The Integrated Care System situation in Hammersmith and NW London as a whole

Many thanks to the NW London NHS campaigner who prepared “facts and speculations” about the Integrated Care System situation in Hammersmith and NW London as a whole, for the #NHS4All campaign planning meeting, held in Leeds on 16th June 2019.

The Department of Health and Social Care and NHS England have abandoned the cuts-driven North West London “Shaping a Healthier Future” plan. This has saved the A&E departments in Charing Cross and Ealing hospitals from closure.

This raises hopes that similar plans to cut and centralise acute and emergency hospitals in other areas could also be for the chop – IF campaigners and Councils can together apply the same kind of pressure as Hammersmith and Fulham did.

But plans continue for shifting services out of hospitals into “the community” still continue – despite £30m of cuts to NHS primary care and community health services in Hammersmith and Fulham.

The campaign to protect NW London NHS goes on. Ealing Save Our NHS said :

“This disastrous Shaping A Healthier Future plan has seen the closure of two local A&Es, Central Middlesex and Hammersmith, as well as the closure of Ealing A&E to children. As a direct consequence, waiting times for Type 1 urgent A&E visits increased greatly. Ealing Hospital’s excellent maternity department was also closed, forcing Ealing mothers to travel long distances and negatively effecting continuity of care for many.

But health bosses appear to have learned nothing and continue to defend the indefensible.”

NW London NHS Commissioners put brave face on Hancock’s decision to scrap hospital cuts plan

The Accountable Officer for the Collaboration of 8 North West London Clinical Commissioning Groups has put a brave face on the scrapping of the 2012 financial plan called “Shaping a Healthier Future”. This was supposed to lead to the closure of Ealing and Charing Cross Hospitals, to be downgraded to “local hospitals”.

Now the A&E departments in Charing Cross and Ealing hospitals have been saved from closure.

The U-turn was announced by Matt Hancock in Parliament in March, in response to a “topical question” from Greg Hands, Tory MP for Chelsea and Fulham. It led to great rejoicing in the two campaign groups, and a special celebration reception at Hammersmith Town Hall as we had “saved the hospitals”. Hammersmith & Fulham and Ealing Councils have supported the hospitals campaigns throughout this period. This is wonderful, yes!

But the other NHS England goals seem to still be in place

The integration of 8 Clinical Commissioning Groups into one “NW London Clinical Commissioning Groups” is still the plan for the summer, to be completed “in the autumn”. Mark Easton, the Accountable Officer, has admitted that there will still be a need for some contracts to be decided at individual on Clinical Commissioning Group level, so will the local on Clinical Commissioning Groups be abolished? Will there be the planned big savings in admin costs? Perhaps not.

Cuts to community services

In addition the last 7 years have seen little progress in creating a network of GP “hubs” “closer to home”, etc. Instead all the Clinical Commissioning Groups (except for the most affluent, Kensington and Chelsea – mysteriously!) have been remorselessly squeezed.

Hammersmith & Fulham are now facing cuts to palliative care, and various community services such as community cardiology, gynaecology and public health (the bits which the local authority does not do). It is relentless.

And of course there is the national scandal of GP @ Hand

This virtual GP practice is based in the surgery of Dr Jefferies and Partners, in Fulham. It now has over 50,000 patients/subscribers (all the GPs for the service are locums). NHS England has just announced that they will reimburse Hammersmith &Fulham Clinical Commissioning Group for the overspend of £21M+ in the current financial year (2019-20) due to all the “out of area” patients, but have said nothing about the previous year and future years.

GP @ Hand is due to expand to Birmingham next, but no date has been set. The Times is finally (2nd June)getting critical of the founder, Dr (PhD) Ali Parsa:

“Blitzscaling Babylon: Ali Parsa’s breakneck scramble for success – The healthcare app’s founder is in a rush to grow his start-up, no matter how many staff leave and what chaos ensues”

The Financial Times has also run articles: “Babylon’s GP at Hand service runs up £21.6m deficit” and in January: “NHS’s digital ambitions spur tech start-ups into action” .

The hospitals trusts are hanging on

Imperial College Trust (Charing Cross, St Mary’s Paddington, Hammersmith Hospital, Queen Charlotte’s (maternity) and the Western Eye Hospital) was only kept afloat by a bung of £20M at the end of the financial year and by spending £16M of its charity’s funds on doubling the size of the A&E depts at Charing Cross and St Mary’s.

The situation at Chelsea and Westminster Hospital is less dire (it’s in Chelsea!) but it too is expanding its A&E and balancing elective turnover between West Middlesex Hospital (in Brentford!) and itself.

No Clinical Commissioning Group in NW London has any spare money

They are “borrowing” from others in the same Sustainability and Transformation Plan footprint. From reading Health Service Journal headlines, the Treasury is only giving out emergency funds, as it is saving money: with a new and irresponsible Prime Minister the Tory Party might well do the previously unthinkable and pitch us out of the EU on WTO terms on 31st October.

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