Thursday, November 30, 2017

PWC report is big step forward for our campaign but work still to be done

The publication of the PWC report is a step forward for our campaign, but the future of King George A&E is still uncertain. The NHS is now considering new options. It will the task of campaigners to persuade NHS managers and the Government that closing King George A&E is not one of them.

Mike Gapes is right to say in the local press yesterday.

 “What I want to see now is the small print for these proposals. If we still have our A&E what is it going to look like?
“We must ensure it will be able to meet the needs of Redbridge residents.
“This is a step in the right direction, but we’re not there yet.”
Full Recorder article is here Recorder 
And Wanstead and Woodford Guardian here Guardian
I cut and paste the NHS statement below. 


29 November 2017

Update on King George Hospital in Goodmayes

Dear partner/stakeholder,
I wanted to update you on the latest position regarding the A&E department at King George Hospital in Goodmayes. 
As you will know, the decision to replace the A&E with an Urgent Care Centre (UCC) was taken in 2011 and much has changed since then. Our east London population is growing and ageing, demand for NHS services continues to increase, and we face ever-increasing challenges as a healthcare system.
Following on from the recommendations in a strategic review undertaken recently by PWC, which is published on our website, we now need to consider more options for the way we deliver urgent and emergency care across our communities. This will allow us to look at how this care is provided locally, taking these challenges into account.
It is important we consider how we deliver these services across both King George and Queen’s hospitals to enable us to deliver care in the best way for patients. Exploring more options will enable us to do this.
This is now an opportunity for us to work with our clinicians, patients, partners and stakeholders to develop a plan to make it easier for people to access the right services, deliver care sustainably, and address the challenges such as an ageing population and increasing demand on A&E services.
The model we finally adopt must provide excellent, safe patient care and meet the needs of local people now and well into the future. 
In the meantime, the existing A&E at King George hospital will continue to operate as now.
I will continue to keep you updated of further developments.
Kind regards

Jane Milligan
Chief Officer NHS Tower Hamlets CCG and Executive Lead for East London Health and Care Partnership (NEL STP)

Tuesday, November 28, 2017

BHRUT want more than 500 dwellings to be built on King George site

The link BHRUT Build on KGH shows BHRUTs representative, Bidwells writing to Redbridge Council in 2016 urging more than 500 dwellings to be built on the King George site per the quote below.

The policy requires “around” 500 dwellings to be developed across the two sites, but the capacity studies undertaken by BHRUT and NELFT suggest that they may have potential for significantly more development. The policy requirement for “around” 500 dwellings may artificially restrict the contribution that the sites can make to housing delivery. Given that the Council is unable to meet its objectively assessed housing need, even with the Green Belt releases proposed across the Borough, placing an artificial cap on the contribution of sites is unjustified and fails to plan positively for the needs of the Borough. It is therefore unsound. To provide more flexibility and to ensure that the full potential of the sites can be realised following their release from the Green Belt, we contend that the policy should be changed to require “at least” 500 dwellings to be delivered across the two sites. 

The footprint below for building does not include Meadow Court:

However, BHRUT go on to say

The Estates Strategy is set in the context of the wider Health for North East London (Health4NEL) Review and BHRUT's adopted Clinical Strategy. Neither anticipate the development of any surplus land at King George Hospital for new healthcare services in the foreseeable future. Indeed, as a consequence of the changes proposed to local service provision by Health4NEL and the Clinical Strategy, which focus on the transfer of acute care and emergency services to BHRUT’s principal service centre at Queen's Hospital in Romford, a substantial reduction in services located at King George Hospital is anticipated.(my emphasis) ENDs

Hardly a ringing endorsement by BHRUT for KGH having a long term future. Meanwhile a another NHS document the STP plan has the potential need for a new Hospital in NE London due to population growth.

It has to a concern that BHRUT is being driven to lobby for more housing on the site due to under funding.

Meadow Court may not be the building footprint for now, but it may well be one day and should the unit close on Thursday it could bring that day closer.

Monday, November 27, 2017

photo shoot Thursday 30th November 1pm outside Beckett House to say Meadow Court should stay open

Redbridge Clinical Commissioning Group is planning to close Meadow Court Nursing Home on the King George Hospital Site at their meeting at 1:30pm this Thursday.

The photo shoot is at 1pm before the meeting starts at 1;30pm at Beckett House, 2 Ilford Hill IG1 2QX

The Meadow Court closure needs to seen in the context of the Decision Making Business Plan passed in 2011 for the closure of King George A&E which states buildings are to be sold off and housing put on the site. Per the extracts below, click on pics to enlarge

The proposed closure of sterile services at King George and then moving it to Maidstone appear part of the same plan. The Sterile Services campaigners won a three month extension before the decision will be made. How can it be safe to stretch a supply chain so far away from the hospitals that need such vital equipment?

Similarly the arguments for keeping open Meadow Court seem equally compelling. The decision making business case for closing Meadow Court rests on the NHS being unable to take over from Care UK, and the private company fee is too expensive to continue with. This is like saying the police no longer have the expertise to catch criminals and have to rely on companies instead.

The key passages from the decision making case for the CCG meeting on Thursday are

Care UK have reported that they have had very limited success in marketing any of their spare capacity (i.e. the non-block beds and the mothballed beds) to other CCGs and local authorities. This is because other CCGs prefer to place patients into AQP homes which cost £427 less per week while providing an equivalent standard of care.  page 31

Re-provide the contract to NHS management The CCG is unable to take over the direct management of the contract as it is a commissioning organisation and is not registered with the Care Quality Commission to provide services. The transfer of the contract to another NHS organisation would require a procurement to take place. page 31

If there was the will Redbridge CCG could find a way to take over and manage Meadow Court, there is no law saying only corporations can run nursing homes. The use of such a flawed argument makes it clear that the real motivation is to carry out a key part of King George A&E closure plan which is clear the site and sell off land for housing.

Due scrutiny has not taken place as the business case for the Meadow Court closure has not been seen by Councillors. When the King George closure plan was passed it went before councillors for comment before the closure plan was passed. It is puzzle that the same process has not taken place this time.

Cut and paste the links below into your browser to see closure plans for KGH A&E and Meadow Court

There is a lot of stuff on the net claiming that moving elderly people from their care home can shorten life expectancy unless expertly managed.

This was at the top of my search list

The last claims regarding closure. It strikes me that Redbridge Council's health scrutiny committee should be able to check that the thresholds for a safe move will be met as set out below.

These matters have now been explored exhaustively in law. Unless there is evidence that parties clearly depart from accepted good practice in their preparations, consultations and implementation of the relocation of an individual or group of residents, there is unlikely to be justification for further recourse to the courts. The legal process carries an attendant risk of adding to the stress for the residents, their families and care staff involved. Although the health, well-being and interests of individuals should never be overlooked, residents should not be used as pawns in negotiations.

The current position

Practitioners must remain vigilant to prevent irresponsible relocation of vulnerable old people such as occurred in Bury-Rossendale 1973. Examples now exist of remodelled services where good overall outcomes have been achieved with the active involvement of residents and their families [9–15]. Life contains risk at every stage. The very old and frail, and people with dementia, are particularly vulnerable as well as being less able to act effectively as their own advocates. They must therefore be protected. Expert medical advice should be sought when revision of services and movement of groups of older people are contemplated.

Thursday, November 23, 2017

The case for a midwife led maternity unit at King George Hospital

At the last save King George A&E meeting we agreed to campaign for a midwife maternity led unit on the King George site.

I confess as a lay person to not being completely confident of the idea, but was influenced by John Cryer's statement that good public services are local public services.

I attended the monthly meeting of the North London Save our NHS last night and was delighted to get the support of the Doctors in the group for a midwife unit at King George and given evidence as to why it is reasonable to campaign for one.

The Inner North East London Joint Health Overview and Scrutiny Committee met earlier this month and had a detailed presentation on the future of maternity in NE London given to them. The full agenda with maternity at pages 23 to 60 is at the link Agenda

  The following grabbed my attention:

The photo above shows a bid has been made to move births to midwife units with a claim to save money.

The page above makes the claim that low risk women have a  safer birth at a midwife unit. It would be interesting to know why, as the expectation would be that a consultant led unit would be best for all women. The page below shows BHRUT with the most births, this must be expected to rise with all the development in the area.

King George is absent from the paper and an assurance is given that sufficient capacity in the system to cope with extra births. However there must be scope for campaigning for a maternity unit at King George, but it will be difficult as the existing plan for King George is to take units off the site and sell land off for housing.

I was assured last night that the new maternity unit planned for Whipps is not for all Redbridge women.

Wednesday, November 1, 2017

A big step forward for the Save King George A&E campaign

The photo below is from earlier today outside King George Hospital. The BHRUT board were asked by me to support the call made by four Councils, Redbridge, Barking and Dagenham, and Waltham Forest for the KGH A&E closure plan to be reviewed by Mr Hunt the Secretary of State for Health. The board declined to do this.

However, the campaign to keep open KGH A&E took a big step forward today with the news that NHS improvement has stepped in to block the closure of Ealing A&E. 

The article is here

With today's BHRUT board meeting hearing a report that A&E demand continues to increase and how at busy periods the hospitals struggle to cope. It seems inconceivable that the closure of KGH A&E in 2019 will be allowed now that the closure of Ealing A&E has been blocked. 

There is a Facebook interview of Cllrs Littlewood and Martin outside the hospital at which will need to be cut and pasted into your browser.