Millions wasted in failed NHS hospital closure programme

https://www.theguardian.com/society/2019/jul/24/millions-wasted-in-failed-nhs-hospital-closure-programme

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Tens of millions of pounds have been wasted on a major failed hospital closure programme, according to an internal NHS document passed to the Guardian.

A confidential, draft document circulated to NHS North West London Collaboration of Clinical Commissioning Groups, which serves more than 2 million Londoners, admits the blueprint for one of the NHS’s largest planned reorganisations has failed.

“NHS commissioners and providers in north-west London have therefore decided to draw the SaHF [Shaping a Healthier Future] programme to a conclusion,” the document states.

The proposal was a flagship for reorganisation of the NHS in England when it was launched in 2012 and involved a reduction in the number of acute hospitals in eight London boroughs from nine to five. Julian Bell, the leader of Ealing council, described it as “a monstrous plan”.

It was part of NHS strategy at the time to replace some acute hospitals with care provided in the community.

The document states that £76m has been spent on management consultants for the failed scheme from 2010-11 until the end of 2018. It outlines how health officials can respond to difficult questions that may be asked about the failed scheme. It also discusses preparing people for new changes as part of the NHS’ long-term plan, which the document states will involve “difficult decisions and trade offs”.

SaHF argued that four acute hospitals in – Hammersmith, Central Middlesex, Charing Cross and Ealing – could be downgraded. The proposal involved the loss of more than 600 acute hospital beds. The document reports there has been a reduction of just seven hospital beds in the last six years.

The closure of Charing Cross was particularly controversial after plans were revealed to sell off 87% of the valuable central London site by the Guardian. But in March the health secretary, Matt Hancock, announced that plans to close A&E departments at Charing Cross and Ealing hospitals would no longer go ahead.

The document says: “Continued growth in demand for acute care, despite investment in primary and community services, a growing underlying budget deficit and shortfalls in our ability to recruit and retain enough staff with the right skills’ means that the plan, as originally envisaged, is no longer viable.”

It provides statistics about an increase of 227,288 in A&E attendances across north-west London since 2012 – a 4% rise per year, with a 2018-19 waiting list of 177,395 patients, which would require the provision of 95 extra beds for a year to clear the backlog. The document adds there has been a 40% increase in patients waiting for non-urgent surgery.

It reveals how officials plan to “spin” this failure by citing improvements such as 100 new midwives and 90 new children’s nurses.

In the document, under the heading “incorrect/sorry”, the question “Will anyone resign over this?” is posed and the answer provided is “no”. The response to the question “What have you learned from this and how will you change the way you make decisions in the future to ensure millions of pounds of taxpayers’ money isn’t wasted?” is “??”.

The notion that some acute hospitals can be closed because NHS care can instead be provided in the community has been refuted in various independent studies including a report from the Nuffield Trust which dispels some of the myths around this “magic bullet”.

Merril Hammer, secretary of Hammersmith & Fulham Save Our Hospitals, said: “The leaked paper is extraordinary. This was the biggest reorganisation project the NHS has ever seen. We still don’t know how much it has cost in total. Since the initial plans were drawn up, campaigners asked for the evidence that ‘out of hospital’ provision could reduce the need for acute hospital beds. This was never produced.”

Cllr Ben Coleman, chair of Hammersmith and Fulham’s health and wellbeing board, said: “This leaked document confirms that SaHF was a grotesque waste of time and public money, which threatened life-saving health services.”

A spokeswoman for NHS North West London Collaboration of CCGs said some of the spending on management consultants predated April 2013, when the CCGs were set up, so could not be verified.

“North West London CCG’s spend on consultancies for the SaHF programme was £43m between April 2013 … and March 2019. There are now strict controls on management consultancy expenditure and we are not currently incurring consultancy costs for the development of our future plans, nor do we intend to.”

She highlighted achievements of SaHF including the transformation of paediatric and maternity services in north-west London and an increase in children being treated without admission to a hospital ward.

She added that while SaHF was no longer going forward and was being replaced with the NHS long-term plan, “we will however continue to learn and incorporate lessons from the previous programme into future work”.