Karen Buck MP’s letter Dr Tracey Batten, Chief Executive, Imperial College Healthcare NHS Trust
I was very concerned to read the recent article Evening Standard which confirms my fears about the impact of dramatically reducing West London A+E capacity. http://www.standard.co.uk/news/health/st-marys-forced-to-use-overflow-beds-when-nearby-ae-is-axed-9458660.html It also worries me that these points were not raised during our discussion about the deferral of the OBC decision when we talked two weeks ago.
I am sure I am not alone in my concern that the A+E and bed capacity at St Mary’s may not be able to cope with the additional pressure, especially in the event of a period of exceptional demand, and certainly not without significant additional capacity outside the acute sector to reduce avoidable A+E attendances/admissions, and ensure speedy discharge of patients.
As of now, I am unconvinced that we have a sufficiently robust plan to switch resources within the NHS and develop community provision to a level where it makes a measurable difference. I would be gravely concerned by the prospect of patients spending longer waiting in ambulances or on trolleys, whether routinely or during a period of winter pressure, just as I am concerned by the fact that St Mary’s is already at “maximum utilisation”- I assume currently, and also before any possible period of exceptional pressure. I am, for example, very aware of the fact that, even before the A+E closures, and even in the absence of a ‘winter crisis’, such as a flu epidemic, St Mary’s has been at capacity in the last couple of winters, with patients being diverted to Central Middlesex and probably elsewhere, as a result
All of this comes of top of my deep disquiet at the chaotic process by which Imperial began implementing the re-structuring of services without consultation with the local authorities or even the CCGs, moving elective surgery to Charing Cross with no transport strategy to support less mobile patients from Westminster (still not forthcoming, almost a year after I began asking about it).
Even for those of who, like me, support the broad principle of concentrating clinical services in centres of excellence at one end, and within the primary and community sector at the other, struggle to have any faith in the implementation of the ‘Shaping a Healthier Future’ agenda in practice. Glossy brochures turn out to have no substance behind them; concrete plans to cope with the actual service transformation are still not in place and critical information, such as the current capacity issue at St Mary’s, are not shared in an open and honest manner.
Imperial, in partnership with the Clinical Commissioning Groups and local authorities, must spell out, as a matter of urgency, how it is intended to cope with additional demands in respect of both A+E and bed capacity in the coming months, and what guarantees there will be that that there will be no increase in waiting times, trolley waits and ambulance waits; and whether patients can expect to be moved outside the Imperial Group for treatment when capacity levels are reached. These commitments must not be made as statements of intent, but with clear evidence based on an assessment of patient flows, attendances and admissions, arising from A+E closures and other service changes in the coming months.
Thank you very much and I look forward to hearing from you.
Karen Buck MP