MP  come and hear what her constituents have to say about the proposals so that she can champion their views in the House of Commons?

Debate NHS changes in Stonebridge tonight

Dr Mark Spencer, proponent of 'Shaping a Healthier Future' will be debating with Graham Durham, of the Brent Patients Association, an opponent of the plans,  at this meeting tonight.

Will Brent Council take on the fight to save Central Middlesex A&E?

In a recent posting I called on Brent Council to take a proactive stance in fighting the proposals for closure of the Central Middlesex Hospital (Park Royal) Accident and Emergency. Ealing Council have already take up such a position.

A resolution at the last Brent Council meeting proposed by Cllr Krupesh Hirani (Lead member for Health and adult Care) didn't quite do that but was a step in the right direction.

This Council condemns the Tory and Liberal Democrat Government for the lack of consideration to Brent residents over the likely closure of Accident and Emergency (A&E) services at the Central Middlesex Hospital, which will lead to people in the poorest part of Brent, having to travel longer distances to address life threatening imminent needs.

Brent Labour recently had a meeting on the NHS which was addressed by  Fiona Twycross, a Labour Assembly Member for London. Perhaps a more militant stance will emerge from that meeting. Is is certainly something the Council should be doing on behalf of its citizens.

Meanwhile at the Willesden Area Consultation Forum the item on 'Shaping a Healthier Future'  was curtailed because Dr Mark Spencer who was giving the talk had another meeting to attend. The result was a rush through a PowerPoint presentation and very little time for elaboration, questions or discussions. Neither Spencer or Abbas Mirza (Communications Engagement Manager for NHS North West London, were available to speak to residents at the break. This was scandalous given the far-reaching and poentially life and death issues being discussed. At the beginning of the presentation Mirza said, 'these are just proposals - nothing has been decided'  but in response to a question from me, Spencer confirmed that there was no option to keep Central Middlesex A and E open. Clearly its closure has been decided ahead of consultation.

Dr Spencer claimed that the A and E at Centrtal Middlesex was under-used, that many who did use it, used it wrongly and would be catered for by other proposals. He said that the privately run (by Care UK) Urgent Care Centre could answer most emergency needs. Central Middlesex Hospital would eventually become a 'localised' hospital for planned admissions only.  Asked by an audience member which A and E they could go to instead, he said that that was a decision they could make for themselves. I am sure I will enjoy exercising that choice when I next get knocked off my bike!

Earlier in the meeting I did a Soapbox where I publicised the campaign that has been formed to oppose the closure of Central Middlesex Hospital A and E and the hospital's run-down and the defend the NHS against cuts and privatisation. We will be marching from Harlesden to Central Middlesex Hospital on Saturday September 15th to buiold support for the campaign. It would be great of Labour councillors joined us.

In my Soapbox speech I said that losing an Accident and Emergency ward was often the first chapter in the running down and eventual closure of a hospital. As a qualified first-aider in  local schools I had often had recourse to Central Mid A and E for ill and injured pupils and knew of its worth. 

I pointed out the need for a  A and E in this poorest part of the borough that would be readily accessible to local residents who were reliant on public transport. Public transport links with Northwick Park Hospital (the proposed alternative A and E) were very poor.

The local area has many possible sites for major incidents requiring A and E and emergency operation facilities. These include the main Euston-Birmingham Railway line, the Bakerloo and Overground Line, Chiltern Line and Jubilee/Metropolitan. Major Roads including the North Circular, Harrow Road and Kilburn High Road. Large industrial areas in Park Royal and around Neasden Goods Yard and the major venues of Wembley Stadium and Wembley Arena.  Accidents at any of these places could involve many people requiring emergency treatment or hospital admission. Could the reduced provision of A and E cope?

Cllr Lesley Jones, who was chairing the meeting, said that the council had been pressurising Transport for London to extend the 18 bus route to Northwick Park for a long time and would continue to do so.