Campaigner's Diary

Articles from John Lister's regular column in the Morning Star, plus other articles for publication.

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NW London publishes fuller Draft of STP

August 2016

The most detailed glimpse yet of what a finished Sustainability & Transformation Plan might look like, a recent draft has been unveiled, raising the question of why the other 43 plans are not yet open to any public scrutiny.

Under pressure from campaigners and from Ealing and Hammersmith & Fulham councils, NHS bodies spanning eight boroughs in North West London, claiming the support of six of the eight borough councils, have finally published what must be at least Version 40 of their STP.

An earlier, less complete draft at the end of June which was not published was numbered v 39: several pages left blank in that draft have now been filled with new material in a densely-packed, almost illegible 54-page document, much of it in tiny 7-point type or smaller.

Amid many vague aspirations to miracle public health interventions that almost instantly reduce hospital admissions and save tens of millions of pounds a year, the hard edge is the goal of closing upwards of 590 beds, and achieving savings towards a "gap" between resources and costs of health and social care estimated at £1.2 billion by 2021.

The savings now explicitly centre on the closure of the already part-dismembered Ealing Hospital, where maternity and paediatric services have been largely removed, followed by the closure of Charing Cross Hospital. When the Shaping a Healthier Future plans were first outlined to reconfigure hospital services in NW London, Ealing had 327 beds and Charing Cross 496.

Other documents have revealed that plans for expanding community health services, once depicted as the way in which hospital beds could be safely replaced, are no longer ranked as a priority in NW London. Indeed it is clear from statements from Simon Stevens that there is NO capital available for any major developments of alternative services.

This leaves the massive, unanswered question: how do the commissioners imagine the existing hospital services in Ealing and Hammersmith can be shut down to deliver cash savings between now and 2020 without triggering a massive further deterioration in performance in the remaining NW London hospitals, as took place when two smaller A&E units were closed in NW London in the autumn of 2014?

Nowhere in the 54 pages are there any concrete plans for how any alternative services might be provided, where the staff would come from, how they might be organised and managed, and how it could be paid for while delivering savings.

It's all literally fantastic: a work of wishful thinking rather than a plan. But meanwhile the run-down of Ealing Hospital continues.

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