A new wing at King George should be one of PM's 20 upgrades

On Tuesday of this week, Cllr Athwal said at the Redbridge Council Cabinet he was writing a plan to extend King George Hospital as the Council submission to the November 2017 review.

The tweet HERE has a video extract from the meeting.

The Recorder post on the November review is below. 

https://www.romfordrecorder.co.uk/news/health/watershed-moment-as-review-announced-into-stupid-king-george-hospital-a-e-closure-plan-1-5300904

Yesterday, at a local forum, Cllr Athwal refused to publish his submission by the end of September. The video is HERE

That is not good enough, Health Scrutiny Chair Cllr Zammett made it clear earlier this month at a health scrutiny committee that A&E performance at Queens and King George has got worse year by year. We need a new wing at King George to improve A&E performance not only at King George, but also to relieve pressure on Queens.

Yesterday, Boris Johnson, our new Prime Minister, made an, as yet uncosted pledge, without any timetable, to upgrade twenty hospitals. His promise is a challenge to activists to make the promise a significant plan to transform our NHS, not only with new buildings, but also with the staff to fill them too.

It is also a challenge to campaigners in Redbridge to make the best case, and as soon as possible, for King George to be one of the 20 upgrades.

With our growing population, the case a new wing at King George is sound.

The best way to save King George A&E is to extend it. We need, Cllr Athwal to make the same committment to building a new wing at King George as he did for seeking to bring the three markets to Fairlop Plain.

Poor show on minister for misleading Mike Gapes MP

Earlier today Mike Gapes MP reported King George A&E was safe.

Unfortunately, that is not correct.

The extract from Hansard shows Mike has been misled. The 2011 decision to close KGH A&E type 1 unit has not been revoked. An A&E has been promised, but not an explicit guarantee of a type 1 unit. A type 2 unit for King George is still being considered as part of the outstanding November 2017 review and the current clinical services strategy review.

Mike Gapes MP says KGH A&E is safe according to health minister Stephen Hammond

Mike Gapes MP has written on twitter earlier today.

"Official. It is confirmed. King George Accident and Emergency will not be closed. Just got very welcome answer from Health Minister Stephen Hammond. It is now time to stop the scaremongering and concentrate on campaigning for improving and integrating services."

I wrote to Mike on twitter to say

"this appears very good news. Can you expand upon this Mike, ie is this a type 1 guarantee to be confirmed in ongoing review started in 11.17 & the clinical services strategy work happening now?"

As yet Mike has not replied.

As well as the qualifications I sought from Mike regarding type 1, we also need Matt Hancock MP, the Secretary of State for Health to revoke the 2011 decision to close the type 1 A&E unit at King George. Why this is important is shown at page 10 of the 2018 failed bid document HERE to close the type 1 King George A&E and replace it with a type 2 unit.

Para 4 states "it is the Trust's view that the project would not warrant further public consultation, provided that any development of services at KGH is not fundamentally different is not fundamentally different from that envisaged in HfNEL.."

"HfNEL" means the 2011 closure decision, so as long as the 2011 decision stays in force, a downgrade of the A&E at King George A&E to a type 2 facility for the elderly is still an option.

Earlier today, I looked at the East London Health Care Partnership (ELHCP) site today and the option of KGH being a centre of excellence for the elderly without a type 1 unit is still being listed per the following:

"Current options for change

 Queen’s Hospital

Queen’s Hospital has one of the busiest and largest emergency departments in England, and so development at Queen’s will be focused on emergency and acute medicine, emergency surgery and acute children’s services. In addition, maternity facilities could also be expanded and developed to manage the continued growth in the number of births in north east London. To facilitate this development, the renal unit at Queens could be moved to the new St. George’s hub with non-acute care of older people, and some elective surgical services moved to King George Hospital.

King George We aspire to develop a new centre of excellence for healthy ageing, working in collaboration with community care, primary care and social services to offer a fully integrated model of healthcare for older people. Centralising planned care will increase the use of beds and theatres. These changes, together with the adjacent Goodmayes Hospital site, create a strategic opportunity to develop a coherent masterplan for housing, education, community and primary health care, maximising land value across the two hospital sites." ENDs

The full plan is at

https://www.eastlondonhcp.nhs.uk/downloads/ourplans/estates/STRATEGIC_ESTATES_PLAN_summary.pdf

So far neither BHRUT nor the ELHCP have put anything up about Health Minister Stephen Hammond's statement, perhaps they will tomorrow.

What we do know is that until Matt Hancock MP gets up in Parliament and revokes the 2011 decision to close King George A&E as a type 1 unit, then the campaign to save our A&E must continue.

Matt Hancock did this for two West London A&Es HERE it would be great if he could do this for King George A&E this week.

And let's hope Mike Gapes can provide more information shortly.

Report from Saturday meeting

Thank you to everyone attending.

Photos from outside King George & at the Town Hall.

The video of the meeting is also below.

The speakers stressed the missing words "for all ages" needed to be added to the recent BHRUT statement HERE to be inserted after "patients" for BHRUT to be offerring a type 1 A&E guarantee at King George.

There was also support for the campaign to lobby for Redbridge Council and other organisations to submitt a submission to the November 2017 review for a new wing at King George Hospital.

A mid-wife led maternity unit, more acute & critical care beds all seem reasonable campaign aims for a new wing to be sited at King George for our growing East London population.

Video HERE

Pete Mason message to the meeting today

Pete Mason one of the organisers of an event today today to get justice for those who have suffered as a result of a fire at Samuel Garside house in the estate he is the Residents Association Chair. Pete done great work to expose the short cuts which have contributed to the fire Experts had warned of fire risk at Barking apartment block

Experts had warned of fire risk at Barking apartment block Robert Booth Independent assessment in January said wooden balconies could accelerate spread of fire

Pete has sent this statement for me to read out and put on the blog and gives his apologies:

"On behalf of east London branch of the Socialist Party and in my capacity as chair of Barking Reach residents association,  I salute this meeting and the immensely hard work Andy and his team do to expose the half hidden plans to downgrade the King George accident and emergency unit into a type 2 A&E exclusively for the elderly and a type 3 urgent care centre

The Barking Reach  residents association invited Andy to address our meeting and we unanimously agreed to write to the heads of the NHS a letter of protest about these plans. The reply that we got  precisely ignored our concerns.

We wrote to Chris Bown, Interim Chief Executive of BHRUT, and Ceri Jacob, Managing Director at Barking and Dagenham, Havering and Redbridge Clinical Commissioning Group because the shocking Barking fire of Sunday 9 June brought home again how vital the accident and emergency service is to us. 

We witnessed a fire at Samuel Garside house which consumed 20 flats and drove out residents of 79 homes. The fire swept through the block in seven minutes or so,  residents escaping with nothing but the clothes on their back, carrying their children amidst terrified screams,  an experience which has traumatized many. 

It was a miracle no one lost their lives or was seriously injured. If it had not been for the swift action of residents,  or if the fire had happened at the back of the flats where the cladding is not interrupted by stairwells,  the ten fire engines which attended the fire would have been swamped by ambulances ferrying burns injuries to hospital.

We need an accident and emergency unit in king George which is open to all. The entirely private Barking Riverside estate has suffered as a result of privatisation, and both the Socialist Party and the residents association oppose the privatisation of the NHS.  I say,  renationalise the NHS, bringing all privatized services into public ownership with compensation only to those who can prove need, and place its management back into the hands of the doctors and nurses that have the medical knowledge to run an NHS in the interests of the 99% and not for profit."

Inviting senior elected representatives to the next save King George A&E meeting

Cllr Jas Athwal - Leader of Redbridge Council

Mike Gapes MP

Keith Prince AM

Wes Streeting MP

Dear Keith, Jas, Wes & Mike

I am delighted to report that Redbridge Trades Council are supporting a save KGH A&E meeting this November.

While there may be difference between us whether a type 1 unit is secure at King George A&E, there appear key campaign aims which we can agree upon on. 

1) Neil set out how dire the A&E performance is at last health scrutiny committee meeting. Neil's views that A&E performance was declining year by year especially type 1 and more beds were required had the complete support of the committee. A new wing at King George with more acute beds & a mid-wife led maternity unit is a reasonable campaign aim for our ever growing population to influence the outstanding 2017 review & the 2019 clinical services review. 

2) Pushing for this November 2017 review to be completed before the clinical services review announced in May.

Watershed moment as review announced into 'stupid' King George Hospital A&E closure plan

Watershed moment as review announced into 'stupid' King George Hospital ... Matthew Clemenson Plans to close a Redbridge A&E, which would have seen Queen's Hospital require millions of pounds of upgrades, h...

 I am on record as saying this review was/is bogus PR stunt, however, the mainstream view that it is genuine exercise.  

It will be a test of BHRUT credibility on the issue for the review to be completed by this November. Completing the 2017 review is a lever to influence the outcome of the clinical review.

3) On balance, my expectation Clinical Services Review will still remain outstanding, despite Joe Fielder who is copied in saying in June at a Seven King Newbury Park meeting that the review will take three months. Whether published or not it will be bound to be an issue in November.

"The initial phase of our clinical strategy review begins soon." comes from the May News and events suggests a November publication is not imminent.

News and events Our clinical strategy – designing the future of our hospitals

4) The purpose of the £6.4M PFI bid announced earlier this year should be known shortly, it may well feature as part of our campaign when the submission bid is eventually published.  

Our alliance to campaign for King George A&E has always has stronger at some times than others. Now is a particularity difficult time and I hope we can avoid another spat over a banner at the town hall. Perhaps agreeing text of leaflets and a banner in advance may be a helpful way forward.  

I hope to hear from you soon with some dates you can make.

Regards

Andy

An appeal to senior Redbridge politicians re KGH A&E

Cllr Jas Athwal - Leader of Redbridge Council

Mike Gapes MP

Keith Prince AM

Wes Streeting MP

Dear Wes, Keith, Mike & Jas

There is a dispute about what the BHRUT statement of yesterday means about the future of King George A&E.

I say the statement does not guarantee the future of King George A&E as a type 1 unit, merely a type 2 unit for the elderly as it does not say the A&E will remain open to all ages.

My request is one of you, or ideally all of you write to Chris Bown, the Interim CE of BHRUT to say the following:

Dear Chris Bown 

I would be grateful if you could confirm that King George A&E will continue as a type 1 A&E regardless of the outcome of your ongoing clinical services strategy.

To be very clear this means an undertaking that your review will not be considering the option of downgrading King George A&E to a type 2 & 3 unit.

Such  an assurance of ring fencing the type 1 A&E at King George Hospital from your clinical services strategy review will be very welcome. END of email to Chris

It would be much appreciated if you could write to Chris at your earliest convenience tomorrow.

Regards

Andy

Midday Deadline today for BHRUT to respond to "3 missing words" press release due to go out today

I will send this to the journalist who ran the BBC TV story on 30th March 2019 if BHRUT do not amend their press release to include "of all ages" into what is currently a bogus statement about the future of King George A&E. Amended press releases will go to other journalists

Dear Sir 

We spoke back in March re the closure of King George A&E about a walk and meeting to save King George A&E to take place on 30^th March.

The day before the meeting on the 29^th the Leader of Redbridge Council issued a statement (1) to say King George A&E was safe. You ran the story anyway and Keith Prince did an interview which was carried on the TV news on the 30^th March.

Due to campaigners' effort a failed 2018 £49M bid to close King George A&E as a type 1 unit, and replace it with a type 2 & 3 unit was published in April 2019.

This bid is attached along with a definition of a type 1,2,3 A&E units.

A key passage of the bid is at page 7, the option 2 (Variant) clearly means downgrading King George from a type 1 unit to a type 2 & 3 unit. Although, BHRUT give the impression that this is not the case using clever sophistry and deception rather than a downright lie. 

Yesterday BHRUT issued a press release to say King George A&E was safe. It implies King George A&E was safe as type 1 unit, but a careful reading shows it as no such thing, the press release is pure sophistry.

The full version is below at (2) below.

The key text extract is as follows:

The A&E at KGH will continue to be a consultant-led service, open 24 hours a day, with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients (currently known as a Type 1 A&E department). We have never suggested otherwise. (my emphasis)

The underlined lined text is entirely consistent with a downgrade to a type 2 unit. A type 2 unit can be everything BHRUT say in the underlined text about a consultant led service etc. but BHRUT leave out the the key words “of all ages” after “the reception of accident and emergency patients” so leaving the door open to a speciality type 2 A&E for the elderly.

The game is given away by saying it is “currently known as a Type 1”. And the second sentence confirms the guarantee is limited to type 2 because what they have suggested otherwise in the past is clearly type 2 per the £49M bid.

BHRUT were given a deadline to insert the three missing words “of all ages” into their press release by midday today. They failed to do so, Mr Bown the Chief Executive of BHRUT is engaging in deliberate deception of East London residents 

Details of walk and meeting for 20th July at

https://www.facebook.com/events/2960949763945148/

1) Leader statement of 1^st March

A&E at King George Hospital: Leader's statement

Published: 29 March 2019

Following publication today of an open letter on healthcare funding in the borough and the future of A&E at King George Hospital, Council Leader Cllr Jas Athwal said:

"After years of hard work, I am delighted that I have been able to guarantee that emergency care will continue to be provided at King George Hospital. Our residents deserve the security of knowing their A&E is close by in times of need, and this letter provides it.

"We should be clear that KGH needs significant national investment not simply to maintain, but to improve the quality of service. It is extremely disappointing that a request for over £70m of national capital investment was unsuccessful.

"I know that there has been a great deal of confusion about this capital bid, with some suggesting incorrectly that our plans to improve local services is actually a new threat to services at the KGH. These concerns are unwarranted, unhelpful and are simply causing unnecessary concern. It gives me great pleasure to be able to categorically deny these rumours.

"Let me be clear, as our letter does today: A&E services at King George will remain open.  It is time for scaremongering to stop."

2) BHRUT press release of 17.7.19

For the past three months we have been examining what Queen’s Hospital in Romford and King George Hospital in Ilford will look like in the future as part of developing a new clinical strategy.

This is an exciting opportunity for us to think creatively about how we provide the best possible services for local people across the NHS while also recognising the key role of our partners, including our councils. We want to make sure we are thinking about solutions which will stand the test of time. We accept that more change is inevitable, and rightly so.

We will share our initial ideas with our staff, local people, communities, partners and stakeholders to test our thinking and shape the final clinical strategy.

We must remain open and flexible to a range of solutions and options to make the right decisions for the people we serve. However, throughout this process we have been clear that the Emergency Department at King George Hospital (KGH) is safe and that there is a need for such provision both now and into the future.

The A&E at KGH will continue to be a consultant-led service, open 24 hours a day, with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients (currently known as a Type 1 A&E department). We have never suggested otherwise.

We are concerned that ongoing false rumours about the future of the A&E unit at King George Hospital could have an adverse impact on our efforts to recruit and retain vital frontline staff and will worry our residents unnecessarily.

Chris Bown
Interim Chief Executive
Barking Havering and Redbridge University Hospitals NHS Trust (BHRUT)

Ceri Jacob
Managing Director
Barking and Dagenham, Havering and Redbridge CCGs (BHR CCGs)

Another bogus statement by BHRUT on their website today

BHRUT have issued another misleading statement on their website today. For their claim to say that type 1 A&E is set to remain at King George to be taken seriously, the following six tests need to be met.

The failed 2018 £49M bid to close King George A&E as type 1 unit which is referred to in the six tests and this post is HERE

Six tests

1 - An explicit undertaking that King George A&E will remain a type 1 unit regardless of their ongoing clinical services review. The reason for this is BHRUT have shown they are quite willing to produce secret type 1 closure plans while publicly stating they are supposed to be engaged in a genuine review. In view of BHRUT's previous deceptions and the current deception in their statement of 17^th July 2019 about them “never” suggesting a type 1 A&E closure we need to nail down their most recent guarantee.

2- Write to Mr Hancock, the Secretary of State for Health, seeking the withdrawal of the 2011 closure plan to be announced in parliament. The 2018 £49M bid to close KGH A&E as a type 1 unit relied upon the 2011 decision at page 10 in the paragraph numbered 4. As long as the 2011 decision stands King George A&E is under threat. Two West London A&Es were recently saved by Mr Hancock in parliament, we need the same to happen for KGH A&E.

3 - Planning permission for Queens to be extended in order to close King George as a type 1 unit was passed in 2018 per page 10 of the £49M closure bid. BHRUT need to provide an undertaking that this application will not be proceeded with. Rather an option for extending King George with a new wing for more acute beds and mid-wife led maternity unit needs to be explored to cope with the growing East London population as part of the clinical service strategy going on now.

4 - https://www.eastlondonhcp.nhs.uk/downloads/ourplans/estates/STRATEGIC_ESTATES_PLAN_summary.pdf page 15 still lists KGH as centre of excellence for elderly this is an unacceptable closure type 1 option and needs to go.

5 Full disclosure of how far this transformation listed at page 12 of the £49M bid to close KGH as a type 1 unit has already gone. Page 12 of the £49M bid talks of “clinical pathways” We need complete disclosure of far the Type 1 closure has gone, with a view to lobbying for these partial closures of the Type 1 service at KGH to be reserved and so stop the apparent overloading of Queens.

6 – Ambulatory care at King George to be a universal all age service This is a key aspect of the closure plan we know about. As preparation for type 2 specialist A&E service for the elderly at King George Hospital, ambulatory care is restricted to the elderly frail. This is unacceptable, a key test of BHRUT goodwill on this issue is whether they will commit to providing an all age ambulatory care service at KGH.

The key passage from the BHRUT's bogus statement of 17^th July is:

“The A&E at KGH will continue to be a consultant-led service, open 24 hours a day, with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients (currently known as a Type 1 A&E department). We have never suggested otherwise.” (my emphasis)

For BHRUT to imply they have not planned to close King George A&E as a type 1 unit in the past is pure sophistry. So their new claim to say KGH A&E is safe as a type 1 unit needs to be scrutinised very carefully. Their current pledge of 17.7.19 is inadequate for the reasons below.

Due to campaigners efforts, the failed 2018 £49M bid, which was agreed in 2016, was published this April which proposed to close King George A&E as a type 1 facility.

This secret 2016 plan to close KGH A&E HERE as a type 1 unit is shown at page 7 as the preferred closure option which closes King George A&E as a type 1 unit and replaces it with urgent care centre and the development of a “centre of excellence” for the elderly. This downgrades KGH to a type 2 & 3 A&E. A complete contradiction of their “We have never suggested otherwise.” claim

Key extracts from the 2018 £49M plan to close KGH A&E as a type 1 unit

Page 10 sets out why the Trust believes that the closure plan “would not further public consultation” as it is based upon the original closure plans of October 2011.

Page 11 describes the plan as “radical”

Page 12 states the plan has “already partially commenced”

Page 13 Sets out the radical nature of the plan to “transform the care of the elderly and frail patients” to produce a “home first” model of care. “The new model of care” seeks to identify these patients through “screening mechanisms”

P14 sets out that ED & UCC activity is expected to grow to c365,000 per annum in ten years at both sites.

P17 sets out the aim of “consolidating certain services” onto one “principal site” rather than two by providing “emergency care at QH and geriatrics at KGH”

So not only has BHRUT planned to close King George A&E as a type 1 unit since 2016, it has actively working towards the closure and deceiving the public, elected representatives and staff at the same time.

Three examples of deception follow:

(1) Deceiving Mike Gapes and other elected representatives

An email dated 1^st 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 above is an example of BHRUT deceiving elected representatives.

It is a deception because the the £49M bid which was published on 11^th April 2019 is clearly a plan to close King George A&E as a type 1 unit. 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 and so KGH becomes solely a type 2 unit and 3 unit

Page 17 below consolidates emergency care at Queens in first sentence below

Page 18 below again talks of consolidating ED services at Queens.

Page 25 below shows at first bullet talks of the “elimination of the need” of a fourth Emergency Department in NE London. The paragraph of the bottom of the page shows the plan means Queens becomes one of the largest A&Es in the country.

(2) Jane Milligan's deceptive statement of 29th November 2017

The second example of BHRUT deception 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 BHRUT deception. 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 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 per the first paragraph below were completed before publication of the Redbridge Council report of February 2018.

(3) The deceptions about ambulatory care at Erica Ward

The third example of BHRUT deception is about 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.

BHRUT did withdraw denying the existence an ambulatory care unit after I sent them a photo of it 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. 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 https://www.nhsimas.nhs.uk/ist/how-to-stabilise-emergency-care-in-england/

I quote:

There is strong evidence that the symptoms felt in emergency departments led to worse patient outcomes. We know, for example, that patients run a 43 per cent increased risk of death after 10 days if they are admitted through a crowded accident and emergency (A&E) department. (Richardson DB, 2006) Waiting for admission in A&E is also associated with significantly longer hospital length of stay – on average 2.35 days longer where a patient stays in A&E for more than 12 hours. (Liew D, Kennedy M, 2003)

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.

The type 1 stats above are truly dreadful, they can be no doubt that we need more beds at King George in order to relieve the pressure on Queens. There has a been a recent drop in life expectancy

per the link 

https://www.theguardian.com/society/2019/jun/23/why-is-life-expectancy-falling

It has to be a concern that the national deterioration in A&E waits will have played a small, but nonetheless, real part in declining life expectancies.

Earlier this week Councillor Zammett makes the case for BHRUT opening more beds at a Health Scrutiny meeting HERE  The recording is poor, but you can hear it maximum volume on a desktop. BHRUT are clearly refusing to back the call for more beds. I would encourage readers to come to our meeting this Saturday at 3pm at Ilford Town Hall to say not only must King George A&E be saved but that our hospital needs a new wing to cope with the growing East London population.

I look forward to hear from BHRUT if they are willing to comply with the six tests.