For over an hour and a half Dr Tracey Batten, Professor Chris Harrison, the Medical Director and Steve McManus, Chief Operating Officer fielded questions which SOH presented directly to them on behalf of patients and the public, covering the plans for services, including the three main hospitals in the Imperial group, and the future of the Trust itself.
Repeatedly referring to the consultation document “Shaping a Healthier Future”, Dr Batten insisted that the proposals were the guiding principles for the future of the Trust. She stressed the role of the PCTs – now CCGs – in embracing SaHF. And she insisted that the Trust would be ready and financially fit to seek Foundation status next year.
Life-threatening cases at UCC's: The care to be offered at a UCC seems to depend on where it is located. Dr Batten confirmed that the UCC at Hammersmith Hospital, for example, would be able to offer (some) consultants, investigative equipment (MRI, CT, X-ray), blood tests. Stand-alone UCCs with only “emergency-trained” G Ps would not. G Ps would do barely more than triage the urgent cases which they couldn't treat. And they would not be employed by Imperial, so legal liability for potential negligence claims is uncertain.
Issues discussed included mental health, dialysis, cancer care and stroke. Other life-threatening emergencies will still end up in Imperial's “super A&E” at St Mary's or another Trust's A&E.
SOH pointed to the arbitrary geographic outcomes – for example three Hyper Acute Stroke Units all in Central London! – but these concerns were dismissed as the unintended result of the borough-focussed CCGs.
For Out Of Hospital care the Trust talked about a small number of pilot projects, but detail was lacking and they seem to be at an early stage.
The Imperial CEO admitted that their transport strategy was still to be worked out. London Ambulance Service is providing two ambulances to ferry urgent cases from Hammersmith and Central Middlesex, but TfL has not changed bus routes to lay on more services to St Mary's from the outlying parts of Hammersmith. Dr Batten agreed that the transport strategy needed to be in place before the hospitals strategy went further.
Key issues outstanding with Imperial, who to their credit seem keen to continue conversations, include finance and the “change and transition” process which has not been mentioned.
The Business Case for the group will be pushed through starting with the Outline BC to the Trust Development Authority by end of financial year 2014/15, with Final BC at end 2015/16. Securing funding from the Treasury or the private sector or a mix will take several years running in parallel. Construction is expected to start in 2016-17, to take three years. Servicing at least £400M of debt seems a stiff obstacle and Imperial's estimate of only £270M expected from land sales at a prime central London location seems to be yet another example of publicly-owned land being sold off on the cheap for private developers to make billions from redevelopment. The directors brushed off concerns about overspends on staff, slow permanent recruitment and uncertainties in the financial reporting.
SOH's call for a new public consultation due to the sharply reduced number of beds at CX fell on deaf ears.
The meeting was a first step in what we hope will be a constructive exchange between Imperial and local campaigners, but we remain clear that our first priority is to ensure that local health needs will be met.
Dr Max Gammon, accident and emergency registrar at Central Middlesex Hospital in 1978-79 wrote to the Evening Standard on Friday 12th September as folllows:
"News of the closure of A&E departments at Hammersmith and Central Middlesex Hospitals is deeply disturbing. When I was the A&E registrar at Central Middlesex in the 1970s the department was regularly blocked solid by patients waiting for attention. Conditions today can only be worse. Apart from the inconvenience and direct danger to patients caused by the continuing closure of A&Es, there is a less obvious but even more serious threat to care quality caused by the loss of training places in acute medicine and surgery for junior doctors".
At the Public Board meeting held on 30th July 2014 "Save Our Hospitals" Chair, Merril Hammer, stood up at the end and made a public invitation to the CEO of Imperial College Healthcare NHS Trust, Dr Tracey Batten. She asked Dr Batten to meet with representatives from SOH to hear their concerns and to "engage" with the full range of issues raised by the proposed reorganisation of health services in north-west London, and especially the closure of 4 out of 9 A&E departments in this zone, and the eventual closure of Charing Cross Hospital as an acute hospital, and its replacement with a much small "cottage" hospital.
A date has been announced for this private meeting: Wednesday 17th September. We think that this is the first time that a CEO of an NHS Trust has met with anti-closures campaigners in this setting. We are hopeful that the private meeting will allow a more wide-ranging and less politicized discussion than has so far been the case.
We are grateful to Dr Batten for finding time to meet us.