We are 100
This is the 100th issue of this newsletter. The first issue was published in May 2013. In that issue we looked at the changing roles of hospitals. We anticipated the 2012 NHS North West London (NWL’s) plans to close the A&E unit at Ealing Hospital. That never happened and we thought the matter was resolved in March 2019 when the Department of Health & Social Care withdrew its support for NHS NWL’s ‘Shaping a Healthier Future’ plans. How wrong we were. Ealing Hospital recently supported the upgrading of Northwick Park Hospital and the downgrading of Ealing Hospital as part of NHS NWL’s response to Covid-19. Rumours are rife that now the pandemic is starting to wane, the Ealing Hospital downgrade will not be reversed.
We also nervously welcomed the arrival of the Ealing Clinical Commissioning Group (ECCG), a product of the 2012 Health & Social Care Act. ECCG seems to be currently falling apart even though its formal closure date is way off on 31 March 2021. Another new kid on the block in May 2013 was the NHS 111 telephone advice service which replaced the NHS Direct telephone advice service. These days anecdotal evidence suggests that the advice received on 111 ranges from brilliant to hopeless.
In August 2019 we issued the eighth version of our NHS NWL Glossary. Along with this birthday issue is version nine of this lexicon of 236 terms, acronyms and jargon.
The Board Which Runs Ealing Hospital Met in Private on 27 May 2020
On 27 May 2020 the Board of London North West University Health NHS Trust (LNWH) met in private. A video recording of the ’Public Session’ of the meeting was placed in the public domain on 1 June 2020. Why the public were excluded from watching and asking questions at the meeting is beyond me. The meeting lasted 80 minutes and some of the highlights/lowlights were:
5 LNWH Staff Members Have Died of Covid-19 – 4 women and 1 man. 3 white and 2 Asian. The LNWH charity donated £8,000 to each of the families. No details about Ealing Hospital staff.
Sickness and Self-Isolation of LNWH Staff Peaked at 1,460 – Current (27 May 2020) level is 433. (Total LNWH staff is 8,316). No details about Ealing Hospital staff.
Staff Absenteeism Peaked at 22.1% in April 2020 – It’s currently at 7.5%. Target is 4%. No details about Ealing Hospital staff.
Non-Covid-19 Backlog Includes 2,500 Ultrasound Scans – again no Ealing Hospital data
ICU Busy Today (27 May 2020) with 37 Patients – presumably this is at Northwick Park Hospital
Role Changes for Junior Doctors Has Been an Issue – (300 doctors re-deployed because of Covid-19). Weekly Junior Doctor Forums and trying to maintain training as mitigations
35 Infection Control Serious Incidents – PPE related
Key Role of Clinical Psychologists – the two regional mental health Trusts providing ongoing support
Currently LNWH has £84 Million in the Bank
LNWH has Covid-19 Tested 2,000+ Staff and Family 18+ – More Than Any Other Trust
The best presentations – crisp, clear, easy to hear were from CFO Jonathan Reid, Chief Nurse Lisa Knight and Director of HR and OD Claire Gore.
The most inarticulate presenters were Chair Sir Amyas Morse, Deputy Chief Executive Simon Crawford and Non-Exec Dr Vineta Bhalla. The Chair failed to introduce himself at the beginning of the meeting, mumbled, appeared slow moving and added no content to the proceedings. However the meeting was well run. The Non-Execs asked good questions. The questions from the public which had been submitted to the Board prior to the meeting were not answered at the meeting. In fact the questions were not even asked at the meeting – except for one from a Councillor. The PR guy said that this was the only question that had been submitted. This was incorrect as I and at least one other had submitted questions and we’d both had acknowledgements of receipt from the Trust! As at 15 June 2020 these questions from the public have still not been answered.
The IT support and training (and adequate equipment at home) seems to be sadly lacking in virtual meetings in the public sector such as this one.
For papers and to view the recording of the ‘public’ part of the meeting:
Ealing CCG Finally Makes a Public Statement About its Covid-19 Response
Informally we have discovered that ECCG staff have been redeployed and worked/are working very hard as part of the Covid-19 response in Ealing over the last three months. But it’s only in ECCG documents released into the public domain on 10 June 2020 have we gained a small, formal glimpse of what ECCG staff have been doing.
There are still no details on Covid-19 deaths at Ealing Hospital. As of 1 June 2020 there have been 1,511 Covid-19 deaths in the nine ‘main’ NHS NWL hospitals. Apparently there have been 55 Covid-19 driven service changes. Only one of these seemingly involved Ealing Hospital – the suspension of overnight surgery at Ealing Hospital. This really is being economical with the truth about the Covid-19 driven changes at Ealing Hospital. Ealing Save Our NHS has written to NHS NWL commissioning supremo Jo Ohlsen about this shoddy failure of disclosure. The actual changes at the hospital also includes all Trauma and Orthopaedic surgery being diverted to Northwick Park Hospital, the transfer of the Breast Clinic, and the transfer of a wide range of critical care equipment and most ICU Beds. Add to this the closure of Ealing’s only Acute Adult Mental Health Wards of Hope and Horizon on the site and the Ealing Hospital Covid-19 downgrade is extremely significant and if not to be reversed very worrying.
Covid-19 testing in the car park behind Mattock Lane Community Health Centre in West Ealing has been confirmed. Local residents remain baffled as to what was/is occurring at this location as its official designation is ‘Local Primary Care Escalation Hub’. The staff running this test centre are employed at Ealing’s only NHS Trust – the West London NHS Trust (WLHT) in Southall. Covid-19 testing for NHS staff is now also taking place in Mattock Lane. ECCG staff worked with WLHT staff at Ealing Hospital on patient discharge. WLHT staff contacted 2,000 Ealing patients to discuss their healthcare needs.
Completely unannounced the Army turned up in the Gurnell Leisure Centre (closed) car park in West Ealing on 13 June 2020 offering Covid-19 testing. Did ECCG commission this? Casually dressed people (with no id) who were bossing motorists around in the car park said they were employed by Ealing Council. (Nothing about this in Councillor Bell’s 12 June 2020 Covid-19 newsletter or in the 130,000 copies of the latest Ealing Council ‘COVID-19 SPECIAL: Around Ealing’).
McKinsey & Co Partner Ms Penny Dash To Become NHS NWL ICS Chair on 1 July 2020
An odd date to start one wonders as the NHS North West London Integrated Care System (ICS) only goes ‘live’ on 1 April 2021. And unless new Government legislation come in before then the ICS will be a non-statutory body. The statutory body, of sorts, that will exist on 1 April 2020 will be the new NHS NWL CCG. Local commissioning for 2.5 million NHS NWL patients – quite some trick that one.
An NHS NWL ICS paper published on 10 June 2020 lists an NHS NWL ICS work programme. What is striking about the programme is there’s no any reference at all to any planned work on social care or healthcare and social care integration.
Research Reveals Covid-19 Largely Arrived in the UK from Spain (34%), France (29%) and Italy (14%)
The Covid-19 Genomics UK Consortium has announced its findings. Only 0.1% of the original Covid-19 cases originated directly from China. The virus arrived on at least 1,336 occasions and the rate of infection peaked around 15 March 2020.
£1.7 Billion Covid-19 Contracts Handed to Private Sector Largely With No Competitive Bidding
The response to the pandemic has seemingly provided ample opportunities for the Government to shower private companies with healthcare contracts to the value of £1.7 billion. Of the 385 contracts entered into, 92% have been commissioned by central Government. Local Government commissioned 5% and the NHS just 3%. So much for the much vaunted local healthcare NHS CCG commissioning embedded in the presumably still applicable 2012 Health & Social Care Act. The emergency has opened up the doors to commissioning without competitive tendering.
This data comes from Tussell, a recognised authoritative source on what the Government is purchasing. Tussell (www.tussell.com) has been releasing data monthly on Covid-19 Government purchasing.
Some of the awards are eye watering in scale compared to the size of the supplier. For example, Pestfix of Littlehampton in West Sussex was recently awarded a £108 million contract for PPE products. Pestfix is a family firm of just 16 employees with net assets of £18,000.
The Department of Health and Social Care has awarded 44 contracts worth £585 million. £33 million has been spent on consultancy support. PwC has won seven contracts worth £10 million. The biotech firm Life Technologies Ltd has four contracts worth £68 million. The cost of testing contracts stands at £421 million.
None of the published data by Tussell included any details of the cost of creating the Nightingale hospitals or the costs involved in the human contact tracing programme. However on 10 June 2020 ‘Health Service Journal’ revealed that the cost of setting up and running the Nightingale temporary hospitals has cost over £200 million.
NHS NWL Abandons Its ‘Health Help Now’ App
Launched by press release in August 2018, the NHS North West London (NWL) home grown ‘Health Help Now’ Smartphone App promised to digitally deliver symptom checking, diabetes support, health news and advice. On 5 June 2020 the NHS NWL Collaboration of Clinical Commissioning Group’s Informatics Directorate wrote to ‘Colleagues’ informing them that the App would be ’decommissioned’ at the end of June 2020. It seems that just 4% of the 2.5 million registered patients in NHS NWL have actually used the App. Other reasons for its failure include lack of clinical oversight and financial unsustainability. No NHS NWL press release about this has been issued and details of the cash spent on it has not be revealed.
ECCG Excludes the Public From its Governing Body Meeting
The NHS Ealing Clinical Commissioning Group (ECG), with just over nine more months of life left in it, is planning to meet virtually on 17 June 2020. It last met in public on 22 January 2020 some 20 weeks ago. However the public will be excluded from this virtual meeting. Just what has the ECCG got to hide? Still to be fair exactly the same approach has been adopted with NHS WLHT and NHS LNWH Board Meetings. It seems that a feature of pandemics in north west London is the loss of real time public scrutiny of NHS statutory institutions.
ECCG’s web site is a bit of a mess. It tells all and sundry that its 25 March 2020 Governing Body meeting was cancelled. In another part of the web site, the Minutes of the 25 March 2020 Governing Body meeting are published, with no attendee list.