Stop huge changes planned for NHS in Hackney!
KONP concerns about potential developments cited by ELHCP in line with the 5-YFV / Next Steps November 2018
Homerton Hospital: The North East London STP (name is: East London Health & Care Partnership (ELHCP)) are considering plans to downgrade local District General Hospitals (DGHs) throughout the ELHCP area, and convert them into ‘Elective Care Centres’. (Called, as might be expected, ‘Centres of Excellence’ – but in reality managing significantly reduced funding). This could mean that Homerton would no longer provide the full range of DGH services and patients (and their visitors) would have to travel to far-flung parts of the ELHCP area for most routine hospital treatments. Specialist centres would also not be able to provide holistic care for those many patients with multiple conditions – no more ‘nipping down the corridor’ to consult with other specialists). Elective Centres would also lose many of the diagnostic services currently available at Homerton, and this would mean both pathology and A&E at Homerton being significantly downgraded (with most patients having to travel to other hospitals for routine hospital treatment). Downgrading DGHs would also have a massive impact on medical training. The NHS relies on doctors being trained in DGHs to develop skills in working with people with multiple conditions and not simply focusing on a single limited discipline. The move to elective centres puts this vital element of training at risk.
(NB of course, KONP recognizes that some specialized services need to be provided in specialist centres. But the great majority of routine hospital procedures can be carried out just as safely and effectively, and much more conveniently, in a good DGH).
Mental Health beds at Homerton (again, NHS): ELHCP’s plan is to move 90+ mental health beds out of Homerton and out of Hackney, to Mile End. Hackney KONP believes MH services need to be provided locally, so people can retain their contacts with their local community, friends and services.
St Leonards site: We all understand that much of St Leonard’s estate is in poor repair and underused. We also understand that this Government will not provide money for the capital re-development we might want. However Government and the London Mayor are providing incentives for land to be sold and used, in part, for redevelopment as housing (alongside and new NHS and social care building). Hackney KONP are opposed to any sell-off of public estate and loss to the NHS - NHS estate must be retained for NHS (and possibly social care) use. A large site like St Leonard’s would be ideal for re-development of NHS and social care services that benefit from co-location: for instance, step-down and rehabilitation services, and/or older people’s services and/or mental health services. We believe a future Labour Government would take a very different view. We don’t want to see any part of the St Leonard’s site lost to Hackney NHS and social care.
Delayed discharge from Homerton (or other acute hospital). To manage this, Hackney needs a very well-resourced multi-disciplinary community team (with community nurses, OTs, physios, psychologists etc). What (peer-reviewed high quality non-anecdotal) evidence is being used to back up claims that a home-based service can be provided more cheaply than a hospital/residential service? (All the reputable evidence suggests there is no basis for this assumption).
Hackney also needs residential step-down and rehabilitation facilities for people who are medically fit to leave hospital, but who still require nursing care and other rehab services and who cannot safely be discharged home (because they need ongoing support through the day that cannot be provided through intermittent home visits, or because home is unfit / too many stairs etc). What plans are there for these facilities.
Contracts: Please can we have an assurance that Hackney Council and CCG will not under any circumstances be party to NHSE’s proposed new contract for an ‘Integrated Care Provider’ (ICP). These are 10-15-year commercial contracts for NHS and social care services that will be procured via the open market – with likely interest from US healthcare giants and finance companies. They risk permanent outsourcing and privatisation of all health and care services. KONP and other NHS Campaigners have been challenging these contracts through campaigns and judicial review (still awaiting the outcome of one JR).
NHS and Social Care: Government is pushing for NHS and social care to be merged into a single organization. Many campaigners believe this would be disastrous for the wider vision of social care as support for holistic ‘wellbeing’, with links to education, leisure, housing etc as well as health. We can still have pooled NHS and social care budgets for specific services, and well-integrated pathways and incentives without merging all NHS and social care. Can we have an assurance that any proposal to merge services will be subject to full consultation.