The Mansfield Commission's Interim Report into the Shaping A Healthier Future consultation states of the programme that would rsult in the closure of four of the nine acute hospital sites in the North West London area and the loss of Central Middlesex A&E:
The SaHF programme in our view was a preconceived solution that was imposed on the North West London health system without there being any clear problem that it was designed to solve.The following recommendations are made:
In particular there was no proper assessment of the needs of the whole area to which the health and social care system would respond.
1. We recommend that the
SaHF programme is abolished / suspended, thereby saving a considerable sum at
one fell swoop.
2. We recommend that an
independent review of the North West London health system is undertaken under
the auspices of a joint health and local authority initiative that builds its
case on a thorough assessment of the needs for health and social care of local
populations, at local levels.
3. There must be no
presumption that so-called ‘reconfiguration’ of acute services is the solution
to what may not be a problem at all.
4. In addition there
must be no presumption that the solution will involve a top-down approach
across the whole area as SaHF assumed; there should be an openness to
consideration of local solutions possibly at the borough level where these can
be shown to work.
5. The NHS and local
authorities must agree to work together to achieve a joint aim to provide good
accessible health and social care to all local populations within a sustainable
financial model.
6. We recommend that the
attempt to close Ealing and Charing Cross hospitals is immediately stopped;
that a guarantee is given to sustain acute health services on these sites –
with no more double talk from NHS leaders – until the above review is complete
and any associated business cases are taken through to Full Business Case
level, which is likely to be at least five years.
7. We recommend that in
the light of current failures in the system in North West London there is an
independent review of the emergency system under the auspices of the above
joint health and local authority initiative; and that this as a matter of
urgency examines the closure of Hammersmith and Central Middlesex A&E
departments with a view to opening these, if that is what the review suggests
is needed, and what local people want. Local people must be given honest and
genuine choices; the opportunity cost of retaining these sites as A&Es must
be made apparent.
8. We recommend that
there is a review of primary care services in the region, and that following
this review, immediate steps are taken to rectify any issues. However any
investment must be based on a clear business case that relates costs and
benefits to changes across the whole system.
9. Likewise we recommend
that there is a review of OOH services in the region, to establish a clear case
if it exists for OOH acting as a way of reducing demand for acute services, and
also as a way of reducing total system costs. Following this review, any
investment in OOH services must be based on a clear business case that relates
costs and benefits to changes across the whole system.
10. In the case of
changes that take place in primary care and OOH services as a result of the
reviews outlined above, there must be a clear business case presented that
makes a clear case for system- wide improvement arising out of these changes,
and this should be consulted on with the relevant local populations; there
should be no assumption that this is the population of the whole of North West
London.
The full report can be read here:
The commission's final public session will be held at the Brent Civic Centre on Saturday 9 May 9am-5pm. Brent Trades Council and Brent Fightback are among those who have submitted evidence. It would be good to have as many health campaigners as possible at this session. More evidence will be heard
