December 2017: the battle lines are emerging

Imperial using its Charity "war chest" to fund essential building work - Charing Cross Open Doors evening: CX and St Mary's cope with "rising tide" of A&E and acute bed demand - Imperial CEO Ian Dalton resigns

Imperial College Healthcare NHS Trust is only surviving thanks to essential building work, to meet increased demand, carried out using funds from the Imperial Health Charity. At the Imperial AGM the full extent of the expenditure was revealed. It is the biggest estates improvement programme in years, worth £18 millions, underway or completed at the two Riverside Theatres at Charing Cross, St Mary’s A&E, outpatient clinics at Charing Cross, Hammersmith and the Western Eye hospitals, and the children’s intensive care unit at St Mary’s (also supported by COSMIC).

Imperial is also buying two new Linacs (Linear accelerators) with Charity money. The Charity paid for the conversion of Marjory Warren ward at CX into a 23-bed acute medical ward and, possibly, to mend the ceiling which collapsed without warning in an active ward at St Mary's in the summer. In January 2018 work is planned to start to double the size of the A&E at Charing Cross.

The NHS is not paying for any of this.

On Monday 27th November Imperial opened its doors from 17.30 to 20.30 to members of the public who had booked for tours of the A&E and a Q&A session with senior clinical and management staff. We saw how cramped the waiting rooms, cubicles and corridors are in the A&E dept. Dr Alison Sanders, consultant in Emergency Medicine, confirmed that only seriously ill people are being treated there, but that the numbers were rising all the time. Later the medical director, Dr Julian Redhead, and the head of Medicine and Integrated Care, Prof Tim Orchard said that as long as there is a "rising tide" of demand Imperial will not be closing the A&E at Charing Cross Hospital. Demand has risen in 2017 by over 11% at Imperial's two A&Es, and the increase is bigger at Charing Cross than at St Mary's. The rise is showing no sign of leveling off, let alone decreasing. Therefore, they said: "Closure is unlikely in the foreseeable future". The plan to build out the Charing Cross A&E in St Dunstan's Road as soon as possible bears out this statement.

At the board meeting in public on Wed 29th November the Chair of Imperial Sir Richard Sykes, announced that the CEO, Ian Dalton, newly arrived in August, was leaving with immediate effect to take up on the following Monday 4th December the post of CEO at NHS Improvement. This is the body which monitors and develops the hospitals trusts in England and Wales. In particular it assesses Business Cases for "reconfigurations" (removal of services and closures) of hospitals. Mr Dalton joins Dame Dido Harding (ex-CEO of Talk Talk) who arrived as Chair just two months before, in October. These two appointments are very significant. These are changes of the most senior directors of the body responsible for deciding on the size and catchment of hospitals. Will they be persuaded by the "business models" produced by NHS middle management "advised" by management consultants like McKinseys? Or will they look at the actual figures of activity at the individual hospitals they are controlling? Let us hope that it is the latter.