Sunday, 16 November 2014

A&E closures - the meltdown

For two years, the Mail on Sunday has warned against Casualty closures... Now NHS figures show waiting times soaring at a key trust after shutdowns

  • Closure of two A&E units causes chaos at nearby hospitals in West London
  • A&E units at Central Middlesex and Hammersmith hospitals downgraded
  • Nearby Ealing and Northwick Park hospitals have since picked up the slack
  • Quarter of patients there have now been left waiting more than four hours for emergency treatment
  • Comes despite assurances shutting Casualty units in would not harm patient care

The closure of two A&E units has caused chaos at nearby hospitals, leaving them with the longest waiting times in the country, The Mail on Sunday can reveal.
Despite assurances that shutting the Casualty departments in West London in September would not harm patient care, the newspaper has found that 25 per cent of patients at neighbouring Ealing and Northwick Park hospitals have now been left waiting more than four hours for emergency treatment.
That is five times the maximum number who should have waited that long under Government targets. 

It is also more than twice the number of patients (11 per cent) who waited more than four hours a year ago – before the two other A&Es were shut.
Ealing and Northwick Park have had to pick up the slack due to the downgrading of A&E units at Central Middlesex and Hammersmith hospitals. 
The revelations are a damning indictment of moves to close A&Es. 
Since the General Election in May 2010, 14 Casualty departments across England have been shut or downgraded to Urgent Care Centres, which may only be staffed by nurses at night and are generally not equipped to deal with the most serious cases.

For more than two years, The Mail on Sunday has been campaigning against the closures, which can leave patients having to travel further or wait longer for life- saving treatment.
Around a dozen more fully-equipped A&Es – including departments in the West Midlands, Manchester and London – are currently under threat.
Last night, campaigners accused health bosses of going ahead with the moves despite warnings they could jeopardise patient care.

Two months ago, David McVittie, chief executive of London North West Healthcare NHS Trust – which covers Ealing and Northwick Park hospitals – confidently told The Mail on Sunday: ‘We do not expect a large impact on Northwick Park as a result of the closure of Central Middlesex and Hammersmith A&E units.’
But campaigner Colin Standfield said last night that Mr McVittie was ‘sticking his head in the sand’ and failing to look at the figures.
A&Es across England have struggled this year to meet the Government target of treating at least 95 per cent of patients within four hours. 
Since mid-September, an average of 8.8 per cent nationwide have had to wait more than four hours – up from 7.4 per cent last autumn. 
Other units are breaking under the strain now 
But at the London North West Trust, this figure was an astonishing 25.2 per cent.
Dr Onkar Sahota, a local GP and the Labour chairman of the London Assembly’s Health Committee, said: ‘The closure of two busy A&E units has left the remaining hospitals in West London breaking under the strain. It is now clear those closures have resulted in North-West London having one of the worst A&E waiting time records in the country.’
Northwick Park, earmarked to become one of area’s ‘super A&Es’, appears to have been worst affected by the closure of the units at both Hammersmith and Central Middlesex hospitals.
A brand new 40-bay, £21 million A&E was supposed to open at the site in Harrow shortly afterwards. 
However, that has now been delayed twice – and there are fears the unit will not start taking patients before Christmas.
Official predictions are that the department, recently lambasted in a Care Quality Commission report for having ‘inadequate staffing levels’, will have to cope with an extra 8,000 patients a year due to the closures. 

But the NHS quango set up to push through the closures, called Shaping A Healthier Future, says shutting the A&Es at Hammersmith and Central Middlesex and replacing them with Urgent Care Centres is only the first ‘phase’ of its programme.
It is widely expected that the A&Es at Ealing Hospital and Charing Cross Hospital in Fulham will lose facilities over the coming years.
In a joint statement, London North West Healthcare NHS Trust and Shaping A Healthier Future said: ‘A number of A&E departments across the country and across London are dealing with an increase in activity at the moment – this is certainly not a situation unique to Northwick Park. Of course, no one should have to wait more than four hours, and we are tackling that problem.
‘The programme of change across North-West London means we are recruiting more A&E consultants and more nurses, Northwick Park and Ealing hospitals are getting significantly more beds, and we are investing in other local health services. Our new £21 million A&E department will open in December.’

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