Whittington ‘can’t take slack’ of accident and emergency closures
Children willl be directed to Archway hospital after units are shut at Royal Free and UCLH
02 October, 2020 — By Tom Foot
A PLAN to send all child emergencies to the Whittington Hospital this winter has left medics fearing they will be overwhelmed, the Tribune can reveal.
There have been warnings that the strategy of closing paediatric accident and emergency units at the Royal Free in Hampstead and UCLH will prove “clinically unsafe”.
And this week an insider at the Whittington’s unit warned they would not be able to “take up the slack” of the other two hospitals.
On condition of anonymity, they told the Tribune: “Winter is the worst possible time to do this. Even in the best of times, in non-Covid times, we are operating on bare bones. So to experiment at this time, by rushing through an unpopular change in service, is unbelievable. They are not listening to the feedback.”
The source added: “There is a lot of anxiety and we all feel powerless to stop it. The big problem is staffing, safe staffing. You need skilled people to be there to deliver the care you need. And there is a big question mark over the numbers of nurses and doctors in the new unit.
“We have been told that half of the nurses due to transfer over from the other hospitals have resigned. We have been told this change is political and it is going to be permanent.”
North London Partners, the health authority behind the plans, insist the strategy is only temporary and for a winter in which hospitals are expected to face a battle with a new wave of coronavirus cases.
Managers at North London Partners say they are within their rights to impose the temporary measures on hospitals without public consultation because of the “national emergency”.
And they have gone on record saying the changes have the backing of clinical advisory groups.
But this official line contrasts sharply with what staff on the ground are saying.
Last week it was revealed how, in an unprecedented internal rebellion, several consultants at UCLH and the Royal Free had written three separate letters raising serious concerns that the changes were “unsafe” and that capacity at the Whittington was a “significant risk”.
The Royal Free shut its A&E for children on Friday, with parents told to use the Whittington.
Seniors sources at UCLH contacted the Tribune warning that the changes had been tabled long before the pandemic struck and that freedoms placed on managers to act decisively during the Covid crisis were being used to force them through.
There would be “high costs” to patients, workforce and hospital budgets and there was “no evidence of an options appraisal” or “evaluation of the changes on impact to children and young people”.
At a meeting of five north London councils’ Joint Health Overview and Scrutiny Committee (JHOSC) on Friday, Brenda Allan, a mental health consultant from the campaign group North Central London NHS Watch, said: “We are concerned the NHS is becoming more centralised and financially driven, rather remote and unresponsive to its users, which would harm us all.”
NLP’s systems lead, Rob Hurd, who is in charge of the “gold command” group behind the A&E changes, told the online meeting: “What we are doing is responding to a national major incident – an unknown disease, pandemic. We are responding week-to-week to what we face in front of us. All the changes are temporary.”
He said there was no legal obligation to consult during the “national emergency”, but added that if a review recommended making the changes permanent the plan would be put to the public.
Mr Hurd said the changes would lead to a “more resilient service for children by consolidating staffing to offer better access through the winter, which we anticipate to be an extremely busy period”.
A further statement from the NLP said: “The recommendations were considered and supported by the North Central London Clinical Advisory Group, the London Clinical Advisory Group and North Central London Gold, comprising chief executive-level representation from health partners across north central London.”
Dr Clare Dollery, Whittington medical director, said the public should be “confident that services are safe and effective for children who require urgent and emergency care this winter”.
PFI site deal collapses
A £30million Private Finance Initiative (PFI) hospital deal has collapsed after a construction firm went bust.
Whittington Facilities Ltd (WFL) – set up in 2003 to build and maintain the main Whittington hospital building until 2034 – has filed for administration.
The collapse of the PFI company means the main building in Magdala Avenue has transferred back into the ownership of the NHS trust that runs the hospital in Highgate.
But the trust is now responsible for maintenance of the building, including the cost of major fire safety refurbishments it had been pursuing the PFI company for under terms of a 30-year contract.
A report to the board said the trust was now “fully responsible for all aspects of fire safety in these buildings”.
Accounts for Whittington Facilities Ltd showed that it had been in a two-year dispute with the Whittington NHS trust over who should pay for a “major fire safety project”, following a blaze in the basement of the main building in 2018.
The fire came in the year after the Grenfell disaster and the Whittington had wanted funding for security guards, fire wardens and extra fire drills until the safety works to remedy “fire defects” were complete.
A Whittington statement said: “In late July, the company running the Public Finance Initiative (PFI) part of our hospital building went into administration. The ownership of the building has now reverted to the Trust. The fact that this company has gone into administration will have no adverse effect on patient care at Whittington Hospital.
“It does not change how we are currently working, and our patients and colleagues can be reassured that Whittington Hospital and all of our services remain open and safe for patients and staff.”