BMJ 2013;347:f6593 doi: 10.1136/bmj.f6593 (Published 1 November 2013)
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NEWS Doctors support biggest local reconfiguration in NHS, says Hunt Adrian O’Dowd London
Ambitious plans to reconfigure nine hospitals across northwest London have the blessing of local doctors, said England’s health secretary, Jeremy Hunt. Hunt announced on 30 October that he was backing plans to reconfigure health services in northwest London that were presented to him in advice from the Independent Reconfiguration Panel, the group of experts that advises the health secretary on changes to NHS services. However, the trade union Unite described the plans as a “cause for considerable concern,” especially the downgrading of two accident and emergency departments to urgent care centres and changes planned for another two emergency departments.
The panel was asked to scrutinise proposals made earlier this year by the Shaping a Healthier Future programme led by eight clinical commissioning groups representing northwest London.1 The groups looked at what changes were needed in the area to maintain high quality care and services in the face of a growing population of older people. The panel reported to the health secretary last month with its official advice and recommendations, which it described as the most ambitious plans ever to transform care by any NHS local area.2 Under the plans, which now have Hunt’s support, major accident and emergency services will be centralised in five rather than nine hospitals—Hillingdon, Northwick Park, West Middlesex, Chelsea & Westminster, and St Mary’s, Paddington—with two smaller emergency departments at Ealing and Charing Cross Hospitals.
In addition, there will be urgent care centres running 24 hours, seven days a week at all nine hospitals; 24/7 consultant cover in all obstetric wards; a new trauma hospital at St Mary’s; new custom built local hospitals at Ealing and Charing Cross; seven day access to GP surgeries; 800 additional posts to improve out of hospital care, which will include a named accountable clinician for all vulnerable older patients; and more investment in mental health and psychiatric liaison services. Accident and emergency units at Hammersmith and Central Middlesex Hospitals would be replaced by urgent care services
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after the winter. Speaking in the House of Commons on 30 October, Hunt said, “A&Es would remain at Ealing and Charing Cross Hospitals but possibly in a different shape and size.” The changes had the unanimous support of all local medical directors, said Hunt, who had written to him saying that there was a “very high level of clinical support for this programme across NW London.”
Hunt said, “Changes to services across northwest London have been designed and driven by local doctors and healthcare professionals who know their patients best.” Rachael Maskell, head of health at Unite, raised fears that the changes would destabilise London’s healthcare just as it was facing another busy winter.
She said, “With A&Es coming under increasing strain and the winter looming, people will be deeply concerned by this move, which will see the Hammersmith and Central Middlesex departments downgraded.
“While the departments at Ealing and Charing Cross hospitals may well continue for the foreseeable future, Hunt’s track record since becoming health secretary in 2012 does not engender confidence that this is any more than a reprieve.” Bernard Ribeiro, the chairman of the Independent Reconfiguration Panel, said, “The current problems and future challenges faced by the NHS in northwest London require large scale change in the way services are designed and delivered.” A spokesperson for Shaping a Healthier Future said, “These changes put forward by clinicians have always been about putting patients first, and we are pleased this has been recognised. The improvements are needed to modernise the delivery of healthcare, fit for the 21st century.” 1 2
NHS North West London. Shaping a healthier future: consultation document. www. healthiernorthwestlondon.nhs.uk/sites/default/files/documents/Shaping%20a%20healthier% 20future%20-%20Consultation%20document_0.pdf. Independent Reconfiguration Panel. Advice on shaping a healthier future proposals for changes to NHS services in north west London. Sep 2013. www.irpanel.org.uk/lib/doc/ 000%20lnw%20report%2013.09.13.pdf.
Cite this as: BMJ 2013;347:f6593 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS Doctors support biggest local reconfiguration in NHS, says Hunt Adrian O’Dowd London
Ambitious plans to reconfigure nine hospitals across northwest London have the blessing of local doctors, said England’s health secretary, Jeremy Hunt. Hunt announced on 30 October that he was backing plans to reconfigure health services in northwest London that were presented to him in advice from the Independent Reconfiguration Panel, the group of experts that advises the health secretary on changes to NHS services. However, the trade union Unite described the plans as a “cause for considerable concern,” especially the downgrading of two accident and emergency departments to urgent care centres and changes planned for another two emergency departments.
The panel was asked to scrutinise proposals made earlier this year by the Shaping a Healthier Future programme led by eight clinical commissioning groups representing northwest London.1 The groups looked at what changes were needed in the area to maintain high quality care and services in the face of a growing population of older people. The panel reported to the health secretary last month with its official advice and recommendations, which it described as the most ambitious plans ever to transform care by any NHS local area.2 Under the plans, which now have Hunt’s support, major accident and emergency services will be centralised in five rather than nine hospitals—Hillingdon, Northwick Park, West Middlesex, Chelsea & Westminster, and St Mary’s, Paddington—with two smaller emergency departments at Ealing and Charing Cross Hospitals.
In addition, there will be urgent care centres running 24 hours, seven days a week at all nine hospitals; 24/7 consultant cover in all obstetric wards; a new trauma hospital at St Mary’s; new custom built local hospitals at Ealing and Charing Cross; seven day access to GP surgeries; 800 additional posts to improve out of hospital care, which will include a named accountable clinician for all vulnerable older patients; and more investment in mental health and psychiatric liaison services. Accident and emergency units at Hammersmith and Central Middlesex Hospitals would be replaced by urgent care services
For personal use only: See rights and reprints http://www.bmj.com/permissions
after the winter. Speaking in the House of Commons on 30 October, Hunt said, “A&Es would remain at Ealing and Charing Cross Hospitals but possibly in a different shape and size.” The changes had the unanimous support of all local medical directors, said Hunt, who had written to him saying that there was a “very high level of clinical support for this programme across NW London.”
Hunt said, “Changes to services across northwest London have been designed and driven by local doctors and healthcare professionals who know their patients best.” Rachael Maskell, head of health at Unite, raised fears that the changes would destabilise London’s healthcare just as it was facing another busy winter.
She said, “With A&Es coming under increasing strain and the winter looming, people will be deeply concerned by this move, which will see the Hammersmith and Central Middlesex departments downgraded.
“While the departments at Ealing and Charing Cross hospitals may well continue for the foreseeable future, Hunt’s track record since becoming health secretary in 2012 does not engender confidence that this is any more than a reprieve.” Bernard Ribeiro, the chairman of the Independent Reconfiguration Panel, said, “The current problems and future challenges faced by the NHS in northwest London require large scale change in the way services are designed and delivered.” A spokesperson for Shaping a Healthier Future said, “These changes put forward by clinicians have always been about putting patients first, and we are pleased this has been recognised. The improvements are needed to modernise the delivery of healthcare, fit for the 21st century.” 1 2
NHS North West London. Shaping a healthier future: consultation document. www. healthiernorthwestlondon.nhs.uk/sites/default/files/documents/Shaping%20a%20healthier% 20future%20-%20Consultation%20document_0.pdf. Independent Reconfiguration Panel. Advice on shaping a healthier future proposals for changes to NHS services in north west London. Sep 2013. www.irpanel.org.uk/lib/doc/ 000%20lnw%20report%2013.09.13.pdf.
Cite this as: BMJ 2013;347:f6593 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
