NHS CROYDON MESS RAISES NEW CONCERNS ON St HELIER

Where’s the money gone?

Heather is playing a major role on a newly-created committee probing the massive hole in NHS Croydon’s finances. She is determined to find out what mistakes were made, who was at fault and what impact it will have on future healthcare in south west London.

The South West London Joint Health Overview and Scrutiny Committee on NHS Croydon finances met for the first time on 6 September and set itself the task of answering three crucial questions.

First, how was it that on 8 June 2011 the year’s accounts were signed off with a £5.54million surplus, yet when the same books were re-examined a year later they revealed a £22.7million overspend?

Second, why were officers – charged with managing a huge and vital job – not properly monitored, and were they given the right tools to do the job?

And, third, why in July 2012 did the South West London Cluster Board decide to try to cover up the huge deficit as a ‘prior period adjustment’?

Heather, one of two Sutton councillors sitting on the committee, said: “It is vital that we reach the bottom of this and that we do that quickly.

“If this is the sort of financial mismanagement we see from NHS bosses how can we be sure that the NHS BSBV team, which is after all proposing a multi-million pound plan which would close vital parts of St Helier Hospital, be able to run such a huge scheme successfully? Their track record is simply dreadful.”

Some observers believe the problems started in April 2010 when NHS Croydon was given the added responsibility of hosting London Specialised Commissioning Group. It is thought that running the £800million project may have stretched the resources of officers beyond their ability to cope.

The committee, which is comprised of councillors from Sutton, Richmond, Croydon, Merton, Wandsworth and Kingston, meet again on 24 September. It will call a number of witnesses including Ann Radmore, Chief Executive of NHS South West London.

Ms Radmore was appointed Sector Chief Executive for South West London in 2009 and led the establishment of the SWL Cluster in early 2010.

Another witness will be Dr Peter Brambleby, who was Croydon’s Director of Public Health from March 2010 to February 2012. On 6 July he blew the whistle on NHS London’s decision on 28 June to try to hide the deficit as a ‘prior period adjustment’ which, despite Dr Brambleby’s revelation, the South West London Cluster tried to repeat on 26 July.

Heather added: “Key personnel involved in the Better Service Better Value team planning the future of healthcare in south west London are involved in this Croydon mess. What confidence can we have in their plans for St Helier?”

MORE CONCERNS ABOUT PROPOSALS FOR St. HELIER

The London Ambulance Service has revealed alarming journey time figures to Sutton Councillors.

[ Heather, Paul Burstow MP and Richard demonstrating their opposition to the threatened closure of of the Accident and Emergency Department, outside St. Helier hospital ]

Alarming figures from London Ambulance Service stunned Councillors at the special meeting, attended by Heather, of Sutton Council’s Scrutiny Committee, a meeting focusing on St Helier Hospital, on Monday June 11.

Bill Arkell, Operations Manager for Sutton and Streatham, shocked the meeting by revealing that journey times for emergency patients will more than double if St Helier’s Accident and Emergency (A&E) ward is closed.

Currently, the average journey time to St Helier is 8.5 minutes. Under the new proposals that will soar to 14-15 minutes to St George’s in Tooting, 16-17 minutes to Kingston and up to 20 minutes to Croydon Hospital.

Liberal Democrat Councillor Mary Burstow, Chair of the Scrutiny Committee, said: “These are truly alarming figures. Report after report has shown that the quicker people get treatment the better the outcome. Doubling journey times can only put Sutton residents at greater risk.”

The well-attended meeting also heard that turnaround time – how long it takes from an ambulance arriving at a hospital to being ready to go on another call – is 15 minutes or less on average at St. Helier Hospital, again half the time of neighbouring hospitals.

Councillor Burstow added: “In light of these figures, it is absolutely astonishing that Better Services Better Value (BSBV) [the NHS body that recommended closure of St. Helier’s Accident and Emergency Department] didn’t bother to ask seek wider views and opinions.”

The BSBV panel last month recommended that St Helier Hospital’s A&E, maternity and children’s wards should be closed – leaving St George’s, Kingston and Croydon to deal with the patients.

St Helier would instead become a centre for planned operations.

Age UK Sutton, which represents around 27,000 people – and Sutton Carers – which has 4,500 registered members looking after thousands of people – also told the meeting that they had also not been consulted before BSBV made its recommendations.

In robust exchanges between councillors and Rachel Tyndall, BSBV Senior Responsible Officer, and Mike Bailey, Acute Medical Director for BSBV, Sutton Council Leader Ruth Dombey referred to previous threats to St Helier saying: “We have been through years of uncertainty, so we are more than a little cynical.”

Councillor Dombey added: “Under the proposals St Helier would become the site for elective surgery for patients from Ham to New Addington.

“Is there any guarantee they would come? What about the transport issues? Where would they park when they got here?”

During the meeting it was revealed that BSBV’s recommendation supposes that between 2013 when the decision is due to be made and 2017 when it should be implemented, up to 50% of A&E patients would be persuaded to seek treatment in the community instead of going to hospital.

Click here to sign our petition organised by local LibDems, on the website of Paul Burstow. [Click on the word “petition”]

Resident served with Sutton’s first ‘Acceptable Behaviour Contract’

A resident has been served with Sutton’s first ‘Acceptable Behaviour Contract’ for the alarm and distress caused to her neighbours by her dogs.

The 24-year-old female dog owner, who lives in a block of flats in Langley Park Road, Sutton, allowed her two Staffordshire Bull Terriers called ‘Roxy’ and ‘Governor’ to:

  • Run out of control off the lead
  • Jump up and intimidate residents
  • Carry on barking for long periods

In addition, she also repeatedly failed to clear up after her pets.

Police decided to take formal action following an incident on Friday 30th March when her dogs ran out of their home in pursuit of a man making a delivery in Langley Park Road. The man was forced to run and jump onto a vehicle to avoid being bitten.

As a result the resident was sent a letter on the 13th April advising that this incident had come to the attention of police. A second letter was sent on 2nd July after her dogs had continued to behave in an unacceptable way.

This second letter included an Acceptable Behaviour Contract – a voluntary agreement between the resident and Sutton Council, the Met Police in Sutton and London and Quadrant Housing Trust – the resident’s landlord.

The contract only named one of her dogs – Governor – as she had given up Roxy at around this time. The conditions in the agreement include:

  • The dog being kept on a lead no longer than three metres in a public place including Langley Park Road, public footpaths and roads within Sutton borough
  • Clearing up after her dog
  • Regularly exercising her dog

Failure to comply with the agreement may result in an Anti-Social Behaviour Order being obtained to stop the resident causing harassment, alarm or distress and the tenancy agreement being reviewed and even revoked.

The action is part of borough’s Local Environmental Awareness of Dogs (LEAD) initiative to make owners of all breeds of dog aware of their responsibilities to their pet and the wider community.

Since August 2011 a total of 27 letters have been sent to residents whose dogs have come to the notice of police.

PC Heath Keogh, of Sutton Police station, who is co-ordinating the LEAD initiative for the borough, said: “Whilst we want to work with residents to reduce the nuisance and concerns caused by their pets, we are equally determined that we will take whatever action we need to make sure that this happens in reality.

“The bottom line for Sutton residents is a breach of an ASBO which could result in five years jail or a fine or both, and a possession order leading to a tenant’s eviction, for those in rented accommodation.”

The LEAD initiative was prompted by the fatal dog attack in Demesne Road, Wallington, on 23 December 2010, when a 52-year-old woman died after being attacked by a dog.

LATE NIGHT NOISE DANGER AVERTED

We were recently approached by residents in Worcester Road concerning the licence application to re-open the former “Academy” public house in Grove Road as a nightclub. They were concerned at a likely impact on late night noise problems in the area.

Following discussions with residents, Richard submitted representations on the prevention of public nuisance to Sutton’s Licensing Committee, and spoke at the public hearing held on 28 March.

He pointed out that it would be a matter of concern for premises so close to many residential properties to be offering music, dancing, films and sale of alcohol (for consumption on and off the premises) until 4.30am, seven nights a week, and then – after a break of just a few hours – starting again at 9.00am.  The application, if approved, would lead to an unacceptable degree of public nuisance, particularly due to noise from people coming away from the premises into neighbouring streets in the early hours of the morning.

Although the premises are not in Sutton South Ward, some of the people coming away from the club in the early hours would walk through our Ward. Concerns had been raised by the police about disturbance and noise late at night, drunken people walking home, alcohol-related brawls and anti-social behaviour. The application should be refused. 

We are pleased say that the application was refused, the Committee citing in particular problems with noise, community impact and alcohol-related crime.

HELP US SAVE ST. HELIER’S MATERNITY AND A and E UNITS !

A panel established under the NHS’s Better Services Better Value review has recommended that St Helier should become the centre for planned surgery in South West London, but losing its Accident & Emergency (A & E) and maternity units.

The review was initiated by the local NHS not by the Department of Health. Decisions about healthcare are taken by the local NHS organisation not Ministers. In the event that the final decision taken was challenged it could be referred to the Secretary of State for Health for a final decision.

As local Councillors who have used the services of St. Helier hospital, we oppose this decision. Heather has already been particularly active in opposing it as a member of the Joint Health Overview and Scrutiny Committee for south west London. On 15 May we joined our MP Paul Burstow in a demonstration against the decision at St. Helier hospital (in the photo above you can see Heather, Paul and Richard in front of the hospital).

Paul Burstow, has raised serious concerns about the way in which the Better Services Better Value review, and the talks about a merger with St Georges, have been handled. Treated as completely separate discussions, in fact they directly impacted on each other.

At this point no final decisions have been taken. Whilst important, the panel’s recommendations are not binding and mark the beginning of a process which will include a public consultation, expected in early autumn.

Local LibDems have previously fought to save St Helier and in 2010 secured £219m to refurbish and rebuild the hospital.

Paul Burstow comments:

“This is a flawed conclusion from a flawed process. There is still a lot of water to flow under the bridge before final decisions are made.

The panel have ignored the pressure on all the A&Es and maternity units in south west London.

A cloud has gathered over St Helier but I believe we can mount a successful challenge to the assumptions that have led the panel to this conclusion.

We have saved St Helier before, and we will fight to do so again.”

Click here to sign our petition organised by local LibDems, on the website of Paul Burstow. [Click on the word “petition”]

WHAT A WASTE!

                                                                                                                                                                                                                                                                                      Heather visited the Viridor Energy Recovery Facility (ERF) in Lakeland near Sough yesterday, 29th February, with Councillor Mary Burstow.

Their aim was to observe at first hand the operation of an ERF similar to that proposed on land currently used as the Beddington landfill site.  This is particularly important given their roles as Vice Chair and Chair of Sutton’s Health and Wellbeing Scrutiny Committee.

For  more information on future plans for the Beddington site visit:    http://www.slwp.org.uk/

St Georges decide not to proceed with merger process.

“As Vice Chair of the Health and Wellbeing Committee and one of two Sutton Council representatives on the SW London Health Scrutiny Committee, I will be following very closely the implications for the residents of Sutton South  of the decision by St George’s Healthcare Trust not to proceed with the merger with  St Helier Hospital. Please see the press release below.”

Cllr Heather Honour

St George’s decide not to proceed with merger process

St George’s Healthcare NHS Trust have informed us and our strategic authority, NHS London, that they cannot proceed with their bid to merge with St Helier and Sutton hospitals.

Throughout the process St George’s have been very positive about the strategic opportunity to merge and the benefits this could bring to patients.

However, due to the financial challenges facing hospitals in south west London and the inability to pre-empt the outcome of the Better Services Better Value review, which is looking at how NHS services are provided across south west London, they do not feel able to proceed at this time.

This is because the review, which will be open to public consultation, could have a significant impact on the financial income of all hospitals involved.

St George’s have however expressed a full commitment to working closely with St Helier and Sutton hospitals in the future.

Jan Sawkins is the Independent Chair of the special Board set up to help St Helier, Sutton and Epsom hospitals to achieve foundation trust status.  She said: “Whilst we have always been aware that a bidder could withdraw during the process, at this stage in the transaction it is obviously very disappointing news.

“The Transaction Board has a meeting scheduled next week (7 February 2012) and we will use this to consider the options and agree a way forward.  This may include re-opening tenders for St Helier and Sutton hospitals.”

Matthew Hopkins, Trust Chief Executive said: “This is disappointing news, but St George’s have been clear to us that their decision is not based on our staff, nor the quality of the services we provide at St Helier and Sutton hospitals.

“As you would expect, the Trust Board and those working on the transaction have been looking at other options in case this happened and we look forward to discussing these with the Transaction Board next week.

“Whilst we are making decisions about the long-term future of our hospitals, our priority will – as ever – continue to be ensuring our patients and local people receive the very best services.”

Asked what this means for Epsom Hospital, Jan added: “It is the current belief that, subject to Ashford and St Peter’s Hospitals NHS Foundation Trust being confirmed as the Preferred Partner for Epsom Hospital, the de-merger could continue whilst we make alternative arrangements for St Helier and Sutton.

“Whilst this would, of course, need further investigation and approval by the Transaction Board, the Trust Board and others, it is felt that this would be in the best interest of Epsom Hospital, its patients, staff and local people.

“However, I would emphasise that the priority remains to secure the future of Epsom, St Helier and Sutton hospitals.”

For more information about the work of the Trust visit our website: www.epsom-sthelier.nhs.uk.  You can also follow us on Twitter (twitter.com/epsom_sthelier) or find us on Facebook (facebook.com/epsomsthelier).

This is what St Georges said in their press release:

St George’s media statement

 St George’s Healthcare NHS Trust submitted a bid for a potential merger with St Helier Hospital in November 2011.

The board is clear that a merger between St George’s Healthcare and St Helier would be an excellent strategic opportunity, with the potential to bring significant improvements to the care of patients across southwest London and beyond.

After careful consideration the board has reached the conclusion that the current terms of the merger prevent us from proceeding further at this time.

The level of financial challenge facing hospitals in south west London,  combined with the inability to pre-empt the outcome of a public consultation around the Better Services Better Value (BSBV) review, means this is not the right time for us to progress with the transaction.

We want to continue to build on the existing links that are in place for clinical services.  We have identified a number of the potential benefits to patients that would occur from an acquisition which could also be delivered if the organisations remained separate legal entities which we shall continue to pursue.

We are particularly keen to develop the clinical and academic networks that span St George’s Healthcare and St Helier, and explore opportunities to establish new networks across services, to the benefit of patients.

A key priority for the trust is to achieve Foundation Trust (FT) status by 2014, and we will focus our efforts on achieving this. The board feels strongly that achieving FT status will strengthen the opportunities for St. George’s Healthcare and St Helier to work together in the future.

This is what Ashford and St Peters have had to say:

Statement re Epsom Hospital

Chief Executive at Ashford and St Peter’s Hospitals NHS Foundation Trust, Andrew Liles, said:

“The decision made by St George’s Healthcare NHS Trust not to pursue their bid for St Helier and Sutton hospitals has not changed our position regarding Epsom and we will continue to progress our plans to acquire Epsom hospital (through merger) in line with the process set out by the Transaction Board.  Of course this is still subject to approval by the Transaction Board, Epsom and St Helier, the local health authorities and others and by our own Board, who will need to be assured that any final decision is in the best interests of both the Epsom and Ashford and St Peter’s catchment populations.

As a Foundation Trust already we feel we are in a strong position strategically to pursue these plans and we know they have already passed through the first stage of the process successfully, meeting the criteria set by local people, stakeholders and staff.  These include new and innovative partnerships – with The Royal Marsden NHS Foundation Trust, Central Surrey Health and Surrey and Sussex Partnership NHS Trust – to create an integrated healthcare campus at Epsom Hospital, bringing additional services and added benefits to local patients and staff.  Our plans are also made more straightforward by the fact that Epsom hospital is not part of the Better Services Better Value review in South West London.

We have also had positive initial discussions regarding financial and commissioning support for our plans, although of course final decisions regarding the preferred provider and agreement of financial support are still to be made.”

For more information please call the Press Office on:  01932 722163

LOCAL MPs RAISE ALARM OVER ST HELIER’S FUTURE

The Borough’s MPs, Paul Burstow and Tom Brake, are calling for the local NHS to pause, listen and reflect over plans for a “headlong rush to merger with St George’s”.
 
The two MPs have told local and London NHS bosses that the plans for a merger with St Georges lack legitimacy because they have failed to secure support from hospital doctors, GPs and local Councils.  The MPs are stepping up the pressure by launching an on-line petition to London NHS boss, Ruth Carnell.
 
St George’s NHS Trust was the only Trust to bid for St Helier.  However, St George’s is struggling with a series of financial difficulties and recently has seen the departure of its Chief Executive.  Amidst growing concerns that St George’s will ‘asset strip’ St Helier, the Borough’s MPs want the merger process to be put on hold to give both St Helier and St George’s the time to sort themselves out and allow other NHS hospitals to come forward.
 
Paul Burstow MP said, “I have been hard-pressed to find anyone in favour of this merger plan.  Health professionals and local councillors feel bounced.  There is growing alarm at the haste with which this process is moving.
 
“The future of St Helier depends crucially on support from clinicians, without that essential goodwill, a merger will become a hostile take-over.  From my discussions with consultants, it is clear to me that the relationships between the two hospitals are toxic, hardly the basis for a genuine marriage in the public interest.
 
Tom Brake MP said, “The priority here is to get the best deal for St Helier, not the fastest one.  The Government has just completed a major national NHS listening exercise, local Health bosses must do the same; stop, pause, take on board people’s concerns and come back with a better offer.”

OAKLEIGH SADLY NO ALTERNATIVE TO CLOSURE

In the  debate on the proposed closure of Oakleigh at Monday night’s Council Meeting, it was clear that this was not a straight  forward matter.  There were many different angles to consider and Heather addressed them in her contribution to the debate.

“None of us can be comfortable about closing a care home for some of the most vulnerable people in our community.

And one that has an excellent reputation.

I visited Oakleigh as part of the investigation by the Health and Wellbeing Scrutiny Committee. The residents were happy and very well looked after.  Care staff  were totally committed to their work. I would be comfortable to see a relative of mine live there.

I took  therefore an challenging approach to  the scrutiny exercise we undertook  about Oakleigh.

From the outset, I was shocked at the very high weekly cost to look after each  resident.  (one thousand and twenty four pounds) £1,024.

This confirmed research I’ve read from  from the  Dept of Health.  Care homes run by councils are much more costly than those run by independent organisations.  This is a nationwide phenomenon.

In the wider context, Sutton’s grant was dramatically cut by central government.  We have to save  over £30 million over the next 3 years.  Savings of £10.5 million have to be found from the adult social care budget.

So the financial situation makes keeping an excellent, but costly,  Oakleigh less possible.

Current good practice says that people should be helped to stay in their own homes for as long as possible.  Many would prefer to do so provided the right level and quality of support is there.

As part of the personalisation agenda, introduced by the last government, everyone eligible for social care has their own budget. This is based on what their needs are assessed to be.  They should then be able to make their own choices about how to spend their money.  All this has to happen within 18 months.

This means that  it could be difficult for people to afford to stay at Oakleigh.

The key question is therefore  whether there are  other good quality care homes available in the borough?

As part of our investigation, we visited a wide range of care homes and found a wide range of quality.

The star rating system by the Care Quality Commission was not as helpful as we expected. ( now to be discontinued)  Oakleigh was given a 3 star rating.  Most care homes in the borough were given a 2 star rating.  We found that some of these were excellent, some not very good.

We therefore recommended, that the Commissioning Unit  and social workers, should work together to improve standards in those homes that had 2 stars.

We needed a Sutton based  quality assurance, reflecting our values and standards.  We could not rely on the Care Quality Commission.  That organisation is in any case changing.

We also recommended that we should challenge the regulations that prevented us from transferring the business of Oakleigh to another, independent provider.

Once again Sutton demonstrated its commitment to consultation.  It did challenge the Care Quality Commission successfully, and then went out for another 12 weeks consultation.  Few councils would take that trouble.

Unfortunately, no independent organisation was ready to bid for Oakleigh, probably because of the financial obligations   when staff are transferred from one organisation to another.

So I have reluctantly concluded that there is no alternative to closing Oakleigh.  I do realise what a blow this will be to those still living there, and to the hard working staff.  Great efforts will be made to help people find new homes.  Like my colleague I would like to say a big thank you to Link and to the dedicated staff at Oakleigh.”