NW London NHS vote to close Central Middlesex A&E with potentially life threatening consequences

Hospital campaigners from Brent, Ealing and Hammersmith and Fulham assembled at a chilly 8.30am today outside the Methodist Central Hall, Westminster in the shadow of Parliament's Victoria Tower. They were protesting against Shaping a Healthier Future plans to close A&Es at Hammersmith, Charing Cross, Ealing and Central Middlesex Hospitals.

Their pleas were ignored just as were their letters, petitions and marches and the Trust went ahead and voted for all four closures.

Campaigners warned that the decision will hit many of the area's most vulnerable residents and could result  in life threatening delays for urgent treatment.

The ITN report on the demonstration and decision can be found HERE

Candlelit vigil marks start of week of action to save our hospitals

Campaigners marked the beginning of the Week of Action to Defend London's NHS with a candle lit vigil outside Central Middlesex Hospital tonight. The Central Middlesex A&E is threatened with closure under the Shaping a Healthier Future proposals. People from Brent, Ealing and Hammersmith and Fulham joined in the vigil. Sarah Cox from Brent said that it was important that people across the three boroughs stayed united to guard against any attempts at divide and rule.

On Tuesday February 19th NHS NW London will be meeting at Central Hall Westminster to make decisions on the closure of A&E departments and many other services at Central Middlesex, Ealing, Charing Cross and Hammersmith hospitals. There will be a demonstration outside Central Hall from 8.30am.

"A farrago, a sham, an utterly dishonest exercise"

It reminded me of those Victorian pictures of the ragged, scrawny child, barefoot in the snow, with nose pressed against a restaurant window staring at the big-bellied rich tucking into their suppers in a warm glow of complacency.

We were in the opulent surroundings of a ballroom in the Hilton Metropole, Edgware Road trying to tell the smooth, expensively suited gentlemen from NW London NHS on the platform just what untold damage their 'Shaping A Healthier Future' (SAHF) proposals would do the people of Harlesden and Stonebridge, two of London's poorest wards. The whole consultation exercise to reach a foregone conclusion has cost £7,000,000

We were presented with a IPSO/MORI consultation report that ignored the thousands who had signed petitions against the proposals but instead went on to suggest that that the far fewer people who had submitted a response to Options A, B or C (all rejected by the petitioners) somehow represented some kind of democratic endorsement. 66,000 signatories on 18 petitions were apparently counted as 18 responses.

Andy Slaughter MP summed it up:

This is a complete farrago,  a complete sham, a completely and utterly dishonest exercise!

This was the beginning of many exchanges about the consultation which I felt rather let IPSO/MORI take the fire that should have been aimed at NW London NHS for the inadequacy and downright dangerousness and dishonesty of their proposals.

Ann Drinkell, put her finger on the dangers towards the end of the Q and A session. She claimed that SAHF had been dishonest about the ability of community care being suddenly able to pick up on the slack when fewer people were admitted to hospital or stayed for a shorter period.

Everyone know we aspire to good community care, good palliative care, but everyone also knows how difficult it is.  It is disingenuous to suddenly think it will be unproblematic. The impact of restructuring and budget cuts on community care and social care will be enormous. You are treating us like children.

Dr Mark Spencer then proceeded to do just that, treating us to a couple of anodyne PowerPoint slides on the 'Programme of Work' and 'Clinical Review of Responses' that would now begin. We were not allowed to ask questi9ons about this.

After a buffet supper (those ragamuffins in my head again) we went into 'Stakeholder Workshops'. These were introduced by Lucy Ivimy, Chair of the Joint Health Overview and Scrutiny Committee, a Conservative councillor in Hammersmith and Fulham.

She said that the initial impetus for the proposals had been the rationalisation of Accident and Emergency wards in the area and the fall out was a consequence of this, The virtual closure of two hospitals had been hidden deep in the plans, Given the wide geographical area and the propensity of people wanting to protect their own local facilities it had not been possible for the Committee to reach agreement.

She said that there were two main concerns:
1. SAHF was premised on success of the out of hospital strategy. This had been promoted for years but in real life admissions had continued to rise. We need more evidence on the strategy and a firm path to follow.
2. Transport was a big issue. Although there was a claim from the ambulance survey that there was little impact on the 'blue light' journeys the majority of journeys to hospital are by other means including public transport. There had been no analysis of these journeys.

A skirmish followed about whether this represented the committee and it emerged that an initial very critical report had been replaced by a much sifter version which was the 'official report'.

The workshops that followed were actually very interesting and dealt with issues that should have been discussed prior to the formulation of the plans. The public were feeding back on their real lived experiences - not going through a desk-top exercise. The world turned upside down.

In the workshop I attended I protested once again that schools as stakeholder had not been consulted at all and that children had been left out at a time when the child population is rising and they will be making demands on the health service. Gurjinder Sandhu, a specialist in infectious diseases, working at Ealing Hospital backed this up describing the importance being able to access hospitals and their presence aiding recovery, how A&E picked up child protection issues and that the difficulty schools would have in trying to deal with fragmenting services.  A&E had a role in detecting TB which was very high in Southall and Ealing - not to mention  HIV.

In the workshop on Urgent Care Centre a disagreement became apparent between practitioners about how reliable UCCs were with a suggestion that staffing levels and expertise were poor and that this represented a risk to patients. This was even more so when there was no A&E on the same site as will be the case with Central Middlesex Hospital.

The strong underlying thread was that health services and access to health services would worsen for the most vulnerable. The ragamuffin has been left out in the cold.

Consultation feedback below:

Brent fight for NHS moves up a gear

The fight to preserve and enhance the NHS in Brent and prevent privatisation took a step forward on Saturday when campaigners met up on the initiative of the 38 Degrees Campaign and planned their next steps.

The 38 Degrees petition asks the Brent Clinical Commissioning Group to protect the NHS from privatisation by including a clause in their constitution affirming that they will commission services from the NHS in preference to private companies. Hackney CCG has already agreed to this

The petition will be presented at the Shadow Brent  CCG at their consultation meeting on 14th November at the Wembley Centre for Health and Care, 116 Chaplin Road, Wembley, HA0 4UZ. The meeting is from 6pm until 8pm.The services currently being commissioned can be found HERE

The meeting will be discussing the Brent Integrated Plan which is a 3 year strategy  that outlines financial planning and details health care services the CCG plans to buy,


On Friday afternoon of this week pressure will be exerted on Sarah Teather, MP for Brent Central, when campaigners present her with a petition against the proposals in 'Shaping a Healthier Future' which includes the closure of Central Middlesex A&E. This petition also opposes privatisation of the NHS. Campaigners will meet at The Nest cafe at Willesden Green Station at 2pm on Friday 9th November and present the petition at Ms Teather's office in Walm Lane at 2.30pm.

When she left her government post Sarah Teather said that she wanted to devote more time to serving her constituents and this meeting will give her the chance to do just that.

On Wednesaday 28th November NHS NWL will be providing feedback on their 'Shaping  Healthier Future' consultation at the Hilton Metrropole in Edgware Road (opposite the tube station) from 5.30-7pm followed by a workshop for the public, patient representatives, clinicians and voluntary sector organisation working in groups on issues raised in the consultation. To attend register HERE

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.

 

Don't let the ConDems make a casualty of our NHS

Hospital campaigners from Brent, Hammersmith and Fulham and Ealing converged on the NW London NHS headquarters in central London today to hand in petitions containing thousands of names opposing the closure of A&Es across West London. Some campaigners wore bandages to dramatise the threat to local people.

The consultation on Shaping a Healthier Future ends at midnight tonight. www.healthiernorthwestlondon.nhs.uk  for the online consultation form  or e-mail to consultation@nw.london.nhs.uk

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

Let's have a 'healthy' Harlesden debate on Saturday

 I had to try for ages to find out what time the Question and Answer session was at the 'Shaping a Healthier Future Roadshow' to be be held in Harlesden on Saturday.

Finally we were told that although the consultation was from 10am until 4pm that the Q&A would be from 11-12. There were problems about the timing of the Q&A at the Wembley roadshow and it began late.

Now expensive advertisements from NHS North West London have appeared in the local papers and guess what? They just have the 10am-4pm timing with no mention of the Q&A and its timing.

The Q&A is of course the only time the public get to hear alternative views about the proposals which include the closure of Central Middlesex A&E. Perhaps they really want to keep it to cosy 1:1s where the PR people have more chance of pulling wool over people's eyes.

Get there at 11am and let's have a public debate!

Harlesden Methodist Church, 11am, Saturday September 29th.

Brent Labour backs Central Middlesex campaign

Following a meeting between Cllr Krupesh Hirani and Cllr Muhammed Butt last weekend  three Brent NHS campaigners last week, Cllr James Denselow, Brent Labour Party's Communications Officer, has published the following statement:

Brent Labour fighting against the closure of Central Middlesex Accident and Emergency (A&E) services

Brent Labour Party has given its full support to the campaign against the Coalitions disgraceful plans. Labour Cllrs condemned the plans in the Council Chamber and have been working with campaigners to raise awareness of the issue. Both Cllr Butt and Cllr Hirani will address the march against the closures on 15^th September.

However, the reason Brent has been unable to run a Council backed campaign against the closures is because unlike in Ealing, there is not cross party support for the campaign. Both the Lib Dems and Conservatives in Brent have refused to criticise the plans put forward by their own Government.

Cllrs from both parties should get behind the campaign so we can fight the plans as a united Borough.

List of action being taken:

1.       Motion passed but only with support from Brent Labour

2.       Letter to Secretary of State Andrew Lansley MP to come

3.       We are out on the doorstep every single weekend in Brent talking to residents on this issue

4.       Online poll has been set up http://krupesh4brent.com/2012/08/20/poll-on-central-middlesex-hospital-ae/

5.       We are meeting with campaigners

6.       Council will be responding to the consultation through scrutiny

7.       Brent Labour will be at the march

8.       Difficult case to use taxpayer resources for a campaign in cases where we do not have cross party agreement – that is why we the Brent Labour Party will be campaigning on this issue without taxpayer resources

Astonishingly, no risk assessment carried out on NW London NHS proposals

The NW London NHS proposals for far reaching changes in health provision have not been subject to a risk assessment despite them involving the closure of four Accident and Emergency facilities, including that at Central Middlesex Hospital, and the down-grading of several hospitals in the area.  The proposals affect 700,000 people.

The revelation was made at the August 2nd meeting of the NW London NHS Joint Overview and Scrutiny Committee on which Cllr Sandra Kabir is Brent's representative. Risk registers are a standard method of assessing the risks on a High, Medium or Low traffic light system, establishing the nature of the risk and who is affected, and the strategies for reducing that risk.  Brent Council has such a scheme in its Corporate Risk Register LINK

Instead the authors of the Shaping a Healthier Future proposals proposed that the risk assessment would only be made AFTER the consultation and when the proposals have been approved. This means that councillors and the general public will have no way of assessing the severity of the risk posed to residents,  which clearly could  be a matter of life or death, during the consultation period. In effect they will be making a response without knowledge of the potential impact of the proposals on people's health and well-being.

The committee was clearly concerned and agreed to 'revisit' the issue at a later meeting.Cllr Lucy Ivimy (Conservative, Hammersmith and Fulham) wrote to a concerned member of the public who attended the meeting:

I agree with you about the lack of a risk register and as you say, for the NHS to produce one only after the decision has been taken is extraordinary. The committee will be looking further into various aspects of risk. I am personally concerned that the full impact of the proposed changes has not been made clear in this consultation process.

A further critical issue was the consultation document's claim that the proposed changes were based on 'tried or tested ways of delivering healthcare' that it claims already work in many parts of NW London and the rest of the county (p20). The two expert witnesses heard by the committee were less sure. Asked about whether the structure worked in other parts of Europe Professor Welbourn admitted, 'there is no evidence the  system will work'. Asked whether it would be possible to deliver the necessary community services involved in the changes, Dr Honeyman said, 'no one knows, no one has ever been here before'.

These revelations show that we are being sold a pig in a poke and it is imperative that the proposals are subject to robust scrutiny at the appropriate committees at the  NW London NHS and local council level. They confirm the need for a broad-based campaign against the changes..

Poor turnout at NHS hospitals consultation

August is a curious month to have consultations, especially an exceptional August when the borough is hosting an Olympics. I was not expecting an enormous turnout at the 'Shaping a Healthier Future' road show on Tuesday but the 6-8 members of the public (some may have been from the PR company or local GPs) who had turned up by 2.45pm at the Patidar Centre was disappointing to say the least. Advertised variously as starting at 1pm or 2pm there were no NW London NHS people at the 2-4pm Q&A until one arrived at 2.45pm. Although a table had been set up for speakers at the back of the room the public chairs were arranged around the edge of the room like a school dance. There were half a dozen laptops on a table in the corner and some panel displays about the proposals. The room arrangement served to split people off from each other.

Because I had to catch a train from Wembley Central shortly after 3pm I button-holed the clinician with my questions. I first asked about the differencee between what the Urgent Care Centre offered and the service provided by A&E. I noted that the consultation document said that most UCCs were housed alongside A&E but that Central Middlesex would not have an A&E.

I was told that UCCs would deal with most cases - it could deal with broken arms but not broken legs! I was assured that cases that had gone to Central Middlesex UCC but could not be treated there would be transferred to Northwick Park by ambulance. Clearly this poses dangers for urgent cases.

I asked how school or work place first aiders would know whether cases should go to Central Middlesex UCC or Northwick Park A&E (would there be a 'menu'?) and was told that people would soon get used to the services offered by both as the changes would not be implemented for 3 or 4 years. Ambulance usage was only expected to rise by 5% (!) and NW London NHS supported the extension of the 18 bus route to Northwick Park to serve the people of Harlesden and Stonebridge.

When I reported the difficulties that a friend had with treatment at what appeared to be an overloaded A&E at Northwick Park I was told that £20m would be spent on expanding the ward, staff would be transferred from Central Middlesex A&E and additional doctors and nurses hired.

I would be interested to hear whether there was better attendance at the evening session and hear about any discussions that took place,

The roadshow is next in Brent on Saturday September 29th at Harlesden Methodist Church, 25 High Street, NW10 from 10am-4pm.

Plans to close Central Middlesex Accident and Emergency confirmed - now organise!

The Brent and Kilburn Times website reports today that Central Middlesex A&E is 'certain to close' as part of the 'Shaping a Healthier Future (sic)' proposals which were launched today LINK:

Speaking at the launch, Dr Mark Spencer, medical director for the programme, said:

We looked at all the options but it is not possible to keep the A&E department open and running as it is now.

Unfortunately when the hospital was built, it was far too big and with too many departments for the people it served so it is not viable to keep it open.

The hospital still has an Urgent Care Centre which is open 24 hours a day and can treat patients within 4 hours of arrival and that will remain open.

The certainty of closure will be challenged by local residents and campaigners who are meeting tomorrow evening at The Trades Hall/Apollo Club 375 High Road, NW10 2JR (close to Willesden Bus Garage) to mobilise opposition.. The meeting will begin at 7.30pm. All welcome.

June 13th: NHS under the knife

Enormous changes to our local health services are being proposed. They include the merger of Ealing Hospital with Central Middlesex and Northwick Park, permanent closure of A & E at Ealing or CMH, or both, and moving many services out of hospitals into the community.

Unless we campaign to oppose them, these changes will open up even more services to the private sector to be run for profit. The population is growing and health needs are increasing, while NHS budgets are being cut.

Community health services are already understaffed and overstretched. If new services are not put in place before hospital services are withdrawn, the most vulnerable patients will suffer