Monday, July 28, 2014

Who Cares? – When Care is Cut

Statement by the Wanstead and Snaresbrook Residents' Alliance [WASRA] about Redbridge CCG’s plans to axe most intermediate care [rehabilitation] beds, which has been slipped out under the radar.

In brief, the situation is:

On 9 July the Clinical Commissioning Groups [CCGs] announced a plan to reorganise intermediate care services [formerly known as rehabiltation services] in the three boroughs of Redbridge, Barking and Dagenham and Havering. Originally the public consultation was to close at 5:00 pm on 1 October but we pointed out the lack of information being distributed and the holiday period so it was agreed at last Thursday's Health Scrutiny Committee that the deadline be 31 October - I am awaiting written confirmation of this from Redbridge CCG.

Currently there are 104 intermediate care beds provided - 48 in Wanstead Hospital, 30 in Foxglove Ward at King George Hospital [KGH] and 26 at Gray's Court Dagenham. The plan is to provide 40 beds at KGH, which could be increased to 61 if necessary. In spite of the mild winter just gone, 75 beds were used: we are concerned about what would happen if we have a 'bad' winter?

Our local NHS perpetuates the myth that we are over provided for in interim care. The three boroughs have a total population in excess of 700,000. The 2013 National Audit of Interim Care Report, which takes community based teams into account, states that the mean number of beds used by 74 commissioning groups was 26.3 per 100,000. By this, we ought to have 184 beds.

We do not want the abysmal performance of BHRUT since their 2010 re-organisation when the warnings over under provision were ignored, to be repeated here.

The reason given for the reduction is the reported success of the two new community based intermediate care teams - the Community Treatment Team and the Intensive Rehabilitiation Service which were set up in Redbridge in November 2013. We maintain that it is not a matter of either or, but both hospital and community based services.

The NHS proposal can be found on . BEWARE the document is highly biased for example:

The consultation claims that this plan is not about saving money: "Isn't this just all about saving money? No. The reason we want to make changes is because we think we can make things better for patients." Later on the same document states: "We do not have enough money to spend on everything that everyone wants and if we spend more on one service then we have less to spend on another."

Also the questionnaire which is attached is extremely biased, in that it gives 5 options for people to choose from - all of them cuts. There is no option provided to keep the present service as it is.

If people want to respond, then it is better to email them on or write to FREEPOST 1 Y 426, Ilford, IG1 2BR.

The campaign

Having just learned of all this, we attended the Redbridge Health Scrutiny Committee last Thursday (24th September), opposing the plan and complained about the lack of information given to the public and the timing - just before the holiday period started. Dr Mathuhukia, the Redbridge CCG member who is leading the campaign agreed to have more information distributed and an extension to 31 October - we have requested written confirmation of this.

1. THIS THURSDAY 31 JULY DR MATHUHUKIA AND COLLEAGUES WILL BE AT REDBRIDGE CENTRAL LIBRARY TO TALK TO PEOPLE ABOUT THE CONSULTATION, BETWEEN 4:00 PM AND 7:00 PM. We suggest that people turn up and complain about the lack of information and the timing and ask for a further library session be held in early September.

2. We have contacted our local councillors - who were unaware of this NHS plan and have contacted John Cryer, our MP who is adamantly opposed to it. We are about to send information to Lee Scott, Mike Gapes and Iain Duncan Smith.

3. In Wanstead, Greg Eglin has started a petition against the plan. If we gain 1,500 signatures we can secure a debate at the next Council meeting in September.

4. Redbridge CCG has offered to send someone to talk to local community groups by emailing or ringing 020 3688 1089. We plan to hold a meeting in Wanstead with our local councillors and MP in early September.

Helen Zammett


  1. These services are about to become yet another casualty of the Clinical Commissioning Groups which are run largely by the medical profession and were invented by Andrew Lansley in his mercifully short term as Health Minister.

    I have always considered that the Government ploy of delivering most of the local NHS financing into the hands of the medical profession by replacing Primary Care Trusts (which worked well) with CCG’s was the near equivalent of giving the keys of the house to the burglars. Since 2012 when these CCG’s were first set up the doctors have at last achieved what they’ve always wanted; control of the purse strings.

    Quite apart from the cuts in care mentioned by Helen Zammett it should be noted that the Chairman of the Redbridge CCG, by enthusiastically advocating the closure of local maternity and A&E services, seeks to override the views and opinions of every local MP, every local Councillor and many tens of thousands of local taxpayers who stand to be deprived of efficient and convenient emergency clinical services not requiring a seven or eight mile journey to reach. His argument is that the present service is ‘stretched too thinly across two sites’ and that the closure plans ‘…were led and agreed by clinicians and subjected to extensive reviews by a range of experts.’ (Ilford Recorder- April 3rd.)

    There we go, those ‘clinicians’ again! Oh yes, and even worse, the ‘experts’. No doubt these sentiments were equally applied to the cuts mentioned by Helen Zammett.

    Why do so many doctors consider that a medical qualification, however arduous to obtain and however prestigious, also gives them the status of holy prophets?

    The present government – ‘the NHS is safe in our hands’ – is intent on disembowelling the NHS but they’re doing it by proxy, through the CCG’s, and the sad thing is, only people like Helen Zammett appear to have noticed.

    Helen, you have a fight on your hands and I wish you the best of luck.

  2. Response from Redbridge CCG

    While local GPs understand concerns from residents about changes to intermediate care services under proposals in our current consultation, we feel we must respond to one or two points in Mrs Zammett’s post.

    Firstly, though - our proposals aim to improve care for people and provide more care in people’s own homes rather than in a rehab unit. We have two new services in Redbridge that are proving hugely successful and we want to keep and expand them. That’s good news for patients.

    The consultation has not been ‘snuck out under the radar’. We have attended many meetings with patients and the public – including with Mrs Zammett – to explain what we are proposing and why. Our GPs will be attending many more in the coming weeks. The local newspapers have all publicised the launch of the consultation and we have taken out advertising to publicise our public drop-in sessions. We have printed 8,000 documents which have been sent to every GP practice and library in three boroughs. Our partners in the voluntary sector have all helped to distribute information about the consultation to their organisations. We have three CCG websites which carry all the relevant documents. We survey our patients every month to check that the new services are providing them with the improved care and outcomes we all want to see.

    Under our proposals care is not being cut. Care, outcomes, and access for patients will be improved. That is an absolute priority for local GPs and it is why we agreed to ‘test’ the effectiveness of the model by trialling the new services, alongside existing bed based care - to ensure it was effective.

    The number of intermediate care beds would be reduced under our proposals. Why? Because we have a number of beds no longer being used, sitting empty in our rehab units. The new home-based services are proving very effective and are seeing more people than the services could previously. CTT and IRS has seen over 7,000 people, where previously only around 1300 patients could access intermediate care, and patients rate them very highly.

    We know that we need between 40-61 beds to care for those people who will still need one. Rest assured, any patient who needs a bed will get one. We can’t be clearer than that.

    We are not ‘overprovided for intermediate care’ locally – but we are over provided for in terms of intermediate care beds. Keeping beds empty and unused is a waste of scarce NHS resources.

    These beds are commissioned, or ‘bought’ by the CCGs and provided by the North East London Foundation Trust. They have nothing to do with BHRUT or the performance of local hospitals.

    Mrs Zammett’s blog says: “We maintain that it is not a matter of either or, but both hospital and community based services.” We could not agree more - we are ensuring everyone who needs a bed will have one, while also delivering more and better services in people’s homes. That is exactly what we are proposing and what people have told us they want.

    And finally, our questionnaire does in fact include an option to keep services as they are now. It is Option 1.

    Please read the document for yourself, come and talk to us, email us at and take part by filling out our questionnaire at:

    Redbridge Clinical Commissioning Group

    1. Heard it all before - and still it's not working.

  3. Meanwhile:
    Halving care beds would 'butcher services' - MP for Leyton and Wanstead, John Cryer via WWGuardian
    Shadow care minister refuses to guarantee King George A&E future via Ilford Recorder

    1. So a very clear choice between being stuffed and being stuffed.