The chairs of four out of five Healthwatch bodies in North Central London, including the chair of Healthwatch Enfield, have written a strongly worded letter to the Secretary of State for Health complaining about the scale of cuts to local NHS services being planned and the secrecy with which the planning work is being carried out. They say that they consider the proposed cuts a "threat to patient safety". In fact, they believe that patient safety in their boroughs is already being compromised as a consequence of "a lack of human and financial resources".
The chairs of four out of five Healthwatch bodies in North Central London, including the chair of Healthwatch Enfield, have written a strongly worded letter to the Secretary of State for Health complaining about the scale of cuts to local NHS services being planned and the secrecy with which the planning work is being carried out. They say that they consider the proposed cuts a "threat to patient safety". In fact, they believe that patient safety in their boroughs is already being compromised as a consequence of "a lack of human and financial resources".
The start of the letter to Jeremy Hunt (the content of the letter is reproduced at the end of this article)The open letter to Jeremy Hunt is signed by Healthwatch chairs in Enfield, Haringey, Camden and Islington and has been published on their websites. The secret list of cuts they refer to was revealed ten days ago in the Guardian newspaper, which had been sent a "leaked" copy of an internal NHS document (see "Devastating" cuts planned for NHS in north London).
The Healthwatch chairs warn that the cuts "will ... impact upon people’s quality of life, increase the numbers of people living in pain and discomfort, and require people to wait longer and travel further for treatment."
They express dismay about the failure to keep their organisations properly informed about the cuts agenda being pursued as part of the North Central London Sustainability and Transformation Programme (STP):
"We are obliged to conclude that there appears to be a two-stream STP; one that is consulted on and the other which is not transparent and is kept from public view."
The authors state that they "are very directly saying that these proposed cuts to services are a threat to patient safety" before, in effect, asking for more money and full disclosure and public engagement about the STP.
The text of the letter to Jeremy Hunt
Rt Hon Jeremy Hunt MP
House of Commons
London
SW1A 0AA
27th June 2017
Dear Minister / Secretary of State,
We are writing to you as Chairs of local Healthwatch in North Central London [NCL] to express our dismay and concern about the situation outlined in the NHS NCL memo reported by the Guardian on 21st June 2017.
The article suggests that a 31-page document was circulated among dozens of top NHS officials in the area on 25 May. The document apparently outlines how the “capped expenditure process” will hit the provision of NHS care to the 1.44 million people who live in our boroughs of Barnet, Camden, Enfield, Haringey and Islington. Patients will apparently be denied treatment, waiting times for operations will lengthen, and A&E and maternity units may be shut under secret NHS plans to impose unprecedented cuts to health spending. It outlines the "difficult choices" NHS bosses nationally are forcing the 10 hospital trusts in NCL to make in the next few months to plug a £183.1m in their budget for the current year.
According to this internal document, doctors in our five London boroughs will have to spend less on drugs regardless of population need, fewer patients will be referred to hospital regardless of need and support for people with severe health needs will be cut as part of the plan. The hospitals have been told to implement draconian cost-cutting measures which will, without doubt, impact on the quality of services and patient safety. They will also impact upon people’s quality of life, increase the numbers of people living in pain and discomfort, and require people to wait longer and travel further for treatment.
At the inaugural meeting of "NCL’s STP Advisory Board" on 20th June 2017, local Healthwatch Chairs, Council Leaders and Provider Chairs were briefed on the appalling financial position faced by NHS NCL. However, we were not briefed on any proposals to achieve huge financial savings. We received the clear impression that NHS England is asking NCL to make unachievable cuts to services that would be very damaging to patient experience, patient care and patient safety.
Our work with patients and the wider public leaves us in no doubt that health services in NCL are already under serious strain. We have, for example, recently witnessed the near collapse of the A&E service in North Middlesex University Hospital. Moreover, in a recent NHS patient survey, the Trust was in the bottom ten performers in England. This is not simply the consequence of bad management, but a lack of human and financial resources. Providers in NCL are struggling to cope with the demands made on them to the point where patient safety, as well as service quality, is compromised; the London Ambulance Service often delivers its worst performance in the outer boroughs of NCL, failing to meet required standards.
Further cuts, as outlined in the "leaked" memo, will only put more pressure on the services and, as accepted in the internal memo, will lead to a significant reduction in the quality of patient care and patient experience across the area.
We are also concerned about proposed reductions to the Better Care Fund. With local authorities in North Central London already struggling to cope with increased demand for services, any reductions in the Better Care Fund or funding for service integration and transformation will put service change plans in jeopardy as well as jeopardising basic social care services for vulnerable people.
Although there has been some (very limited) consultation on the STP and its potential to achieve greater efficiency, at no stage has there been any discussion about such substantial cuts in services. Indeed, the Equality Impact Assessment attached to the STP for NCL paints a picture of very positive impacts on all “protected characteristic” groups – this is clearly an impossibility with such reduced funding.
We are obliged to conclude that there appears to be a two-stream STP; one that is consulted on and the other which is not transparent and is kept from public view. There is already substantial scepticism about the STP process in our local communities but measures envisaged in the memo, together with the lack of transparency, will undermine any remaining confidence that the process might result in service improvement.
Local Healthwatch have a duty to monitor the impact of health and social care services on our population and to highlight concerns relating to patient safety. The experience of MidStaffordshire NHS Foundation Trust showed that ignoring patients’ experiences and perspectives can lead to a catastrophic system failure. As Chairs of these organisations we are very directly saying that these proposed cuts to services are a threat to patient safety and we are asking for:
- a review of the financial constraints within which NCL is being asked to operate;
- NHS NCL to be provided with sufficient funding for upfront investment and any ‘dual running’ costs needed to achieve service transformation for the benefit of local people; and,
- publication of, and engagement of local citizens in, NCL STP work-stream plans, processes and proposals.
We would welcome the opportunity to discuss this with you and other stakeholders.
Yours sincerely,
Healthwatch Chairs in North Central London:
Camden: Saloni Thakrar
Enfield: Deborah Fowler, FRSA
Haringey: Sharon Grant, OBE
Islington: Olav Ernstzen
Source: healthwatchenfield.co.uk/news/are-cuts-coming-to-nhs
