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)

North West London Healthcare Commission – Call for Evidence

From Michael Mansfield QC 

In 2012 the government consulted on proposals to make significant changes to the healthcare economy of North-West London, set out under the heading “Shaping a Healthier Future”. This involved the downgrading of several hospitals across North- West London to “local” hospitals without A&E provision, closure of acute provision and reduction or downgrading of specific services. It also promised commitments to investment in capacity of out-of-hospital and community services in order to offset reductions in acute provision.

Two years into implementation of “Shaping a Healthier Future”, Brent, Ealing, Hammersmith & Fulham and Hounslow Councils are keen to review its implementation; in particular, the impact of reductions to acute provision on the North West London population, the extent of progress with investment in capacity and capability of community and out-of-hospital services to meet local needs, and the extent to which demand for acute services has changed as a result of those investments.

The North West London Healthcare Commission was launched on 1 December 2014 by the four councils to review the impact of the changes to the North West London health economy, arising from the implementation of “Shaping a Healthier Future”, and to assess the likely impact of planned future changes. I have been appointed to chair the Commission and my fellow Commissioners are Dr John Lister and Dr Stephen Hirst.

In order to assist us in the task of reviewing the implemented and planned changes, I invite you to submit written evidence that may assist the Commission in its consideration of the impact of these changes on patient care in the area. Any such written evidence should be submitted by Monday 2 February 2015 to Peter Smith, Clerk to the Commission, at Hammersmith & Fulham Council. Submissions should be addressed to him at Room 39, Hammersmith Town Hall, London W6 9JU or sent by email to peter.smith@lbhf.gov.uk. Later submissions will be forwarded to the Commission but may not be given the same attention as those received by the deadline.

I look forward to reading any submission you may wish to make. Yours faithfully

Michael Mansfield QC
, Chair, North West London Healthcare Commission