Published: 27 January 2015
The Royal College of Nursing in London is today responding to a major review led by Michael Mansfield QC into the Shaping a Healthier Future programme of hospital reorganisations in North West London.
You can read the full RCN London response to the review online here.
RCN London has backed calls for the suspension of further hospital closures in the area, until guarantees can be given about investment in out of hospital care.
The RCN says it has become increasingly clear that the promised investment in out of hospital care to make up for local A&E closures has not been delivered on the scale needed to keep patients safe.
This winter the remaining A&E units in the area have experienced some of the longest waiting times in the country.
The impact of the programme for patients is now being reviewed by Michael Mansfield on behalf of Brent, Ealing, Hammersmith & Fulham and Hounslow Councils under the name “The North West London Health Commission”. RCN London invited members working locally to contribute to our response to the review.
Among the problems raised by local nursing staff were:
- Increased waits for ambulances outside hospitals and dangerous diversions due to capacity problems
- A perceived lack of understanding by patients about the status of the new units. One member said “patients and particularly their carers are frightened and confused about the A&E service closures.”
- Pressure on GP services, damaging the ability of practice nurses to carry out preventative health interventions – a clear driver over time of the increase in sick people presenting to A&E who should have been kept well earlier in the system.
- An “unsafe and unmanageable” strain on district nursing staff.
- Difficulty in transferring patients between services which have been differently arranged, creating delays for living donors and mental health patients
- Registered nurses “burnt out, tired and frequently unable to get their time for the study days”, jeopardising continuing learning
RCN London Regional Director Bernell Bussue said: “The RCN will always support service reorganisation which delivers improvements in the quality of patient care. However it is just not clear that patients have seen any benefit from these changes so far.
“The positive case for the Shaping a Healthier Future programme was based on an increase in out of hospital care to enable more patients to be kept well or treated at home to reduce hospital admissions. In practice, little seems to have been done to boost capacity elsewhere in the system to make up for the closures. Proper replacement services, transition arrangements, funding and a workforce plan should have been in place before the existing units were cut.
“Nursing staff working in the area have told us the closures have damaged patient care. The remainder of the Shaping a Healthier Future closures should be suspended until out of hospital capacity is properly expanded.”
For further information about the work of RCN London please visit www.rcn.org.uk/london