Friday, August 21, 2015

Intermediate Care - Is Redbridge Being Sold A “Pig In A Poke”?


Redbridge Healthwatch has recently published its findings following visits to Wanstead Hospital and King George Hospital. By law, organisations which run and regulate health and social care services have to listen to what Healthwatch says. Healthwatch [HW] will report them to national agencies like the CQC and central government if they feel any services are inadequate. They have the right to visit and view anywhere they wish to see within the NHS.
As you will see from the attached press release and report, various concerns are expressed:

The Press Release
  1. HW believes that unless patients and carers are involved in the planning of the new inpatient rehabilitation services, some of the current services will be lost.
  2. Staff at Wanstead Hospital [WH] did not feel sufficiently involved in the planning of the new inpatient rehabilitation service.
The Healthwatch Redbridge Enter and View Report
Some of the key points are:
  1. Patients have had difficulty in getting rehabilitation beds and discharge pg 5.
  2. The staff at WH do not trust their employers, so that they do not wish to be named pg 6. This applies to various staff there telling Helen Zammett that although Heronwood ward and its 24 beds was not officially closed, they have been instructed not to allow any patients to be admitted on to the ward. Local hospitals had their daily requests to send patients there, denied. Now the Redbridge Clinical Commissioning Group deny that this is true – they are claiming that there was no demand for the beds in Heronwood and so the ward should be closed. It appears that the same tactic was used at Grays Court, the other intermediate care hospital in Dagenham.
  3. The body which runs the intermediate care service North East London Foundation Trust [NELFT] failed to provide any of the information which HW requested as preparation for their visits pg 8. NELFT’s response that 5 working days was not sufficient notice is a lame excuse – operating details are always kept up to date.
  4. When Healthwatch visited WH they found Heronwood was closed: they were told this was because of underuse. Pg 9.
  5. NELFT knew that Foxglove Ward in King George Hospital [KGH] was not suitable as an intermediate care ward but failed to improve conditions there in the 3 years since it began to be used pg 12.
  6. There is doubt over whether or not intermediate care is being adequately staffed pg13.
  7. The standard of intermediate care at Wanstead Hospital is far higher than that being provided at Foxglove Ward in King George Hospital pg 14.
  8. HW was told that there were problems about delays in patients being transferred to WH from Whipps Cross Hospital, so that some patients had to wait longer than necessary for a bed. Pg 14.
  9. Not even Healthwatch were told where the new intermediate care wards would be at KGH pg 16. 14 months after announcing the plan to close WH the Redbridge Clinical Commissioning Group [RCCG] is refusing the name the wards to be used and is saying that it is too early to discuss details about what will be provided in each intermediate care ward.
  10. HW was told that there would be a “Centre of Excellence” pg 16 and so HW is asking for a definition of what a “Centre of Excellence” is pg19 and how it would be created at KGH. The Wanstead and Snaresbrook Residents’ Alliance [WASRA] cannot see how all that is listed on pg 16 can be fitted into KGH, given its current chronic shortage of beds there.
  11. NELFT says that HW and the three borough councils will only be shown the plans for the new intermediate care wards when they are completed pg 16. This contradicts the promised involvement of Councillors, HW, patients and carers in the process of the planning, which was promised at the 6 July Health Scrutiny Committee [HSC] meeting. HW is concerned about this pg 17.
  12. Some WH staff feel that they have not been given adequate information about what is to happen there pg 18.
  13. HW would like to be given a full explanation as to what constitutes inpatient rehabilitation services pg 19.
The WASRA View
NELFT and RCCG have plenty of assurances but few facts and solid information to offer after 14 months. When the planned closure of WH was announced, why didn’t they say where the replacement 40 – 61 intermediate care beds would be? Did they ever have a proper plan?
66% of NHS patients in hospitals are over 65 years of age. With all our local hospitals in special measures, why close 48 highly assessed beds in a well provided, purpose built facility?
We suspect that the real motive behind this plan is to save money. However, now that a new “Centre of Excellence” is to be created, how will the cost of its establishment and running compare to the cost of maintaining Wanstead Hospital?
When severe winter pressures created a crisis in bed availability, would the rehabilitation patients be given precedence over those with acute needs?

Conclusion
To put it basically, none of this adds up. Assurances cannot replace basic facts and solid information. Why is there so much delay and evasion? Is there something to hide?
The HSC has a duty towards, and key role, in scrutinizing the planning, delivery and performance of local health services. If the HSC feels that a substantial change in their local health provision has not been adequately consulted upon, they can refer the matter to the Secretary of State. This would enable the whole situation to be thoroughly investigated by an independent team of experts – exactly what is needed – urgently.

Helen Zammett

1 comment:

  1. Should we be surprised at this? Answer - no, because the attitude of the Clinical Commissioning group is to run a service into the ground and then say that there has been a decrease in demand.
    I would remind people that this is the same group of know-alls who decided the fate of the 2 doctors surgeries giving less than a week's notice for each of them.
    This current proposal does not stack up with the guidelines for older patients who are supposed to be under the care of a named GP - and we are short of those in Redbridge, so yet again we have this group piling on the pressure elsewhere.
    Surely the whole aim is that if a person is ill, you want them to get treated as soon as possible in an environment that will do that? What is the point of shutting a place that is known to WORK, and transferring them to goodness knows where because this same group have not been polite enough to discuss it with anyone.
    I have come to the conclusion the only way to ensure a decent service in this Borough is to dismiss the current clinical group and start again - perhaps we might get people who listen?!
    Vanessa

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