The NHS North West London ‘SHAPING A HEALTHIER FUTURE‘ TRANSFORMATION IS FINALLY ABANDONED

The NHS North West London ‘SHAPING A HEALTHIER FUTURE‘ TRANSFORMATION IS FINALLY ABANDONED By The Department of Health

Secretary of State Matt Hancock MP announced the end of SaHF in the House of Commons on 26 March 2019 in response to a question asked by Greg Hands MP for Chelsea and Fulham.  This ends years of SaHF failings and NHS bosses being in complete denial. It also marks a campaigning victory for many people, especially Ealing Save Our NHS (ESON), Save Our Hospitals (Hammersmith & Fulham) and Brent Patient Voice.

Changes to Ealing and Charing Cross Hospitals mandated by SaHF will not now be implemented.  

SaHF all started in 2012 with an awfully flawed public consultation which effectively set up nine NHS North West London ‘Major’ Acute hospitals to compete with each other for survival.  SaHF promised ‘..changes that will improve care both in hospitals and the community and will save many lives each year’. Annual savings of 4% were promised. SaHF promised that these changes would take ‘at least three years.’ By 2013 Ealing Hospital and Charing Cross Hospitals were singled out in SaHF to be closed down as ‘Major’ hospitals. In September 2014 SaHF closed A&Es at both Central Middlesex and Hammersmith Hospitals. A&E performance throughout the whole of North West London dropped immediately and massively. It has never really recovered over the last 4.5 years. Subsequently Ealing Hospital ‘s Maternity unit and Paediatric units were closed down.

In 2015 Michael Mansfield QC led a masterful Independent Healthcare Commission which concluded that SaHF was neither affordable nor deliverable. In 2016 Hammersmith & Fulham and Ealing Council commissioned Roger Steer, John Lister and Sean Boyle to review SaHF and the related NHS NWL Sustainability and Transformation Plan (STP). The authors recommended that SaHF should be abolished/suspended.

In November 2017 after years of painstaking research and data collection Colin Standfield reported that NHS NWL had spent over £88 million on management consultancy since 2009/10 – the bulk of it on SaHF.  What a tragic waste of public money.

No SaHF cost savings have been announced. In December 2016 SaHF asked NHS bosses for £513 million for building work, which was refused. NHSE/I London described the SaHF business case logic as ‘counterfactual’. In 2018 SaHF asked NHS bosses for £260 for building work. It received only £10 million but kept on believing it was going to get the big bucks – until today when reality hit hard.

 

A New Clinical Commissioning Group CCG) for NHS North West London (NWL) Could Mean 100s of Redundancies at the 8 NHS NWL CCGs

As a requirement of the January 2019 NHS Long Term Plan, an Integrated Care System (ICS) needs to be created for each CCG. At first I naively assumed this would mean eight ICSs in NHS NWL to ‘match’ the eight CCGs. But this is apparently not so. What seems to be on the cards is the creation of a new NHS NWL CCG which would commission the new NHS NWL ICS. As night follows day this new CCG would replace the existing eight CCGs.

This new ‘regional’ CCG would simply blow out of the water the original 2013 notion that CCGs would be locally led by local GPs who would have local knowledge. So how might a Southall GP sitting on the new NHS NWL CCG have any sort of knowledge of health care and social care issues in, say, Westminster?

I have not counted the staff in the eight NHS NWL CCGs, but as of 31 March 2019 there were 680  staff members in just four of the CCGs (Brent, Ealing, Hillingdon and Westminster CCGs). Surely the new CCG would not employ anything like this figure so one can assume lots of redundancies. Also no rational person would surely advocate that the 17 Public Relations staff currently employed by the eight CCGs would all be given jobs in the new NWL CCG.

It looks as if at a borough level in the absence of CCGs eight Integrated Care Partnerships (ICPs) will be established for each ‘town’. These ICPs would have no statutory legitimacy in terms of the 2012 Health and Social Care Act. The ICPs concept (originally conceived as ACPs) were STP vehicles for functional service delivery (not commissioning). In fact the 2016 NHS NWL STP cites ACPs to deliver elderly care in 2020/21. All very confusing.

 

The New Ealing Out Of Hospital (OOH) Services Single Supplier Initiative

On 14 February 2019 a 10 year Ealing OOH Services Single Supplier contract was signed by ‘West London and Ealing CCG’ (whatever body that might be) and West London NHS Trust (WLNT). WLNT is what used to be called West London Mental HealthTtrust and is the only NHS Trust which is based in Ealing.

The 2017 Ealing OOH Services single supplier proposals stated that the preferred provider would begin operation by the end of June 2019. A 1 May 2019 start date was also stated as a target.  July 2019 is now the estimated start date being quoted by WLNT.

It will be interesting to discover when this service begins when the Single Point of Access (SPA) for Ealing OOH services will go live. In the 2017 plan, the SPA would go live (with clinical triage) by 1 October 2019. When the SPA does go live, it might well take a while for patients, service users and carers to understand to which healthcare and social care services the SPA relates. Of course it won’t deal directly with any OOH mental health services, but will refer callers to the mental health SPA.

Of the 15/16 members of the Strategic Oversight Partnership Board, who will ‘oversee’ the new   Ealing OOH Services performance, four are Ealing Clinical Commissioning Group (ECCG) bosses. When the ECCG closes down by 2020/21 (and is replaced by a new North West London CCG) these four will have to be replaced.

Since 2017 Ealing Save Our NHS (ESON) has repeatedly asked ECCG to see a copy of the Ealing OOH Single Supplier business case. The ECCG is still refusing to supply this to ESON. Now that the contract has been awarded and the award presumably blessed by NHS England and the Department of Health bosses it seems ridiculous that ECCG should continue to withhold the business case.