More views on the 8th February Sustainability & Transformation Partnership ‘consultation’

From the Save Southend NHS Facebook page: https://www.facebook.com/SaveSouthendNHS/

Campaigners Slam Flawed Consultation

Local health service campaigners who attended a consultation event organised by the Mid and South Essex Sustainability and Transformation Partnership in Southend’s Cliffs Pavilion on 8th February about the future of regional NHS services condemned NHS leaders for failing to give credible answers over their plans.

The changes are designed to plug a predicted £500 million funding gap across the area. Critical services, including stroke, emergency orthopaedic surgery and others, are to be removed from Southend Hospital and relocated to either Basildon Hospital or Chelmsford’s Broomfield Hospital. The plans assume that it will be possible to keep patients away from hospital by using unspecified technology to develop ‘self service’ and allowing people other than GPs to deliver ‘primary’ healthcare.

Hundreds of critically-ill patients who can no longer be treated locally will have to be transported to other hospitals across the road network.

Transport plans ‘meaningless’

Senior managers who presented the plans were repeatedly asked to explain how their grand scheme could be delivered given a stunning lack of detail in their proposals.

One member of the public asked if a study of the traffic issues involved in transport across busy roads including the A13, A127 and A130 had been undertaken. Ronan Fenton, speaking for the STP claimed that it had, but could not explain what it said or why he had not presented it to the meeting.

Campaigners believe this makes a mockery of ‘consultation’ when the problem of being able to transport seriously ill people across the area is clearly a critical issue. If an appropriate transport service is not delivered then patients will quite simply be at risk and the overall STP plan may fail. It was pointed out that the East of England Ambulance Service were not even represented at the event. We wonder how the public can be asked to give a considered opinion when they were given no evidence to go on?

Despite repeated questions, no concrete proposals were made about who would provide transport or how this could be done safely given that the Ambulance Service is already severely overstretched and struggling to recruit and retain paramedics.
Where are staff to come from?

Health staff and public all asked how the STP could guarantee that new staff with specialist skills can be recruited when there is a crisis in recruitment across the NHS. Speakers simply said that ‘it will be tough’ and ‘it will be a challenge’.

The experience of recent changes to NHS services is that they can have a negative effect on staff. For instance, in the ‘Pathology First’ service, which took microbiology skills away from Southend Hospital, there has recently been a mass resignation of ten staff. This hotly-contested change was also supposed to be a ‘centralisation’ and ‘specialisation’ of health services which has utterly failed to deliver an improvement and which has actually led to the recent scandal over incorrect cervical cancer tests.

‘Pie in the sky’ assumptions

The current proposals will have a massive impact on the shape of NHS services across Mid and South Essex. We were told that without them there would be a catastrophic gap in funding. However, the solutions proposed all depend on plans which have little substance.

There is a crisis in social care, cuts to Public Health budgets and a chronic shortage of GPs but the STP assumes that local government and ‘community’ services will improve social and primary care to keep patients away from A&E in order for the new hospital configuration to work!

Once patients are in hospital, the STP then assumes that ‘bed blocking’ can be dealt with. However we are in a climate where in Southend, a residential care home can be closed in favour of a boutique hotel and where serious consideration has been given to using “Air B’n’B” style services to discharge patients.

We believe it is clear that even where proposals may be welcome, such as the specialist stroke facility to be provided at Basildon, outcomes for patients may be worse unless adequate services are provided locally. The specialists at the meeting were clear that without the ability to assess patients thoroughly 24/7 at a local hospital, all a central facility might mean was that vital life-saving time would be lost in transferring vulnerable stroke patients to Basildon.

The STP’s plans gave no answers on key areas barring vague assurances and the Save Southend NHS campaign queries the realism of the assumptions they laid out.

Not democratic

Campaigners were dismayed to hear senior NHS staff say that any decision would not be ‘democratic’ and that the consultation was not ‘a referendum’. Indeed, when pressed as to why the merger of the three hospital trusts had not been consulted on, we were told that the NHS were consulting on the current STP proposals because they ‘had to’. This gives us no confidence that the STP see the consultation as anything but a ‘tick box’ exercise which does not give the public any real say in what happens to our services.

A spokesperson for the save Southend NHS Campaign commented:

“It seems frankly incredible that a consultation which makes such a big difference to our health services told us almost nothing concrete about how any changes would be achieved.

How dare the STP fail to even provide any evidence about the safety of something as basic as transporting critically-ill patients between hospitals?

Whether it was on staffing, on a transport service, on GP services or on the back up for the proposed specialist stroke unit, the STP just can’t tell us how services will be delivered or how they will achieve improvements for patients while saving vast amounts of money.

The presentation missed out the fact that £30 million a year has to be saved at each hospital and the senior NHS representatives tried to wriggle their way out of admitting that even the £118 million of capital funding they have trumpeted is not actually guaranteed at all!

We have warned all along that these changes are motivated by the need to make huge savings across the local NHS. We are urging people to attend their local consultation events and to ask questions about the impact of the plans, but we are very worried that the public consultation can’t be meaningful in any real way when the plans are so vague and when so much is left unexplained.

We think local councils and MPs need to stand up for their constituents’ interests and demand that that this process is halted. Let’s at least have a consultation based on some real information and with some proper evidence.

We’re worried that if the changes go forward as proposed, they will be a disaster for the NHS that we need and a threat to patient safety.”

Sign the petition HERE: https://you.38degrees.org.uk/petitions/stop-the-mid-south-essex-stp-downgrading-southend-hospital#SaveSouthendNHS

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CAMPAIGNERS TO DEMONSTRATE IN CHELMSFORD HIGH STREET THIS SATURDAY

From the Defend Our NHS – Chelmsford, Mid-Essex Facebook page – https://www.facebook.com/defendourae/

Midday (near Lloyds/Waterstones)

Health campaigners will be in the middle of Chelmsford High Street (near Lloyds/Waterstones) this Saturday (17th February) from midday to protest against plans to a cut a further £400 million from health budgets over the next few years, and a proposal as part of these plans to merge Broomfield Hospital with the hospitals in Southend and Basildon. The protest will be addressed by health campaigners, and passing members of the public will be asked to sign letters of protest for their local MPs. The protest comes during an ongoing consultation into proposed changes into health services locally.

‘Our NHS is not failing, but it is being failed by this government’s underfunding’, said Defend Our NHS Chelmsford campaign coordinator Andy Abbott. ‘We will be sending out a clear message on Saturday. No Cuts. No privatisation. No merger.’

‘After seven years of cuts our NHS is already bleeding and on its knees’ continued Mr Abbott. ‘It will not survive further cuts via the government’s so called Sustainability & Transformation Partnership [STP] programme. Despite all the spin, a look at the Mid & South Essex STP’s current consultation document reveals the truth, as it talks about “closing our financial gap”, “address[ing] the financial challenges”, “to live within our means” and “more economical ways” to deliver local health services. Even in their own words, and despite previous promises by the government to keep the NHS free from austerity, the proposed changes are driven by cuts.’

‘It is also worth noting at what the same consultation document says about merging Broomfield, Basildon, and Southend hospitals,’ Mr Abbott pointed to. ‘While it talks about a closer working relationship, it warns about “averting the disruption caused by a formal merger at this time”. So why have they changed their minds? And why so quickly? What has changed in just a few months? The proposed merger also makes something of a mockery of the current consultation process.’

Report on the Sustainability & Transformation Partnership consultation – 8th February

From the Save Southend NHS Facebook page: https://www.facebook.com/SaveSouthendNHS/

The Mid & South Essex Sustainability & Transformation Partnership (STP) refused to change to a larger venue or rearrange seating to accommodate more people at the original venue, Maritime Rooms at the Cliffs Pavilions, in spite of tickets to last night’s consultation event ‘selling out’ two weeks ago. Instead they decided to employ a firm of security guards to prevent entry of many non-ticket holders to the event, originally billed as ‘just turn up’.

#SaveSouthendNHS had a presence of thirty or so supporters outside the venue to distribute leaflets illustrating the real effects the STP is likely to have on local NHS services, and talk to attendees as they arrived.

Around 200 people were admitted to the 300 capacity venue to hear the standard spiel touted by the STP and its advocates. Their basic line is that with an ageing population and more demand on the NHS, they can’t adequately staff the three hospitals of Southend, Basildon and Broomfield.

According to the STP, changes to the way primary care (GPs etc.) is delivered will make our population much healthier, resulting in an amazing reduction in the need for service, including up to a 45% decrease in the number of hospital outpatients.

They will create ‘specialist centres’ at different hospitals to deal with the likes of complex orthopaedic (broken bones), lung, vascular, heart, urology, abdominal surgery, etc. At the moment all of these can be done at each of the three hospitals, ‘specialist centres’ will be created by removing these capabilities from two of the hospitals, making the remaining one the only one able to carry out the procedures and therefore, by default, a ‘specialist centre’.

The STP then propose to transport seriously ill patients in need of these treatments, significant distances across Essex’s highly congested roads to reach the care they need. How are they going to transport these patients? Well, that’s not entirely clear. The STP have a vague idea about a new fleet of dedicated ambulances in which the patients will be accompanied by specialist nurses, doctors or consultants, depending on the level of care they need. Figures on how many patients this will affect seem unclear with estimates ranging from between 15 – 25 every day – that’s a lot of journeys, especially when you consider the medical staff also need to return to their bases.

With an ambulance service already failing to fill its many vacancies and respond to even life threatening calls within an acceptable timeframe, it begs the question; where are these paramedics coming from, to say nothing of the extra medical staff needed to attend these patients in transit? As with most of the STP’s answer, they’re a combination of hazy outlines mixed with optimistic assumptions. When the STP panel were asked where the East of England Ambulance Service representative was, there were some awkward and embarrassed mumbles before saying: “we’ll look into it.” There are mass Doctor and nurse vacancies already so we are unsure where they will get these specialist transfer clinicians from in an already overstretched workforce.

Additionally the STP are saying that transport will be provided for outpatients and visitors having to travel further afield, possibly in the form of an interlinking bus service. Plans are again currently at the ‘back of a cigarette packet’ stage.

The jewel in the STP’s crown is the Hyper Acute Stroke Unit (HASU) planed for Basildon. The idea here is for each of the three hospitals to have 24/7 MRI facilities along with specialist trained doctors and nurses. Once patients have been assessed at their local hospital, those in need will be transferred the HASU. This plan has been developed in conjunction with local consultants and, if fully funded and implemented properly, will be a major step forward for improved patient care and outcomes. By ‘implemented properly’ we heard from Dr.Guyler that the gold standard for early stroke intervention at each site is a 24/7 MRI scanning service plus a 24/7 specialist stroke Dr and nurse to diagnose and commence treatment prior to onward transfer to the HASU. A regional Thrombectomy service is also required according to Dr.Guyler. We heard last night that it will be down to specialist commissioners to fund this after the proposals have been accepted, which seemed to cast some doubt over whether this was a guaranteed move. The STP WOULD NOT commit to this gold standard despite heavy public pressure being applied – see our video!

They STP team claimed the lives will give current staff great opportunities and will attract new recruits yet there has been no formal staff survey conducted – yet again utter spin.

The atmosphere at last night’s event was certainly tense. The public aren’t buying the spin put out by the STP. At the root of their plans is a need to cut in excess of £500 million from the projected spending on the NHS in our area by 2021. Tempers flared as audience members failed to get straight answers from the STP panel that included Dr Celia Skinner – Chief Medical Officer for the three hospitals, Dr Ronan Fenton – Joint Medical Director of the STP and Tom Abell – Deputy CEO & Chief Transformation Officer of the three hospital trusts. There is no way that in the two hours allotted to last night’s event could the STP come anywhere close to answering all the questions people wanted to put. This is one of 18 events planned during the public consultation across mid and south Essex with an extra event now scheduled in Southend at the same venue on the 7th March – two days before the consultation ends.

If the STP really are listening to the people of Essex, they will go away, completely rethink their vague, delusory plans and come back with something that is actually based on clinical evidence and is fit to deliver top quality health care, locally, that patients deserve. Their proposals aren’t currently even fit for consultation! How can the public respond to consultation plans which have no substance and the linchpin of service centralisation is on a transfer service that they have provided absolutely no data about.

Why the STP will not work

This is from the Save Southend NHS Facebook page: https://www.facebook.com/SaveSouthendNHS/

Long and detailed post. You need to read it and understand just WHY #SaveSouthendNHS so strongly object to The Mid and South Essex STP. Their principles ‘claim’ to be bringing much of your care ‘closer to home’ however, the whole disgraceful and dangerous plan is financially motivated to ensure they have saved in excess of £400 million by 2021 from the now (conveniently) merged Southend, Broomfield and Basildon Hospitals.

The principles contained in their public consultation are flawed at almost every level and will enforce a postcode lottery for care on the 1.5 million people the combined hospitals serve. Critically ill patients will face longer journeys to obtain so called ‘specialist’ care – care that mostly is currently available at your LOCAL hospital but will be centralised and re-branded as ‘specialist’ – just now further away – if you survive the journey by their unplanned, un-staffed, un-costed ‘internal transport service’ allegedly to be manned with highly skilled Doctors and Nurses.

Okay, so let’s point out 2 things – the numbers of Doctors and Nurses are at a critical level. Where are they going to magic these staff from to man a 24/7 transport service to keep you alive down the A130 or A127 in order to access your ‘specialist care’. We hear you cry BUT WHAT ABOUT THE AMBULANCE SERVICE?? Indeed, our army in green are amazing yet they too are in crisis, often unable to meet response times for the most life-threatening of emergencies, let alone with the increased burden of transporting a ‘guesstimated’ upwards of 775 very unwell patients PER MONTH between Southend, Basildon and Broomfield.

YES 775 critically ill patients being shunted around Essex for emergency surgery, stroke care, orthopaedic issues, breathing problems. Disgusting – yet marketed as being in your best interests: http://www.echo-news.co.uk/news/15909025.More_patients_will_have_to_be_transported_between_hospitals_after_merger_than_originally_thought/

If you have the time, read the links below that give a full and detailed picture of the NHS staffing crisis and a view from the floor on how the NHS could be fixed:
https://www.theguardian.com/society/2018/feb/05/more-nurses-needed-to-avoid-new-mid-staffs-style-scandal-says-rcn | https://www.theguardian.com/commentisfree/2018/jan/30/nhs-crisis-jeremy-hunt

Whilst you’re at it – remind yourself please by watching this speech at our rally from an actual Consultant, a brave one who really actually cares about people and isn’t just in it for the cash, or a step up the career ladder, or a job in the Department of Health (unlike the Clinicians on the STP team) once the STP has ‘delivered’ and CEO Ms. Panniker has been awarded a chest full of medals by Jeremy Hunt: https://www.facebook.com/mark.beadle.79/videos/10156153072269540/

Let’s not forget the ‘integrated community hubs’ also called ‘GP Hubs’ or ‘Locality Hubs’ depending on who you speak to and all meant to confuse you even further so you don’t comment or voice your angst at their public consultation. Are THEY bringing your care closer to home? Are they hell. The small, personal, familiar surgeries are for the kosh – partly due to the huge local and national GP shortage and partly because the Government’s STPs both here in Essex and nationally would much prefer to have the likes of Virgin, G4S or Care UK ‘managing’ the contracts for these shiny new health centres….that won’t be as close to where you live as your current practice and will likely be part of an ACO or ACS (for those that aren’t aware what these are – we shall explain further down the line so as not to confuse you – just know that they are NOT good news for our NHS). GP Hubs will serve a much larger population group and you will have a variety of hoops to get through including receptionist ‘triage’ and numerous other practitioners (if they can find any – remember that health professional crisis?) before you ever get the chance to see a GP.

The Mid and South Essex STP is bad news for the majority (of yet un-consulted) staff who will be forced to work across sites and don’t want to, and bad for us, as patients – as those staff will leave and then we will be in a bigger mess than we are in already but we think that’s what they want – especially for Southend. Run it down, run it into the ground, make it un-safe, make it fail, increase the vacancy rate – then they have every excuse to transfer out even more specialities than those currently on the table. We aren’t scaremongering. We are angry and we are well informed by those in the know and we trust the real Doctors far more than the Spin doctors.

So what can you do?

Attend the STP discussion events listed via this link and ask them questions: https://www.eventbrite.co.uk/o/mid-amp-south-essex-sustainability-and-transformation-partnership-stp-15872139649

Sign our petition: https://you.38degrees.org.uk/petitions/stop-the-mid-south-essex-stp-downgrading-southend-hospital

Follow our page and invite your friends, share our posts, get the message out there.

Write to your MP and elected Councillors: https://www.writetothem.com

Respond to the Mid and South Essex public consultation by emailing your views to: england.midsouthessexstp@nhs.net cc’ing in your MP. You can also write to them via this address – STP Programme Management Office

Mid and South Essex STP
Swift House
Colchester Road
Chelmsford
Essex CM2

Above all, remember how their team lied to everyone about the A&E downgrades being clinically led (we smashed that claim to pieces!) look further than the glossy images, pretty presentations and questionable evidence base – any scheme which cuts an already underfunded NHS even further to the bone in order to save an extra £400 million really is NOT going to be better for your health.

#StopTheSTP | #SavesouthendNHS

Reflections on the Save Southend NHS march and rally

On Saturday 27th January, over 1000 people marched through the centre of Southend to protest against the ‘Sustainabilty & Transformation Partnership’ (STP a.k.a. Slash, Trash & Privatise) plans for ‘rationalising’ services between Southend, Basildon and Broomfield hospitals. It was also in protest at the merger of the three hospitals which was sprung upon everybody during the STP ‘consultation’ process. The protest was called by Save Southend NHShttps://www.facebook.com/SaveSouthendNHS/ Check out their Facebook page for frequent, accurate and to the point updates and bulletins about the campaign and the implications of the STP.

The aim of the protest was to draw the attention of the wider public in Southend to the threats posed to NHS services by the STP plans. Threats which if not challenged, will lead to a two tier service with those that can pay getting a better standard of treatment followed by eventual privatisation and the loss of a free at the point of use health care.

The full implementation of the STP with the re-location and ‘rationalising’ of services relies on having the capability to transport patients swiftly between hospitals. One you start reading what Save Southend NHS have found out, it’s very clear that Southend, Basildon and Broomfield hospitals do not have the vehicles, let alone the staff to provide this capability. Even if they did have the capability, they would have to deal with a road network in the region that more often than not is congested. Congestion that in an emergency blue light situation could in some cases be the difference between life or dying in the back of an ambulance.

The STP also relies on patients and their families, friends and carers accepting that more often than not, they will have to travel a lot further for treatment and visits. Even in this day and age, not everyone drives and having to endure a journey on a series of buses to get halfway across the county is going to be a stressful and distressing experience for many. All of this shows that the STP plans have nothing to do with improving services for patients and everything to do with cost cutting and privatisation.

As for the march and rally, we felt it did the job of getting the message across to the public about the threats posed to NHS services in the region by the STP plans. What was good was that it was a lot more than just the ‘usual suspects’ with a good number of ordinary people joining the march and rally. One of the strengths of Save Southend NHS is that it’s a broad, community based campaign that doesn’t have a party political agenda. One of their other strengths is the network they’re building up with other campaign groups across the region and beyond. Both of these will be essential in dealing with the inevitable games of divide and rule that those behind the STP plans will try in their desperation to thwart opposition to them.

All in all, the march and rally were a great success in that they brought people together, boosting the morale of campaigners and supporters in the process and sent out a clear signal that opposition to the STP plans is growing. The organisers certainly deserved their celebration in The Railway afterwards! However, a march and rally is just one tactic on one day in an ongoing campaign and there’s a lot more work to come in the future. Here at the Stirrer, we’ll be doing what we can to support this fight.

Service reconfigurations = CUTS!

This is from the Save Southend NHS Facebook page – https://www.facebook.com/SaveSouthendNHS/

STP PLANNED SERVICE RECONFIGURATIONS!!!!! READ AND SHARE!

Dear supporters. Southend currently has a GENERAL HOSPITAL but under the proposals by the Mid and South Essex STP, not for much longer – here is the list of all the service relocations. In case they wish to argue, these are from their web site (which is exceedingly hard to navigate – even for us) http://www.nhsmidandsouthessex.co.uk/current-proposals/proposals-for-hospital-services/

Patients in need of emergency general surgery that require a hospital stay to be at BROOMFIELD Hospital.

Gastroenterology services for people with complex gut and liver problems requiring a hospital stay to be at BROOMFIELD Hospital.

Patients requiring a hospital stay for complex lung problems to be located at BASILDON Hospital.

Patients with complex kidney problems who need a hospital stay to be located at BASILDON Hospital.

Patients diagnosed with acute stroke would be transferred to a Hyper Acute Stroke Unit at BASILDON Hospital.

Patients with vascular issues requiring a hospital stay for diseased arteries and veins to be located at BASILDON Hospital.

Patients who need a hospital stay for treatment of complex heart problems to be located at BASILDON Hospital.

Patients who require emergency Orthopaedic surgery which require a hospital stay (e.g. for broken bones) to be at BASILDON Hospital ( BROOMFIELD for Mid-Essex).

Patients who require a hospital stay for Urological surgery (e.g. for kidney and bladder problems) to be at BROOMFIELD Hospital (except for urological cancer operations which are already located at Southend Hospital).

Patients who require PLANNED orthopaedic surgery (e.g. for bones, joints and muscles) to be at SOUTHEND (though at Basildon if the patient has other complex health issues).

Women requiring gynaecological surgery who need a hospital stay and gynaecological cancer who need a hospital stay to be located at SOUTHEND Hospital.

Allegedly, you will be seen if an emergency at Southend A&E under a ‘treat and transfer’ plan and then transferred on by their currently non-existent, un-planned, un-staffed internal transfer service. They state: “If you needed to transfer to a specialist service, where you would have a higher chance of making a good recovery, we propose to invest in a new inter-hospital transport service with full clinical support, travelling with a doctor or a nurse for a safe and rapid transfer to the care you need.”

There is no documented plan of providing (or costings of) a fleet of vehicles, how they will staff this with Drs, nurses, paramedics (remember that one of the reasons for the whole STP is that there are recruitment problems) and very scant clinical evidence that is a few cases this will improve outcomes or be cost efficient. The ‘on the floor’ clinicians have stated most of these plans are dangerous and will not achieve either desired improvement patient outcomes OR financial savings OR improve staffing issues and this is backed by a wealth or clinical evidence by research organisations such as the Kings Fund who have conducted research on centralisation of hospital services. Plus they need to slash £400 million by 2020/21 therefore do you honestly think that this will be BETTER for us? Our NHS is in crisis as it is let alone with more budget slashing. This is an enforced postcode health lottery for the good people of our community and the majority of these plans are dangerous and a downgrade by stealth to our local GENERAL hospital. This is why we must fight!

No To £400 Million Local Health Cuts – Save Our NHS

This is from the Defend Our NHS – Chelmsford, Mid-Essex Facebook page – https://www.facebook.com/defendourae/ The proposals from the ‘Sustainability and Transformation Partnership’ affect Southend, Basildon and Broomfield – this Facebook page is part of a coordinated response to what is essentially a programme of cuts.

Saturday, 17th February, 12noon – 2pm | Outside Waterstones, 78 High Street, Chelmsford, CM1 1EJ | Facebook event page: https://www.facebook.com/events/1977513352574494/

The bottom line is these proposed STP (now renamed the Sustainability and Transformation Partnership, though Slash, Trash, and Privatise is perhaps more appropriate?) changes are not clinically driven. These proposed changes are being driven by huge government cuts.

Basildon has not been able to deal with demand in recent years as it is, so how will it cope as the specialist emergency centre for mid and south Essex? Their A&E has regularly been on black alert. Does it really have the capability for all this extra demand? It will be overwhelmed.

Furthermore, with public transport links so poor between Chelmsford and Basildon, there will be those who find it very difficult to impossible to visit relatives and friends in Basildon. And such support networks are vital to patients in recovery.

We are also worried about how the victory we gained in the summer will be maintained. By losing many of the services currently being offered at Broomfield to Basildon, Broomfield will inevitably also lose medical staff to Basildon. Without these medical staff, can Broomfield continue to offer a full A&E service? It looks like it will be a downgrade of blue light emergency services by stealth.

Please join us in the High Street (by Lloyds/Waterstones) to say no to NHS cuts and privatisation.