NHS rebut latest Labour scaremongering about Charing Cross Hospital

Hammersmith and Fulham Council persists in claiming that the NHS threatens to close Charing Cross Hospital including its A&E. The NHS persists in denying this (see the latest letter below from the last Imperial NHS Trust board papers.) Even if the NHS did have such a plan Labour’s “early pledge” in the last council elections to “block” such plans was dishonest as the Council has no such power.

If forced to choose whether to believe doctors or Labour councillors I would tend to go with the former. Having said that the NHS certainly haven’t done themselves any favours with their communications. Their messages have been pretty impenetrable and contradictory at times.

What I am absolutely clear about is that I do not support the closure of Charing Cross Hospital or its A&E – nor do any of my fellow Conservative councillors. Labour keep pushing this lie in the most offensive and emotive terms. Increasingly their message inspires intimidatory behaviour from the Corbynista fringe – which Labour councillors have not yet disowned despite instances being raised with them. It is the “politics of hate” and Labour should cease promoting it.

Instead they should focus on running the Council. On the many issues which they are responsible for. At present they seem to be trying to deflect attention from their failings.

18th July 2017 

Dear Councillor Cowan 

Thank you for your letter of 12 June 2017 responding to the complaint we raised with you in March. Your response, and subsequent mailings to local residents, continue to provide an extremely partial account of the facts about the future of Charing Cross Hospital. Our only motivation in challenging your approach is to end the unnecessary distress this is causing to our staff, patients and local communities, especially at a time when our health services are under particular pressure. 

Through our regular meetings with your councillors and officers and frequent attendance at the Council’s health overview and scrutiny committee, we believe we have set out the facts clearly: 

In 2012, we published plans for a reconfiguration of health services across North West London to respond to rapidly changing health and care needs.  We undertook a full public consultation which set out plans for a more integrated approach to care, with the consolidation of specialist services onto fewer sites, where this would improve quality and efficiency, and the expansion of care for routine and on-going conditions, especially in the community, to improve access.  Charing Cross was envisaged as a ‘local hospital’ within this network of services, building on its role as a growing hub for integrated care offered in partnership between hospital specialists, local GPs and community providers. 

After the consultation, the Joint Committee of Primary Care Trusts (JCPCT) met to make their decisions. One of those decisions related to an alternative proposal that we had developed for the Charing Cross Hospital site in response to feedback from the public consultation. This proposal, which saw a wider range of services on the Charing Cross site, was recommended by the JCPCT in early 2013. 

The decisions of the JCPCT were then referred to the Secretary of State who asked the Independent Reconfiguration Panel (IRP) to look at the proposals. On the advice of the IRP, in October 2013, the Secretary of State supported the proposals in full, adding that Charing Cross Hospital should continue to offer an A&E service, even if it was a different shape or size to that currently offered.  He also made clear that there would need to be further engagement to develop detailed proposals for Charing Cross. 

Our subsequent work to engage patients and the public in the development of detailed plans for Charing Cross was paused as increasing demand for acute hospital services highlighted the need to focus first on the development of new models of care to help people stay healthy and avoid unnecessary and lengthy inpatient admissions. Our approach of actively not progressing plans to reduce acute capacity at Charing Cross unless and until we could achieve a reduction in acute demand was formalised in the North West London Sustainability and Transformation Plan published in 2016. The plan made a firm commitment that Charing Cross will continue to provide its current A&E and wider services for at least the lifetime of the plan, which runs until April 2021. We also made the commitment to work jointly with staff, communities and councils on the design and implementation of new models of care.

Our commitment to Charing Cross is demonstrated further in the £8m we invested last year – to refurbish urgent and emergency care wards, theatres, outpatient clinics and lifts and to create a patient service centre and the main new facility for North West London Pathology. And in the further, significant investments we are planning for this year. 

You have consistently failed to acknowledge any changes in our approach to Charing Cross since the original public consultation on proposed service changes for North West London. This is demonstrated most clearly by your latest mailing to local residents which included a copy of outline service proposals published five years ago.   
In response to your detailed questions about how and why we shared our complaint to you in March, we felt we had no choice but to make it public. This was entirely a decision of the Trust and CCG leadership. Unfortunately, we do not have the resources to send materials directly to every house in the borough. We published our letter to you on our websites on 28th March 2017, the day after it had been sent to you and with full disclosure of our approach, to help allay unnecessary public concern. Unsurprisingly, there has been follow up media interest in our exchanges which our communications teams have responded to, as appropriate.

Concern about changes to local health services is entirely valid and understandable. Far from wishing to prevent debate, we encourage and welcome open discussion, especially with patients and the public.

We have to create a shared understanding of the huge challenges we are facing in the NHS – and social care –  if we are to address them effectively. We very much wish to work with all of our local authorities as key partners in this endeavour but it is only possible if the considered and honest opinions of our organisations, including  those of our senior clinicians, are not actively misrepresented.     
 
Yours sincerely, 
 
Dr Tracey Batten      

Chief Executive

CWHHE  Imperial College Healthcare NHS Trus

Clare Parker  

Chief Officer

SRO – Shaping a Healthier Future 

NHS hits back at Council’s “incorrect and misleading claims” that closure of Charing Cross Hospital is planned

The Imperial College NHS Trust chief executive Dr Tracey Batten and North West London collaboration of clinical commissioning groups chief officer Clare Parker have challenged Hammersmith and Fulham council leader Stephen Cowan over inaccurate and misleading claims about Charing Cross Hospital.

A recent letter from Cllr Cowan to all of the borough’s residents says that ‘NHS bosses have re-launched plans to close Charing Cross’ as part of the north west London sustainability and transformation plan (STP).

In their joint response, Dr Batten and Ms Parker point out that there have never been any plans to close Charing Cross Hospital and that the STP actually makes a clear commitment that there will be no reduction in Charing Cross’s A&E department or wider services within the lifetime of the plan – that runs until April 2021.

They also highlight the recent £2.5 million investment in urgent and emergency care services and theatres at Charing Cross.

The letter goes on to say that it’s more important than ever for the NHS and local authorities to work closely together.

It says:

We are writing to express our concern at your leaflet ‘Save Charing Cross Hospital – stand with us to fight the latest closure plan’ (attached), which you circulated with council tax updates to the residents of your borough this month. This material made a number of incorrect and misleading claims about the future of Charing Cross Hospital which is likely to cause significant, unnecessary distress to patients and staff.

As you will be fully aware, there have never been any plans to close Charing Cross Hospital.

You will also know that, far from “re-launching” proposals for changes at Charing Cross, the North West London Sustainability and Transformation Plan (STP) made a clear commitment that there will be no reduction in Charing Cross’s A&E department or wider services within the lifetime of the plan (that runs until April 2021). And we recently updated you on a £2.5 million investment in urgent and emergency care services and theatres at Charing Cross.

Like the rest of the NHS, we are working hard to respond to growing and changing demand, especially to support frail and elderly patients with a range of health problems. We also want to continue to offer the residents of NW London the very best in specialist health care, as we do, for example, at the Trust’s dedicated heart attack centre, stroke unit and major trauma centre. And this is all within the context of increasing financial pressure. It’s more important than ever that the NHS and local authorities work closely together to develop better and more integrated ways to help local people stay as healthy as possible and to get fast access to the right care when and where they need it.

As such, we do believe health and care services need to continue to change along the lines set out in the service strategy for NW London, agreed in 2013 following a full public consultation. We made further commitments through the STP that we will work jointly with communities and councils to design new models of care as set out in the strategy and that we will first progress and test new out-of-hospital models before looking to reduce acute hospital capacity.

It is difficult to understand why the Council would choose to spend significant sums of public money fighting ‘closure plans’ that do not exist and when your NHS partners have clearly set out that service changes over at least the next five years will be focused on providing better ways of helping local people stay healthy and avoid unnecessary hospital admissions or long stays.

As such, through this letter, we are raising a formal complaint with you regarding this publicity material and its content which we believe has clearly breached the Code of Recommended Practice on Local Authority Publicity, specifically around objectivity and even-handedness. We request that you stop any further promotion of this leaflet and publicly retract your misleading claims. Further details on the grounds for our complaint are attached.

We will be making this response publicly available as part of the effort now required to reassure residents, patients and our staff that Charing Cross Hospital continues to be a vital part of the Trust and the NHS in NW London, and that we are continuing to invest in its future.

Why does Hammersmith and Fulham Council ban vaping?

Research has established that there are no health risks from “passive vaping”. There is no law against vaping in public places. It is a highly effective method for smokers to give up. Yet Hammersmith and Fulham Council bans vaping on its premises – without being able to give any proper justification for doing so.

I wrote to Debbie Morris, the Director of Human Resources as follows:

“I was concerned to see from this FOI response that “staff and visitors are expected to vape outside” from Council premises.

https://www.apps7b.lbhf.gov.uk/cus/servlet/ep.getImg?ref=D387184&st=NOHEADER&auth=10051

Please note that Public Health England argue that we should make a distinction between smoking and vaping.

https://www.gov.uk/government/news/vaping-in-public-places-advice-for-employers-and-organisations

I would propose that council staff should be encouraged to give up smoking by being allowed to vape from their desks. Please may I have your comments.”

She replied:

“Thank you for your email dated 7th November. In response to your query ‘that council staff should be encouraged to give up smoking by being allowed to vape from their desks.’

“Vaping is covered under the same restrictions as cigarette smoking under the current workplace policy. All policies are regularly reviewed according to latest evidence. HR and Public Health are committed to a joined up tri-borough approach and policies relating to vaping will be reviewed jointly due to the rapidly emerging evidence base.”

H&F Council refuses to back defibrillators scheme

shaun-bailey-100x100Some residents may remember that Shaun Bailey was the Conservative candidate for Hammersmith in the 2010 General Election. Unfortunately he didn’t make it but the good news is that this year he was elected a member of the London Assembly and he has already produced an important report about saving lives for Londoners.

He says:

“Placing defibrillators in disused and redundant phone boxes is a fantastic way of getting life-saving devices into highly visible and easily accessible locations.  My research found 10,211 people suffered a cardiac arrest in London in 2014/15 and, despite the London Ambulance Service having some of the best performance ratings in the country, survival rates remain as low as nine per cent.”

The cost would be relatively modest and Hammersmith and Fulham Council has a huge annual Public Health budget of £22.7 million which is overwhelmingly wasted. So I wrote to the Council’s Director of Public Health Mike Robinson proposing that the Council back the scheme:

Mike,
Please advise:
1. Whether your team provides any training in secondary schools for pupils in First Aid and specifically cardiopulmonary resuscitation and using Automated External Defibrillators.

2. Whether there are any plans to fund from your budget the adaption of redundant telephone boxes in Hammersmith and Fulham for defibrillators. I gather BT offer a scheme of selling the phone box for a pound and the cost of installing the defibrillator is around £1,000.

My questions were prompted by reading this report which provides more
background:
http://glaconservatives.co.uk/wp-content/uploads/2016/07/Never-miss-a-beat.pdf

Best wishes,
Harry

The reply I got was as follows:

Dear Cllr Phibbs,

Thank you for your enquiry regarding the potential use of public health budget to support initiatives for increasing the availability of and the training in the use of defibrillators in community settings.

Although this is clearly an initiative that has been found to have some benefit in aiding in the acute response to cardiac arrests, and is something that has had recent Government support as well as from organisations such as the British Heart Foundation, available public health budget is currently targeted where possible on primary prevention and not for acute response.

Therefore, in response to your questions:

1.This is not something the public health budget is currently used to support and therefore no public health funded initiatives currently take place that support or provide training in secondary schools for pupils in First Aid and specifically cardiopulmonary resuscitation and using Automated External Defibrillators.

2.There are currently no plans to use the public health budget to fund the adaptation of redundant telephone boxes in Hammersmith and Fulham for defibrillators.

Please let me know if you would like to discuss further.

Regards

Mike Robinson

A very disappointing response. Really just a policy of inertia. The challenge should be for the £22.7 million to save as many lives as possible. But the Council just leaves the bureaucrats to drift along while the councillors supposedly in charge collect their allowances. A terrible failure of leadership.

Cllr Andrew Brown: World TB Day – Important Globally and in Hammersmith & Fulham

andrewbrownA guest post from Cllr Andrew Brown

Today, 24th of March, is World TB Day. This is of particular significance this year, as tuberculosis has become for the first time in many years, the deadliest infectious disease, killing 1.5 million people last year. TB has overtaken Aids/HIV as the leading infectious killer, and that is partly because it is a difficult disease to deal with. It is not easy to diagnose and its treatment is lengthy requiring over six months of treatment with multiple pills every day. TB is also a disease of the developing world, so unfortunately has not attracted as much funding from government or the pharmaceutical industry for the development of new treatments and vaccines.

What is particularly concerning about TB is that in some countries, the levels of the disease that are resistant to some or virtually all antibiotics is becoming worryingly high. If this trend continues, TB could become as much of danger in 21st century Britain as it was in the 18th century.

I was privileged to attend the All Party Parliamentary Group on Tuberculosis events in Parliament yesterday, and have a personal connection to the academic side of TB, as my first job after finishing my university studies was for the Faculty of Medicine at Imperial College researching the impact of the Global Fund for Aids, Tuberculosis and Malaria’s funding in the developing world.

The Global Fund, like the Gates Foundation is an incredibly important NGO that is doing important work to help eradicate diseases worldwide. As a conservative I am extremely proud of the support that this Government has provided to the Global Fund, being the third largest donor. This is extremely important this year, as the Global Fund raises money through replenishments, and this year is a replenishment year.

But what does this have to do with Hammersmith & Fulham? Many of you may be surprised to know that TB has unfortunately become a problem again in the UK and in particular in London. Whilst the incidence has fallen since 2011 due to action taken by the Government and the NHS it is still a concern, especially for some of London’s most deprived communities.

Hammersmith & Fulham unfortunately has on average 43 cases per year (2012-2014). This may not seem a lot, but compared with the national average of around 12 per 100,000 population, H&F’s is twice that at 24.2 per 100,000. I am going to write to the clinical commissioning group and the council to ensure that we are doing all we can to reduce the incidence of TB in H&F.

TB is something we have the knowledge and treatments to eradicate globally, especially if we address anti-microbial resistance. Let’s make a start by eradicating it Hammersmith & Fulham and across London.

H&F Council spent £777,000 on “Personal Health Plans” – one person gave up smoking, 15 drank less, six lost weight

I have written before about my concerns that the £22.7 million spent by Hammersmith and Fulham Council on public health fails to achieve value for money. When I asked for a budget breakdown it included the following item – costing £777,000 a year:

“Delivery of personal health plans – individual goal oriented planning and support for 1,560 people a year and 1,800 community health checks delivered each year; the service helps people to lose weight, become more active, reduce alcohol use, stop smoking and eat more healthily, and is focused on areas of deprivation.”

That’s pretty expensive. Just under £500 a head. But to get an idea of whether it was good value for money I asked a further query:

“How many of the 1,560 people that we have funded personal health plans have drunk less, lost weight or given up smoking as a result?”

The results:

15 people reported reduced alcohol consumption.

1 person gave up smoking completely.

6 people reported reduced weight.

Of course there will be other health targets. But these are pretty obvious ones and the figures are derisory. It works out at £37,000 a time for each of those 21 achievements. Furthermore how many of those outcomes would have happened anyway regardless of signing up to the personal health plan?

This is the context in which the Council claims there is no money available from the Public Health budget to promote shingles vaccine. Or restore drinking fountains. Or provide dust suppressant spray on the roads to reduce air pollution. Or provide hypnosis for pregnant women to give up smoking or residential rehab for drug addicts. Or provide blood pressure tests for middle aged men. Or peer support for mental illness.

Or really just about anything at all that might be of greater real, practical value than the £777,000 for the Personal Health Plans. It would be quite a challenge to think up a less effective way of spending the money.

H&F Council still refuses to take practical action over poor shingles vaccination rates

Cllr Lukey: Refusing to take practical action.

Cllr Lukey: Refusing to take practical action.

Last week I reported on the terrible news that Hammersmith and Fulham has only half vaccination rate for shingles as the national average.

I suggested that the Council could make a difference by using a relatively modest amount from its £22.7 million Public Health budget with practical measures to increase the take up of the jab.

The Council could write to all qualifying residents to urge them to take the jab. They should back this up with visits. They could fund the NHS to make it as easy as possible – for instance offering the vaccination on site in sheltered housing accommodation and indeed in residents’ private homes. They could also pay for the vaccine itself for borough residents aged 73-77? (At present those who were 70, 71, 72, 78 or 79 years old on the 1st September, 2015 qualify for a free vacine from the NHS.) Preventing elderly residents from getting this very unpleasant disease would actually save the Council money in terms of the adult social care budget.

I have wrote to Cllr Vivienne Lukey, the Cabinet Member for Health and Adult Social Care urging her to take action. I’m her reply read to me like a collection of excuses for doing nothing very much at all. She rejected my proposals – but didn’t offer any very tangible alternative – apart from holding lots of meetings. Here is her reply in full:

“Dear Cllr Phibbs,

Thank you for your email. Shingles is a horrible condition – you may have had family experience of this, as I have. Prevention is better than cure and I am determined that we get our health partners to improve on past performance.

I am unclear as to whether you have misunderstood the letter from Stuart Lines or have chosen to disregard what he has explained. NHS England has both the duty and the budget to commission GPs and NHS providers to carry out immunisations . There is no funding for this within our Council Public Health budget, which (as you well know)  is being cut by the Government. Given the other pressures on our funds, it makes no sense to me to attempt to take on a job which other bodies are paid to do so I cannot accept your original suggestions. I realise you put forward  these ideas before you had been briefed about statutory duties and am sure you were trying to be helpful.

But of course we will want to do the best we can to reduce shingles in our borough. We have an absolute commitment to defend our NHS services and improve health outcomes for our residents.

What we will do is to use our health and wellbeing leadership role to hold our partners to account and use our Council , voluntary and independent sector communication channels to encourage take up by educating residents about the consequences of getting shingles and signposting them to immunisation. I have asked for further work to be undertaken about eligibility for the vaccination (since it is restricted to older people) so we can see whether we need to lobby the Government for wider access.

We  set up a multi agency partnership group last summer which is led by the Council, and attended by myself and Cllr Holder. It has developed new ways of publicising  immunisation across the sectors and increasing take up in a wider range of venues and at weekends. This has proved a very effective forum for pressing NHS London Public Health officials and GP management for a proactive and sustained programme , which the Council can in turn promote. As Stuart Lines explained to you in his letter, this  will be our vehicle for driving up performance.

Thank you for taking an interest in what we are doing.

Best wishes

Cllr. Vivienne Lukey
Labour Councillor for Fulham Reach Ward
Cabinet Member for Health and Adult Social Care”

I have replied as follows:

Thanks, Vivienne.

I do think that your reply is quite disgraceful.

Just because we do not have a statutory requirement to do something does not preclude us from doing it. Nor do I accept that there is not the funding available given that there is £1.8 million unallocated from the Public Health budget for this year and that much of the total £22.7 million budget is ineffectively spent at present.

While you say that you wish to reduce the level of shingles in our borough you fail to back any practical measures for doing so but instead offer bureaucratic waffle.

Best wishes,
Harry