Sustainability and Transformation Plan cuts, closures and downgrades mayhem

A few days ago, Christine emailed supporters of her petition to Stop Sustainability and Transformation Plans,  asking them to email STP Agony Aunt with news of NHS cuts, closures and downgrades in their area – particularly ones that Local Authorities’ Health Scrutiny Committees have referred to the Sec of State.

These are the answers STP Agony Aunt received in one day.

Many thanks to all who sent info.

Please sign the petition if you agree with it and haven’t yet signed.  Also, Sustainability and Transformation Plans are now morphing into Accountable Care Systems. If you would like to take part in the 999 Call for the NHS grassroots campaign to Stop Accountable Care Systems, please consider signing up as a Stop ACS Ambassador here

Current referrals to the Secretary of State where the Independent Reconfiguration Panel has not yet started or published their review

West Cumberland Hospital, Whitehaven – Our brand new hospital has had around 30 departments transferred to the Cumberland Infirmary (PPI) in Carlisle this last five years. Our Consultant Led Maternity Unit is under threat and downgrading of maternity was referred to the Secretary of State, but the IRP decided against a national review so it’s a “sort it out yourselves” situation with a new independent group looking at it locally. We are well over an hour and a half to Carlisle. They want to close Paediatrics as well. Both these services have been working well since 1964 when WCH opened.

Rothbury Hospital ward closure – Save Rothbury Hospital Our campaign has been successful in getting our Community Hospital Ward closure referred to the Secretary of State for Health.

Dorset County Council’s health scrutiny committee has unanimously voted to refer the CCG’s plans to the Secretary of State for Health Jeremy Hunt for an independent review, pending a meeting of the joint health committee in December.

East Riding of Yorkshire proposed substantial developments and variation to its Minor Injury Units (“MIUs”) and community hospital beds – Closures/downgrades that East Yorkshire Riding Council has referred to the Sec of State include the 12 bed community ward closed at Withernsea hospital. Also the minor injury unit is being downgraded to an appointment only centre, so no more walk ins. Driffield minor injury unit is also being downgraded to appointment only. The minor injury unit is to be closed at Hornsea Cottage Hospital.

Update 13.12.17 – The Independent Reconfiguration Panel has decided not to undertake a full-scale review into the CCG’s urgent care and community care services proposals.

Recent referrals where the IRP has published at least their initial review

Oxfordshire

Oxfordshire Joint Health Overview and Scrutiny Committee referred the decision to permanently close the maternity unit at the Horton hospital, Banbury, to the SoS, which was then referred to the IRP. Decision awaited.

The closure of a GP surgery in Witney, Deer Park Health Centre, was also considered by the IRP. The result was a smack across the knuckles for both the Clinical Commissioning Group and Joint Health and Overview Scrutiny Committee and the directive to hold a meeting with patients in Witney and surrounds to discuss proposals for primary care. A recommendation that has been hijacked by the Clinical Commissioning Group to discuss wider proposals to close 8 community hospitals to be replaced by 4 ‘hubs’ across Oxfordshire.

Devon
https://www.gov.uk/government/publications/irp-torrington-initial-assessment

Other recent cuts/closures/downgrades referred to Independent Review Panel that are listed on their website

https://www.gov.uk/government/publications/irp-thurrock-initial-assessment

https://www.gov.uk/government/publications/irp-grantham-initial-assessment

https://www.gov.uk/government/publications/irp-hartlepool-apms-initial-assessment

https://www.gov.uk/government/publications/irp-redbridge-initial-assessment – “intermediate care services be referred to the Secretary of State on the grounds of inadequate consultation and not being in the long-term interests of patients”.

Other closures/cuts/downgrades – not referred to Sec of State (why not?)

Bedford Hospital

Bedford Hospital and Luton are to merge. Within a week or so of the announcement, news that the Stroke ward at Bedford is to transfer to Luton site, about thirteen miles away.

The only positive to come from this is that Pathology services at Bedford are to be transferred from Viapath back to NHS in September 2018. What happens afterward is not clear. Will they be re-privatised, services completely outsourced or remain in house? It has been very sad to see how Viapath have extracted maximum profit from the Trust during their eight years contract with scant regard for patients.

Hospital closures – Cumbria

Under the so-called ‘Success Regime’ (STP precursor) which has tried to close facilities at the West Cumberland Hospital at Whitehaven – and the consultant-led maternity decisions got referred – three North Cumbrian community hospitals are to close, in Maryport, Wigton and Alston.  The decision was voted for referral, only for the decision to be reversed after a ridiculously speedy ‘resolution’ meeting.

Hospital/ward closures – Derbyshire

There are plans to close Newholme hospital in Bakewell, what happens to this prime site land???apart from loss of services.

To my knowledge, Spencer Ward at Cavendish Hospital Buxton is to be closed shortly. Six miles away, a six bed respite care unit at Ecclesfold has closed down in the past year. Two of the beds were NHS sponsored. Both these facilities were/are for the care of the elderly. See The Buxton Advertiser for news of these closures.

Bolsover Hospital,
Matlock Whitworth,
Stockport/High Peak’s Shire Hill, Babington.
All for the chop.

Hospital/ward closures – Devon

In Devon, all our local hospitals are being shut down or losing all beds. These were able to relieve the three main hospitals when patients were ready for discharge, also making it easier for visits.

There are thee main hospitals in Devon,  Royal Devon and Exeter based in Exeter,  Torbay based in Torquay, and Derriford based in Plymouth.  In the Teignbridge area 12,000 houses are being built, when these are occupied the strain on the already overstretched hospitals will be enormous.  Devon and Cornwall are large counties with many rural communities, these now have to travel vast distances to be seen.

Inpatient beds were closed in Honiton, Okehampton and Seaton hospitals in August 2017. We are waiting to see what the future for these and also Axminster and Ottery St. Mary hospitals, which lost their inpatient beds earlier, will be when North East and West Devon Clinical Commissioning Group’s estates strategy is finalised.

Honiton and Okehampton are also losing their maternity units.

In this area of South Devon the following small hospitals have been closed:-

Ashburton, Buckfastleigh, Paignton, Brixham, and Dartmouth.  The Ashburton people now have to go to Totnes which is the “hub” for the area, there is no bus route from Ashburton to Totnes!

In East Devon the following small hospitals have been closed – Honiton, Exmouth, and Whipton.

Holsworthy hospital has been closed. This is causing huge hardship and heartache. A  friend has driven 6000 miles visiting her husband who has been moved from place to place when he could have been nearer in Holsworthy.

Devon Health Scrutiny Committee voted not to refer the beds closure decision, causing a huge outcry against the Tory majority who betrayed a massive protest campaign across eastern Devon over the previous 9 months. It seems that these closures have not been referred to the Sec. of State because they are deemed “temporary”.

The Committee last discussed the STP on 21 September when they decided to establish a Scrutiny Standing Overview Group to look at areas of concern within the STP. On the one hand, the County Council was not a formal signatory to the STP at this stage (because opposition parties have criticised the overall framework, underfunding of NHS etc. behind it), but on the other there’s County Council and other local authority involvement in the ongoing development of the Plan and integrated delivery of services.

A&E/maternity departments/paediatric departments/community hospitals closures – Dorset

If you look at  Dorset Echo news for November 14th 2017 you will see reported proposals which have been made for changes to health and hospital services in West Dorset, which means patients will have to travel up to 20plus miles to either Bournemouth or Yeovil for services which are available in this area at present. They are also proposing to close several residential homes for the elderly in an area which is well known to have a high number of elderly residents.

Another very important point in question is West Dorset is a rural area where many villages are isolated and travel to get from A to B can be very difficult, especially now we have lost a great number of our local bus services.

The final thing I would like to remark on is the congestion which occurs on the roads in this area especially in the summer, this being a major holiday area, it can take hours at times to travel a few miles, so how long it would take to get a person who was seriously injured or ill to Bournemouth or Yeovil is questionable- helicopters cannot be supplied to transport every very ill patient!

Ward/hospital closures – East Yorkshire

As well as the closures/downgrades that East Yorkshire Riding Council has referred to the Sec of State,  Bridlington Hospital has had several wards closed.
http://www.bbc.co.uk/news/uk-england-humber-37628965
This is part of the Capped Expenditure Process.

A&E closure Essex

Our dearest Jeremy Hunt is desperate to close our local A/E at St. George’s hospital Ilford… needless to say we are fighting tooth and nail….. the man obviously has no idea whatsoever about health… the hospital is on the A112 a very busy main road leading into London with frequent road works, he said at last interview that it is only 15 mins away from next hospital….. yes at 3am and no holdups…….. but with traffic! As a retired state registered nurse I can tell you 15 mins can make the difference between life and death.
http://www.itv.com/news/london/2017-10-14/campaigners-urge-government-to-protect-ilford-a-e-unit/

Ward/hospital closures – Gloucestershire

There is currently a consultation recommending closing the two existing hospitals in the Forest of Dean and building a new hospital with fewer beds – HOLD – Hands Off Lydney and Dilke hospitals

2 local Hospitals with around 80 beds to be replaced with one Hospital with 25 beds, that will not have a Maternity Unit when the population of the Forest has grown year on year with many families with young children. Part of Gloucester STP

Hospital/ward closures – Hampshire

Alton Community Hospital (Hampshire) – Health services to the Alton and surrounding village area are currently under review – we are served overall by the North Hampshire Trust (who run Basingstoke and have recently taken over Winchester and Andover hospitals).  There is an indication that the Alton community hospital (comparatively newly built!) is under threat.   Would be great if this situation could be monitored – it could actually provide far higher levels of general health/outpatient appointments  (public transport in the area to either Basingstoke or Winchester is dire) and has an underused x ray /hearing clinic/podiatric and  other various services with closed wards which are unstaffed… …..

Hospital/ward closures – Kent

Kent & Canterbury A & E closure and Taylor (heart) Ward- Just to let you know that  this summer the Emergency Centre and Taylor Ward has been closed at Kent and Canterbury Hospital.

Hospital/ward closures, Leicester

There has been a fight here in Leicestershire to keep the children’s heart surgery unit at Glenfield Hospital open.This is a world class facility, but NHS England want it shut .The final decision comes on Nov. 30th.

https://saveglenfieldheartcentre.wordpress.com/about/

https://saveglenfieldheartcentre.wordpress.com/blog/

Hospital/ward closures – London

North west London STP – On 28th September NHS Improvement did not approve the Strategic Outline Case 1  (the one for “outer” Clinical Commissioning Groups) for NW London and sent it back pending further information  “after concerns about activity projections”. In other words NHSI didn’t believe the projections from the Accountable Officer for the STP (Clare Parker), who is also the Chief Officer for the collaboration of 8 NW London CCGs, for reductions in A&E and acute medicine activity. This article is from Health Service Journal on 1st November

Hospital/ward closures -Nottinghamshire ( the land of Centene)

There is a local neurorehab (Chatsworth) ward closing in Mansfield and also the mental health intensive  care ward at Millbrook hospital. It saddens me what is happening to our  NHS.  Many community roles like health vìsitor and school nurse and public health nurses have transitioned employers … then their roles seem to disappear or at least diminish due to poor funding in local authorities.

However, there is a fight going on to keep Chatsworth open.

#weareallchatsworth photo on Tom Hunt’s fb page

Hospital/ward closures – Oxfordshire

As well as the closure of maternity unit at the Horton hospital, Banbury – which has been referred to the Secretary of State – we have had wards closed across Oxfordshire and have lost over 300 beds: 110 as part of a permanent closure of beds following a phase 1 consultation as part of the Oxfordshire element of the Bedford Oxfordshire and Berkshire STP (with 36 more awaiting confirmation from Thames Valley Clinical Senate); 50 trauma beds lost as a result of a cladding concerns, following tragedy at Grenfell tower; 100 Delayed Transfer of Care; 92 from unavailability of staff (a chronic problem here).

Horton General in Banbury is one hospital under threat as a result of the inception of STP. Along with our stroke ward, the CCG has already voted to allow the temporary downgrade of our obstetrics and Special Care Baby Unit wards, leaving a Midwife-led Unit in its place, but we are 25 miles from the Consultant-led Unit in Oxford, which would be the only fully functioning hospital in the county under these plans, and this is well over an hour’s drive from Banbury due to traffic. Our A&E and paediatrics are also under threat in the next phase of consultation (Ours was the only STP split into two consultation phases, a ridiculous thing in itself).

Keep The Horton General action group is fighting back though- we have a judicial review due to take place early next month on the failure of the trust to consult properly, and the downgrade of obstetrics and Special Care Baby Unit was referred by our Health and Overview Scrutiny Committee to the Independent Reconfiguration Panel- the mechanism by which it was saved 9 years ago.

We have a vast and increasing semi rural catchment spanning three countries and there have been reports of the John Radcliffe Hospital in Oxford being quite unable to cope with the influx of births that have already come its way from the north. One baby has already been born deaf and blind due to complications arising at the Midwife Led Unit in Banbury, and mothers have been labouring in the waiting area at the John Radcliffe and treated little better than cattle in the baby factory the JR is becoming.

If you would like more information in the proposals for the Horton, please visit http://www.keepthehortongeneral.org/whatsgoignon2013.htm

Wantage Community hospital closure

Wantage hospital which served the community and relieved pressure on the Oxford hospitals has been closed. I think originally they said it needed work doing to prevent risk of legionnaires disease. Sure this was a ruse. First the main wards then the maternity section went, then physio shut in September this year. Nothing’s happening now. Convinced they plan to sell off the land. It’s a crime as the community need the hospital.

Save Wantage Community Hospital facebook group has an email up date from Ed Vaizey MP for Didcot and Wantage:

Wantage Hospital is currently in a state of limbo – Oxford Health announced in April 2016 that they would be closing the hospital due to concerns over legionella in the old pipe system. This decision is subject to a consultation by Oxfordshire CCG – a consultation which was previously promised in October 2016.
Phase one of the [STP] consultation did not take place until January 2017, three months after the full consultation was promised. As Wantage is a community hospital it is not covered by this phase. Phase 2 of the consultation has yet to take place, and no date has been announced for when it will begin. This leaves the hospital effectively closed with no end in sight.
After an online petition was signed by almost 4,000 people it was agreed to keep the hospital’s physiotherapy and maternity services open. However, Oxfordshire CCG re-tendered the hospital’s physiotherapy services and the contract passed to HealthShare. The company has since had to close all physiotherapy services provided in Wantage, leaving the hospital with just limited maternity care…

A&E closure -Shropshire

We have two hospitals in our area (Shropshire)  But the authorities are trying to have only one A & E unit in Shrewsbury, the other hospital in Telford where I live still has its A & E at present but its future looks uncertain, unfortunately.

Ward/Hospital Closures-Somerset

Shepton Mallet and Chard Community Hospitals

In 2015 Somerset CCG Patient Participation Group chairs’ Network discussed the closure of eight Somerset Community Hospitals. Last month we learnt that the first two of those Somerset Community Hospitals were being closed! (Shepton Mallet – inpatient ward closure- and Chard) where the CCG has told the Public that the closures were ‘temporary’?

I cannot understand the closures: at this moment in time one of the most discussed NHS topics is ‘Bed Blocking’ where nobody seems to recognise that one of the most important functions of Community Hospitals is Hospital Rehabilitation for the elderly. Why is no one shouting about these closures and the negative effect this has on NHS beds?? Somerset STP
Downloadable (pdf) Somerset STP

Weston super Mare A&E closed at night for lack of staff.

Here are the North Somerset Council Health Overview & Scrutiny Panel meeting papers.

The Chair is Cllr Roz Willis. At the October 2017 meeting  they were scrutinising cuts and changes to Weston hospital, there is a paper full of gobbledygook about it . Once you cut through the gobbledygook what they are proposing is quite dire.

It looks as if they are planning to set up something like Accountable Care System (which they call an “integrated and proactive local health care system”) where the hospital will be part of a “provider alliance with a capitated budget model.” This is to cut costs and take services out of the hospital into the “community”. (A capitated budget model is a fixed budget, based on a specific amount per person, to cover the whole population.) It doesn’t say what the other “providers” in the “alliance” will be but in other areas it includes the local authorities (public health and adult health and social care departments) the Clinical Commissioning Group/s, hospital trust/s and community service providers which are often private or 3rd sector companies.

The detailed Bristol, North Somerset and South Gloucestershire Clinical Commissioning Groups doc that the scrutiny panel paper refers to is here Healthy Weston: Joining up services for better care in the Weston area.

This is  part of the Bristol, North Somerset and South Gloucestershire Sustainability and Transformation Plan (which I see from the Healthy Weston paper that the Bristol, North Somerset and South Gloucestershire Clinical Commissioning Groups call a “System Transformation Plan”. Same thing:  Cuts, privatisation and the introduction of system of healthcare designed to turn the NHS into a version of medicare/medicaid – a basic system for those who are too poor or ill to get private health insurance.

Minor Injuries Unit and Walk In Centre closures – South Yorkshire

The NHS closures that I am aware of in Sheffield are the closure of the Minor Injuries Unit at the Royal Hallamshire Hospital; the scaling down of the Eye clinic there, and the closure of the (still relatively new) NHS Walk-In Centre at Broad Lane. These services will be relocated to the north of the city, and everyone will now have to travel to the Northern General Hospital campus. Here is a link the Sheffield Star article.

Hospital/ward cut/downgrades- Staffordshire

You will be aware of the downgrade of South Staffs hospital a while ago , well now North Staffs is to stop planned surgery over the winter as they don’t have enough beds !!!

You couldn’t make this up. The NHS is so ridiculously complicated because it is being run as a business. And the business is costing a fortune. I am gravely concerned that it may be too late to save the NHS from privatisation  and ruin. What we are seeing now, has been a long time in fruition and planning, Since Margaret Thatcher in my experience.

We have had no main hospital beds close in Stoke-on-Trent, indeed quite the opposite, we’ve taken on extra patients, without a corresponding increase in resources (both financial and personnel), following the closure of services at Stafford General Hospital.

Staffs Community Hospital beds

However we have seen our community beds decimated. North Staffordshire CCG have closed the beds in four community hospitals in North Staffs. Cheadle, Longton, Bradwell and Leek Moorlands. We have mounted a very big campaign but the accountability officer for the CCG is determined. They have failed to set up enough care in the community and the acute hospital UHNM are struggling to cope in many ways but especially with bed blocking.

To illustrate the futility of the decision, now the chief of UHNM is demanding the reopening of some wards at Bradwell just a week after the final ward was closed at Leek when staff and patients were scattered everywhere.

Suffolk & NE Essex

Colchester and Ipswich hospitals are going to have any cross specialties amalgamated into one or the other hospital resulting in more travel for patients.  People in North Essex have been arguing against it but the committees are pushing ahead with it.

My Labour MP is very concerned but says that if we don’t accept this, the specialties will be moved even further to Cambridge or Norwich as the local CCG needs to make cuts.
Suffolk & North East Essex STP Board

Another person added,

I’m not sure it is a cut but I am pretty sure it will become one. Ipswich Hospital and Colchester Hospital are being amalgamated and come under the management of one board. They keep saying it will not affect anyone but we all knew that will not be the case.

The hospital merger outline business case includes the possibility of a combined trauma and orthopaedic unit as well a cardiology service for those with coronary syndrome, which includes heart attack and angina. A GP has said they fear the merger would increase ambulance response times if certain specialists were based at one of the hospitals and not the other, meaning paramedics might have to travel further with patients.

In April 2016 Nick Hulme, chief executive of Ipswich Hospital, told the Essex County Gazette and Standard it is “likely” services will be centralised at one of the two sites and patients in both trusts would end up having to travel longer than usual for care.

Under the new system, only emergency departments, urgent medical care and full doctor-led maternity services are “certain” to remain at both sites.

Hospital/ward closures – Sussex

Local psychiatric hospital, The Neville Hospital, Hove, closed in recent years.

A&E downgrade – West Yorkshire

Dewsbury District Hospital

A few months ago Mid Yorks hospital trust reduced the A&E facilities at Dewsbury hospital to virtually a walk in centre. All emergencies are now either taken or directed to Wakefield, a hospital which is smaller than the one it replaced and is now being overloaded. This new hospital actually replaced 2 in Wakefield and has also had other services transferred in from both Dewsbury and Pontefract. The reorganisation also resulted in some cancer patients now having to travel to Leeds for treatment that was previously given at Wakefield. Like Huddersfield, Dewsbury has some remote areas with poor or non existent public transport, and this is a major problem for many people, particularly elderly and infirm. The additional time taken to get to Wakefield could potentially lead to a life threatening situation, especially with the changes which have also been made to the ambulance service.

A&E  downgrade – Worcestershire

I refer you to the Alexandra hospital in Redditch. I am sure you have heard of the “Save the Alex” group. The downgrading at the Alexandra  has taken place and most emergencies are now diverted to Worcestershire Royal (WRH) hospital. Last Sunday 5/11/17  the wait in A&E  was 19 hours !!
They are preparing to increase the size of the A&E at WRH  at a huge cost (WRH is a PFI . Senseless.

Sexual health services – cuts and downgrades

North London Sexual health clinical downgrades
The Marlborough Sexual Health Clinic in the Royal Free Hospital has been merged with the Ian Charleston centre and now only offers HIV testing and treatment. It used to offer full sexual health screenings and advice. It was also somewhere that offered both appointments and a walk-in clinic. Also, the Archway Sexual Health clinic has been scaled back and no longer offers a walk-in appointment clinic. Last time I checked, waiting times were 3-5 weeks

Reduction in sexual health services – Surrey

From last April, with very poor communications beforehand, Surrey County Council reduced the budget for sexual health services which includes contraceptive services by £2million, and a NHS trust – Central and North West London picked up the contract. The result is closures of all satellite clinics in a huge part of Surrey, leaving us with just 3 “Hub” clinics, in Guildford, Woking and Redhill. The idea is that the public will have greater choice of which services to use, being able to book in on line. The latest “improvement” is that clinics where young people could just walk in at certain times in the week, now are moving towards appointment only, for a while “walk ins” will be seen but eventually bookings only.

I have heard this is happening in other parts of the country too. Although Surrey County Council said they had met with stake holders, CCGs etc., it was little known about.

It is done now, and am sure it won’t be undone – losing services that women fought for from many years ago.