New information about lack of evidence to support hospitals cuts and “Care Closer to Home” scheme

Calderdale & Kirklees 999 Call for the NHS sent this information (below) to the Calderdale & Kirklees Joint Health Scrutiny Committee members, before their Reconciliation meeting on Monday 12th December with Calderdale and Greater Huddersfield Clinical Commissioning Groups.

The meeting was an attempt to resolve the problem that the CCGs have ignored all the Joint Health Scrutiny Committee’s recommendations on the Right Care Right Time Right Place plan to cut acute and emergency hospital services, move many outpatients and community services out of hospital into the community and set up “new models of care” for primary and community services, called “Care Closer to Home”.

If the reconciliation process is unsuccessful, the Joint Health Scrutiny Committee may refer the Right Care Right Time Right Place proposals to the Secretary of State for Health in February 2017.

New information about the lack of evidence for both the hospitals’ reconfiguration and the Care Closer to Home scheme

We have recently come across additional information about:

  • Cramlington Specialist Emergency Centre not performing as claimed
  • Hospital bed shortage & lack of evidence that community based care will make up for hospital bed cuts
  • Unintended adverse consequences of electronic health records

Cramlington Specialist Emergency Centre doesn’t perform as claimed

At the Threeways Centre consultation drop in & elsewhere, Calderdale Clinical Commissioning Group Governing Body members said that Cramlington Specialist Emergency Centre is the model for turning Calderdale Royal Hospital into an Emergency Centre.

Calderdale & Kirklees 999 Call for the NHS questioned evidence that Cramlington Hospital was living up to the claims that had been made for it before it opened.

Since then,  we have found this in the September 2015 Minutes of Newcastle Hospitals Board meeting :

“The Specialist Emergency Care Hospital in Cramlington was not shielding Newcastle. Rather, emergency caseload was increasing here, including an additional 8-12 ‘blue light’ ambulances per day and receipt of more routine cases from Tynedale. Repatriation to local DGHs [District General Hospitals] was proving to be increasingly challenging.”

So, well before the public consultation started and before the Pre Consultation Business Case was written it was known that Cramlington Specialist Emergency Hospital wasn’t performing as claimed.

Calderdale & Kirklees 999 Call for the NHS hope the Joint Health scrutiny Committee will bring up this matter of EVIDENCE and TRUTHFULNESS during the Right Care Right Time Right Place reconciliation process that they have set up with the Clinical Commissioning Groups.

More recent news that Cramlington Specialist Emergency Care Hospital SIMPLY DOESN’T WORK: the Northumbria Healthcare NHS Trust which runs Cramlington and other hospitals in the area is shutting A&E services overnight at the 3 “feeder” urgent care centres in Hexham, N Tyneside and Wansbeck because Cramlington can’t cope with winter A&E pressures, so it needs the urgent care centres’ staff.

It was supposed to be an all-singing all-dancing all-Keogh solution to A&E problems. Now imagine this happens here, and Huddersfield would be without any overnight urgent care.

This provides clear evidence that excessive centralisation and specialisation does not work. Every major town needs its own hospital with the full range of basic services, including A&E. We are being shortchanged with all the cuts closures and amalgamations.

Hospital bed shortage & lack of evidence that community based care will make up for hospital bed cuts

The NHS is now so far above the 85% occupancy rate once considered ideal that 12,000 extra beds would be needed to return to it. This is from a Nuffield Trust Report.

The Right Care Right Time Right Place bed cuts are supposed to be ok because Care Closer to Home is meant to reduce hospital admissions.

But Southwark and Lambeth Integrated Care research has found NO evidence that community-based care made the planned cost savings or the planned reduction in hospital admissions in the short term.

And when Save Lewisham Hospital asked how their equivalent of Right Care Right Time Right Place – Our Healthier  SE London – was going to do away with 700 hospital beds when there is NO evidence that the new model of community-based and primary care makes the cost savings or the planned reductions hospital admissions in the short run, Our Healthier South East London said “the evidence is mixed”; when asked what would happen if their plan to avoid the need for an additional 700 beds didn’t work, OHSEL said the plan is not guaranteed to succeed and if it were to fail, “your guess is as good as mine”.

Unintended adverse consequences of electronic health records

A recent report identifies new unintended adverse consequences of electronic health records. These include:

  • complete clinical information unavailable at the point of care;
  • lack of innovations to improve system usability leading to frustrating user experiences; inadvertent disclosure of large amounts of patient-specific information;
  • increased focus on computer-based quality measurement negatively affecting clinical workflows and patient-provider interactions;
  • information overload from marginally useful computer-generated data.
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