Wednesday, December 7, 2016

Save KGH Planning meeting 9th December Midday Ilford Town Hall

All welcome with time to work for our hospital.

Agenda

1) Apologies

2) Planning for 18th March  2017 Rally and march. Town Hall Lettings have reserved the Town Hall for us. The advertised cost is £1950. Crowd funding is an option.

3) Did we want to organise a photoshoot outside number 10 in January 2017?

4) Any other business

5) Date of next meeting

Regards


Andy Walker 07956 263088

Tuesday, November 29, 2016

Save King George Hospital A&E Event on 18th March 2017

After writing to MPs delighted to announce afternoon of  18 March 2017 for rally in Ilford.
Further information to follow after planning meeting on 9th December.

Monday, November 21, 2016

Inviting MPs to support a march

Following the public meeting last Thursday I have written the below to MPs in Redbridge, Barking and Dagenham and Havering seeking their support for a march.


Dear MPs

The attached tender document states that Barking, Havering and Redbridge University Hospital (BHRUT) is seeking a "business case for full closure" at King George Hospital. BHRUT is not saying whether this document is genuine or not, but it seems virtually certain to be so, My questions about the document remain unanswered, although I have put in Freedom of Information requests. The timetable is below:


Issue of Invitation to Tender
27th September 2016
Closing Date for Questions
3rd Oct 2016
Tender Return Deadline and initial review/evaluation of tenders
4th Oct 2016
Evaluation of tenders
10th Oct 2016

I quote from the "invitation to tender"

"NELAR has agreement as part of the NEL STP, to commence work on the development of a business case for full closure, the completion of ED service centralisation at Queen’s Hospital and the development of an enhanced Urgent Care Centre at King George Hospital. The Trust has committed to developing a Business Case by March 2017. The format of this Business Case is yet to be confirmed with NHSE/NHSI, but it is likely to constitute an OBC/FBC conforming to using a five case model.
The Trust is seeking expertise from the market place in developing the Business Case by the end of February 2017 with approval process during March 2017 to enable implementation to commence as soon as possible in 2017. Suppliers are invited to provide sufficient information with supporting evidence to meet the requirements. All requirements are mandatory."
The basis for the tender is the "2010 the HfNEL Decision Making Business case" which is referenced in the tender which is attached for ease of reference.
Page 123 of the plan shows the closure meaning the loss of 25% of BHRUT medical staff. 
Steps have already been taken to close KGH A&E with 115 acute beds cut since 2011. I go into detail here Crammed King George Hospital shows why bed cuts need reversing


Community beds for rehabilitation have been opened on the KGH site at the expense of acute beds. Now 272 acute beds remain at KGH, should they be closed it seems inevitable that various safety benchmarks such as the 4 hour A&E waiting time and cancer waits will get worse at Queens and other hospitals.
There is substantial academic work which suggests long waits in A&E departments lead to worse patient outcomes.



"There is strong evidence that the symptoms felt in emergency departments led to worse patient outcomes. We know, for example, that patients run a 43 per cent increased risk of death after 10 days if they are admitted through a crowded accident and emergency (A&E) department. (Richardson DB, 2006) Waiting for admission in A&E is also associated with significantly longer hospital length of stay – on average 2.35 days longer where a patient stays in A&E for more than 12 hours. (Liew D, Kennedy M, 2003)
We know that speed of treatment is vital in many conditions. For example, people with the most severe form of pneumonia have less than a one in two chance of surviving. Those chances improve considerably if effective treatment is started early.  However, research suggests that delays of more than four hours in administration of antibiotics to patients coming into hospital with pneumonia can affect 70 per cent of patients on days when an A&E is crowded. (Pine JM et al, 2005)This undoubtedly affects mortality."
& From

Abstract

The Effect of Emergency Department Crowding on Patient Outcomes

Background: An extreme excess of patients exceeding the capacity of emergency departments (EDs) to provide care is an emerging threat to patient safety and health systems worldwide.
Aim: The purpose of this literature review was to investigate the effects of emergency department crowding on patients outcome.
Method and Material: A comprehensive search of the medical literature in Pubmed/ MEDLINE database was performed to identify all original articles that were published or available on-line between January 1, 2003, to January 1, 2013, and related to the concepts of ‘‘emergency department’’ and ‘‘crowding’’ or ‘’overcrowding’’.
Results: Of the 1327 studies that were initially retrieved, 484 were excluded because they had no relevance to the topic and 843 after checking for eligibility criteria. From remaining 61 articles, a total of 35 studies were finally included in the review. The three main categories that were constructed based on the studies, were delays in treatment interventions, increased medical errors or adverse events and increased mortality.
Conclusions: The body of literature in aggregate strongly suggests that ED crowding is associated with potential of poorer performance and adverse clinical outcomes, including mortality. Further research is needed to fully understand the precise mechanism through which crowding adversely affect patient care. Policies must also be targeted to adapt of emergency care system in the fluctuation of inputs for better care that translates into better outcomes for patients visiting EDs..

Author(s): Filippatos George and Karasi Evridiki

BHRUT rarely hits the 95% 4 hour safety margin and has worse than average mortality rates. I quote from the 24 November2016 Basildon and Brentwood CCG Board papers which are attached.
"• The CQC returned and inspected the same areas on Friday 16 September 2016 at both Queens Hospital and King Georges Hospital. They did not provide any feedback on that occasion. The CQC informed the trust that they would carry out a further announced inspection on 11- 12 October 2016. This would focus on governance and the well-led domain • BHRUT have reported an overall 55% staff appraisal rate. • Turnover of registered nurses has increased to 17.05% when compared to June (16.77%). This is the highest it has been in the past year. The turnover of registered Midwives has increased to 20.22%, from June (19.78%). • Septicaemia, Pneumonia and Respiratory Failure have higher numbers of observed deaths in comparison to expected with Pneumonia triggering an internal alert. • BHRUT are above the national average (PST) for all falls and falls" (my emphasis)"
The previous MP for Ilford South, Lee Scott said that patients would die unnecessarily as a consequence of  King George A&E. The evidence points to unnecessary deaths now at both Queens and King George Hospital due to a combination of a rising population and bed and staffing cuts at King George.
There was a public meeting on Saving King George A&E last Thursday to which Cllrs from three boroughs and across the political spectrum attended. There is support for a march in the spring to say no to the proposed closure of King George A&E.
Saturday 4th March may be the best time to hold the march, maybe from Queens or Havering to Town Hall to a rally at Redbridge Town Hall.
I have coped in Matthew Hopkins, Chief Executive of BHRUT in case he should wish to comment especially on the "Septicaemia, Pneumonia and Respiratory Failure have higher numbers of observed deaths in comparison to expected with Pneumonia triggering an internal alert." quote from the CCG papers.
I would be grateful if you could let me know if you could make the afternoon of the 4th March, or if not perhaps supply me with some alternative dates. 
Press reports say 4000 in Devon and 6000 in Grantham have tuned out for their A&E. It would be great if we could a big turn out here as well.

Regards

Andy Walker
120 Blythswood Road
Ilford 

IG3 8SG 07956 253088

Wednesday, November 16, 2016

Photoshoot 6pm Thursday 17th November 6pm Redbridge Central Library & thank you.

I regret to report that the BHRUT press department phoned me yesterday evening to say they would neither confirm or deny whether the document here:

https://www.lppsourcing.org/procontract/LPP/attachment_5.nsf/dsp_frm_attachments/ATT-AE7C-9YZC5A/$FILE/Acute%20Reconfiguration%20Tender.doc

which appears to be an invitation to private companies to draw up a plan to close King George Hospital A&E department is genuine. 

Nor would BHRUT say if the contract was awarded to a private company last month as indicated by the document. Instead I was referred to their Freedom of Information Department. How can Councillors effectively perform their statutory duty to monitor what is happening in our hospitals if they and the public cannot be told if important documents are genuine?

My belief is that this document is real and it is a breach of Andrew Lansley's, then Secretary of State for Health, promise on 27 October 2011 to the residents of NE London which follows:

"However, no changes will take place until the Care Quality Commission, which published its own report on local services today, has assured the Secretary of State that the services provided by Queen’s Hospital and other local health services are of a high standard." End quote

A screen shot containing the guarantee is below. I will be writing to Councillors in Barking and Dagenham, Havering and Redbridge informing them of the news in the hope that some will attend the photoshoot, if not the whole meeting.

There appears to be someone in local NHS management who has broken their contract terms and leaked the document above. While, I am very grateful to whoever did this as it means we know more about what is being planned for our hospitals. I do not encourage any NHS employee to leak documents as they could lose their jobs if caught. 

Inline image

Monday, November 14, 2016

Why have BHRUT put out tender to Close King George Hospital as an acute Hospital?

Earlier today I was sent a link


https://www.lppsourcing.org/procontract/LPP/attachment_5.nsf/dsp_frm_attachments/ATT-AE7C-9YZC5A/$FILE/Acute%20Reconfiguration%20Tender.doc

Which suggests BHRUT is asking private companies to draw up a plan to close King George Hospital as an acute hospital per the business case passed by Andrew Lansley, then Secretary of State for Health on 27 October 2011.

The 2011 closure plan would leave some community and other beds on the King George site, but it would be closed as as an acute Hospital taking emergency admissions.


I am seeking clarification as to what is happening from BHRUT as the 27 October 2011 Department of Health press release which passed the closure plan made clear there would be no changes made until the KGH & QH were found to be of a high standard by the CQC.

It also odd that BHRUT are planing to close King George as an acute Hospital when the NEL STP says a new hospital may be needed for NE London

An extract from the invitation to bid is below.

The time table is given as



I have cut and pasted the full tender below:
  1. This is an invitation to tender only. Barking, Redbridge and Havering University NHS Trust (The Trust) reserves the right to vary any or all parts of the information contained in the Invitation to Tender and will review the tender return date accordingly if required.
  2. Barking, Redbridge and Havering University NHS Trust intends to accept the tender which scores the most marks against the criteria set out in this ITT document. Barking, Redbridge and Havering University NHS Trust at its sole discretion, reserves the right to accept or reject any Bid submission. The Trust does not bind itself to accept the lowest priced or any tender and shall not be liable for any costs incurred in the production of your submission.
  3. The Trust reserves the right to change the timing or any other aspect of the procurement process or to cancel the procurement process at any stage or not to proceed with the procurement for any reason whatsoever without prior notice. Under no circumstances will Barking, Redbridge and Havering University NHS Trust or any of its advisers be liable for any costs or expenses incurred by Bidders and/or their members in this procurement.
  4. The Trust reserves the right not to disclose information that it feels would put them or it’s suppliers at a commercial or unacceptable contractual disadvantage.
  5. All documents and all correspondence relating to this tender must be written in English.
  6. Barking, Redbridge and Havering University NHS Trust may evaluate the financial status of the Preferred Bidder by reviewing its audited accounts for example to ensure contracting with it does not pose a risk to the Trust. Where the Trust feels the bidder does not have the financial capability to carry out the contract, it reserves the right to appoint the next highest placed bidder as Preferred Bidder (subject to the same assessment).



  1. The Requirements


In 2010 the HfNEL Decision Making Business case was developed (Please see attached supporting documents file name: Decision Making Business Case 2010). The business case included the consolidation of Barking Havering and Redbridge University Hospitals Trust (BHRUT) Emergency Department services at Queen’s Hospital and the development of an enhanced Urgent Care Centre at King George Hospital. The Secretary of State formally signed off on the business case in February 2012.
In January of 2016 a new programme board, the North East London Acute Reconfiguration Programme Board (NELAR), was formed. Chaired by the Chief Executive of BHRUT, the board focused on the development of plans to implement the closure of the Emergency Department at King George Hospital in two phase, the first phase being the overnight closure and the second being the full closure. Further to the completion of detailed impact analysis in early summer 2016, Barts Health confirmed plans that would create the necessary capacity at Whipps Cross and Newham Hospitals by September 2017 to accommodate phase 1. Work is now on-going to finalise the plans and develop supporting assurance to achieve the overnight closure.
NELAR has agreement as part of the NEL STP, to commence work on the development of a business case for full closure, the completion of ED service centralisation at Queen’s Hospital and the development of an enhanced Urgent Care Centre at King George Hospital. The Trust has committed to developing a Business Case by March 2017. The format of this Business Case is yet to be confirmed with NHSE/NHSI, but it is likely to constitute an OBC/FBC conforming to using a five case model.
The Trust is seeking expertise from the market place in developing the Business Case by the end of February 2017 with approval process during March 2017 to enable implementation to commence as soon as possible in 2017. Suppliers are invited to provide sufficient information with supporting evidence to meet the requirements. All requirements are mandatory.
Responses to the Trust must be provided by 4pm on Tuesday 4 October 2016 in electronic format via Due North (Trust e-tendering portal). Printed copies of relevant materials are optional.


The Trust would be informing all suppliers of the outcome during week commencing Monday 10 October 2016.



  1. Timetable


The timetable for the procurement is as follows:


Key Actions
Dates
Issue of Invitation to Tender
27th September 2016
Closing Date for Questions
3rd Oct 2016
Tender Return Deadline and initial review/evaluation of tenders
4th Oct 2016
Evaluation of tenders
10th Oct 2016
Contract Award
TBC
Contract Signed
TBC
Contract Work Commencement Date
TBC


  1. Bid Submission’s


  1. Bid submissions must be submitted in accordance with the following instructions;
  • Tenders must be written in English and in Pounds Sterling
  • Commercial proposal must be submitted separately from the technical proposal
  • Bidders must not make any changes to the tender documents.
  • Any attached files must be clearly named with both your company name and the subject matter of the data.
  • All pages of the tender must be numbered (including any forms to be signed and returned).
  • Hard copies of your written tender submission are not required/permitted. All bids Submissions to be received via Due North.
Evaluation Metric:
Outline Business Case 40%
Reference 10%
Project Management & Support 20%
Finance 30%




















Appendix 1
Commercial Proposal
Role
Rate
Total Days
Total Excluding VAT
Total Price Including VAT
Principal Consultant




Senior Consultant




Junior Analyst




Total number of consultants




Total Cost















Appendix 2








Friday, November 4, 2016

Public Meeting 17th November Redbridge Central Library 6pm: Say No to the planned overnight 2017 closure

Every NHS Region in the country produced a sustainability and transformation plan (STP) on the 21st October stating how the local NHS should develop in the future.

A number of these plans have been leaked to the press and some councils have been critical of plans to close Accident and Emergency units within their local STP.

The Health Service Journal reported yesterday that seven councils have come against out their STPs with Ealing saying.

 “Ealing council cannot sign up to a plan that will signal the closure of A&Es at Ealing and Charing Cross hospitals and result in them being downgraded to local hospitals."

At time of writing the North East London STP remains unpublished, but it appears almost certain that closing King George A&E is a central part of the STP.

The Ilford Recorder edition of 3rd November claims to have documents stating King George A&E is to be closed from September 2017 on an overnight basis. The story is here

http://www.ilfordrecorder.co.uk/news/health/king_george_hospital_a_e_closure_nears_as_hospitals_reveal_possible_date_for_overnight_closure_1_4760250

Could this 2017 overnight closure be part of the STP?

Right now hospital managers could be being influenced by a plan that has not had public scrutiny. This has to be wrong because the public own the NHS, we have to have sight of and be able to comment upon key documents that determine the future shape of the service to make public NHS ownership real.

Councillors in Redbridge, Barking and Dagenham and Havering will be written to in the hope that some will attend.

November Board papers for King George and Queens Hospitals available here.

http://www.bhrhospitals.nhs.uk/papers-minutes?smbfolder=134



Show our hospitals missing 3 cancer treatment targets and the 95% A&E safety 4 hour standard.

The closure of King George A&E which will mean the loss of 272 acute beds along with the medical staffing to keep them open seems certain to make these sad statistics worse. I hope you can attend the meeting on the 17th to discuss with me how best to campaign to have the closure plan binned.


Saturday, October 8, 2016

Crammed King George Hospital shows why bed cuts need reversing






A Redbridge resident has written about his daughter's experience of KGH A&E, it shows why we need the 115 acute beds closed at King George Hospital since 2011 to be re-opened, A father's report of King George A&E follows:

" I've had recent personal experience of KGH and A&E which I think may help support your campaign. In January my daughter was home from uni and got a urinary infection that developed into sepsis. Loxford Clinic sent her straight to A&E where she was prioritised waiting only about 30 mins instead of the 3+ hour wait as it was then.  She was taken straight through to a cubicle and in no time they had set-up IV saline, antibiotics and paracetamol.  But then everything stalled and as we were by the board it was obvious that staff were already worried about breaching the 4 hour limit as there were no beds available in wards. As time went on they eventually started bringing beds into A&E and my daughter was transferred to one still in the same cubicle. I left at about 1am when it was obvious she was going nowhere and by this time there were people sitting on chairs in A&E because cubicles couldn't be freed up and complaining that they had been waiting for hours. I went back the following morning and she was still in the cubicle until they eventually found her a bed in the Renal Unit. I'm sure you've heard many stories like this, but I thought I'd chip in."

The graph is from the decision making business case of 2011 showing 387 acute beds at King George Hospital, the Freedom of Information request, the freedom of information is from hospital management showing beds cut to 272 at 31 August of this year.