Northwick Park A&E falls well below national targets

The North West London Hospital Trust is failing to meet targets for A&E according to figures submitted to the Brent Health Partnership Overview and Scrutiny Committee LINK.  The national target is that patients should spend no more that four hours in the department from entry to exit. The annual average for Northwick Park (Type one) is 90.55% and in the week leading up to the report was only 73.71%. One quarter of patients were there for more than four hours.

Central Middlesex A&E figures, on a much lower total of patients, were 97.05% and 95.45% respectively.

Commenting on Northwick Park, Tina Benson, Deputy Director of Operations at the Trust, states:

Navin Shah: Expecting Harlesden people to use Northwick Park A&E is 'absurd' '

Navin Shah, Londoin Assembly member for Brent and Harrow has published this statement on the closure of Central Middlesex Accident and Emerency unit.

I marched on Saturday (15th September) with local residents to keep Central Middlesex Hospital open.

The NHS plans to demote four hospitals in North West London. The proposals recommend the closure of Accident and Emergency departments at Ealing, Central Middlesex, Hammersmith and Charing Cross Hospitals.

This would mean Hammersmith and Fulham, Brent and Ealing will be without A&E departments, and will affect the provision of health care in North West London. Other departments at risk in the affected hospitals include intensive care, emergency surgery, paediatrics and maternity units.

Neither closing A&E at Central Middlesex Hospital, nor restricting its opening hours makes any sense. From personal experience I can vouch for how overwhelmed and over-stretched the A&E at Northwick Park Hospital is.

Since the very restricted opening of Alexandra Polytechnic the demand on A&E at Northwick Park Hospital has greatly increased. It is absurd to expect residents from the Southern parts of Brent like Harlesden to use Northwick Park Hospital given the, very poor public transport links. I would like this ill conceived closure proposal to be withdrawn, until this happens I am committed to fighting the closure plans to save local health services for the local community.

By Navin Shah AM

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..

Anger mounts in Harlesden over Central Middlesex A&E closure

 I was down in Harlesden this afternoon for our regular spot publicising the closure of Central Middlesex Hospital A&E and the planned protest march on September 15th. We often had queues waiting to sign the petition to local MPs asking them to take a stand against the closure and opposing the privatisation of the NHS.

Local people, many wearing  special T-shirts and Jamaican colours ahead of the 50th anniversary of Jamaica independence, expressed anger at the closure, blamed the Coalition and its attitude to the poor and several took away petition forms to collect additional signatures in the community.

Many expressed support for the hospital where they had been treated and where their children had been born and stressed that the needy local community, particularly the young and the elderly, needed a readily accessible local A&E. They were scathing about the proposal that they should go to Northwick Park in future.There was fury at the likely downgrading of the hospital after millions of 'our money' had been spent up grading in the recent past.

There were frequent comments about privatisation and comments such as 'this government wants to make this country like America where you don't get treated unless you have the money'.

One local shopkeeper who has signed the petition last week came over and told me that he had been down to Central Middlesex to try and find out what was happening. He said that he had been told it was a 'done deal' and that the Trust intended to sell off surplus land created by the closure to build  housing or a hotel. I was rather doubtful about the latter but the sell of makes sense in terms of the Trust's debts. Once again it seems that it will be the poor who pay, this time with their health or in the worst scenario, their lives.

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.

Persuade Brent Council to campaign on Central Middlesex A&E Closure

Could local hospitals cope with something similar after closures?

 Local resident Carol Foster has launched the e-petition below: Anyone of any age who lives or works in Brent can sign the petition. Follow this LINK

We, the undersigned, petition Brent Council to do all in its power to prevent the closure of the Accident and Emergency Department at Central Middlesex Hospital. This will include making the case against the closure and seeking support for this position on all appropriate bodies on which the council is represented.

SUPPORTING INFORMATION

•  North West London NHS is consulting on proposals in 'Shaping A Healthier Future' which would mean that Central Middlesex Hospital's Accident and Emergency Department, already closed overnight, will close for good. This is likely to be the first step in the complete down-grading of the hospital and its potential closure in the long term.
• The hospital serves some of the most deprived wards of South Brent which have poor transport links with Northwick Park Hospital, the likely alternative A & E.
•  The area is the location of major roads including the North Circular and the Harrow Road; railway lines including the Euston-Birmingham main line, Overground, Bakerloo, Chiltern, Metropolitan and Jubilee lines, a major industrial area in Park Royal; as well as waste management and other potentially pollution causing processing plants in the Neasden area. The area also includes the major venues at Wembley Stadium and Wembley Arena.
•  All of the above are potential locations for major incidents necessitating ready access to an Accident and Emergency facility.
•  Ealing Council has already committed itself to actively fighting the proposals and Brent Council should do the same.

Damning report on hospital closure plans

Plans to drastically cut health services are exposed in a hard hitting Report “North West London’s NHS - Under the Knife”, written by John Lister, Director of London Health Emergency.

 

The Report, commissioned by Ealing, Brent and Harrow Trades Union Councils, shows that far from improving or modernising services, the outcome of the NWL NHS plans, “Shaping a Healthier Future” , would inevitably be a massive reduction in both hospital beds and services, without any corresponding increase in alternative provision.

  

Dr Lister states that the proposals “could result in the loss of 1750 NHS jobs in 12 months, and 5,600 jobs by 2015, along with the downgrading and downsizing of many local hospitals and services, and the closure of up to 4 of its 8 A&E units.”

 

Although NWL NHS try to avoid stating which hospitals and A&E Departments are under threat; Dr Lister’s analysis shows that the targets of the cuts are likely to be Ealing, Central Middlesex, Charing Cross and Hammersmith, leaving a massive area of London without A&E provision.

 

He goes on to say that “trendy arguments ... suggesting that new “settings” can deliver services more efficiently and effectively than hospitals: the only snag is that these “settings” and services exist only on paper, lacking the funds, facilities, staff and any political commitment to make them a reality.”

 

Dr Lister will be the headline speaker at the Ealing TUC public meeting on Tuesday 26th June at 7.30pm in Ealing Town Hall.  

The report is posted below:

Campaign launched to save Central Middlesex Hospital

The overnight closure of the Accident and Emergency service at Park Royal's Central Middlesex Hospital is likely to be the first step in running down the hospital and its eventual closure a Harlesden meeting was told last week.

North West London NHS is currently consulting on an amalgamation of Ealing, Central Middlesex and Northwick Park hospitals and it looks as if Harlesden and Stonebridge, the poorest areas in Brent may lose their local hospital and have to travel to A and E at Northwick Park, despite very poor public transport links. It is likely that A and E at Ealing, Charing Cross and Hammersmith may also close.

John Lister addresses the meeting

 John Lister, from the London Health Emergency has been commissioned by Ealing, Brent and Harrow Trade Union Councils, to write a report on the likely impact of the cost-cutting changes. The report will be available soon and a condensed version will be distributed as a tabloid newspaper.

Lister said that the pattern was one of a gradual reduction of different services, starting with A and E, eventually leaving the hospital as an nearly empty shell, which is then closed because people are not using it and nurses and doctors are reluctant to apply for jobs there,

With £314m cuts to be made by NW London NHS by 2015 the hospital closures are just the beginning. Stressing that decisions are being made in order to balance the books, and not on clinical grounds, Lister said that 1,750 jobs will go in the near future, of which 1,000 are clinical.

The aim is to direct patients to 'lower cost' settings, including the setting in which you die. That setting may be your front room and the carer yourself. Jargon such as 'pathway redesign' and 'corporate efficiency' conceal an overall strategy to reduce the number of patients seeking treatment and to restrict access to expensive treatments. The target is to reduce emergency cases annually to a level equivalent to 391 hospital beds and a 22% cut in out-patient appointments.

A further aim is to introduce private providers into the service so that the NHS, the largest public sector organisation, is open to exploitation for profit. The NHS will be left with A & E and maternity services, which are 'too dangerous' for private companies but 'any qualified provider' will offer other services (Virgin, Sainsbury's) undermining pay structures and qualification systems. Lister stressed that with PCTs due to go,GP commissioners will be left holding the baby, but wouldn't have been responsible for the changes that have been made.

John Lister urged local people to use the consultation period to build a movement against the local changes AND against the privatisation of the NHS, lobbying GPs, MPs and local councillors.

Candy Unwin urges broad-based campaigning

 Candy Unwin from Camden Keep Our NHS Public recounted campaign success in saving Whittington Hospital . Different hospitals, cross party and non-party political groups, trades unions, tenants and unions had come together in a united campaign. She said that 1 in 6 Labour members of the house of Lords and 1 in 4 Tories get money from private companies and that 30 MPs get funding from Virgin, one of the main bidders.

Phil Rose, a regional official from UNITE, said that the changes would result in high quality provision for private patients and low quality for the rest of us. He said that one thing standing in the way of privatisation was NHS workers' terms and conditions which the private sector cannot match. The pensions changes was an attempt to reduce these conditions to make the sector attractive to the private sector. He urged support for the '68 is too late' campaign on retirement age and drew parallels with the creeping  privatisation of schools. Job cuts, down-grading of jobs and pay cuts were all in the offing.

In a powerful speech a member of the Methodist Church spoke about Harlesden being a poor area and needing and valuing its local hospital and pledged herself to make people aware of the situation. She said 'Some people are going to die because of these changes'.

 I spoke about the link between health and schools as not being just in terms of the privatisation issue, but also that schools were frequent users of A and E when children have accidents and reliant on accessible emergency treatment in incidents such as that at Chalkhill Primary (see below). With its many railway lines, the North Circular Road, Wembley Stadium, industry at Park Royal and Neasden, there was a risk of a major incident and we needed accessible emergency services to cope. Added to that, although things were quieter at present, there was the possibility of violence and the need for a hospital experiences, as Central Middlesex is, in the treatment of gun shot and knife injuries.

Graham Durham's suggestion of a march in September from Harlesden to Central Middlesex Hospital under the banner of Save Central Middlesex Hospital, Save North West London Health Services, was enthusiastically endorsed by the meeting as was a message of solidarity to doctors taking action on Thursday.

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

Hospital Merger Plans Challenged

36 people turned up at the Sattavis Patidar Centre, Forty Avenue last night to discuss the proposed merger of Ealing and North West London Hospitals Trust (covering Central Middlesex, Northwick Park and St Mark's hospitals). This compared with 100 at the recent Ealing meeting and a 'client' base of 800,000 people.


Professor Rory Shaw, Medical Director, made the case for the merger. The organisational merger would enable the joint Trust to have larger specialist teams which would be more viable than the present small teams, enable shift-work to take place and would attract high calibre staff Economies of scale would mean the Trust could keep pace with developments by buying up to date equipment and make resources, including scanners and operating theatres 'work harder' and the buildings 'earn their keep'. 

He said that Northwick Park's  stroke care unit was a good example of the merits of large, centralised teams and had led to better survival rates and fewer cases of paralysis.


Although the Chair of Brent LINk (Local Involvement Network) had stipulated that the meeting was not to discuss services, Shaw said that the merger was being proposed against the consultation on the commissioning of services that would take place in Summer 2012.  The focus would be on prevention and long-term conditions and more care and treatment in the community. He claimed that the latter was bothe cheaper and more effective.


He said that the move was taking place as a time when there was a general recognition that bigger was better. Other speeches from the six suited males on the platform extolled the merits of 'an army of generic workers', with an implication that these might be volunteers, who could help patients at home with hospital-home transition. We were treated to the management  mantra 'Localise where possible, centralise where necessary'.


Challenged that the presentation had not mentioned the financial plight of the NWLH Trust and that the merger proposal was a cover for cuts, the platform said that there was a financial saving involved of £7m and that this was specified in the Business Plan. Savings would be made in management and through reduction in 'back office' costs. Asked if  'developing the estate' meant selling off prime sites, especially in the light of the apparent running down of the Ealing and Central Middlesex hospitals, they said that sell-offs were not in the Business Plan but 'there may be scope for that in the future'.

Carers criticised the emphasis on volunteers and a speaker from the Sickle Society was concerned about the speed of the changes and poor consultation with users. He said that there had not been sufficient consideration of the needs of people with Sickle Cell and Central Middlesex Hospital's historic role in providing specialist care.

The platform was challenged on the implications of patients having to travel further for treatment and concern that the disadvantaged population of South Brent would be further disadvantaged if Central Middlesex was run down. Health inequalities would increase. A speaker from the floor made a strong demand for a Equality Impact Assessment. Despite repeated requests the platform were un able to advise which bus patients should get from Harlesden to Northwick Park Hospital.

Behind it all was the implication that larger teams would mean each site would have different specialisms which would not be offered at other hospitals in the Trust. The platform argued that routine care would still be provided at each hospital. A question asking if the new arrangements would be able to cope with a 'major incident' in South Brent with its many railways, the North Circular, waste sites and commercial premises; was not answered.


Brent LINk will be putting together its response and you can contribute: brentlink@hestia.org Tel: 020 8965 0309. Brent LINk Unit 56, The Designworks, Park Parade, Harlesden, London, NW10 4HT

Harrow LINk will hold its own consultation:
HARROW LINk: Thursday 12 January 2012. Registration and refreshments from 5.30pm. Event starts at 5.50pm and will close at 8pm. Premier House Banqueting, Canning Road, Harrow, HA3 7TS. Places are limited. If you like to attend please contact Harrow LINk at info@harrowlink.org.uk
or call 020 8863 3355.


TIMETABLE
November 2011 Outline Business Case for merger signed off by NHS London
March/April 2012 Full Business Case approved by the Trust Boards and NHS London
May 2012 Submission for approval by Department of Health Transaction Board
July 2012 Merger takes places
Autumn 2012 Commissioning of Services

Shahrar Ali's report on the meeting is HERE

Brent Battles to Save the NHS

We had a very positive reception from the public at Northwick Park Hospital when leafleting about the public meetings and demonstration in  support of the NHS  (see below). Those most concerned were the elderly, who stopped to talk to us about their concerns that some services would be cut and waiting times  increased, and parents of whose young children needed high quality treatment and continuity of care. The role of private companies, 'they are only in it for the money and not for us' was one comment, was a major focus.

It was significant that the elderly had been around before the birth of the NHS and recognised its achievements. They also acknowledged the gains that had been made in terms of waiting lists and quality of care over the last decade or so and knew what they might lose. When they saw 20-30 year olds refusing the leaflets they remarked that they were a generation that took the NHS for granted and didn't realise what things used to be like and what they stood to lose.

 Click on image to enlarge

Brent Fightback will be leafleting in Central Square, Wembley (next to Wembley Central Station)  this afternoon between 1pm-3pm and will organise further leafleting for the demonstration at the public meeting on May 12th.  Further information from: brentunited@gmail.com or check out Brent Fightback on Facebook.