Wednesday, October 9, 2019

Campaign For New Wing For King George needs your help over missing document & misleading stats

I wrote to Cllrs in B&D, Havering and Redbridge earlier today

Dear Councillors

1) We need information for a meaningful consultation for the BHRUT clinical review
The evidence for a new wing at King George relies on a 2017 PWC report published at the start of the BHRUT clinical review. This PWC report states that more beds needed to be provided at a cost of £125. The report was silent on whether the beds should be located at King George or Queens. The PWC report was available until recently on the East London Health & Care partnership (ELCHP) site, however today the link is no longer working. A copy of the report is available at PWC 2017 report saying £125M needs to spent at BHRUT goes missing on net






Secondly, Cllr Zammett, the Chair of Redbridge Health Scrutiny, says that type 1 A&E attendances at King George & Queens have been under reported. A video extract from the meeting is at my twitter feed at Andy Walker on Twitter






BHRUT need to disclose the correct type 1 figures which have been under reported for more than a year as soon as possible. Both the PWC report and the correct type 1 are helpful to the campaign for a new wing at King George to relieve the pressure on Queens. Under reporting of type 1 makes it easier to close the type 1 A&E at King George. The under reporting happened around the bid to close KGH A&E was written. For the avoidance of any doubt, I am not accusing bad faith by BHRUT in manipulating data to advance their closure plan. However, it must be right for BHRUT to disclose why they under reported the statistics. I have submitted a detailed freedom of information request to BHRUT seeking information about the type 1 under reporting and other information to make public participation in the clinical review more meaningful. BHRUT sometimes refuse my requests and I expect to write more on this in due course.

Should you agree with me that the accurate type 1 statistics and the PWC paper should be published as soon as possible on NHS websites please can contact whoever you think appropriate to progress the publication.
2) Type 1 guarantee should be cautiously welcomed
This recent guarantee by BHRUT of a type 1 unit continuing at King George is welcome. However, the BHRUT management team have credibility issues. BHRUT put in a £49M bid last year to close the type 1 A&E at King George and spent taxpayers money get legal advice to suppress their plans. Chris Bown, the BHRUT Interim Chief Executive, is still denying the £49M bid is a closure plan which undermines the type 1 guarantee he is providing.
Keith Prince was right to be critical of BHRUT pursuing this secret plan in the Romford Recorder recently.
The freedom of information request at the end of this email seeks information to find out exactly what work has been done in perpetration for the type 1 closure with a view to reversing the changes.
    3) A plea for help from East London Health & Care Partnership
    The ELCP have issued their draft five year plan recently for the East London NHS. A key extract is:
    Demand is projected to outstrip our resources and capacity which means we need to look at how we provide care and our financial models and systems.”
    Demand outstripping supply is already happening: type 1 4 hour A&E performance at Queens was less than than 50% in January and February of this year. This situation is set to get worse unless more resources both hospital beds and primary care are found for East London's growing population.
    4) Meeting and walk for a new wing for King George on 9th November
    The final ELCHP plan is due to be published on 15th November, to influence the final plan, the save King George campaign team have organised a meeting on the 9th November at 3pm at Ilford Town Hall with a walk assembling at King George at 1:30pm.
    The event page is at A new wing for King George Hospital The page includes a statement from BHRUT saying Queens is often at 99% bed occupancy which is damaging patient care.



    A petition is below:






    Your assistance with promoting the campaign for a new wing would be much appreciated. The aim is to build a cross party and cross borough consensus that King George is the site for additional acute capacity in East London due to its location beside the A12 and the space available for a new wing and car parking.

    The immediate aim is for the ELCHP to reference the 2017 PWC paper in their final report of 15th November 2019 as an option to be considered within the next five years.


    Andy – Freedom of Information request follows
    I seek the following information which is referenced in the £49M bid to close KGH A&E type 1 unit, which I attach for ease of convenience states:

    1) Page 19 states "patients not to be admitted due to a lack of capacity" and states "up to 50 major/complex cases cancelled per month in winter"

    I seek (i) the number of patients could not be admitted to either King George or Queens for the months of January and February 2019 on a site by site basis and (ii) how many patients had major/complex cases cancelled in January and February 2019.

    2) Page 12 if the £49M bid to close states: "that this process of transformation has already partially commenced" and goes in to list two bodies tasked with carrying out this "transformation"

    "The acute reconfiguration project team"

    & the "BHRUT Oversight and Assurance Group"

    I seek all minutes and agendas for these two bodies, The acute reconfiguration project team & the BHRUT Oversight and Assurance Group. I say it is the public interest for this information to be disclosed in full so we can find out how far out exactly what steps have been to close the KGH type 1 A&E unit and how many patients have been transferred to Queens as a consequence.

    On 12th September 2019 I was sent a large bundle of documents as a result of a subject access request. I seek the following items as a consequence of this request:

    3) A list of all documents identified per your letter to me of 4th July 2019.
    4) A list of all documents actually sent to me per your letter of 12th September 2019
    5) Two documents were almost completely redacted dated 12th and 30th April. The document of 12th April  says "Has Mr Walker joined in" and the document of 30th April mentions a visit to 10 Downing Street. I say the redaction has gone too far and more information should be released so I can work out more of what is being said about me. BHRUT should specify exactly why they will not disclose more in these documents. "National Security" considerations do not seem relevant here for example. I also say the two documents in question should be published with more text published to allow me to judge what is being said about me.
    6) Pages in the subject access request include the £49M bid to close KGH A&E as a type 1 facility, page 26 of this bid states under the heading "Indirect Economic Benefits.." mentions community beds at bullet point 4. Where it states:

    "...space released by the removal of emergency admissions will enable greater support for community services. These services provide vital support for patients who are medically ill but not ready to return home. King George Hospital already provides beds for these services and there will be opportunity for capacity to be increased."

    I seek the number of these community beds not used for emergency admissions at King George and the wards they are in:

    For September 2019
    For September 2018
    For September 2017
    For September 2016
    For September 2015

    7) Page 59 of the BHRUT quality account sent to me for 2018-2019 says BHRUT has seen a doubling of stroke patients due to the addition of West Essex patients. Please can you disclose how many stroke patients were admitted to Queens as in-patients in January 2019 and February 2019 and also for January 2016 and January 2016. For the same four dates can also please advise the average length of stay for these stroke in-patients at Queens.

    8) At the September BHRUT board meeting it was disclosed that Queens A&E has recently had its busiest day ever. The number attending Queens A&E wad given at 692. Chris Bown said at AGM this was the past Monday.

    Please can you supply

    i A breakdown of the type 1,2 & 3 attenders providing the total of 692.

    ii The percentage of type 1 attenders who were seen within the four hour limit.

    9) 12 monthly mortality assurance reports for September 2018 to August 2019 per the attachment.
    10) Internal documents relating to the coding change to type 1 A&E attenders in 2018 which seemed to happen around July 2018, the statistics taken from the NHS website illustrate my point. This coding change has led to big reduction in type 1 attenders, the public need to know what has happened here.

                                         Type 1  2019                                  Total

    April                               15289                                          25619
    May                                15246                                          26710 
    June                               15250                                          25684 
    July                                15852                                          27016
    August                           14697                                          25227 

                                          Type 2018                                    Total
    April                                20369                                         23786                     
    May                                 21582                                         24918 
    June                                21187                                          24592
    July                                 19303                                          25166
    August                             15473                                         23400 
    11) Any letter sent from the Department of Health or similar national NHS management body to say the 2011 decision to close King George A&E has been revoked.
    Regards

    Andy Walker


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