Wednesday, January 7, 2015

BHRUT maintains hospitals safe

I asked the following questions earlier today at the BHRUT board meeting of Matthew Hopkins, Chief Executive of BHRUT who referred them to his deputy Steve Russell.


a) If he agrees that the non-maternity beds need to go back into KGH?
b) Has BHRUT identified what beds have been lost from KGH since the publication of the HfNEL KGH A&E closure plan
c) Will BHRUT publish separate bed numbers for KGH and QH on their website each month so that bed numbers can be tracked accurately in future?

Pleased to report that BHRUT will be reporting bed numbers each month on their website. However, BHRUT is unable to describe what type of bed has been removed from KGH. 86 KGH beds in total have been closed since 2010 and it seems that BHRUT accepts not all of these are maternity.

Steve said there were no plans to put any beds back into KGH which is a disappointment because both KGH and Queens consistently fail to reach 95% 4 hour waiting times and have long periods when the bed occupancy is more than the recommended 85% bed occupancy level.

Steve disputed my assertion that Queens and KGH are unsafe. I say this because of the consistent failure to reach the 95%  A&E 4 hour waiting times.

I quote from a Guardian Article http://www.theguardian.com/society/2013/nov/06/accident-emergency-overcrowding-costs-lives-doctors

Dr Cliff Mann, the CEM's president, said: "There's clear evidence from America and from the UK that if you have overcrowded emergency departments then the mortality rates for patients going through that department increases."

The BHRUT board papers mention the case of a patient who was waiting on a trolley for 12 hours before found a bed. Delays like these must increase the risk of poor patient outcomes.

BHRUT distributed a paper on how overcrowding increases the risk of poor care at their October meeting. The link is here http://savekinggeorgehospital.wordpress.com/2014/10/07/report-from-bhrut-board-meeting-exit-block-kills-at-queens-and-king-george-ae/

The pledge made by Andrew Lansley, the then Secretary of State for Health, back in 2011 about no changes to KGH until it was safe to do so, appears to not only been broken but also contributed to QH and KGH being unsafe. I hope our MPs and Councillors and will ask questions about this.

BHRUT need to provide more information on what beds have been lost from KGH.




Tuesday, January 6, 2015

Will BHRUT agree that beds cut from King George Hospital be replaced?

At the end of this post is a extract from a recent BHRUT document, it shows that at 11 November 2014 there were 301 beds at King George Hospital (KGH). The HfNEL (Health for NE London) KGH A&E closure document approved by Andrew Lansley, the then Secretary for Health in 2011 shows 387 beds at KGH, an extract is here http://savekinggeorgehospital.blogspot.co.uk/2014/12/why-have-228-beds-gone-from-queens-and.html This is a loss of 86 beds from KGH, not all of which appear to be maternity, at time of writing BHRUT are unable to identify what type and numbers of beds have been closed, ie maternity, child. adult etc. 

In a response to six Councillors from three boroughs going to 10 Downing Street, asking for the KGH A&E closure plan to be scrapped, the Department of Health (DoH) in a letter dated 17 October 2014 said the "HfNEL scheme be allowed to proceed. However, in doing so, he also said that no changes were to take place until he was assured that the quality of services...had improved" further on the DoH say "There has been no downgrading of services at King George Hospital." The DoH letter is at the same post as the HfNEL extract.

It seems very difficult to reconcile these statements by the Prime Minister's representatives of no changes at KGH with bed closures which, on face of it, have contributed to the decline in care and placing into special measures of KGH and Queens.

I will be asking Matthew Hopkins, the Cheif Executive of BHRUT the following questions at the board meeting of 7 January:

a) If he agrees that the non-maternity beds need to go back into KGH?
b) Has BHRUT identified what beds have been lost from KGH since the publication of the HfNEL KGH A&E closure plan
c) Will BHRUT publish separate bed numbers for KGH and QH on their website each month so that bed numbers can be tracked accurately in future?


Extract from December 2014 BHRUT document
 
 
Topic 4: Bed numbers

Andy Walker suggested we had closed over 200 beds. He had looked at a document from 2010, health for north east London decision making business case p91-92 that states in 2010-11 there were 387 beds at King George Hospital and 740 at Queen’s Hospital.

An FOI that we replied to on 11 December 2014 we stated that on the 11 November 2014 the number of adult medical and surgical beds we had was 620 at Queen’s Hospital and 279 at King George Hospital. 3 We explained that Andy was not comparing like with like. The table below explains the breakdown of our beds. We also explained that in some specialties it is quite right that there is a reduction in beds, for example, cardiac patients. Due to advances in technology people are seen and treated much more quickly in some specialities and do not need to spend long periods of time in hospital, which may have historically been the case.

We are currently identifying what data was used to inform the Health for NEL business plan to help explain the difference. At that time maternity services were run from King George and NELFT also now manage some of the beds that we were previously responsible for.

Table 1: Available beds at December 2014 (overnight beds only – day case beds are excluded)

Queens Hospital
King George Hospital
TRUST Total
Medical and surgical Beds
(inc. assessment units and specialist beds)
620
279
899
Adult Critical Care (incl. neuro)
32
8
40
Neonatal Critical Care Beds
25
0
25
Paediatric Beds
25
14
39
Maternity Beds
63
0
63
TOTAL
765
301
1066