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

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 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.

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..

Stand up for Central Middlesex A&E tomorrow

As public concern and anger mounts about the closure of Central Middlesex Accident and Emergency, North West London NHS is holding an open day on its proposals called 'Shaping a Healthier Future', renamed by some as 'Dictating a Dangerous Future'  as it includes no option of keeping Central Middlesex A&E open. It is likely that the closure will lead to the eventual down-grading of the hospital.

This is their blurb:

On Tuesday 31 July, the ‘Shaping a healthier future’ team will be hosting a public event at Patidar House, 22 London Road, Wembley, Middlesex HA9 7EX from 2pm – 8pm

•              Local clinicians will host a dedicated question and answer session from 3pm - 4pm and 7pm - 8pm

The event is part of major public consultation programme taking place across North West London this summer Views are being sought on clinically-led proposals to improve healthcare for nearly 2m people in North West London in response to changing health needs, medical advances and rising standards.

Everyone will have the chance to learn more, put questions to the programme’s clinical leaders and fill in the consultation response form when the ‘Shaping a healthier future’ consultation roadshow comes to Brent.

It will be held at Patidar House, 22 London Road, Wembley, Middlesex HA9 7EX from 2pm to 8pm and will be attended by local clinicians and members of the programme team who will be on hand to talk local residents through the proposals. 

A further roadshow will be held in Brent on Saturday 29 September from 10am - 4pm at Harlesden Methodist Church.

Care UK or DON'T Care UK?

Guest blog by Sarah Cox:

If the Accident and Emergency Department at Central Middlesex Hospital closes, as proposed in every option in the NHS NW London consultation document Shaping a Healthier Future, residents in Brent’s poorest wards with the greatest health needs will be at the mercy of private health care provider Care UK which runs the Urgent Care Centre at Central Middlesex.

Urgent Care Centres are designed to take the pressure off A & E departments by dealing with minor injuries and less serious illnesses. Fine, but one of the reasons people go to their doctors or to A & E when the doctor isn’t available, is that they are not medically qualified so don’t necessarily know how serious (or not) their condition is. One of the NW London NHS documents gives the example of a mother who takes her baby to A & E with a high temperature. She is told that the baby is just teething. One of the functions of qualified medical staff should be to reassure patients. What about the case where the baby’s high temperature is not caused by teething but is a symptom of meningitis? Meningitis is hard to diagnose, but if not treated very quickly, can be fatal. There have been reports of Urgent Care Centres failing to spot meningitis and sending a stroke victim home http://www.telegraph.co.uk/health/healthnews/5185165/Urgent-care-centres-putting-patients-lives-at-risk-doctors-warn.html

 

As a patient, Care UK’s record doesn’t fill me with confidence: 

X-rays: At the CMH Urgent Care Centre, Care UK failed to carry out the required checks on 6,000 x-rays, missing such details as broken bones http://www.channel4.com/news/flaw-leads-to-review-of-patient-x-ray%20records. All x-rays should be reviewed by a specialist to make sure that nothing has been missed, they should also be checked against the child protection register and GPs should be informed when their patients have attended the UCC. Care UK neglected to do this and took more than a year to find the flaw in their system and start to review the x-rays. Channel 4 reports, ‘Asked how it had happened, Care UK blamed it on "a couple of changes in the management structure of the team that ran the centre". They also failed to report it to the Care Quality Commission. Care UK said that although it was not legally obliged to do this, it "probably should have told CQC, but nobody picked up the phone".’ What a caring attitude!

The contract to run the CMH Urgent Care Centre was given to Care UK by the former Brent Primary Care Trust. All eight Brent NHS clinical directors wrote urging them not to sign the contract, but were told they were too late. Former members of that PCT are now non-executive directors of Care UK and NHS Brent is tied into a contract with Care UK that they cannot get out of.

Friends in high places: The wife of Care UK’s then chairman gave £21,000 to Andrew Lansley when he was shadow Health minister to help run his constituency office in the run up to the general election, an investment that has certainly paid off when you see how many contracts the firm has been awarded in the NHS and social care sectors. 

Tax avoidance  Care UK, which operates NHS treatment centres, walk-in centres and mental health services, has a reduced tax bill by taking out loans through the Channel Islands stock exchange and coming to an agreement with HMRC Guardian 17.3.12 Care UK join the likes of Vodaphone and Jimmy Carr in claiming that they’ve done nothing wrong.

There’s more about Care UK, but I’ll leave that for the next instalment. What’s your experience of Care UK or specifically of the Urgent Care Centre at Central Middlesex?