CQC Enforcement Notice: A crisis in local healthcare

In Shropshire, Telford and Wrekin Defend Our NHS, we welcome today’s intervention of the Care Quality Commission (CQC), and the issuing of an enforcement notice. The observations of hospital inspectors – leaked and widely publicised last week – were genuinely shocking.

It is wholly unacceptable that patients in our hospitals have been ‘boarded’ in inappropriate areas, because of a lack of beds – on corridors, in areas without access to call bells or oxygen, or on wards so crowded with extra beds that a resuscitation trolley could not be pushed through.

It is disgusting that hospital inspectors had to go to the aid of patients multiple times because of staff shortages. It is close to unbelievable that those patients included a diabetic patient left without food or fluid for 15 hours; close to unbelievable, too, that a high dependency area was left completely unstaffed for 15 minutes.

We applaud the courage of staff who approached hospital inspectors, and told them of the problems. It was staff who blew the whistle here. A letter from the CQC to hospital trust SaTH reported: “Staff across all areas and grades raised concerns with us about this practice (‘boarding’) and told us they felt it was unsafe, demeaning, undignified, and disgusting. Two staff members told us they felt patients who were boarded were treated like ‘animals’ and ‘cattle’.”

Something has gone very badly wrong at our local hospitals. Julia Evans is Secretary of Shropshire, Telford and Wrekin Defend Our NHS, and is a former A&E Nurse at the Royal Shrewsbury Hospital. She says, “NHS cuts lead to shockingly bad care – and that is the fundamental lesson that must now be learned from the crisis at Princess Royal and the Royal Shrewsbury Hospitals”.

The key questions are around what happens next. We call for the following:

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‘Care Closer to Home’: Another Nail in the Coffin of Future Fit?

Today, Wednesday (1st August), we have finally learned the plans for ‘Shropshire Care Closer to Home’ – community services in Shropshire – and the plans are as bad as they could be.

Future Fit relies on moving care out of the remaining acute hospital, whether that’s at Shrewsbury or Telford, and into community settings. There is a need for new and better community services. The bed, workforce and financial modelling of Future Fit are all dependent on this. The Pre-Consultation Business Case outlines plans for a 35,738 reduction in bed days, a reduction of 5,054 emergency admissions, and a bed base reduction of 110 beds[1]. If community services fail to prevent poor health and to treat people in the community when they do become ill, then Future Fit will also fail.

Then and now – what a difference. In August 2015, Dr Caron Morton – as Chief Officer of Shropshire CCG – wrote to local GPs to inform them of new investment in community services[2]. The plan was for the ‘transfer of financial resources into community provision – identified as £5.3 million recurrently per annum’.

And what has that £5.3m a year been replaced with? The ‘Care Closer to Home’ overview[3] released by Shropshire CCG today states bluntly, ‘SCCG has no additional money to pay for this way of working’! Instead, the plan is to close existing community services to pay for new services – but that means taking community NHS care away from people who depend on it now.

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Statement: Local Politicians betray the NHS

Telford and Wrekin Council’s rebranding of ‘PRH4Me’ as ‘NHS4All’ is little more than a sleight of hand to cover up their parochialism. In calling for support for the Future Fit Option 2, using their tagline “Option 2 – better for all”, they are calling for the Royal Shrewsbury Hospital A&E to be closed and the hospital downgraded. It seems that their ‘4All’ doesn’t include the residents of Shropshire and Powys.

The same parochialism is on offer from the Liberal Democrat Councillors of South Shropshire. They are calling for support for Option 1, with its closure of the A&E and the Women’s and Children’s Centre at the Princess Royal Hospital. Putting Ludlow first means not caring about the residents of Telford and Wrekin.

And all six of our MPs covering the Future Fit region are trying to avoid comment on the proposed cuts and closures altogether by focusing just on the £312m capital funding – forgetting to mention it’s a loan that must be paid back, with much of the funding coming from a PFI-type deal (Project Phoenix).

All these politicians, councillors and MPs alike, are avoiding the real question. Future Fit is bad for everyone – no matter which A&E is closed. No one benefits from the Future Fit plans to cut hospital nursing staff by over 20%. No one is helped by the plan for a 10% cut in the number of medical beds – the beds available for urgent and emergency patients admitted to A&E. It is the shortage of these beds that led again and again to long trolley waits and A&E crisis in both our hospitals last winter. No one benefits from an ambulance service, already stretched to breaking point, being asked to take on more and longer journeys with no extra resources. Ambulance wait times will increase for everyone. No one benefits, either, from mortgaging our financial future with loan repayments of £10-20m a year taken away from spending on local patient care.

The health bosses will say that if you support either Option 1 or Option 2, you are supporting the underlying package with all its associated cuts. It will not matter what caveats or concerns are expressed. Support for either option means precisely that: support, including support for cuts and closures.

Up until last summer, the health bosses had publicly promised there would be a third option – keep things as they are. They took that option away at the Joint CCG meeting last August. They realised most people want to keep both our A&Es open. They are now back to playing a divide and rule game. That’s why the only thing they are asking people to comment on is which A&E gets closed. We say a National Health Service means decent quality health services for everyone, no matter where they live.

Simon Wright, the Chief Executive of hospital trust SaTH, let slip the truth when he was speaking to a meeting of Shropshire Patients Group in November 2015: “We would all prefer to have two A&Es”. He then explained that the reason Future Fit was going to close one of them was that “only one is feasible given our resources.” In other words, it’s a cut to clinical care on the basis of NHS underfunding.

Some of our elected politicians seem to think the best way to play Future Fit is ignore the real damage it will do, and just say to their local voters, “I’m sticking up for you”. Presumably they are hoping no one will blame them for the real cuts in NHS services that they are effectively supporting. They seem to think that supporting one variant or another of NHS cuts is the best they can do –in both Telford and Ludlow, councillors are saying the option to keep two A&Es is not on the table.

That’s allowing the health bosses to set the agenda. We don’t have to do that. In Huddersfield a two-year campaign that united people in saying they needed both of their A&Es won a victory last month. The Secretary of State halted a plan to downgrade the Huddersfield Royal Infirmary that had been proposed by the local health bosses. Unity across the area affected by the closure led directly to that victory.

We can do the same. Let’s not be taken in by the health bosses divide and rule tactics. Let’s say no to both options. Let’s say no to fewer nurses and fewer medical beds. Let’s fill in our Future Fit Surveys marked ‘STRONGLY DISAGREE’ for BOTH Option 1 and Option 2.

Shropshire, Telford & Wrekin Defend Our NHS
04 June 2018

 

Future Fit: Either Choice a Disaster for Patients

The Future Fit consultation is a sham. They are attempting to get people from Shropshire, Telford and Powys to choose between two options, both of which will mean worse healthcare for everyone – fewer nurses and fewer medical beds in our hospitals, longer waits for ambulances everywhere, and cuts to our community health services.

Whatever some politicians and health bosses are saying, it is not a done deal. Just a couple of weeks ago the Secretary of State halted the plan to close the A&E in Huddersfield, forcing people to travel to one further away (9 miles, not the 18 we are threatened with). They won this victory because of united campaign that didn’t say “close their’s, not our’s”. And they used many of the same arguments with the Secretary of State that we have raised locally. Read their campaign’s statement here.

ConsultationSurvey

We are calling on people to fill in the Future Fit Survey and answer “Strongly Disagree” to both options. You can download the Survey from here.

And some Facts you won’t find in the Future Fit consultation documents:

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‘I think is it really important we remember that the best solution is to keep both A&E departments open.’

WhatsApp Image 2017-11-03 at 10.33.27.jpg‘I think is it really important we remember that the best solution is to keep both A&E departments open’.
Simon Wright, Chief Executive of Shrewsbury and Telford Hospitals, September 2017

That’s the second time Simon has said both A&Es should stay – and he’s right! Our two hospitals cover an area 3 times the size of Greater London. One A&E for an area that size is nonsense. Research shows that longer journeys to get to A&E mean more people die.Government cuts mean NHS spending in our area will be slashed by £135m a year. Future Fit is part and parcel of that big cuts plan. That means cuts to hospital care. Telford is set to lose the Women’s and Children’s Centre and urgent care beds, Planned Care will be stripped out of Shrewsbury, there will be 100s fewer doctors, nurses and therapists, and fewer hospital beds.

Community NHS services and social care are being cut too. There’s an onslaught against community hospitals and Minor Injuries Units. Public health funding is being slashed. GPs are already stretched to the limit. Health bosses think we can all take care of ourselves instead! ‘Community resilience’ and ‘self-care’ are the future, they claim.And Future Fit, they quietly admit now, won’t solve the problems recruiting Consultants.

• We need BOTH our A&Es, BOTH our hospitals, and community services that work.

• We need proper funding for the local NHS, instead of one of the lowest levels per person in England. Will our MPs fight for fair funding for our area? They need to!

• We need an NHS that works, not Future Fit cuts and closures.

Can you help us defend our NHS? We need people who can give out leaflets, help organise meetings, write letters to newspapers, write leaflets or posters, and share your ideas on building this campaign.

Email info@shropshiredefendournhs.org

Find us on Facebook and at https://shropshiredefendournhs.org/

Ludlow GPs Challenge Community Services Review

The Shropshire CCG’s Community Services Review was launched with the intent to cut costs of community services. The initial report that is being discussed by the CCG Governing Body today (October 11) concludes that ‘change’ is necessary. The conclusions imply the closure of our rural Minor Injuries Units (MLUs) and all beds in our Community Hospitals. In practice, that means the closure of Community Hospitals.

The GP Partners at the two Ludlow practices have issued this statement challenging the review on the eve of the Governing Body meeting.

Letter to the press on behalf of the partners of Portcullis and Station Drive Surgery, Ludlow

The partners of Ludlow medical practices are surprised by the public launch of the community services review in the media where it has been announced that a working document will be discussed in the CCG Board meeting tomorrow. We feel this discussion is premature as the data used in this working document is still incomplete and can be potentially misleading and may lead to bias. A number of requests have been made to the CCG to improve the data so that it is more accurate, more representative and less subject to potential bias and many of our requests have been ignored. Continue reading

Future Fit: What a Shambles

Today, 13th September, Shropshire CCG nodded through the next stage of the ‘Future Fit’ NHS cuts and closures plan. The ‘Pre-Consultation Business Case’ has been approved by the CCGs and will be submitted to NHS England for assurance on Friday. ‘Consultation’ – in a manner of speaking – will probably begin in mid-October and run for 14 weeks.

Last month, the two CCGs – Shropshire and Telford and Wrekin – published an independent review of Future Fit, carried out by KPMG[1]. The review identified ‘three overarching areas for attention’ and added ‘We recommend these are addressed by the programme before moving to public consultation’. Has that been done? No, very conspicuously not. Continue reading