An independent charity called Healthwatch Central West London has produced an interesting report on Charing Cross Hospital asking the NHS for greater clarity about the future. Research included interviews with 218 outpatients. There was a high level of satisfaction with the hospital and a range of opinions on various matters – for instance on whether any services should be switched from the hospital to GP surgeries.
Imperial College Healthcare NHS Trust has stated that there will be no changes until at least 2021. But after that there is a possibility of it becoming a “local hospital”. If it did, do patients feel that their “health needs would be fully met”? Among the residents taking part in the survey, 17 said yes (30.36 per cent) eight said maybe (14.29 per cent) 27 said no (48.21 per cent) and another four (7.14 per cent) declined to answer. Understandably a lot of people wanted to know what a “local hospital” would mean.
Healthwatch Central West London asked what the definition was and the Imperial College Healthcare NHS Trust responded:
“The consultation document (August 2012) for the plans to improve local NHS services in North West London as part of the SaHF programme, identified eight different settings for care. Section 10 of the consultation described a ‘Local hospital’ as follows: “Local hospital – this type of hospital provides all the most common things people need hospitals for, such as less severe injuries and less severe urgent care, nonlife threatening illnesses, care for most long-term conditions such as diabetes and asthma, and diagnostic services. It basically provides the kinds of services that most people going to hospital in NW London currently go there for.”
The NHS Trust does also say, in a tortuous phrase:
“Our approach of actively not progressing plans to reduce acute capacity at Charing Cross Hospital unless and until we could achieve a reduction in acute demand.”
As Charing Cross Hospital has been coping with an “increasing demand for acute hospital services” it would seem unlikely that would change any time soon.
However the NHS does argue that cutting the number of beds could be a measure of success:
“Over 30 per cent of inpatient beds in acute hospitals are occupied by patients whose care would be better provided elsewhere in their own home or community. Clinical audits regularly show that over 30 per cent of patients in an acute hospital bed do not need acute care. It is best for patients if they are able to return home at the optimal time for them, to be subsequently cared for in the most appropriate setting, preferably their own homes…..
“Charing Cross Hospital currently has just over 400 inpatient and day-case beds. Successful programmes have shown that high-quality interventions that support patients before they become acutely unwell can reduce non-elective admissions and slow progression of a disease. This can contribute to a reduction in overall care costs through the removal of acute beds when out-of-hospital solutions are in place. It does not necessarily mean planning to treat fewer people – it means treating people in a different way or different place.”
In another report the NHS Trust says:
“We have recently seen some of our largest ever investments in new facilities and equipment at Charing Cross Hospital, much of which has been made possible by the support of Imperial Health Charity.
“Over the past 18 months, some £6 million has been spent on major new developments including: Riverside theatres; main outpatient clinics; a new acute medical assessment unit; our first patient service centre; and the main new facility for North West London Pathology. In addition, we are spending almost another £8 million on replacing imaging equipment and installing two state-of-the-art LINAC radiotherapy machines so we can provide the most advanced cancer treatments.
“And our maintenance spend at Charing Cross this year is another nearly £6 million, around a third of our total Trust spend on backlog maintenance.
“As part of our investment in urgent and emergency care services and theatres at Charing Cross, we have co-located our acute medicine beds on the ground floor of the hospital, near to the A&E department, and closer to the imaging department. This has enabled medical patients to be admitted more quickly.
“In addition, we are currently working up a multi-million pound refurbishment and expansion of the A&E department at Charing Cross, to begin in the early part of 2018. The likely timescales however, mean that the improvements will impact after the current winter period.”
On its own website the NHS Trust says:
“Since 2016, we’ve committed over £20 million for building improvements and new imaging and radiotherapy equipment at Charing Cross.
“We’ve also developed new services and employed extra doctors, nurses and other healthcare staff. More investment is already planned for 2018 and 2019, including a refurbishment and expansion of the A&E department.”
That report also says:
“We can currently predict that it will be some years into the future before acute demand has reduced sufficiently for us to look to reduce inpatient bed numbers or A&E capacity.”
2021 is not very far away. It would be good to have a clear guarantee that the A&E will continue and that the hospital will not be downgraded after that date. I am as confused by the convoluted jargon and changing messages from the Imperial College Healthcare NHS Trust as anyone else. But the fact that the A&E is currently being expanded is very welcome and clearly an encouraging sign for the future.