Save King George Campaigners on 20th March 2019 before a BHRUT board meeting earlier this year calling for the new KGH A&E closure plan to be published.
Years
ago I attended a training session at a company introducing the
concept of “salesman's truth”. This meant that the salesman
believed with a passion that they sold the best product on the market
and that their product was best for the customer. Anything else did
not matter. This approach has been rife in business and has led to
high profile scandals. The financial sector is a prime example:
pensions, endowments, PPI etc were all sold on the basis of the
salesman's truth. The mortgage backed bonds which were nearly
worthless and led to the 2008 financial crash are another example of
how damaging salesman's truth can be.
The
NHS variant of “salesman's truth” is “manager's truth”.
Anything can be said to protect it no matter now detached from
reality the statement is. The NHS has been riven over the years by scandals where manager's truth has wrecked care for patients.
The most famous is Mid-Staffs where a pursuit of Foundation Trust
Status, became the manager's truth and care became the second
priority per the link.
The
BHRUT statement in the Wanstead and Woodford Guardian on 8th
May by NHS managers is example of manager's truth.
The
statement in the press article:
“We
want to be very clear, the threat of closure of the Accident and
Emergency unit arising from decisions in 2011 has been removed. There
will continue to be an Accident and Emergency unit at King George
Hospital.”
This
appears completely certain and beyond question, but with a little
digging and examples of BHRUT manager truth it is clear it is
misleading and false. The closure plan referenced below is at closure plan was published on 11th April 2019.
Three examples of BHRUT manager truth:
(1) Deceiving Mike Gapes and other elected representatives
An email dated 1st March 2019 to Mike Gapes MP
and other elected representatives from a BHRUT manager states:
The Wave 4
Capital Bid was not a bid to close King George Hospital
(KGH) A&E Department. The £49m was to make a range
of improvements to urgent and emergency care at both hospitals,
including the emergency department at KGH, as well as increasing
the size of our assessment units and rearranging some of the ward
configurations - again across both sites - to improve patient flow.
This
email is a deception and attempts to mislead elected
representatives, and an example of BHRUT manager truth.
It
is a deception because the the £49M bid which was published on 11th
April 2019 is clearly a plan to close King George A&E. The
extract below is from page 4. Bullet points one and 2 make it clear
that emergency ambulances are no longer to go to King George
Hospital.
The
extract from page 7 below makes it clear that KGH is to become a
Enhanced Urgent Care Centre at bullet point 1 under option 2 with a Ortho-Geriatric
Receiving Unit at bullet point 3:
Page
17 below consolidates emergency care at Queens in first sentence below
Page 18 below again talks of consolidating ED services at Queens.
Page 18 below again talks of consolidating ED services at Queens.
The
second example of BHRUT of manager truth is the statement by by Jane
Milligan of 29 November 2017, this was spun in the press as a
watershed moment by Wes Streeting MP. I and all other campaigners
welcomed it too. It has been copied from the BHRUT website.
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, 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) ENDs
This statement is more NHS manager truth. The reality is the new
closure plan was agreed in 2016 per the extract below from page 7 of the
£49M King George closure plan per the first sentence.
At
page 10 below the depth of the sophistry becomes clear. BHRUT say the
new closure plan is not “fundamentally different” from the 2011
plan and spent money on legal fees in autumn 2017 to keep the new
plan secret! The current public position of BHRUT is this is not a
closure plan, this extract shows BHRUT believes the exact opposite.
The final sentence on the last line is a corker, showing what we thought was a genuine
review into the future of King George A&E per Jane's letter of
29.11.2019 above was really a sharing of the “current status of the
project” to close King George A&E.
What
is jaw dropping is that Wes Streeting MP led a February 2018
Redbridge Council working party into the future of King George A&E
and Jane Milligan hid from Wes that a new closure plan was agreed in
2016!
The
working paper report (1) chaired by Wes runs to 110 pages and at page
4 lists contributions from ten BHRUT managers. It was prompted by a
petition presented by me to Redbridge Council in January 2017. Not
only was the plan hid from Wes and Cllrs, the new closure
plan being also being implemented during the time Wes and Redbridge
Councillors were preparing the report. Bullet point three below from page 12 of the closure plan explains why the ambulatory care ward at Erica Ward is restricted
exclusively to the elderly frail as a small part of the plan to
close King George A&E. The £1M works at Queens Hospital for
additional facilities were completed in January 2018 (2) per the
first paragraph below were completed before publication of the
Redbridge Council report of February 2018.
The third example of BHRUT manager truth is the deception about the restricting ambulatory care at Erica Ward at King George Hospital to the elderly frail. Ambulatory care means same day emergency care, it is not to be confused with care provided by ambulance. When challenged about this BHRUT gave two responses. One response was to say ambulatory care at King George did not exist per the Freedom of Information request below.
The second deception was the statement below in the Recorder of 18th October 2018
“Due to the low levels of admitted adult patients from the Emergency Department at King George Hospital, a full ambulatory care unit is not required and we do not believe it would be the best use of our resources.
“It is more effective to centralise this service at Queen’s Hospital.
“Any increase in admissions or ambulatory support is monitored daily.
“However, due to the levels of demand from our frail elderly patients, we do offer a dedicated ambulatory care service for these patients at King George Hospital.” ENDs
We now know that refusing entry to younger patients at Erica Ward and so referring them to Queens was part of the new plan to close King George A&E per page 12 of the plan copied above at point 2 stating " A new pathway".
The 27.9.18 extract from Redbridge Clinical Commissioning Group below could be a rough indication of the numbers going to Queens as a decision to exclude younger patients from Ambulatory care at King George. It is difficult know precise numbers. This is because when I challenged Chris Bown to produce an equality impact assessment of the decision to exclude younger patients from ambulatory care at a recent BHRUT board meeting he refused to do so.
How the target of closing King George A&E is damaging care
Page
66 of the Redbridge Council report of February 2018 shows around 160
beds cut from BHRUT as part of the preparation for closing KGH A&E (1) Page 23 of the same report shows an approximate drop in admissions at King George from 1500 a month in 2015 to 1300 a month by 2018.
This
substantial capacity cut is a cause of the dismal type 1 performance
stats at Queens and King George per the below.
Too
many patients are being sent to Queens. There is evidence that long
waits at A&E lead to worse patient outcomes, including longer
lengths of stay and higher death rates per the link HERE
Save King George A&E/Don't overload meeting on 20th July 3pm Ilford Town Hall
BHRUT have for years been deceiving us about their plans for King George & Queens. Until senior NHS managers apologise for their past deceptions and accept the £49M plan to reconfigure King George Hospital is a closure plan for King George A&E we cannot believe BHRUT claims that King George A&E is safe.
The Lambourne room at Ilford Town Hall has been booked for a meeting to say no to the closure plan and instead campaign for a King George to be extended and so relieve the pressure on Queens.
An early test of BHRUT credibility about King George is whether they will open more beds at King George to reduce the pressure on Queens along with ending the discrimination against younger patients for ambulatory care at King George.
The Francis report was a result of the poor care at Mid-Staffs, the report relied upon openness and transparency as guarantors of good care. BHRUT''s recent actions have trashed the values of Francis and they need to change their conduct. The recent decision by BHRUT to stop releasing bed numbers, critical bed occupancy rates and excess mortality rates for King George and Queens, rather than an aggregate rate reveals a commitment to secrecy rather than transparency.
It was ordinary people coming together at the photo shoot above and the meeting on 30th March that persuaded BHRUT to publish the new King George A&E closure plan. Keith Prince AM speaking at a BBC News interview on 30th March was very helpful as has been the support of Havering Councillors Dodin and Deon Burton along with Tower Hamlets Councillor David Edgar. Strengthening this coalition by 20th July is bound to increase the prospects of our campaign succeeding.
Any reply to this post by BHRUT will be posted on this site and BHRUT will be given an invite to speak on the 20th July.
The Lambourne room at Ilford Town Hall has been booked for a meeting to say no to the closure plan and instead campaign for a King George to be extended and so relieve the pressure on Queens.
An early test of BHRUT credibility about King George is whether they will open more beds at King George to reduce the pressure on Queens along with ending the discrimination against younger patients for ambulatory care at King George.
The Francis report was a result of the poor care at Mid-Staffs, the report relied upon openness and transparency as guarantors of good care. BHRUT''s recent actions have trashed the values of Francis and they need to change their conduct. The recent decision by BHRUT to stop releasing bed numbers, critical bed occupancy rates and excess mortality rates for King George and Queens, rather than an aggregate rate reveals a commitment to secrecy rather than transparency.
It was ordinary people coming together at the photo shoot above and the meeting on 30th March that persuaded BHRUT to publish the new King George A&E closure plan. Keith Prince AM speaking at a BBC News interview on 30th March was very helpful as has been the support of Havering Councillors Dodin and Deon Burton along with Tower Hamlets Councillor David Edgar. Strengthening this coalition by 20th July is bound to increase the prospects of our campaign succeeding.
Any reply to this post by BHRUT will be posted on this site and BHRUT will be given an invite to speak on the 20th July.
1
– Redbridge Council report of Feb 2018 on King George Hospital athttp://moderngov.redbridge.gov.uk/documents/s113032/BHRUTEDScrutinyWGoutcomereport-final.pdf
2
“Queen’s urgent care centre
(UCC) capital development completed 10 January 2018 and is supporting
the delivery of 24 hour 7 days per week UCC at Queens' taken from
page 77 of Joint Committee of Barking and Dagenham, Havering and
Redbridge Clinical Commissioning Groups of March 2018. This is
described at page 12 if the £49M as part of the closure program.
HERE
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