Tuesday, 16 September 2014

Serious concerns about Imperial hospitals reported to Chief Inspector

Serious concerns about financial management at Imperial College Healthcare NHS Trust, and consequential service cut-backs, have been raised with the Chief Inspector of Hospitals.
The Chief Inspector is currently reviewing Imperial’s performance ahead of a decision on its Foundation Trust application for new financial freedoms.
Hammersmith & Fulham Council has written to the Chief Inspector, after hearing from senior Imperial clinicians concerned about the impact of the trust’s current £2.5 million budget deficit. The Chief Inspector is being asked to investigate widespread reports that the trust’s financial position is leading not only to the rushed closure of Hammersmith’s A&E, but also to cuts to critical care services and bed closures.
The Evening Standard reported on Wednesday that a senior member of staff sent a memo about the deficit to section heads with the title: "Finances – urgh!"
The memo apparently reports that the surgery and cancer division ‘does not have adequate control of spending’ with a series of drastic measures being introduced to curb the overspend, including the ‘closure of unfunded intensive care beds’. The memo threatens the scrapping of the trust’s application for foundation status.
The council says the state of the Imperial budget shows it is not ready to take on foundation status, a critical step in NHS plans to reorganise health care in north west London, which include the closure of all four local A&E departments and the sale of the majority of the Charing Cross Hospital site.
Local campaigners and H&F council have been fighting these closure plans, saying they are being rushed through to balance the books, without adequate alternative arrangements being put in place.
St Mary’s hospital in Paddington is expected to take over most of the cases displaced by west London’s A&E closures, with Hammersmith Hospital A&E closing on Wednesday. The council argues St Mary’s is already overstretched and struggling to cope with its existing cases.
Stephen Cowan, leader of the council, says; "The management and the board of Imperial are simply not up to the job and that is putting lives at risk.
"I raised the board’s failure to question capacity at St Mary’s and the closure of Hammersmith Hospital’s A&E with Imperial’s CEO on 20 June 2014. At the time neither she nor her team had any answers on how they planned to deal with this or why their board hadn’t once queried it. At the second meeting on 14 July 2014 they informed me that they would be opening a new ward to increase capacity at St. Mary's.
"We do not believe that the opening of the previously decommissioned Lewis Lloyd ward at St Mary's Hospital is an adequate response to the closure of Hammersmith A&E. We have anecdotal evidence from patients that another previously decommissioned ward, Victoria and Albert ward, has only one lift which when broken can take several days to fix. In at least one instance this resulted in a patient being man-handled down the stairs by staff members.
"Now we hear that a £2.5 million overspend at Imperial’s hospitals means a cost-cutting frenzy is taking place. That raises huge concerns that need honest and open scrutiny. The public, who pay for and rely on, these services, have the right to know what is going on."
"This does not look to me like a well-managed organisation that is ready to take on the extra responsibilities of foundation trust status and I am urging the Chief Inspector of Hospitals to investigate this further as part of his current inspection of the trust’s competencies."
Health managers say their proposals to reorganise hospital services, set out in their Shaping a Healthier Future document, are designed to improve the quality of emergency care, by ensuring patients are taken to centralised, specialist services, with back-up from the full range of medical and surgical specialists. They say Charing Cross will retain its A&E, although they admit that they do not yet know how emergency services there will be changed.
The case against west London’s hospital closure plans
The closure of four A&E units across north west London would mean that there are 395,440 people per A&E, 52% more than the national average.
Population growth has been seriously underestimated. Our figures show that by 2039 there is a potential discrepancy of 72,659 given the amount of development that is planned.
Replacing A&E units with Urgent Care Centres is inadequate and made worse by the fact that Imperial intends to refer to them as A&Es. This will cause patient confusion and delay.
There will be an unsustainable pressure on the remaining acute beds across the area, leading to delays in treatment and a reduction in the quality of care.
There will be increased pressure on primary health care without the necessary plans and investment being in place to accommodate this demand.
So quick to scrutinise our hospitals but I would take a very close look at your housing situation.
From Sarah on 15/09/2014 at 13:40
From angela on 14/09/2014 at 00:50
It is outrageous to think that St. Mary''s will be able to cope. The A&E facility at St. Mary''s is smaller than Charing Cross, it is crowded and cramped. St. Mary''s is warren of Victorian corridors and does not resemble at modern hospital in 2014. Who on earth is doing the thinking? Surely not the people who will forced to use the facilities.
From Beatrix on 12/09/2014 at 13:08
It is outrageous to think that St. Mary''s will be able to cope. The A&E facility at St. Mary''s is smaller than Charing Cross, it is crowded and cramped. St. Mary''s is warren of Victorian corridors and does not resemble at modern hospital in 2014. Who on earth is doing the thinking? Surely not the people who will forced to use the facilities.
From Beatrix on 12/09/2014 at 13:06
It's very clear from the report that the A+Es are being closed because Imperial can't afford them. It's nothing to do with any clinical or patient analysis of needs. There should be all-party support to stop this happening. I wonder if there is? I hope the Council keeps up the pressure at local and parliamentary level to stop the closures.
From Fiona on 12/09/2014 at 11:27
This is a very worrying situation for the people in Hammersmith & Fulham - The Hammersmith & Charing Cross Hospitals are already overstretched - where will all these people be treated in the event of an emergency or non emergency come to that. I wonder what will replace Charing Cross - luxury flats no doubt.
From Joan on 11/09/2014 at 22:46
It is ludicrous to close Hammersmith and charing cross A&E departments given 13all the new residential and business that are currently being built and will be built on the coming years. We need substantial and effective health services. The current closures are criminal uncaring and short sighted, please think again and do what is right for our commitment.
From A Robertson on 11/09/2014 at 18:31
Share your anger at what''s happening by signing the petition put up by Save Our Hospitals: Hammersmith and Charing Cross via the 98 Degrees website: https://you.38degrees.org.uk/p/moratoriumonnhsclosures

or access the petition via the Save Our Hospitals website (just google it!) The petition is calling for a moratorium on A&E closures and hospital reorganisations.
From Merril from Save Our Hospitals on 11/09/2014 at 18:30
This situation continues to be fraught with huge problems and it is clear from the latest research that the Trust management have simply ignored the thousands of letters and emails pouring into them pleading with them to see sense and to stop this insane move which will leave West London residents with little or no health care. They are clearly far more interested in selling off the site for executive housing to be purchased as investment properties by foreign buyers who no doubt will not live in them, thus creating yet ghost town like so many now in London. This in a so-called developed country. Nye Bevan would be turning in his grave. The Trust is heading for a disaster scenario, only they are too blind and insensitive to see it.
From Gaunt on 11/09/2014 at 17:55
At last the truth comes out ! Imperial have been , and are incompetent. In a frantic effort to cover up its mis-management, it has decided to put thousands of lives at risk. If it is necessary, I think the police should be kept up to date, and get themslves involved,
From Jaymel on 11/09/2014 at 17:35
In seeking Trust Status in 2013/14 they took their eye off what was happening in all their hospitals. In the Supplement of the HSJ (Health Service Journal) 5th September they are not mentioned as one of the BEST PLACES TO WORK In the Acute Trusts but The Royal Marsden FT and Chelsea and Westminster FT are. It is a weekly Journal all should read interested in Health and Social Care that will soon have to be working closer together and Councils are going to have to be more involved.
From June Bennett on 11/09/2014 at 17:35
A �2.5million deficit in an organisation with an income of �980 million, ie a deficit of 0.25%? "Serious concerns"? Hardly! What's the council's budget deficit like in percentage terms?
From Alex on 11/09/2014 at 17:22
I hope this isn`t too late the has been no joined up thinking about these closures when you have University Collage one end of the Marylebone Road St Marys just over a mile away and then the vast expanse of West London with nothing seems crazy. On cost saving do the "trust" own their offices in the Marylebone Road? Even if they lease then surely they could move to one of the "underused" hospital sites and save money.
From Steve on 11/09/2014 at 16:29
This problem needs to b addressed ASAP as I overheard a conversation outside Chelsea and Westminster Hospital that it is already virtually impossible to attract new staff at Charing X because of the uncertainty of their futu
From Milky on 11/09/2014 at 15:53
What an excellent and sane piece of writing from our council. I was recently a patient in St Marys for a fortnight. The clinicians told me they were 30 beds short and had asked the Trust for them but were turned down. The AandE is already over run. The Carnival with 17 stabbings did not help! The Trust is obviously being poorly run. Keep up your pressure. Well done so far.
From Michael Wale on 11/09/2014 at 15:35

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