Wednesday, March 23, 2016
Thursday, March 3, 2016
Dear Barking and Dagenham, Havering and Redbridge Councillors
I attach a letter from Steve Russell (available at http://savekinggeorgehospital.blogspot.co.uk/2016/03/bhrut-right-of-reply.html ) BHRUT Deputy Chief Executive of BHRUT on why BHRUT cancelled the recent meeting I wrote to you about last month.
Steve's letter also contains a changes the as to how the public scrutinise the board by restricting the number of questions a member of the public can ask to two. Previously, members of the public could ask any number of questions. The number of questions were limited by the time available depending upon when the main business of the meeting was finished.
Dr Dalziel, Chair of BHRUT announced at yesterday's board meeting a further change to public scrutiny, From the April meeting onwards, four days notice of questions will have to be given. This additional restriction damages public scrutiny because the board papers are usually published the day before the meeting. So unless the board bring forward the publication date of their papers, questions relating to agenda items will not be permitted.
The benefit of allowing without notice questions is that it allows members of the public or journalists to listen to what is being said during the meeting and then ask a question about a statement made during the meeting. This will no longer be possible if the four day notice change goes through.
Any events, such as a CQC inspection, a Freedom of Information request or press story for the four day period before the meeting will also be off limits for questioning if the change goes through.
If you agree with me that these changes to public scrutiny are wrong, I would be grateful if you could raise the matter with your health scrutiny team.
Yesterday saw the board depart from usual practice in that the answers to my February questions to the board were not published in the March board papers, instead I was given the answers in the document attached before the meeting started.
In the answer to question 3, BHRUT make the claim that cutting 29 beds last year (along with the doctors and nurses who staff them) leads to "improved care for patients". I attended the Save KGH A&E meeting organised by Wes Streeting MP to hear from Dr O’Sullivan, a paediatric consultant at Lewisham and Greenwich NHS Trust who made the opposite claim, that the number of hospital beds does influence care.
A paramedic got up at the meeting and said patients would die if King George A&E were to close. BHRUT is working on a mortality review shown at page 91 of the attached board papers.
Page 94 lists death rates over a two year period ending September 2015. BHRUT cut acute beds at King George hospital from 293 in May 2015 to 265 in September 2015. A&E waits also rose over the May to September period (p155). The trust is not routinely releasing A&E waiting times for each hospital so we do not know whether Queens A&E waits got worse as a consequence of the bed cuts at King George Hospital.
Page 94 shows Pneumonia and Bronchitis in a table of 17 illnesses where BHRUT has a higher than expected death rate. My concern is that the paramedic might be explaining what is happening now. That is, as a consequence of bed cuts at King George there may be already a very small increase in death rates due to the extra distance being travelled to Queens for some patients along with higher A&E waits at Queens which would impact upon the local population coming to Queens A&E. The evidence for the concern is at the NHS website How to stabilise Emergency Care in England: NHS Interim Management and Support - NHS IMAS
"We know that speed of treatment is vital in many conditions. For example, people with the most severe form of pneumonia have less than a one in two chance of surviving. Those chances improve considerably if effective treatment is started early. However, research suggests that delays of more than four hours in administration of antibiotics to patients coming into hospital with pneumonia can affect 70 per cent of patients on days when an A&E is crowded. (Pine JM et al, 2005)This undoubtedly affects mortality."Ends
It would be helpful if BHRUT were to publish pneumonia deaths and other deaths where speed of treatment is vital along with the postcode of the deceased patient so elected representatives and the public can judge whether the BHRUT claim of cutting beds means "improved care for patients"
Page 98 reports monthly mortality data reports are being sent to the BHRUT board. These reports should be published on the BHRUT website and from part of the board papers to aid public and council scrutiny.
March board papers are available here http://www.bhrhospitals.nhs.uk/Board%20of%20directors%20meeting%20March%202016.pdf