Winter NHS figures show A&E Charing Cross patients faced with more than four hour wait

During one week in January almost 40% of people using the emergency department missed the four hour target set by the government

​Charing Cross Hospital in Fulham Palace Road

New NHS data reveals more than 350 patients had to wait more than four hours to be seen at Charing Cross Hospital’s A&E in a one week period earlier this year.

Figures from Imperial College Healthcare NHS Trust, which runs a number of hospitals including Charing Cross, showed almost 40% of people using the emergency department in the second week of January missed the set government target.

Hospitals aim to see 95% of patients in the A&E department in four hours.

Other findings showed a big increase in patients being treated at the blue-light unit following the loss of A&E departments at Hammersmith and Central Middlesex Hospitals in 2014 as part of the Shaping a Healthier Future (SaHF) programme .

The findings come amid a backdrop of uncertainty surrounding the future of emergency department at Charing Cross Hosital, in Fulham Palace Road, Hammersmith, with Hammersmith and Fulham Council and campaigners fearing plans are under way for it to be downgraded.

​I​

mperial gave assurances over the A&E and said the similar pressures were being encountered in A&Es around England.

                               Ambulances outside Charing Cross Hospital

The figures revealed 889 people attended A&E at Charing Cross during the second week of the year, with 60% seen within the four-hour target set by the government.

Hammersmith and Fulham Council leader, Stephen Cowan , said: “With A&E under greater demand and hard-pressed staff struggling to keep waiting times down, the plan to effectively close A&E at Charing Cross Hospital is both cavalier and dangerous.”

According to the NHS figures, in November, the last full month for which statsitics are currently available, the number of patients treated by A&E at Charing Cross Hospital was 3,712 – an increase of almost a third on the figure from the same month two years previously, which Cllr Cowan blames on the closure of neighbouring A&Es.

At the same time, the A&E department at St Mary’s Hospital , also run by Imperial, saw almost half of adult patients wait more than four hours to be seen.

Vanessa Redgrave fights for Charing Cross A&E

​Check the video clip here:

​http://www.getwestlondon.co.uk/news/west-london-news/winter-nhs-figures-show-ae-12518383

Cllr Cowan said: “Local people are suffering, and being forced to wait unacceptable amounts to time, as dedicated hospital staff do their best in the face of these cuts.”

The pressures put on staff in the trust has been highlighted in the BBC documentary "Hospital", set at St Mary’s in Paddington.

Demand at Charing Cross A&E increased during the summer months , which came ahead of the expected annual winter spike and flu season, and as the A&E department was extended with a new 13-space acute assessment, as well as a new 35-bed acute admissions ward.

Imperial said there were complex causes for the increase.

The trust said: “With the support of Imperial College Healthcare Charity, we are currently making significant improvements to a range of facilities at Charing Cross, including A&E, acute medicine, outpatients and theatres.”

Hammersmith and Fulham Council is one of several Labour-run local authorities in west London fighting the SaHF plans.

It commissioned an Independent Healthcare Report put together by Michael Mansfield QC which labelled SaHF “flawed” and called for its immediate halting.

​Get West London​

BYGOOLISTAN COOPER

• 09:19, 30 JAN 2017
  ​  HTTP://WWW.GETWESTLONDON.CO.UK/NEWS/WEST-LONDON-NEWS/WINTER-NHS-FIGURES-SHOW-AE-12518383​
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SECRET CUTS TO OUR NHS

Dear Supporter,

First, Happy New Year to our supporters. It's been a very busy start to what is going to be a very active year in support of our NHS. Following the very successful meeting organised by H&F in December - thanks to all who came! - campaigners from Brent have extracted secret information from local NHS bosses using a Freedom of Information request. What we have learned is not reassuring about plans for OUR NHS. As we said in our press release:

Secret Plan to cut almost 8,000 NHS jobs and slash services in NW London.

Plans to slash NHS jobs and services have been developed in secret by NHS bureaucrats and only been uncovered thanks to a Freedom of Information request by a Brent health campaigner.

This revealed the NW London Delivery Plan for the STP Oct 16 labelled "strictly confidential not for wider circulation" and unseen even by some of the councils involved.

The plans include

The loss of 3,658 NHS jobs in NW London next year 17/18 - rising to 7753 job losses by 20/21
Almost 50,000 planned admissions and 222,370 outpatient appointments cut by 20/21. Already patient waiting times for planned operations are at record levels - these plans will only make things much, much worse.
The loss of 500 - 600 hospital beds with the closure of Charing Cross and Ealing as major acute hospitals
A reduction in A&E attendances by 64175 in the next 5 years.

More very ill patients have arrived at the remaining A&Es in NW London this year than ever before - there is NO evidence that there will not be a need for these departments and acute beds in the future. Merril Hammer, Chair of Save Our Hospitals, said ‘These plans threaten patients' lives. We need more beds and more staff, not ongoing cuts.’

The cost of planning this massive cuts and closure programme is spiralling out of control with many millions pocketed by private management consultants.

Faced with this crazy set of damaging proposals for NW London's health services it's no wonder Tracey Batten Chief Executive of Imperial NHS Trust (and the highest paid NHS CEO in London) resigned yesterday. Dr Batten is leaving her £340k job at Imperial to return to Australia. Imperial controls 5 hospitals across NW London. As Merril Hammer also said ‘Our campaign fears that Imperial management will spend months looking for a new CEO when they should be tackling the unprecedented A&E, bed capacity and treatment crises.’

Already, this has been picked up by Ross Lydall and used in the Evening Standard:
http://www.standard.co.uk/news/health/boss-of-london-hospital-trust-featured-in-cancelled-operations-documentary-to-quit-a3451621.html

HOSPITAL STAFF WORKING FLAT-OUT

Supporters watching the BBC's documentary, HOSPITAL, will have seen Imperial Trust's staff working under almost unbearable pressure. At the Imperial Board meeting last week some of the key facts behind this pressure were revealed by clinical managers. Patients coming to A&E were waiting for hours to see doctors yet, as Prof. Tim Orchard, Director for Medicine and Integrated Care at Imperial, eloquently pointed out 'Patients who are coming in the the A&E need to be there. They have real conditions. They're often elderly. They need beds for several days. The trouble is, there are not sufficient beds.'

And another medical director pointed out that Imperial is falling way behind treatment targets in orthopaedics. The difficulty, he explained, is that need is rising but facilities are not expanding to meet genuine patient need. He also reported that many patients, offered private treatment, refuse because the private companies only treat simple conditions. This private treatment is paid for by the NHS and is therefore a loss of revenue to the NHS.

It is clear that inadequate funding and understaffing are putting patient health at risk.

WE ALSO NEED MORE NHS AMBULANCES

Tom, pictured above, gave a dismaying account of how he had suffered from lack of adequate ambulance provision following an accident recently. (He has provided SOH with photo and details.)

He fell off his bike, on black ice, rang emergency services but was left waiting on the side of the road before an NHS ambulance arrived. He was given some help by the crew of a passing private ambulance, but they did not have the appropriate training to treat him fully. When, eventually, the NHS ambulance arrived, Tom had a long trip to an Urgent Care Centre and then another long wait before being transferred to an appropriate acute A&E where his wounds were dressed publicly in a overcrowded waiting room.

PATIENTS SHOULD NOT HAVE TO SUFFER LIKE THIS! It is undercapacity in both hospitals and the ambulance service that leads to this poor treatment.

MARCH FOR THE NHS ON 4TH MARCH

JOIN SAVE OUR HOSPITALS

11.00am  at Lyric Square - or from 12pm Tavistock Square, WC1

This is promising to be a massive demonstration in defence of our NHS. We urge all our supporters to attend if at all possible.

Can you help publicise the demo? We need your support to distribute leaflets as widely as possible. If you can help in your area, please contact us on SCH&X@gmail.com

DATES FOR YOUR DIARY

Monday 30th January     5-7pm Healthwatch St Pauls Hammersmith. We will be leafleting from 4.45 with details of the demo.

SATURDAY 4TH FEBRUARY   2-4pm SPECIAL STALL LYRIC SQ.  Valentine's Day special - come and sign our We Love the NHS Valentine's card and publicise the demo.

Wednesday 8th February  7.30pm Hammersmith Town Hall. SOH organising meeting. All welcome.

Saturday 11th February 2-4pm Stall at Charing Cross Hospital and Welcome to Unite the Community NHS bus. A good crowd would be good fun!

Tuesday 14th February   12-2pm Charing Cross Hospital - stall and presentation of Valentine's Card to Charing Cross hospital

Wednesday 15th February  EALING PUBLIC MEETING - 7 - 9 pm Ealing Town Hall - Debate on Health Provision. Come and Support Ealing and H&F Councils in not signing up to closures of hospitals. (see www.ealingsaveournhs.org.uk )




Best wishes,

Merril
Chair SOH

London health chiefs facing A&E crisis spend £2.3m on management consultants

Health chiefs in a part of London where hospitals have run out of beds this winter have spent £2.3 million on management consultants, it can be revealed.

The 19 contracts include six-figure payments to firms including McKinsey and Deloitte at a time when an estimated £876 million needs to be cut from the NHS in five north London boroughs.

Two of the area’s hospitals, the Whittington in Archway and North Middlesex in Edmonton, have not had a single spare bed on numerous occasions since the start of the year due to unprecedented winter pressures, NHS England figures show.

The consultants were hired to draw up the sustainability and transformation plan [STP] for North Central London, which covers Islington, Camden, Barnet, Enfield and Haringey. This blueprint outlines how services should be pared back to cope with dwindling resources for the health service.

A freedom of information response to the British Medical Association revealed that one firm, Methods Advisory, was paid £617,850 in the year to last November for “programme management and strategy support”.

McKinsey was paid £360,000 for proposals to change mental health services. Deloitte received £267,336 for finance modelling and “development of governance models”. Carnall Farrar, a management consultancy run by former NHS London chief executive Dame Ruth Carnall, was paid £115,882 for a review of “commissioning arrangements”.

Dr Farah Jameel, a Camden GP and chair of the borough’s local medical committee, described the expenditure on consultants as “shocking, disgusting, appalling and ultimately not surprising”. She said: “We are in the midst of a winter crisis. These monies would be much better spent on frontline services like A&Es and general practice.”

BMA council chair Dr Mark Porter said “every penny” of NHS cash was vital at a time when hospitals were in “crisis” due to the collapse of social care. He questioned how many proposals within the “vast, bewildering” STP plans would come to fruition.

He added: “Doctors will find it galling to see that so much vital resource has been handed to consultancy firms for their part in plans which, ultimately, may never come to fruition.”

The Standard revealed last year that the five STPs in London aim to axe £4.5 billion from the capital’s health services by 2020.

The North Central London STP warns of a shortage of GPs and A&E consultants and missed opportunities to detect cancer early due to the “huge shortfall” in diagnostic equipment. It said that action was needed to address the increased demands from an ageing and growing population. 

David Stout, programme director for North Central London STP, said: “The use of management consultants to support strategy development is usual across the NHS. Unlike some other STPs across the country, there has been no recent history of strategy development for health and care services across North Central London. 

“The level of spending on consultancy and project management reflects the need to develop the plans at speed. We expect the level of consultancy spend on the STP to reduce in future years.”

ROSS LYDALL

Evening Standard

http://www.standard.co.uk/news/health/london-health-chiefs-facing-ae-crisis-spend-23m-on-management-consultants-a3450476.html

Boss of London hospital trust featured in BBC2 ‘cancelled operations’ documentary to quit

Surprise departure: Dr Tracey Batten Crispin Hughes

The boss of the London hospital trust seen in a groundbreaking TV documentary battling against crisis levels of patient demand and cash shortages is to quit, the Standard can reveal. 

The revelation that highly respected Dr Tracey Batten is to leave Imperial College Healthcare, which runs five west London hospitals including St Mary’s and Charing Cross, will send shockwaves across the NHS. 

Many will see her departure as evidence of the impossible task that hospitals face contending with rising demands and diminishing resources. 

The trust has been openly criticised by its own consultants in the BBC2 documentary Hospital, which has given the public unprecedented insight into the scale of the NHS crisis.

Patients have been seen having critical operations cancelled on numerous occasions — as entire surgical teams sit waiting in their scrubs and operating theatres go unused — because of a shortage of intensive care beds. 

The latest episode saw Imperial’s chief neurosurgeon, Kevin O’Neill, question if Imperial was right to send patients stuck on waiting lists to private hospitals for operations rather than keep the money within the NHS. 

Ms Batten, who was the highest-earning London chief executive in the NHS, earning £340,000, was recruited to Imperial in 2014. A trust spokeswoman confirmed she would return home to Australia later this year. 

Her decision comes after campaigners revealed that health chiefs in north- west London are secretly planning to axe 8,000 healthcare jobs in a bid to save cash as part of the sustainability and transformation plan (STP) that plans to downgrade Charing Cross and Ealing hospitals. 

Campaigners confronted Ms Batten with the figures this week, only for her to indicate she welcomed their success in making them public. The figures were obtained after a long freedom of information battle. The job cuts were unseen even by some of the councils involved. The plans include:

The loss of 3,658 NHS jobs in north-west London next year (2017/18) —  rising to 7,753 job losses by 2020/21. Almost 50,000 planned admissions and 222,370 outpatient appointments cut by 2020/21. 

The loss of 500 to 600 hospital beds with the closure of Charing Cross and Ealing as major acute hospitals A reduction in A&E attendances by 64,175 in the next five years.

ROSS LYDALL

Evening Standard

http://www.standard.co.uk/news/health/boss-of-london-hospital-trust-featured-in-cancelled-operations-documentary-to-quit-a3451621.html

Press Realease - Secret Plan to cut almost 8,000 NHS jobs

Secret Plans

Secret plans to cut almost 8,000 NHS jobs in NW London in the next 5 years are exposed in Save Our Hospitals' latest press release. The papers are marked "NW London Delivery Plan for the Sustainability & Transformation Plan Oct 16 Strictly confidential not for Wider Circulation". They were obtained after a Freedom of information request by Gaynor of Brent Patients' Voice. (We've attached copies below). The STP paper includes

* The loss of 3,658 NHS jobs in NW London next year - rising to 7753 by 20/21

* Cutting the number of outpatient appointments by 222,370 by 20/21

* Reducing planned hospital admissions (for operations, investigations, treatment etc) by almost 50,000 by 20/21 

* A reduction in A&E attendances by 64,175 in the next 5 years.

There's NO evidence that there won't be a need for these staff, hospitals and acute beds in the future. A&E attendances & operation waiting times are at record levels.

The Royal College of Emergency Medicine attacked bed losses triggered by STPs in the British Medical Journal today. Vice President Chris Moulton said:-

“Despite the obvious problems we’ve got, the STPs are often about cutting beds. It seems like lunacy in the current situation.”

Imperial Boss Resigns

Coincidentally (or not) we heard today that Tracey Batten, Chief Executive of Imperial NHS Trust resigned yesterday to spend more time with her family - her husband is on the board of private health company BUPA. She was the NHS chief executive with the highest overall pay package in London - £290,000 plus a £50,000 relocation payment to move from Australia in April 2014. She is in charge of planning the closure of 300 plus hospital beds at Charing Cross.

If this information makes you angry or sad do something about it. We need people writing to the papers highlighting these cuts and their consequences. You could also join

HealthWatch

Healthwatch have a remit to be champions for users of the NHS. They're holding an Info & Engagement event on Monday - be good if people could go, meet them, raise issues they are concerned about and try to identify areas of common interest. https://www.eventbrite.co.uk/e/info-and-engagement-event-hammersmith-and-fulham-tickets-31028540199

HealthWatch Info & Engagement Event Mon 30th Jan 5 - 7pm St Paul's Centre St Paul's Church Queen Caroline St W69PJ

K & C STP Public Consultation

This will hopefully be a chance to raise the issue of job losses and bed closures as NHS bosses present the STP and follow it up with a panel discussion. SOH will have a stall at the event and if you'd like to help with this do get in touch.

K & C STP Public Consultation Tues 31st Jan 6 - 8.30 Small Hall Kensington Town Hall Hornton St W8 7NX (5.30 if you're helping on the stall).

Catch the Bus

West London Unite have booked a bus to travel round all the threatened hospitals in NW London. It's sounds an amazing tour starting at Southall and ending at West Middlesex Hospital. Itinerary 11.00 Depart Singh Saaba Gurdwara, 2-8 Park Avenue, Southall, UB1 3AG, 11:20 Arrive at Ealing Hospital11:50 Depart, 12:25 Arrive at Northwick Park Hospital 12:55 Depart 13:30 Arrive at Central Middlesex Hospital 14:00 Depart 14:30 Arrive at Hammersmith Hospital 15:00 Depart 15:40 Arrive at CX Hospital 16:10 Depart 16:40 Arrive at West Middlesex Hospital 17:10 Depart 17:40 Arrive back at Singh Saaba Gurdwara

West London Unite Community NHS Bus Sat 11th Feb SOH will have a stall outside CX Hospital to greet the bus from 2 - 4pm.

If you'd like to join in for all or part of the journey giving out leaflets and raising awareness get in touch with Rajrgill38326@aol.com  07983 977775

Also

* Eleanor spoke about the STPs at Brent Trades Council this week, they donated £50 to SOH.

* H&F Commissioners are decommissioning the anticoagulation service, a vital way of managing housebound people on warfarin - so much for care closer to home. 

* The conservative majority on Westminster Council whilst failing to condemn the STP did agree that the council should ''take steps to lobby government to provide extra funding in the upcoming budget, in order to tackle the immense shortfall in social care.'' 

Regards AD

Private firms receive £2.3m to draw up STP plans

Private firms have been paid a ‘shocking’ £2.3m to draw up controversial plans which will cut health and social care spending by more than £1bn in a part of London.

According to health leaders drawing up the North Central London STP (sustainability and transformation plan), six-figure sums were paid to eight different companies – including accountants Deloitte and management consultants McKinsey – for services stretching from ‘administrative support’ and ‘financial modelling’ to ‘communications support’.

A firm called Consultants Methods Advisory Ltd, which describes itself as ‘shaping public services for the digital age’, racked up the biggest costs, invoicing £617,850 for ‘programme management office and strategy support’.

Doctors leaders described the figures as ‘appalling’.

BMA council chair Mark Porter said: ‘While hospitals fall into crisis, social care hits rock bottom and the Government blames hard-working GPs for its political choice to underfund the NHS, every penny of health service money becomes more desperately valuable and doctors will find it galling to see that so much vital resource has been handed to consultancy firms for their part in failing plans which, ultimately, may never come to fruition, while frontline staff struggle to provide safe patient care in a service increasingly becoming unfit for purpose.’

Pick and choose

BMA News analysis last year revealed that the STP process – which has seen England divided into 44 ‘footprint’ areas, with each asked to produce a plan to integrate and transform local services – will need to cut some £26bn from their budgets by 2021.

And in December an NHS Improvement board paper revealed that only projects which were ‘shovel ready’ would be likely to be funded – with capital resource too tight to pay for all the projects.

Dr Porter added: ‘NHS Improvement has admitted that it will pick and choose the parts of these vast, bewildering plans it can actually put into action and, as such, it leads me to question whether all of this money handed out to private companies will be completely wasted – yet another example of vital resource being frittered away in a health service devoid of direction and leadership and lurching from one unnecessary crisis to another.’

The North Central London STP – and its final iteration: a 68-page word document in PDF format – aims to combine ‘radical service transformation and incremental improvements’. It reveals that the area faces a funding shortfall of £1.2bn in 2020/21 if spending and funding levels continue as expected.

In the plan, health leaders admit to ‘not having all the answers’ and still expects its NHS organisations to be in the red by £75m in five years – even after all the cuts.

'Shocking, disgusting and appalling'

Camden GP and local medical committee chair Farah Jameel said: 'As a practising GP struggling to meet patient needs with ever tighter resources, the words that come to mind when presented with these financial figures are shocking, disgusting, appalling and ultimately not surprising.

'The Government should be held accountable for allowing this inappropriate use of funds and be encouraged to focus attention on addressing the very real challenges affecting those who work in and rely on the NHS.

'We are in the midst of a winter crisis, the NHS has systematically been stripped of much needed resources translating into services performing under extreme pressure and stress, in this context these monies would be much better spent on frontline services like A&E's and General Practice.

'I remain acutely aware of the Government's agenda to transform and reconfigure services to better suit the needs of the population within the constraints of a shrinking financial envelope.

'With that in mind the absence of strong clinical input regarding service capacity and patient need in the planning process is frankly disappointing, especially given the large figures of tax payers' money involved.'

A new norm?

In total 17 different firms were paid for their involvement in putting together the STP.

McKinsey and Company were given £360,000 for ‘strategy assessment’ and ‘financial modelling’ particularly related to mental health services and initiatives.

Deloitte LLP was given £257,336 for ‘finance and activity modelling’.

And recruitment specialists Hunter Healthcare Resourcing charged £282,518 for administrative support.

Methods Advisory Ltd did not respond to BMA News’ request for comment. But a column on its website said: ‘We have worked in health and care for over 25 years, with all its incarnations and ambitions.

'This gives us the ability to know what has worked (or not) before, alongside knowing what the potential… [to be] the "new normal” in health and care.’

Leaked costs

The revelations come months after a letter was leaked to the BBC revealing the cost of external providers to an STP in Cheshire and Merseyside.

PricewaterhouseCoopers were paid £300,000 – less than a seventh of the total cost in North Central London – to help draw up the Cheshire and Merseyside STP, a plan which requires savings of £999m within five years.

Explaining the costs, Louise Shepherd, lead for the Cheshire and Merseyside STP, said: ‘This is to provide additional capacity and expertise to help and support our clinicians and managers design our future care models while still delivering a very challenging “day job”.’

NHS Improvement and the North Central STP lead have been contacted for comment.

The North Central London patch includes: Barnet, Enfield and Haringey Mental Health NHS Trust; Camden and Islington NHS Foundation Trust; Central and North West London NHS Foundation Trust; Central London Community Health Care NHS Trust; Great Ormond Street Hospital; Moorfields Eye Hospital; North Middlesex University Hospital NHS Trust; Royal Free London NHS Foundation Trust; Royal National Orthopaedic Hospital; Tavistock and Portman NHS Foundation Trust; University College London; and Whittington Hospital.

Transfer of care delays threaten to capsize the NHS

Find out more about STPs

Read the figures in full

Read more from Peter Blackburn and follow on Twitter.

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England

Created: 19 January 2017 by Peter Blackburn

​BMA​

https://www.bma.org.uk/news/2017/january/private-firms-receive-two-point-three-million-to-draw-up-stp#.WIONToSCYWA.twitter