Council opposes Hospital Changes

Last night I moved, and Mel Collins seconded, a motion at the Borough Council meeting expressing serious concerns about the impacts of closures of Accident and Emergency at Charing Cross and Ealing hospitals  would have on the West Middlesex Hospital and on local communities.  Labour and UKIP Councillors supported our motion and the Tories abstained.

The proposed closure of Charing Cross hospital is a major issue raised by people in Chiswick when I meet them on the doorstep.   When it was proposed to close the A&E department last year  the community feared this would spell the end for the whole hospital.  The anti closure campaigns have been joined by leading clinicians, and the cross borough, cross-party Joint Health Scrutiny Committee. There are real fears about longer journey times for ambulances, patients admitted to a bed being cared for further from home, and the loss of clinical excellence.

What was originally a proposal to close the A&E  at Charing Cross, along with that of Ealing and Hammersmith hospital, now involves the complete demolition of Charing Cross, all 500 beds, and the building of an urgent care centre (walk in non "blue light") and a 60 bed GP centre on the site.

Few who use or work in hospital services would deny that there is a need for change.  And change can work - the reorganisation of acute stroke services in London  have transformed recovery rates from being the worst in the country to among the best. But those changes were properly funded and properly planned - a very different situation to that experienced in North West London now. 

Ironically one of the eight "fewer larger" hyper stroke units is at Charing Cross and would now move to St Mary's Paddington.

So; will the proposed cuts and changes be better for residents in Chiswick and the rest of Hounslow?
A year ago Hounslow's Cabinet agreed to support Option A - designating West Middlesex University Hospital  a ‘major hospital’ and Charing Cross  a local hospital.  But this was a qualified support based on little available data.  Firstly; we requested assurances from the NHS that West Middlesex Hospital will be able to cope with increased numbers of patients using its accident and emergency, maternity and other services.

and secondly we specifically said that no hospitals were to close under the proposals.  Yet the complete demolition of Charing Cross as we currently know it has been added since that Cabinet meeting - with the loss of not only A&E, but a whole host of specialist units that have saved the lives of thousands of local residents over the year.

  

 There is increasing clinical opposition to having fewer A&E units - the success data is not there, and there is concern that where Urgent Care Centres are not attached to an A&E, there are too  many serious ill patients unable to quickly transfer from one to the other.  

The cross borough, cross party, Joint Health Overview and Scrutiny Health Committee

is very concerned about the changes.  In particular; the ability of Out of Hospital care to expand sufficiently quickly to reduce the demand on acute beds in the remaining major hospitals, the ability of the hospital and public transport system to adapt to the changes in patient travel, the impact on services to people arriving at hospital with mental health problems or disabilities. They are not assured that the finance is there, nor adequate measurable targets, nor adequate risk assessments

  I have twice heard the presentation by our local Clinical Commissioning Group about how they plan to reduce the expected pressure on West Middlesex's A&E and acute beds, by developing an extensive out-of-hospital service.    No-one can argue that it's in everyone's interests to get and keep frail elderly people, and people with chronic conditions, out of hospital. 

But what I have seen are nice plans with no targets, and no funding guaranteed. They are aspirational.  

Without committed funding, and clear targets they are little more than wishful thinking. 

These changes are being planned to be implemented within three years, at a time when A&Es are being swamped by rising numbers of frail elderly people, who in large part are victims of an underfunded social care system.  Last winter the West Mid saw more patients than ever - they coped without per-patient waiting times increasing - but they are at capacity. There are no accurate population projections built into the out-of-hospital plans and no adequate answers for those living near Charing Cross, as to the likely journey times they would need to factor in to get through West London's busy traffic.  

Jeremey Hunt must review these changes, for the sake of the future health of the people of north west London.