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A Difficult Year for City Hospital

2008-12-01T11:25:00.010Z

As we enter the last month of 2008 it is worth reflecting on where City Hospital stands.
Internationally and nationally there have been seismic changes in the economic and financial situation. The very foundations of capitalism have been shaken to the core. The nation, heavily in debt, is being exhorted by the government to spend its way out of recession as people struggle to pay their bills. Get yourself more in debt to save the nation seems to be the plan.

Is this going to make building a new hospital easier or more difficult? The government at one time talked about trying to avoid unemployment by proceeding with more public building projects. However all public building projects costing more than £1 million have to be funded by the Private Finance Initiative. I may have missed it, but I do not think PFI, surely one of the greatest follies of both Tory and New Labour governments has been suspended temporarily or permanently. Therefore the Sandwell and West Birmingham Hospitals NHS Trust needs a commercial enterprise to loan them the £350-400 million required so that they can waste taxpayers money paying 6% interest to fat cats. How likely is this to happen in the present climate as many of the fat cats have gone to ground? The Strategic Health Authority has asked the Trust to delay the new build once this year so that the putative date is now 2015. However after what has happened recently that date seems overly unrealistic. There is of course outline planning permission from Sandwell Council for what it's worth.

The construction of a 24 hour Surgical Assessment Unit by refurbishing a ward is under way at City Hospital, and when it is complete we will see acutely ill surgical patients needing longer than 24 hours in hospital bundled off to Sandwell. It is clear that this is no short term arrangement. The local people will have to live with it for a long time. Meanwhile we still wait patiently for the Equality Commission to say something meaningful about the question they were asked by City Hospital Supporters back in the Spring of 2007. Perhaps somebody can explain to me the point of having an organisation with an impressive name like the Equality Commission? When asked to adjudicate on an important question of racial equality affecting the lives of many people it takes 18 months and appears to have got precisely nowhere. The matter has been passed on to some other individual. The workings of this organisation as far as City Hospital Supporters are concerned have been totally opaque. I fear the only conclusion to be drawn is that England has an Equality Commission so that we can say we have one. The box has been ticked, but in reality nothing is being done, at least for the citizens of West Birmingham.

The Sandwell and West Birmingham Hospitals NHS Trust has a very important campaign running at the moment. It is called "Listening into Action." I think I can hear your hollow laughter. I believe management consultants have been involved with this exercise and now every member of staff has been sent a DVD on the subject which apparently only cost 40p per person! The thrust of Listening into Action is that managers should take note of what front line staff are saying and incorporate their ideas into management decisions. This was applied to a ward and apparently it made a big difference. Gosh isn't that truly amazing! Perhaps a Nobel Prize for management is in the offing. It would not surprise me in the upside down world that is England in 2008. Any manager worth his/her salt knows that it is essential to listen to the people working at the coal face and the customers.

What a pity the Trust were not prepared to implement Listening into Action over their consultation questionnaires for the Interim Reconfiguration. Local people rejected their plans resoundingly as did the consultant medical staff at City, but the only action that followed was implementation of the plans regardless of the views expressed.

Interestingly some planning towards the new hospital has been taking place but Listening into Action has not been applied to consultant medical staff once again. Apparently there will be no room for offices for consultants if and when the new hospital is built. This is another stupid short-sighted decision. The consultant medical staff of a hospital are fundamental to its success. You need to attract the best calibre candidates to look after the local population. You need to encourage doctors to stay on site and be available to support junior and nursing staff. They need somewhere to have one to one meetings in private. They need somewhere to hang a coat and a desk to sit at. Somewhere to work on case notes, referrals and all the activities that go with being a consultant. No office sends the message to them that they are not valued and their role is not understood. It will encourage them to leave the premises as soon as they have completed their contracted hours. I would suggest that if accomodation is tight because the new build is on a shoestring, they should make managers not involved directly in providing or supporting clinical care redundant, especially those on the higher payscales. This would save valuable revenue for more important activities and free up offices for consultants.

Talking about saving revenue I note that the Trust's Communications Team or should that read Propaganda Team consists of ten individuals plus a chief! Wow big bucks there, it must be costing a fortune and think of all those offices. If we had fewer propagandists could we afford more nurses? Now that would be putting Action into Listening!!

And so another year draws to its close. What is in store for the NHS? In one word AUSTERITY. Literally millions and probably billions of pounds have been wasted pouring money into an NHS fundamentally badly managed. It is not in good shape to withstand the cold wind of the new economic climate we are now facing.

The number of emergency medical admission at City continues to rise inexorably. The Accident and Emergency Department is doing a fantastic job under enormous pressure. In my PERSONAL view the best Christmas present for the people of West Birmingham and Smethwick would be a sudden change of tack, with agreement to build a new hospital on the existing Dudley Road site. Sandwell Hospital would be welcome to join in.

I do not believe this would delay the new hospital because I do not believe the present plan is viable. Is it possible for us to see a change of plan? Anything is possible. Maybe a change of government would help. Undoubtedly City Hospital Supporters need to start making their views known in no uncertain terms.

Happy Christmas to you all. Ken Taylor

A Worrying State of Affairs.

2008-02-13T18:03:00.005Z

The wheels of British justice turn exceedingly slowly. City Hospital Supporters made a formal complaint to the Commission for Racial Equality in the first half of last year. In essence this pointed out that the City Hospital population had three times the Black and Asian Ethnic Minorities as inpatients compared to Sandwell Hospital using the Trust's own data.

It is the City Hospital patients (Children and Emergency Surgical cases) that will receive less safe, higher risk care with more travelling inconvenience for their families and friends as a result of the Trust's Interim Reconfiguration proposals. We believe this constitutes discrimination. Interestingly City Hospital Supporters are not aware that there were any members of the Black and Asian Ethnic Minorities on the Trust Board as non-executive Directors prior to its decion to proceed with its plans in May last year. Subsequently some members of the ethnic minorities have joined the Board.

The Trust should have done an Impact Assessment of its proposals to determine exactly how the ethnic minorities would be disadvantaged BEFORE it went out to consultation and certainly before deciding to proceed with its plans. An Impact Assessment after implementation is hardly treating the minorities with the respect they deserve.

City Hospital Supporters urged the Commission for Racial equality to speed up their investigation. However in the autumn of last year the CRE underwent a transformation to become the Equality and Human Rights Commission. This change delayed all the cases under consideration. However a recent letter from a Senior Legal Officer at the Commission indicates that they are definitely on the case.

The "Independent"? Reconfiguration Panel were made aware by City Hospital Supporters that a referral on the grounds of racial discrimination had been made. They chose to ignore this completely. It is noteworthy that there were no members of the Black and Asian Ethnic Minorities on the group of four members of the IRP who attended Birmingham.

The Secretary of State for Health also chose to ignore the fact that the EHRC were actively considering the case when he endorsed the IRP'S decision to allow the Trust to proceed with its reconfiguration plans.

Now all this is very worrying as far as democratic ethical government goes. Why have a body with a grandiose name such as the Equality and Human Rights Commission if government and their representatives can carry on with their activities without even waiting to see the outcome?

Lastly it has recently been reported that the Sandwell and West Birmingham Trust has been asked to delay proceeding with the new hospital. I wonder how often we will hear that refrain? The ink has hardly had time to dry on the great plans for a new hospital, and already the date for it to open its doors is being pushed further into the future. No wonder City Hospital Supporters have serious doubts it will actually be built at all.

The Latest Propaganda on TOWARDS 2010

2008-01-09T20:12:00.000Z

I have been looking at the publication "Towards 2010" circulated to all staff by the SWBH Trust. On the front page it says that "local NHS staff believe care should be provided as close to home as possible." I think they must be talking about local health care managers who are doing as they are bid by government. I have not met many NHS medical or nursing staff who believe this to be true. I have not met many patients who believe this to be true either.

Apparently "we (the Trust in partnership with the Heart of Birmingham PCT, Sandwell Council and Birmingham Council) will help people to stay healthy, stop smoking and adopt healthier lifestyles." It sounds miraculous, it sounds too good to be true. Indeed if you examine the evidence for achieving these goals in the long-term others have failed where our crusaders hope to succeed.

There will be new larger health centres. GPs will be brought together into larger health centres offering a wider range of services with social care and other community services.

What do the existing local GPs think of these plans? Have they been consulted? What does the Birmingham Local Medical Committe think? Having spoken to a key person in that organisation the answer is--not a lot.

There are to be Community Diagnostic Services delivered from Community Hospitals so that most people could have tests done without travelling to a specialist hospital. It sounds nice, so convenient. However any sensible person must realise that for every advantage in this life there is a disadvantage. The more diagnostic services that you have divided up in different places the higher the cost. This may mean that the state-of-the-art specialist hospital has a distinctly less state-of-the-art X-ray Department than it should have.

There is to be more active involvement with people who have a long-term health condition to help them maintain independence, using telecare and rapid response teams to deal with crises locally. What can this mean? Does it make sense? Can anybody tell me what contribution telecare is going to have? Perhaps it means that fragile immobile people will have cameras in their homes so that when they collapse or fall over somebody watching the big screen can report it to somebody? This country already has more cameras watching every aspect of life from speeding to walking down the street and possibly in the future you will not be able to be seriously ill in private.

What about outpatients? This is very simple. Most outpatient appointments and specialist consultations will be provided in local communities. Why? Have the patients asked for it? NO. Will it provide better care? No evidence to support that contention. Will it train the doctors of tomorrow better? Definitely not. Will it destroy consultant led care as we have known it in the UK. It sure will.

Latest techniques. It says that they will use the latest techniques to ensure people recover quickly and need to spend less time in hospital. Are we using the latest PROVEN techniques now to get people better quickly? You bet, all doctors want their patients to get better as quickly as possible not to cut the number of beds, not to save money although that is important but first and foremost because it is good for patients.

Intermediate care. Where is that going to be provided? Oh yes in the community along with everything else. Who will medically supervise all this community care. Will it be the GPs? Will it be the Consultants? This is an important issue. The old community hospitals were a complete disaster. Mostly they were primary care beds. Patients tended to get neglected and overlooked and were often admitted to hospital to have things properly sorted out.

On the front page of this paper there are eight headings before we reach the last one about the new hospital. Does that tell you anything?

What will happen to the City Hospital site? The Birmingham Treatment Centre will carry on as normal. The Birmingham and Midland Eye Centre building will form the core of the new community hospital. The Sheldon Block may also be kept as part of that new facility. The rest of the site will be sold for redevelopment. Birmingham will lose the enormous expertise concentrated in the present Birmingham Eye Hospital, what a waste, what bad news for the people of Birmingham.

It has to be complete madness to give up prime NHS land in a prime very convenient site for the people of West Birmingham to have their hospital only to go and buy more land a mile down the road to build another hospital. Where is the sense? Especially as inpatient Children's services and inpatient Emergency Surgical beds are being lost years ahead of any new hospital.

There has to be very serious doubts about whether the new hospital will ever happen. All we have at the moment is an aspiration and a lot of very hot air.

New Year's Demo at City

2008-01-02T22:54:00.000Z

Despite the best attempts by the powers that be to bury the bad news, demonstrators turned out yesterday to campaign against the downgrading of City Hospital's A&E service which was recently rubber stamped by the government funded "Independent" review panel. This article in the Stirrer implies that it is a stitch-up by Sandwell, but I am not convinced; this whole episode is just another example of the incompetence of the Trust board that happens to be less worse to Sandwell than it does Birmingham. After all, as the article points out, if the new hospital ever gets built, Sandwell effectively loses its hospital, despite claims to the reverse of the Trust Board.

Well done to all those who turned up. The fight is not over.

Some sobering thoughts for 2008.

2007-12-28T15:18:00.000Z

2007 is ending on a sad note for the people relying on City Hospital for its care. Impossibly bad decisions have been made affecting the future of that hospital by people who neither have the interests of the patients or the hospital at heart.

As a result of City Hospital Supporter's efforts we will see a 24 Hour Children's Assessment Unit and hopefully a 24 Hour Surgical Assessment Unit but essentially these two groups of patients have been condemned to second class care like no other patients in Birmingham.

The management of the Hospital Trust is pushing ahead with its plans for children and surgical services which do not have the support of the community served by City Hospital or the consultant medical staff working there. These plans will provide a worse service for patients and relatives and have been shown to be unnecessary by the relevant staff with the children's doctors even producing a plan that would have saved the Trust a lot of money.

It was very unfortunate that the Birmingham Health Scrutiny Committee referred only the proposed changes to Surgical Services to the Secretary of State but not those to Children's Services. This immediately laid that Committee open to the criticism that if they would permit children to be treated in this way then what was wrong with it for surgical patients?

City Hospital Supporters always had doubts about the word "Independent" in the title of the Independent Reconfiguration Panel. It is a government-funded body with close links to the Department of Health. This Panel demonstrated its alignment right at the start by appointing the local Director of Reconfiguration who had drawn up the plans to which we were objecting as their lead person organising the timetable of visits. Our concerns strengthened when the Panel refused to hear anything related to Children's Services. Clearly they felt they could save time here if they had no intention of objecting to the plans for Emergency Surgery. Furthermore although they were considering services to surgical patients they did not have a surgeon on the Panel. The only doctor was a Medical Oncologist not a surgeon. Turning to their account of their findings on the website it is notable that they do not record that they met a fourteen person team from City Hospital Supporters Group nor do they provide any coverage of the case that was presented with supporting evidence. The Trust's position is restated and none of the statements are challenged. Having spoken to a number of people there is agreement that the Reconfiguration Panel is a rubber stamp for the Trust's plans and their assessment is completely worthless.

The community served by City Hospital need to remember that the Heart of Birmingham Primary Care Trust has been complicit in these plans. Their local MPs have done nothing to stop the downgrading of their services, worth bearing in mind when election time comes round once more.

What of the future? The Trust is going for "Foundation status." Do they really have the confidence of the local community? The community whose opinion they asked during the consultation and then ignored it completely. Is this what local accountability is all about? The future is meant to be all about polyclinics with as much as possible being treated in the community. Will this give better patient care? There is no evidence that it will. Will it be cheaper? Almost certainly not the case. Will it be at the expense of hospital care? We fear that it will be. Apparently the only buildings to be left standing on the City Hospital site will be the Birmingham Treatment Centre, the Sheldon block and the Birmingham Eye Centre. No doubt the rest of the site will be cleared and the land sold to the developers for housing and shops.

Will there be a new hospital on the Grove Lane site within the next ten years? Do Sandwell residents want to travel to within a mile of City Hospital for their care? If they do why not go the extra mile and use the land that is already available on the City Hospital site, saving much time, money and trouble.

After all the expenditure of capital money in the community will there be enough for a new hospital? Is the plan to leave the hospital care needs of West Birmingham to the newly rising University Hospital? Will there be enough room in this new hospital? It will be accommodating the patients from the QE and Selly Oak as well as providing for many Regional Specialties. Additionally we are going to see a new town rising on the rubble of Longbridge which will add significantly to the catchment population. Will it cope? Will there be enough beds? Will the numbers of people trying to gain access to this super hospital as patients or visitors overwhelm the transport infrastructure?

If the SWBH Trust, the Heart of Birmingham Primary Care Trust and the Reconfiguration Panel had really been thinking about the welfare of the people of West Birmingham they would have maintained full services at City Hospital until the new hospital opened its doors. The fact that this has not happened more than anything else must cast serious doubt on the long-term intentions of these people.

IRP Reach Wrong Decision

2007-12-19T17:18:00.000Z

We were under the impression that the IRP would be reporting in January as per our previous post, so I was shocked to find this announcement on the BBC that the IRP and the Secretary of State had backed the Trust's proposals to remove emergency inpatient surgery beds from City hospital, ignoring the views of the medical profession at City and the patients who use the services and instead backing the managers who have overseen a transformation from a three star Trust back in 2003 to a Trust that was rated 'fair' in Quality of Services and 'weak' in Use of Resources in 2006. Please also see the following links for reactions:

http://www.thestirrer.co.uk/1912072.html

http://deirdrealden.blogspot.com/2007/12/bad-news-for-birmingham.html

The consensus is this is an attempt to "bury bad news" over the Christmas season in an attempt to avoid protests.

Despite following quite closely the campaign via Ken Taylor as part of the City Hospital Supporters Group, there had been absolutely no indication that this was coming. It is an absolutely disgraceful way to treat the patients who pay for hospital services via taxation, but then do not seem to get their views listened to when a "consultation" takes place

I am sure Ken Taylor's reaction will follow soon.

When do we hear the verdict of the Independent Reconfiguration Panel?

2007-11-19T12:40:00.000Z

The answer is mid-January 2008. Apparently the report of the Panel goes to the Secretary of State at the end of November and would normally be made public at the end of December, but because of Christmas it will be delayed by about a fortnight.

Children's Beds Closed at City Hospital 5th November

2007-11-11T17:12:00.000Z

The Sandwell and West Birmingham Hospitals NHS Trust went ahead and closed the children's beds at City on the 5th November. The views of local people expressed as a decisive vote, the views of the consultant medical staff at City Hospital have been completely ignored.

The Trust have produced a 38 page Operational Policy for their new Children's Assessment Unit and a 21 page Children's Transfer Policy. Staff will turn over quite rapidly at both hospitals. Just imagine the scope here for confusion!

Let us look for a moment at what the Operational Policy for the Children's Assessment Unit has to say about General Practitioner Referrals. All calls to the children's doctors at City will go to the Sandwell Children's Registrar. Apparently children may be triaged over the phone and sent to the inpatient unit at Sandwell. No choice here for parents or children. This makes a complete nonsense of the government's choice agenda, at least as far as the deprived area of West Birmingham is concerned. Everybody else gets their children cared for at their local hospital.

Apparently if it looks as if a child needs less than 23 hours in hospital, the GP will be able to send the child to the Children's Assessment Unit at City. However if the child fails to beat the clock and the 23 hour deadline is looming then it's off to West Bromwich.

Interestingly they have a plan. If the beds are full in the City Hospital Children's Assessment Unit, a child may need to be "accommodated" in the Emergency Department. Is this high quality care?

There will be only 12 beds on the Children's Assessment Unit. This sounds like a totally inadequate number to me. This probably explains why they are clearly worried about what to do when 10 of them are full. There is talk of the poor Senior House Officer or Registrar "reviewing the situation" and ascertaining any possible discharges or transfers. "In extreme circumstances and for short periods of time, children awaiting discharge will vacate their beds and step down into a chair or an extra bed flex-up will be utilised while discharges and/or transfers are arranged."
Real 21st Century Care for the children of West Birmingham!

The West Midlands Ambulance Service has been requested not to bring any child requiring "blue light" ambulance transfer to City Hospital Emergency Department. As Birmingham Children's Hospital is only increasing its bed complement by three where will these poor children go? To Sandwell if they have a bed, if not further afield, Heartlands? Good Hope? the Manor Walsall? Who knows?

It continues: "Any seriously ill unstable child/young person will remain in the Emergency Department until they are stable enough for transfer to the Children's Assessment Unit. If they are likely to need inpatient stay over 23 hours they will be transferred to the inpatient unit (Sandwell) as soon as they are stable enough for transfer in an ambulance from the Children's Assessment Unit."

We have moved from a high quality Children's Service at City Hospital where children received all their care under one roof to one where the children will be moved from pillar to post. Continuity of care will be a nightmare. The changing junior medical and nursing staff will need to keep the script with them in order not to lose the plot.

This inferior service has been thrust on local people for no supportable reason. There was an alternative plan that would have kept the lights on in the Children's Ward at City Hospital but it was ignored by the Trust Management.

An Absolute Disgrace!

2007-10-30T10:22:00.000Z

Unless a miracle happens a grave injustice will be done on the 5th November when 18 children's beds currently at City Hospital in Birmingham are moved to Sandwell Hospital in West Bromwich.

Up to 1800 children go through these beds in a year that is between 4 and 5 children a day. These children are from one of the poorest and most deprived districts in the UK. Many of these children are from the ethnic minorities. The consequence of this change of location of the beds is that sick children will face an additional and unnecessary ambulance journey putting the young patients at increased risk, and their parents to increased inconvenience.

This is not happening like much in the health service for any sensible reason that can be justified. Indeed the children's doctors at City Hospital have produced a workable plan that would enable the beds to remain at City, meet all requirements and save the Trust managing the two hospitals about half a million pounds per year.

During the consultation the people were asked to vote on the changes to children's services. They did so and rejected the proposals by a sizeable majority.

Emergency Surgical patients also faced losing their beds at City Hospital and still do. However the Birmingham Health Scrutiny Committee decided they were very unhappy about this aspect of the proposal and so referred it to the Secretary of State for Health who in turn referred it to the Independent Reconfiguration Panel. They will not be presenting their report and recommendation until the 30th November.

Why the Birmingham Health Scrutiny Committee were worried about the surgical patients and not the children God only knows.

Why is the Sandwell and West Birmingham Hospitals NHS Trust rushing ahead to move the children without waiting for the outcome of the Independent Panel? The Trust has been asked by one of the city's MPs to hold off the move until the Panel reports. The outcome of that request is still awaited.

If the Trust do not do so and proceed with the move of the children and the Independent Panel decide the Emergency Surgical beds should remain at City, we will be in the ludicrous situation that a move is considered unsuitable for adults but OK for children!

At present the outlook for the children of Birmingham that will be affected looks bleak. If this thoroughly unnecessary change in emergency service provision goes ahead a lot of people should not rest easy with their consciences. Before it is too late they must ask the question what could I do to prevent this bad thing happening to these children. This could apply to the Trust management,the Heart of Birmingham Primary Care Trust, the Strategic Health Authority, the Birmingham Health Scrutiny Committee, the Department of Health, the Birmingham MPs, Birmingham Councillors and the media.

November the 5th is the 400+ anniversary of a tragic event in British history. Guy Fawkes and fellow conspirators plotted to blow up the Houses of Parliament. It was a Catholic plot against a government ruled over by the Protestant King James 1. It was one of the milestones of this country's evolution to a modern democracy.

How far have we come and how democratic are we? We are just about to allow some children in the city to have an inferior quality of care forced upon them. The local population voted against it. 97% of the consultants at City Hospital voted against it.
Why are they proceeding with it?

The Presentation to the IRP

2007-10-13T11:45:00.000+01:00

Click here for the presentation that was given to the Independent Review Panel regarding the proposed interim reconfiguration plans which affect City Hospital's emergency & trauma surgery and emergency paediatric beds. It provides a concise summary of the arguments against the proposed reconfiguration, and is well worth a look whether you have been aware of this campaign from the start or are new to the arguments.

You do not have to sign into google to view the presentation. Just click on the link "View published presentation in a new window" to open the slideshow. To navigate through the slideshow, either use the arrows in the bottom left-hand corner of the screen or just click anywhere on the screen to view the next one.

Personally, I believe that this presentation blows the arguments of the Trust away. Given the size, support and arguments made by the City Hospital Supporters Group, if we do not get the Trust's decision overturned, it really begs the question as to what we, the users and taxpayers of our National Health Service have to do to decide how our money is used to treat our health needs.

NB: Due to the conversion from a powerpoint presentation to a web based presentation, there may be some problems with formatting on the version above. An alternative version is available here where you have to click to progress the sideshow point by point. Rest assured that these were perfect when we presented to the IRP!

A Very Constructive Meeting

2007-10-06T17:37:00.000+01:00

Thursday 4th October finally arrived. Bringing the City Hospital Supporters team together did give me moments of anxiety, but we made it in the end with four members of the local community, two GPs from the area, two Acute General Surgeons, two Trauma and Orthopaedic Surgeons, a Senior Physician, a Senior Paediatrician, a representative of all the non-medical staff at City Hospital and yours truly.

We met four Panel members with two from their Secretariat. The IRP arranged to record everything that was said so the Anne Gibson Room was wired for sound. The Panel arrived promptly at 2pm and there were introductions all round. The Panel began by explaining to City Hospital Supporters what they had been doing so far. I then began our presentation using Powerpoint and after about half a dozen slides handed over to the members of the local community and the GPs.

Members of the community stressed to the Panel the importance of having City Hospital providing a comprehensive range of Emergency Services that were fully supported. They stressed the terrible problems the locality faced. They spoke from first hand as either their families or their friends had needed care at the hospital. They spoke very highly of the care that they had received there.

One lady had thoughtfully travelled from City Hospital to Sandwell Hospital on the bus and back again. It had taken 1 hour and 35 minutes, excluding waiting time and cost £4.80. She had also tried it by car on two occasions, considerately avoiding the rush hour. The mileage for a single journey varied between 5.1 and 5.9 miles depending on route, and the time taken had varied between 20 and 35 minutes. On arriving at Sandwell a very real problem was the parking. For completeness our thoughtful member enquired about the cost of the taxi fare from City to Sandwell and it was £8 each way. During the presentation it was pointed out to the Panel that 50% of our population relied on public transport.

The GPs just could not understand why the Trust wished to lose Emergency Surgical and Children's beds and they felt it was quite unacceptable. They were very complimentary about City Hospital saying that it was the hospital that accepted emergency referrals with alacrity and without question. They also both made the important point that GPs on the patch had not been consulted. Perhaps one or two GPs with management roles in the Heart of Birmingham Primary Care Trust had given their views on the Trust's proposals, but it would seem those views were not aligned with their colleagues at the coalface. Prior to the meeting the most senior GP had confided to City Hospital Supporters that he did not wish to be identified because he was concerned about the possible consequences and he felt the same applied to many GPs in the area.

The Panel went on to hear about City Hospital Supporters concerns about the failure of the Trust to conduct a proper Impact Assessment of their proposed changes to the service on the different ethnic groups served by the Trust. The absence of any mention of the problems of going out to consultation with such an ethnically diverse and socio-economically deprived population in the specification for the contract for the consultation process.

It was a long list of problems which included a failure to mention in plain language of any description that the important consequence of implementing the Trust's plan was that sick children and surgically ill adults needing longer than 24 hours in hospital would face a further journey by ambulance for no medically justifiable reason.

Further problems with the consultation that were touched upon included a failure to circulate the document to the target population, a need to be able to leave a message on an Answer Phone in English or navigate a website in English to be able to download a version in the relevant language. A lack of awareness that an inability to read in that language is not uncommon. City Hospital Supporters had looked into the English reading age required to comprehend the document Shaping Hospital Services for the Future. It was in excess of 17 using the Fry Readability Graph which is the reading age required for a newspaper such as the Times. Using the Frisby Formula the Reading Ease Score was 27 indicating 4.5% of an average population would understand it and the IQ required for comprehension was 126+ which is superior and required for reading a scientific magazine.

The Panel heard that of the consultation forms returned only 15.6% were from the Black and Ethnic Minorities, whereas they represent 45.9% of City Hospital's inpatient population. It was also pointed out to them that the Black and Ethnic Minority population of Sandwell Hospital is 13.4% and all these figures are either the Trust's own data or from QUAD RESEARCH who conducted the consultation. A key issue that emerged here was that City Hospital patients containing three times the Black and Ethnic Minorities attending Sandwell would be the ones to receive an inferior quality service. The Panel were reminded that a complaint has been made to the Commission for Racial Equality. This is currently being processed although it is delayed because the CRE is changing to become the Commission for Equality.

At this stage the Panel were reminded that in spite of all the problems with the consultation the Emergency Surgical plan had been rejected by 47% to 31% and losing Inpatient Paediatrics at City by 46% to 29%. The margins were likely to have been wider if the target population had been properly consulted.

We moved on to the Consultant Ballot that rejected the proposed changes to Emergency Surgery and Children's Services by a majority of 97% of those voting, where the turnout was 60% and the overall majority 58%.

Subsequent meetings of City Hospital's Medical Staff Committee rejected the concept of sick patients of any specialty arriving at City Hospital and having to be moved to another hospital for non-medical reasons, putting them at increased risk and the whole family to enormous inconvenience.

We went on to consider the reasons that the Trust had chosen Sandwell Hospital as the site for concentrating Emergency Surgery. City Hospital Supporters were perplexed that no single reason was put forward about any benefit for Emergency Surgery patients and indeed the last reason put forward by the Trust was that if patients were really stuck there were other hospitals in Birmingham that they could go to such as UHB or Heartlands!

We then looked at the reasons put forward by the Trust for proposing the changes, and then went on to hear from the doctors directly concerned. These reasons were rejected quite emphatically. It was at this point that the Panel invited the surgeons to come forward with their plan ensuring that they were able to meet the necessary requirements. Our surgical colleagues have accepted the challenge and have gone away to commit their plan to paper and present it to the Panel in the near future.

The Children's doctor present handed to the Panel a document setting out the plan from the Children's doctors at City Hospital that would retain some beds at the hospital, meet all necessary requirements and save the Trust £500,000 a year.

Nearly two hours had passed remarkably quickly. It had been a very good meeting. The Panel had been extremely attentive and had asked some searching questions. There was good interaction between the Panel and City Hospital Supporters. We thanked each other and then thankfully retired for tea and Panel members then faced the long journey home. We were most grateful for their time and trouble.

There is one very troubling issue, and that is Children's Services. Unfortunately the Birmingham Council Health Scrutiny Committee did not refer Paediatrics to the Secretary of State for Health back in May this year just Emergency Surgery. It is City Hospital Supporters belief that the Scrutiny Committee may have been misled and this is being pursued. It would appear from everybody but the Secretary of State that the IRP are not able to consider Paediatrics. This seems to be a remarkable example of where due process is getting in the way of doing the right thing. It is clear to City Hospital Supporters that a grave injustice is being done to the people served by City Hospital. Emergency Surgery has the chance of reprieve, but the little children are condemned to an inferior service. Can that be right?

After this meeting I went home and had another look at the letter from the Secretary of State for Health to the Chairman of the IRP Dr. Peter Barrett. I am reproducing it here because I feel it is important for others to see it:

From the Secretary of State for Health Alan Johnson to the Chairman of the IRP Dr. Peter Barrett.

"TERMS OF REFERENCE
The Panel is asked to advise the Secretary of State by Friday 30 November 2007:
(a) whether in the light of the grounds of referral as set out in the correspondence from the Birmingham Health Overview and Scrutiny Committee to the Secretary of State of 18 May 2007, it is of the opinion that the proposals to consolidate emergency surgery provision at Sandwell Hospital, as set out in the decision of Sandwell and West Birmingham NHS Trust Board on 10 May 2007 will ensure safe, sustainable and accessible services for the people of Sandwell and West Birmingham, and if not, why not;
(b) ON ANY OTHER OBSERVATIONS THE PANEL MAY WISH TO MAKE IN RELATION TO THE PROPOSALS FOR CHANGES TO EMERGENCY SERVICE PROVISION AND IMPLICATIONS FOR ANY OTHER CLINICAL SERVICES;
(C) IN THE LIGHT OF (A) AND (B) ABOVE ON THE PANEL'S ADVICE ON HOW TO PROCEED IN THE BEST INTEREST OF LOCAL PEOPLE."

Now if that does not apply to Paediatrics I do not know what else it can be. I have written to the Secretary of State pointing out my concerns that his letter is being misinterpreted somewhere, I suspect in the Department of Health. I did get a reply to my letter not from the Secretary of State, but from a Mr. Alan Addison in the Customer Service Centre of the Department of Health. He closed the door firmly on the little children citing the Birmingham Scrutiny Committee as the reason.

The question is should we just accept the word of somebody in the Customer Services Department of the Department of Health. I am not their customer. City Hospital Supporters are not their customers. The children of West and Central Birmingham are not their customers. They are potential patients needing high quality patient care when it is required by their local hospital without facing any increased risks or inconvenience. City Hospital Supporters is going to continue to fight for them and for their right to TRUE EQUALITY OF ACCESS TO HIGH QUALITY HOSPITAL CARE.

DO YOU THINK WE ARE RIGHT OR DO YOU AGREE WITH MR. ADDISON IN CUSTOMER SERVICES AT THE DEPARTMENT OF HEALTH?

WE NEED YOUR SUPPORT ON THIS ONE AND THE CHILDREN CERTAINLY DO!
LET US HAVE YOUR COMMENTS PLEASE.

Meeting the Independent Reconfiguration Panel (IRP)

2007-09-23T20:32:00.000+01:00

City Hospital Supporters have waited a long time for this opportunity. It will happen on Thursday 4th October at City Hospital. We have a representative group meeting the Panel consisting of some members of the community and representatives of the staff non-medical and medical. We will be making a presentation which we hope at some stage after the event to make available via this website.

I know how very worried people are out there. People are concerned that they have not been consulted properly. They find it unbelievable that in these days of a Labour Government seeking a fourth term of office, there are people proposing to move the sick around in ambulances, not for any medical benefit and indeed not for any sensible, rational reason.
Over the last few months I have had the very pleasant experience of meeting many people living close to City Hospital and who have used its services many times over the years. They all speak with great respect and affection for it. They know how important its Emergency Services are to them. They are very glad this Independent Panel is looking at Emergency Surgery, and nobody wants us to abandon the children. We will not do so.

Our fervent hope must be that not only will we get a fair hearing on the 4th October, but that it will lead to City Hospital keeping those beds and continuing to look after its patients properly until that new hospital opens in Grove Lane.

Birmingham Post Appeal to Locals

2007-09-22T21:21:00.000+01:00

I have been informed that the Chairman of the Independent Review Panel(IRP) investigating the interim reconfiguration plans affecting City Hospital's A&E services has a letter in Thursday's Birmingham Post inviting people to write in and comment on the Trust’s plans. I don't know if anyone can confirm this in the comments below, while looking at the Birmingham Post edition online I could only find this article which seems to be a similar request but as an article rather than a letter (although letters pages along with editorials do not tend to be included on the online editions).

Obviously the IRP are not from round here, but one would have thought they would have checked which local newspaper the people in the vicinity of City Hospital would be likely to read. The Birmingham Post would almost certainly be the least likely one if anything. Reading the article I am also concerned that they seem most concerned about the transport links between the two sites. Although this is of course an important point that was raised by locals, this was also something the Trust conceded and planned to work with Centro to improve in order to proceed with the plans. To be fair though, they did mention the expertise in gunshot and stab wounds at City, and the fact that patients with these injuries come to the hospital in a variety of ways, which will need to be considered alongside the Trust's proposals. This of course is one of the big arguments against the Trust's proposals, and one which they have not given a satisfactory answer to as yet.

A Very Good Meeting.

2007-09-11T15:29:00.000+01:00

Last Tuesday 4th September the City Hospital Supporters Group had one of its regular meetings
We learned that we have over 200 members and we are about equally balanced between members of the local community and members of staff.

Members heard from Ken Taylor a detailed report of all the activities since the last meeting at the end of April.

They took careful note that the Trust's Interim Reconfiguration plans have been referred to the Commission for Racial Equality.

They were very pleased at our success in persuading the Health Overview and Scrutiny Committee to refer the Emergency Surgery proposals to the Secretary of State and his subsequent referral to the Independent Reconfiguration Panel (IRP.)

There was great disappointment that Children's Services had not been referred but everybody felt we must do all that we can to stop City Hospital losing its Children's beds. The members felt that local people would get a much poorer service for their children as a result. We will continue to press for children to be included in the IRP review. Everybody agreed that if it was poor patient care to make adult patients travel on unnecessary ambulance journeys to Sandwell or elsewhere, why is it OK for the children. Have people taken leave of their senses? A referral to the Health Service Ombudsman on the Children's issue could be the next step.

Since last week's meeting we have heard that City Hospital Supporters will be meeting the IRP on the afternoon of the 4th October. We will be fielding a strong team of people from the local community, some patients and doctors and a staff representative.

Members deplored the fact that Postgraduate Centre staff had been cautioned by management for helping the Group to communicate with staff. They also heard about the problems with staff accessing the website from some computers within the Trust. The two questions everybody asked were do we still think we are living in a democracy, and is it right that those paid their wages out of tax payers money can treat fellow citizens in this way?

We heard the good news that we continue to maintain a satisfactory financial position and members were impressed at the value for money they had been getting.

It was agreed to meet again when we have the result of the deliberations of the IRP to decide our next actions.

Access from SWBH computers to this website

2007-09-05T11:38:00.000+01:00

When many people at the Trust attempt to log on to this website they get the following message displayed:

"Your organisation's Internet use policy restricts access to this web page at this time."

This does not apply to all the Trust's computers but to very many of them.

We have to ask ourselves the question WHY?

Is this an obscene website or where deliberate untruths are told?

Do we block the opportunity for opposing views to be expressed as comments?

Are employees going to be spending large amounts of time reading the material and wasting Trust time?

If the Trust's employees are denied acces to the website at work will they only have the Trust's view on the important issues of the day?

If the Trust had sound evidence and sound reasoning and full staff support behind its reconfiguration proposals would it want to block access to this website?

Would we even need our own website if the above statement were true?

The Holidays Are Over!

2007-09-02T12:23:00.000+01:00

September is here already and the new term is almost upon us. A fateful few weeks lie ahead for City Hospital its patients and staff.

The key event this week is the meeting of:

CITY HOSPITAL SUPPORTERS GROUP ON TUESDAY 4TH SEPTEMBER AT 12.30PM IN THE ANNE GIBSON ROOM AT CITY HOSPITAL.

At this meeting members will be able to hear about all that has been happening with the campaign over the summer. Additionally there will be the opportunity to approve the thrust of our proposed presentation to the Independent Reconfiguration Panel when it visits Birmingham during September and October.

Please do your best to attend this important meeting.

YOU KNOW IT MAKES SENSE!!!!

2007-08-22T16:52:00.000+01:00

It is turning out to be quite a week. There has been the excellent paper from the people at Sheffield showing that the further seriously ill patients are transported to hospital, the greater the risk and the higher the mortality.

Why is this so amazing I can here everybody asking? We all knew that, it's only common sense! Yes but nobody has done a careful study and proved it to be a fact until now. Now it has been done and the results are unequivocal.

Now we have the evidence it should influence policy. As a physician I always try to practise evidence-based medicine. Surely the organisation of care should be evidence-based? Indeed one of the great causes that I believe the entire medical profession would unite behind is that government should use available evidence as the basis for all its health policies and plans.

I suspect the profession would also agree that there are serious issues with the advice that government receives. This should be about "horses for courses." If you want advice on emergency medical care, ask a doctor who has a great deal of experience in that area.

Another pitfall is building your plans around a collection of individual professional perspectives. The Cancer Tsar will have one set of recommendations, the Heart Tsar another and so on. They could well pull in quite different directions. Add in various statutory requirements such as the EWTD and MMC and you have all the ingredients for a complete shambles.

Common sense and talking to patients over many years brings out the really important themes. Patients want to see their GP when they are ill. When they are acutely ill they would also like to see the GP, preferably the usual GP. Patients think continuity of care is quite important. They like doctors and nurses that understand them. People they can trust. How can you trust anybody when you have only just met them once? Trust is built over time. They do not want GPs masquerading as Consultants or vice versa. They do not want nurses replacing doctors or health care assistants replacing nurses. Informed patients understand the "concept of dumbing down" and the affluent and insured consult the internet and find their specialists.

When patients are really ill they want to go to their local hospital until they are better. They would like their common serious illnesses managed under one roof but appreciate they may have to be moved for something very clever. They do not believe that closing or downgrading their local A&E Department is an improvement and suspect ulterior motives quite rightly in my view. They are also quite rightly extremely suspicious and sceptical about treatment in or nearer their own homes. They also find this difficult to equate with losing services from the local hospital.

Now how does all this bear on City Hospital. Well under current plans the sick children and surgical adults would have to face that additional ambulance journey of six miles minimum, more if Sandwell had run out of beds. Current plans clearly do not make sense.

Lastly I hear from Louis that the Sandwell and West Birmingham Hospitals NHS Trust has blocked this website for the staff at City Hospital. I wonder why? Has hospital productivity fallen because everybody is so busy eagerly scanning this website? I doubt it. Could it be something to do with preventing the staff hearing the other side of the argument? When an organisation blocks freedom of communication warning bells should be sounding. It suggests they are on the wrong course. A healthy organisation is one open to and welcoming of criticism and confident enough in its own evidence-based decisions to allow all its staff access to all the arguments. I suspect banning us will lead to more hits than ever so we must watch the website monitor most carefully. (Update 29/08: The website appears to be accessible from Trust premises again. Someone must be paying attention!)

ANOTHER REMINDER.

CITY HOSPITAL SUPPORTERS GROUP MEETING TUESDAY 4TH SEPTEMBER 12.30PM ANNE GIBSON ROOM CITY HOSPITAL.

Cameron Visit Sandwell, Report Condemns Plans

2007-08-21T22:19:00.000+01:00

A lot of national news stories relevant to the campaign hit the news today. The Stirrer has an excellent article here including an interview with Ken Taylor over the criticism of A&E closures by the Medical Care Research Unit at Sheffield University.

Also, David Cameron visited Sandwell Hospital today amid criticism by the press over his claims that 29 district general hospital are facing cuts to emergency and maternity services. One of the 29 hospitals the Conservatives are referring to is City Hospital, Birmingham.

Now I do not know about the other hospitals, but the mainstream media coverage seem to be getting bogged down in petty political points scoring. Sandwell & West Birmingham Hospitals NHS Trust are quoted here on the BBC in the following manner:

Sandwell and West Birmingham Hospitals NHS Trust said there was "no threat" to the accident and emergency department nor the maternity unit at City Hospital in Birmingham.
Trusts react
Other NHS trusts have also contradicted the Conservative claims.

Quite frankly, I think this is sloppy reporting. It is an indisputable fact that emergency general trauma and surgery and emergency paediatric services are under grave threat at City Hospital. Anyone who says otherwise has not done their homework. The Trust delivered a typical communications tactic of concentrating on what is not changing at the hospital, and the national BBC reporter has fallen for this line hook line and sinker (this is in contrast to the excellent local BBC reporting of the issues on the Radio WM, Midlands Today and the Politics Show who have sought balance by interviewing both the Trust and the City Hospital Supporters Group in an attempt to get to the truth.

In other news it seems this site has been blocked by the Trust, so you will have to access this site at home in future to keep up with campaign news. If you are reading this, I guess you already knew that. (Update 28/08: This site seems to be accessible from Trust computers again. Someone must be paying attention!)

Next Meeting of City Hospital Supporters

2007-08-19T12:34:00.000+01:00

Will be on Tuesday 4th September at 12.30pm in the Anne Gibson Room close to the Postgraduate Centre. It is a meeting open to all members of the Group and I hope as many as possible will attend.

It will be an opportunity to hear about all the activities over the summer, and discuss the imminent visit of the Independent Rconfiguration Panel to Birmingham to review the Trust's plans for Emergency Surgery. We have not received any dates as yet but understand it wil be during September and October.
Please do your best to join us.

Bed Numbers.

2007-08-01T19:44:00.000+01:00

It has been pointed out to me that I have used an incorrect figure for the bed complement at City Hospital. Having carefully researched the matter I realise that the figure of 1100 beds was historical going back to the time before a previous management had enhanced the size of the car park by demolishing the wards for elderly patients, thus thrusting West Birmingham into the mainstream of care in the community. It also saved money by removing the need to pay the capital charges and saved on the maintenance bill.

Getting accurate data on beds is always difficult because it is frequently changing. Should we consider only beds that are open, or take into account those that are closed whether it be permanently or temporarily?

The data I now present was obtained from very reliable sources on the 1st August so it is bang up to date.

The potential full bed complement for City Hospital is 715 beds. However the following wards are closed:
Two Elderly Care Wards on Sheldon Block each containing 28 beds.
M8 the Rheumatology Ward containing 17 beds.
D29 Ward containing 17 beds.
D28 Ward containing 17 beds.
D22 Ward containing 18 beds.
D19 Ward containing 20 beds.
D9 Ward containing 20 beds.

Total beds closed 165.

If we subtract 165 from 715 we get the current bed complement at City Hospital which is 550.

Now let us look over to the other half of the Trust.

Again the data was obtained today:
The potential full bed complement for Sandwell General Hospital is 397 beds.
However believe it or not Sandwell has:
Priory 3 Ward closed, an Acute Cerebrovascular Accident Ward 28 beds.
Lyndon 4 Ward, a Medical Ward is closed 32 beds.

So with 60 beds closed Sandwell's current bed complement is 337 beds.

What about Rowley Regis Hospital?
This hospital has 84 beds for Rehabilitation and mercifully they are all open.

Why are so many beds shut? A very pertinent question. In purely financial terms beds means nurses. Less beds means fewer nurses. There is a big turnover in nursing staff and it is easy to reduce the nursing complement to match the bed complement by restricting recruitment. Furthermore it is possible to reduce the bank and agency nursing bill. So good news the financial deficit has been miraculously transformed but there has been a price.

If we consider the closed beds as a percentage of the total bed stock, 23% are closed at City and 15% at Sandwell if we ignore Rowley Regis Hospital, or 12% if we include it.
City Hospital remains the larger hospital but if this differential closure rate were to continue the hospitals could become of similar size in bed terms.

Within the last few weeks a very good friend of mine a senior gentleman was admitted to City Hospital. He presented with a severe bout of pneumonia and needed IV antibiotics and the care of the physicians. He was full of praise for the medical and nursing staff. He thought the nurses were a greatly committed bunch of people. However he was rather dismayed to have been nursed on the ladies ward. He did not mind too much but he felt really sorry for the ladies!
Do we need those beds? You bet we do.

A Good Medical Staff Committee Meeting

2007-07-31T12:55:00.000+01:00

The senior medical staff of City Hospital met last night. The subject of the meeting was the Trust's Interim Reconfiguration proposals. It was the plan for Inpatient Paediatric beds and Emergency Surgery beds moving to Sandwell that was under the spotlight. Some very clear messages emerged from that meeting without dissent:

If a patient is brought to hospital as an emergency and they need to remain in hospital, it is not good medical care for them to be moved to another hospital for a non-medical reason. The transfer would put the patient at an increased and unnecessary risk.

If the Trust's plans were to go ahead this would apply to both the children acutely ill needing inpatient care, and surgically ill adults at City Hospital. This would affect at least 1000 children a year and this is a conservative estimate. A more realistic figure was thought to be 1800 children.

The doctors went on to hear of an excellent plan that would keep inpatient Children's Services on both sites, create greater equity in staffing between the two sites and save the Trust £500,000 annually. Sadly the Trust has not been prepared to listen to this plan to date. Common sense would surely dictate that they cannot afford not to look at it very carefully. It sounds like a win win deal!

A very helpful proposal was made by one of the senior doctors that had widespread support. The Royal College of Paediatrics and Child Health should be asked to review the Trust's plan on Paediatrics together with the one put forward by the City Hospital Paediatricians.

So all in all a good and constructive meeting. The senior doctors have been consistent in their view. In the recent ballot 97% of those voting rejected the loss of the inpatient beds in Paediatrics and Emergency Surgery at City Hospital. They have now expressed that concern within the Medical Staff Committee at City and spelt out the principal reason for that concern. It is an issue of risk to the patient as a result of an unnecessary transfer.

There was a representative of management at the meeting who wheeled out the usual Trust reasons for making the changes: the EWTD for junior doctors hours, Modernising Medical Careers, working in larger groups, recruitment and retention. However the consultants were having none of it and made it clear that these were not valid reasons for the form of reconfiguration proposed.

It became very clear during the meeting that the City Hospital doctors are a thoughtful bunch who wish to be engaged by the management in planning the future. They have the desire and the ability to sort out the Trust's future plans. Yes they need to get together with their Sandwell colleagues, but there has to be acceptance of preservation of good patient care on both hospital sites until this new hospital opens. The Trust's plans have put City Hospital patients in jeopardy not Sandwell's. Quite rightly City Hospital doctors must stand up for their patients and do all in their power to ensure that patient care is not threatened. We would expect no less of Sandwell doctors for their patients.

A Sign of Things to Come?

2007-07-22T17:33:00.000+01:00

John Adler wrote in a recent letter to Ken Taylor:

"I was also disappointed that your letter to consultants took a very pessimistic view of the prospects for the new acute hospital which these plans are, in part, designed to prepare for."

Well perhaps John Adler should pay some attention to this story from the BBC. It shows that Ken Taylor is taking a realistic view, while the Trust delude themselves that the new hospital is a done deal when they have not even purchased the site.

As Ken constantly states: let's reconfigure the services when the new hospital is there. Otherwise you may end up with worse services at the original sites permanently.

Media Cover Independent Review

2007-07-20T22:29:00.000+01:00

There was widespread media coverage yesterday of the decision by the new Secretary of State for Health, Alan Johnson, to refer the interim reconfiguration proposals on emergency surgery and trauma to an independent review panel. Phil Upton covered the story on Radio WM in the morning, interviewing both Ken Taylor and John Adler for their reactions to the news. Ken Taylor swatted away the claim by the Trust that this was old news, pointing out he had a letter dated 16th July from the recently appointed Alan Johnson. He believed the independent review was great news for the campaign, because it would allow us to put forward the case to a geniunely independent panel. Although Paediatrics has not been included in the review, the letter from Alan Johnson said that all significant reconfigurations would be independently reviewed, holding out hope that this may also be referred separately. Failing that, it is possible that the City Hospital Supporters Group will look for a judicial review.

Chief Exective John Adler put on a brave face, claiming he was looking forward to the opportunity to put forward the Trust's case to the independent panel and that this was actually old news being recycled from May. This is not strictly true, as although the plans were referred to the Secretary-of-State in May by the Birmingham City Council Health Scrutiny Committee, it is only this week that the referral to an independent panel has happened.

The Birmingham Mail also ran it as a main story which can be found here.

Reasons for choice of Sandwell as Emergency Surgical site.

2007-07-17T20:50:00.000+01:00

A further attachment with the letter on the Trust's Reconfiguration Plans:

Both City and Sandwell Hospitals are busy, large general hospitals serving deprived and diverse inner-city communities. The reasons for choosing Sandwell Hospital as the main emergency surgical site and City Hospital as the main elective surgical site were:
*The Trust already has a number of elective surgical specialties concentrated at City including ENT, Gynae-Oncology (the Trust is the tertiary centre for the Pan-Birmingham Network) and Ophthalmology.

*The Trust's elective surgical site requires greater theatre capacity than the emergency site. This level of capacity is available at City Hospital (in part due to six new theatres in the Birmingham Treatment Centre) but is not available within current facilities at Sandwell Hospital. Unless absolutely unavoidable investment in new theatres at Sandwell could not be justified in the context of the plans for a new acute hospital.

*Removing emergency surgery from Sandwell in addition to the elective surgical services already based at City and other services such as Urology which the Trust intends to concentrate alongside Gynae-Oncology would have resulted in a significant reduction in the general surgical service at Sandwell that would over time have become unsustainable.

*There are other A&E Departments in Birmingham (including at UHB and Heart of England NHS Foundation Trusts) providing possible alternatives for patients if necessary (although the Trust has designed its plans to minimise the risk of significant catchment loss.)

These reasons have been explained to the Overview and Scrutiny Committees and other key stakeholders as part of the pre-consultation and consultation process.

Some comments on this are required.
City Hospital Supporters feel very strongly that the communities served by both hospitals deserve at the very least fully supported Emergency Services at BOTH hospitals. The Trust's plans seem all about making elective surgery paramount at the expense of Emergency work at City Hospital. City Hospital is 1100 beds to Sandwell's 400. City sees far more emergencies and in particular far more surgical and trauma emergencies. Why are we compromising this excellent emergency service to fulfil some grand elective design ahead of the new hospital being completed?

Perhaps the most incredible statement of all time is for our Trust Board to be reminding the world that there are other A&E Departments in Birmingham such as UHB and Heart of England. Who are these people working for? Who are they representing? The Chair of the Trust made the same comment on the Politics Show on TV back in May. Can anybody have confidence in a Trust Board identifying other hospitals for its patients as part of its grand plan for the future?

The people of Birmingham and Sandwell need a management team that is standing up for their interests and providing at the very least good emergency services on both sites until they have produced the new hospital. We may be called City Hospital Supporters because that is the hospital that is under attack, but we would not wish to see Sandwell patients lose any of their emergency services. This ethos was enshrined in the letter from the Department of Health that approved the formation of the Trust with the merging of the two hospitals.

Attachment 2. Reasons for choice of preferred option in surgery.

2007-07-16T21:52:00.000+01:00

This attachment also accompanied the letter from the Chief Executive.

1. The plan allows the concentration of elective general surgical specialties inpatient activity at one main site presenting the benefits of improved critical mass for future service development.

This advantage needs to be set against the very major disadvantage of not having properly supported emergency services on both sites, and in particular at the larger of the two hospitals namely City.

2. The plan allows the consolidation of elective inpatient orthopaedics alongside the elective general surgery to provide a major elective surgical site.

It seems elective work is taking precedence over emergency work. Surely this has to be seriously questioned with a hospital the size of City situated right in the centre of Birmingham and with the workload of its A&E Department? 103,000 referrals a year.

3. The plan separates emergency and elective workstreams enabling improved management of patients in a larger more focused emergency inpatient site.

At present City Hospital is able to deal with nearly all its emergencies in house giving a first rate service. Why are we undermining the service at City for something only to be achieved if and when this new hospital materialises?

4. The plan retains maximum possible local access for elective work with outpatients, day cases and 23 hour stay surgery retained at both sites.

The status quo or would retain a First Class Emergency Service on both sites. When the chips are down the people need a decent Emergency Service.

5. The plan retains maximum possible cover for the elective site including:
- on-call consultant surgeon and orthopaedic surgeon
- on-call surgical registrar
- junior doctor presence on site through HaN team
- out-of-hours access to emergency theatre
- full anaesthetic cover

But means about 12 patients a day who are acutely surgically ill or traumatised will have to make an unnecessary journey to Sandwell Hospital in order to find a bed. Their relatives will have to travel further to see them.

6. The plan retains maximum possible local access for emergency surgery through a 24 hour Surgical Assessment Unit at the elective site to provide good local assessment services.

People not only need good access for emergency surgery they need to remain in the hospital they have been admitted to unless there are over-riding medical reasons for a move.

Attachment 1: Reasons for service reconfiguration in advance of new hospital - surgery.

2007-07-16T15:06:00.000+01:00

This has been sent out to everybody on the 6th July from the Chief Executive.

1. Changes to the Medical Workforce. Both MMC and the next stage of EWTD implementation have a significant impact on junior doctor numbers in key specialties including surgery. This makes it increasingly difficult to cover two sites in the way we do now. The effect of MMC is already becoming apparent.

The Paediatricians and the Surgeons assure City Hospital Supporters that these are not valid reasons for losing their beds to Sandwell. They are able to put forward plans that would provide cover on both sites and not be more expensive than the Trust's proposals.

2. Critical Mass for Future Development. Many of our services (especially surgical services are too small at each site to have a sufficient critical mass for future development.

It is very unlikely that this applies to City Hospital. However the reason for the new hospital is to bring services together on one site. The sooner the new hospital is built the sooner this can happen. However this is not going to happen imminently and emergency services should not be compromised while the community waits for its long overdue new hospital.

3. Recruitment and Retention. Continuing to recruit and retain the best clinical staff in a competitive labour market requires services that are large enough to attract high quality individuals.

Medically there has continued to be no significant problems recruitng doctors. The Trust were not too bothered about retention when they lost a large number of nursing posts recently in order to help solve the financial problem.

4. Productivity improvements. The next stage of productivity improvements required to ensure best use of resources will be supported by larger inpatient services.

Now this is a new one. Sounds like the supermarket approach. Is it a justifiable reason for making patients suffer an extra ambulance journey and for relatives to travel further? City Hospital Supporters do not think so. This is a gain to be made when the new hospital opens.

5. Preparation for the new hospital. The new hospital will require single clinical teams working in new ways; bringing services together now prepares for this.

Very unconvincing. Time enough to start on that when the new hospital is actually being built assuming it happens. There is absolutely no guarantee that it will.

Responding to some key points.....

2007-07-15T16:14:00.000+01:00

Dear Mr. Adler,
Thank you for your letter of the 11th July. The City Hospital Supporters Group ballotted the consultants at City Hospital, the far larger hospital serving a very diverse multi-ethnic population because that is the hospital faced with losing its inpatient Paediatric, Emergency Surgery and Trauma beds. It is the sick children and surgically sick adults needing to stay in City Hospital longer than 24 hours that will have to face the additional ambulance journey to Sandwell with relatives forced to travel further. The ballot showed that those voting (an absolute majority of the members of the Medical Staff Committee)were almost unanimously opposed to these plans. This sends the Trust Board a very clear signal indeed.

Turning to the "very pessimistic view" taken on the new hospital I would choose the word "realistic". The Trust Board are very optimistic portraying the new hospital as very much "a done deal" when it is no such thing. The land has not been bought, the finance has not been secured, very real concerns about the ability of the local health economy to afford another large PFI in the Birmingham conurbation with the Coventry experience only too fresh in our minds, and the new hospital would be the last piece in the jigsaw after establishing all the new builds and services in the community to ensure that the future hospital is not too large. If we apply the legal concept of reasonable doubt, then there has to be reasonable doubt that the new hospital will be achieved until we have some concrete evidence (literally)with it actually under construction. Planning for working together on one site can take place until then, followed by any necessary service modification during the construction but keeping the needs of patients and their families uppermost in our minds.

City Hospital Supporters are delighted that you are going to continue working closesly with the clinicians. A major problem to date is that although there may have been close working it has not influenced the Trust Board's proposals. It is my clear understanding that the Paediatricians at City Hospital and the majority of the Surgeons are opposed to their patients moving to Sandwell Hospital. They have put forward plans for retaining the beds at City that would be perfectly viable in terms of the EWTD on junior doctors hours and with MMC and would not be more expensive than the current proposals. I have checked my facts with key people before writing this letter. It is time that these plans saw the light of day so that all can judge their viability for themselves.

The only aspects of reconfiguration that worry City Hospital Supporters are those affecting inpatient Paediatrics at City and Emergency Surgery and Trauma beds. We believe that over the remaining weeks of summer there is an opportunity for the Trust to modify its position on these services by heeding the results of its own formal consultation, the consultant ballot verdict, the views and evidence of the clinicians directly involved, and the concerns of the Health Overview and Scrutiny Committee of Birmingham City Council.

Yours sincerely,

Dr.K.G.Taylor MD.,FRCP
On behalf of the City Hospital Supporters Group

Ms. D. Lee, DOH Secretary of State Private Office
Mr. T. Shaw, Independent Reconfiguration Panel
Councillor Alden, Birmingham Overview and Scrutiny Committee
Ms. C. Bower, West Midlands Strategic Health Authority
Dr. S. Bradbrook, Heart of Birmingham PCT
Mr. R. Bacon, Sandwell PCT
Mrs. S. Davis, SWBH
Mr. R. Kirby, SWBH

John Adler's Ballot Response

2007-07-15T11:23:00.000+01:00

The following letter was sent to Ken Taylor by the Chief Executive of Sandwell & West Birmingham Hospitals NHS Trust in response to the recent ballot, which saw 95 out of 98 City consultants who voted voting against the interim reconfiguration proposals, a majority of 57% of those who could have voted. The original version is available here.

Sandwell and West Birmingham Hospitals NHS
NHS Trust
City Hospital
Dudley Road
Birmingham
B18 7QH

Tel: 0121 554 3801

http://www.swbh.nhs.uk/

Tel: 0121 507 4847
Fax: 0121 507 5636

Dr. K.G. Taylor
‘Redstacks’
1 Priory Road
Halesowen
West Midlands B62 0BZ
11th July 2007

Dear Dr. Taylor,

Re: City Hospital Supporters Group Ballot

Thank you for your letter dated 23rd June 2007 setting out the outcome of the ballot of City Hospital based consultants organised by the City Hospital Supporters Group.

I note that your ballot did not include the substantial body of consultants based at Sandwell who are also affected by these changes. I was also disappointed that your letter to consultants took a very pessimistic view of the prospects for the new acute hospital which these plans are, in part, designed to prepare for.

As you know, the Trust has developed its proposals for change with significant clinical input over the last 18 months in order to reach a considered assessment of the best option for each of these services. This has included detailed consideration of the options with the clinicians directly involved as well as a number of opportunities for the wider clinical body to contribute. We will continue to work closely with clinicians as we develop our plans further.

Finally, I would like to take the opportunity to confirm how the Trust intends to proceed. We will be continuing to ensure our clinicians are engaged in the process of developing our plans. We will in this way proceed with changes where either there is no significant argument or where there are clear operational reasons for needing to deliver the change as quickly as practical. This includes the changes to pathology (move to City), neonatal care (move to City), inpatient paediatrics (move to Sandwell) and the first stage surgical changes (inpatient urology, vascular and breast cancer will move to City). The proposals for emergency surgery and trauma are subject to the Secretary of State’s decision and we will continue to work on the detail of our plans in this area with clinicians pending the outcome of the review. This approach was agreed by the Trust Board last week.

I trust that this letter confirms the current position.

Yours sincerely,
John Adler
Chief Executive
cc: Ms. D. Lee, DOH Secretary of State Private Office
Mr. T. Shaw, IRP
Councillor D. Alden, Birmingham OSC
Ms. C. Bower, West Midlands SHA
Dr. S. Bradbrook, Heart of Birmingham PCT
Mr. R. Bacon, Sandwell PCT
Mrs. S. Davis, SWBH
Mr. R. Kirby, SWBH

Ken Taylor will be posting a response to this later today.

A Ray of Hope??

2007-07-06T23:55:00.000+01:00

An e-mail came to all inboxes at City Hospital and presumably to all healthcare workers throughout the country on the 4th July. It was from the new Health Secretary Alan Johnson and he was announcing a wide-ranging review of the NHS led by a surgeon who will continue to practise his craft.

This is most welcome news. What better way to convince the front line troops than with a person who knows what it's all about leading the way. May be some common sense can now effectively influence the decisions taken at the top of government.

Policy must be evidence-based with clinicians from both primary and secondary care, patients and local community representatives in the driving seat. From all my experience of talking to patients not one has said that that they want more choice. They want to see the local GP when they are ill, preferably before they get too ill. Seeing the same GP with some continuity of understanding of the problem as well as care would be good. Patients want to be seen at the local hospital for serious common garden complaints. They would prefer to have the children, themselves and their elderly parents cared for in the same hospital.

They would like the hospital to be clean, free from infection, the food to be adequate and edible without the need for the family to bring in extra rations. It would be good not to be taxed for parking the car in some grotty flooded car park especially when they are elderly, infirm and supporting sick family members.

They also find it hard to understand that the treatment you can get depends on where you live. Not only do people have to move address for the schools in 2007 but also to get the treatment they need. They wonder can it really be a NATIONAL Health Service?

The consultants feel sidelined and ignored. Primary Care Trusts now decide what they are going to buy. Let us be clear Primary Care Trusts do not represent GPs in my experience. They have their own agenda and I have great sympathy with my GP colleagues. When the GPs sit down with the consultants and work out what is best for patient care and where it should be done most effectively and economically we will really be reforming the NHS. I am hearing about patients with diabetes being denied a specialist foot clinic at the hospital in spite of developing gangreneous toes. I hear diabetic patients with renal failure may be discharged to primary care. This is going back to the past, not forward to the future. In parts of the country specialist nurses are being lost.

Much more money has been invested which is fantastic but I fear that much has been wasted. All these Trust Boards, all the non-productive people that are not contributing to patient care, all those management consultants, all the glossy brochures, all those organisations set up to monitor this and that, all those collecting data to determine if targets are being met, all those working in public relations and communications.

The NHS now has a business ethos. Money rules the roost. Looking after patients who are vulnerable and ill is something very special. We need an NHS that has a caring ethos but with business sense. Trusts are not accountable to local people. The Labour Government made a big mistake abolishing the Community Health Councils. They stood up for the health needs of the local community and gave the providers of health care a hard time when things were not right. They were the local watchdogs of the health service. Bring them back. It is true wisdom to recognise when mistakes have been made and then to correct them.

Turning to our vitally important local issue. I have today written to Secretary of State Alan Johnson setting out the key issues regarding the Interim Reconfiguration proposals and copied the letter to Professor Sir Ara Darzi. I am hoping that this will lead to referral of both Paediatrics and Emergency Surgery to the Independent Reconfiguration Panel. If this happens then I hope the evidence will speak for itself.

Race for Health

2007-07-03T21:01:00.000+01:00

A news item in the 30th June British Medical Journal caught my eye. Race for Health is an organisation sponsored and funded by the Department of Health. Surinder Sharma the National Director for the Equality and Human Rights Group is the Department of Health's sponsor.

"The programme is led by the Primary Care Trusts and it aims to create an NHS in which the health needs of black and minority ethnic people drive the services they receive. Its focus is on three key areas: workforce development, commissioning, service improvement."

This has great relevance to City Hospital at the moment. Why is the Heart of Birmingham Primary Care Trust agreeing to commission an emergency service that will clearly be disadvantageous to the ethnic minority population served by City Hospital? Having to move hospital if you are a child or a surgically ill adult and need to stay in hospital longer than 24 hours is a worse service than at present. Why would they want to purchase such a service? If they cannot improve the service they could at least maintain the status quo while awaiting the wonderful new hospital.

Interestingly there are 15 pioneer Primary Care Trusts. One of these is the South Birmingham PCT. Perhaps Heart of Birmingham PCT needs to take a leaf out of their neighbour's book?

If you want to find out more visit the website www.raceforhealth.org.

City Hospital Supporters Appeal to New Prime Minister.

2007-06-29T16:42:00.000+01:00

A letter was dispatched to Mr. Gordon Brown on the day he became Prime Minister. The idea to write to him was inspired by his declaration that he intended to make the NHS and listening to local people his top priorities. Undoubtedly he has the chance to do so right here in Birmingham with the City Hospital Reconfiguration debacle.

Dear Mr. Brown,
Firstly I am writing this open letter to you on behalf of the City Hospital Supporters Group in Birmingham and we would like to congratulate you on becoming the new Leader of the Labour Party and Prime Minister. We were delighted to hear this most welcome news. We were also very pleased to hear that you were to make the NHS one of your top priorities and were particularly delighted that the views of local people were to be listened to.

City Hospital is the hospital closest to Birmingham City Centre. It serves the 4th most deprived district in England with wards such as Ladywood, Handsworth, Soho and Aston. Its A&E Department saw some 103,000 referrals over the last year with approaching 20,000 children. The hospital has an excellent A&E Department that has developed special expertise as it sees more penetrating injuries from gunshot and knife wounds than any hospital in the Midlands and probably the whole country.

City Hospital Supporters is a recently formed group consisting of members of the community served by the hospital and members of staff of every occupation. We are committed to ensuring that the community continues to receive the same high quality of care they have been used to, provided by City Hospital. This hospital had its own Trust Board until a few years ago and it then merged with Sandwell Hospital NHS Trust. The long term plan is to replace the two existing hospitals with a single hospital in Grove Lane Smethwick that will serve a combined population of 500,000. City Hospital Supporters endorsed this development when it went out for consultation in November last year. The new hospital is but a plan at present at a very early stage. Finance has to be organised throught the Private Finance Initiative, the land purchased and the building plans produced. The new hospital will not open its doors before 2013/14 assuming no slippage.

Our major concern is the Interim Reconfiguration Proposals recently approved by the Trust Board. These proposals would see inpatient Paediatric and Emergency Surgery beds moving from City Hospital to Sandwell Hospital with 24 Hour Assessment Units being established in these specialties at City Hospital. City Hospital is the larger hospital with 1100 beds compared to 400 beds at Sandwell. It serves a socio-economically deprived population and one with a very high concentration of the ethnic minorities. Some 50% of families are without their iwn car and public transport links are not good.

If the Trust's proposals were implemented about six of the children admitted and about 12 of the adult surgical patients who were admitted via the 24 Hour Assessment Units each day would need to be moved to the beds at Sandwell because they needed to stay in hospital longer than 24 hours. These journeys would not be medically necessary as they would not be moving patients to higher levels of care such as Intensive Care or High Dependency beds, they would be moved to ordinary ward beds. This has to be unacceptable care in the 21st century for the hospital at the centre of England's second city.

The actual formal consultation was flawed because the ethnic minority population was not effectively addressed. However those who returned consultation forms rejected the Trust's proposals for Emergency Surgery 47.2% to 31.4% and for Paediatrics 45.6% to 29%.

As if this were not bad enough these proposals fly in the face of the Trust's own Racial Equality Policy. This is because from data provided by the Trust on their website City Hospital has an inpatient population consisting of 45.9% ethnic minorities against Sandwell 13.4%. Thus ethnic minority patients at City would be unfairly disadvantaged and put at greater risk. A complaint has been made to the Commission for Racial Equality and I understand that it is being investigated.

Last week a secret ballot of all the consultants at City Hospital drew to a close. 97% of those retuurning ballot papers supported the prospect of the new hospital but opposed losing the Paediatric and Emergency Surgery beds. Only two ballot papers were received voting the other way and we had an overall majority of 57.9%. No previous ballot had been conducted by the Trust.

I am sure you will agree that this is a totally unacceptable situation, particularly as the Trust did have options on the table that would have preserved Emergency Services at both hospitals until the new hospital is built. These options would have been perfectly acceptable to City Hospital Supporters. The good news is that the Birmingham City Council Health Scrutiny and Overview Committee has referred the Emergency Surgery proposals to the Secretary of State for Health who has to decide if referral should be made to the Independent Reconfiguration Panel. However Paediatrics has not been referred.

This is a very clear example of the local community not being effectively consulted about a major change to the provision of their hospital services. In spite of the flawed consultation they have rejected a reduction in services at their local hospital, but they have been ignored by the Trust. The senior doctors at the hospital have spoken with one voice on the Trust's proposals but to date it has had no effect.
Referral of both the Emergency Surgery and the Paediatric plans to the Independent Reconfiguration Panel would at least give us a chance to present the facts to an independent and external group of people, so that the case for preserving effective emergency services at City Hospital until the new hospital opens could get a fair hearing.
With kind regards and good wishes for the future.

Yours sincerely.

Dr.K.G.Taylor

On behalf of City Hospital Supporters Group.

Media Cover Ballot Results

2007-06-27T22:46:00.000+01:00

There was plenty of coverage of the results of the recent ballot on Friday, with both the Evening Mail and the Birmingham Post running the story. The ballot was also reported on Midlands Today during the 6.30pm News and on News Bulletins on Radio WM. Our very own Ken Taylor did a 10 minute slot on New Style Radio 98.1FM on Saturday evening at 8.40pm with Marie Welch, a mother and very active member of the City Hospital Supporters Group. For those of you who are unfamiliar with the station, it is based at the Afro-Carribean Millenium Centre where the big debate took place earlier this year.

The Birmingham Post coverage has some excellent quotes from an unnamed City Hospital consultant. In contrast, the Birmingham Mail's coverage contains some ridiculous quotes from a spokesman for the Trust.

"We accommodated the work of the group during the consultation. Now the board has made its decision, it is no longer appropriate for the group to continue using trust facilities and premises to try and force the board to reconsider its proposals."

said head of communications, Jessamy Kinghorn. It is really a sad state of affairs when staff are banned from using Trust premises while attempting to maintain high quality care for their patients if it goes against Trust Board Policy.

Who exactly do you think is guilty of a conflict of interest? Leave your answer in the comments below.

Informing the Trust of the result.

2007-06-25T16:28:00.000+01:00

Today a letter should have reached the Chief Executive and I copy it here for all to see:

Mr. John Adler Chief Executive,
Sandwell&West Birmingham Hospitals NHS Trust

Dear John,
I am writing to formally let you know the method and result of this ballot. The list of consultant staff ballotted was the current list used by the Medical Staff Committee. Each consultant was allocated a number which appeared on the ballot paper and also on the envelope in which the paper was returned. I enclose a copy of the ballot paper. These were sent out the week commencing the 4th June and the closing time was 5pm on the 20th June.

The count took place at the Afro-Caribbean Millennium Centre and the Independent Referee was Mr. XXXXX of the Birmingham Council Health Scrutiny Committee. All the ballot papers received were in envelopes. The envelopes were opened and the ballot papers arranged in numerical order. A check was made to ensure that there was only one ballot paper with each number, and there were no papers without numbers. All the ballot papers had the preference clearly marked.

The number of ballot papers returned was 98 giving a percentage return of 59.7%. 95 of those papers were in favour of the motion i.e. 96.9%. There were two papers cast against the motion and one abstention. The votes in favour of the motion expressed as a percentage of the papers sent was 57.9% this being the overall majority. Thus in the event of all the non-voters having voted against the motion those in favour would still have carried the day.

This is a very clear cut result with good participation, an almost unanimous result on the votes cast and an overall majority.

The message from the consultant staff is absolutely clear. It is that they supported the prospect of the new hospital on the Grove Lane site, but rejected the current interim reconfiguration proposals to move Paediatric and Emergency Surgery and Trauma beds from City to Sandwell Hospital.

In the light of this result I call upon the Trust to reconsider the options available for any interim reconfiguration and select one that does not impact upon the emergency service provision of City Hospital.

Yours sincerely,

Dr. Ken Taylor

On behalf of City Hospital Supporters Group.

cc. Secretary of State for Health and others.

I am sending a copy of this letter to all members of the senior medical staff at City Hospital and no doubt they will be discussing the situation in the near future.

It's Almost Unanimous!!!

2007-06-21T22:49:00.000+01:00

At last the senior doctors at City Hospital have expressed their verdict on the Trust's proposals for a new hospital on the Grove Lane site, and in the interim moving inpatient Paediatric and Emergency Surgery and Trauma beds to Sandwell.

95 out of 98 effectively said YES to the new hospital and NO to moving the beds. For the mathematically inclined this is a 96.9% majority of the votes cast. 164 ballot papers were issued using the current medical staffing list for City Hospital giving an absolute majority of 57.9% or in other words if all the non-voters had voted against the motion it would still have been carried. The count today was supervised by an independent referee.

We now have a situation where however flawed the consultation, the proposal to move the Surgical beds was rejected 47.2% to 31.4% and the Paediatric beds 45.6% to 29% by those in the community consulted. In view of the very obvious ethnic issues the Commission for Racial Equality is involved. The Emergency Surgical proposal has been strongly criticised by the City Council Health Scrutiny committee and referred to the Secretary of State, and now the consultants at City have spoken with one voice endorsing the view of those consulted.

Can there be a louder or clearer message to those managing the Trust?

Would the majority of senior doctors have rejected the interim reconfiguration proposals if they had felt there were essential reasons for moving the beds to Sandwell?

Now is the time for the Trust to be reviewing the situation. There ARE other options. PROTECT the emergency services to the local community. The people NEED them.

Can somebody, anybody tell me why oh why are we having to fight to prevent something really important being taken from those with the greatest need?

I now understand what Julian Tudor Hart meant. He is an eminent and greatly respected Welsh GP. He is a youthful octogenarian but an angry one who invented the" inverse care law" back in 1971.

This law states that "those people most in need of health care tend to receive the poorest service."
This must not happen in this great City of Birmingham to our people, and we must do all in our power to prevent it happening.

A final point, it would be good to hear from some of you reading this blog. If you click on comments at the end of this piece you can have your say. I know people are worried about identifying themselves, so just adopt a pseudonym or perhaps use a christian name. This website is for all those people who wish to stand up and support good hospital care for the people local to City Hospital.

Fears About Confidentiality of the Ballot

2007-06-19T21:04:00.000+01:00

As the ballot of senior medical staff reaches its final day tomorrow I have been talking to colleagues and urging them to vote. The ballot closes at 5pm so if you have not voted take your envelope to the Postgraduate Centre in person please.

There clearly are concerns about confidentiality. I must emphasise that the ballot papers must be numbered so we can prove to the independent referee that nobody has voted twice. We can tell who has voted but assuming everybody puts their ballot papers in sealed envelopes with numbers on the outside we simply tick off the list that they have voted and do not open the envelopes.

The count will be held at the Afro-Caribbean Millennium Centre on Thursday 21st June at 11am. The independent referee is Mr. Darren Wright the Principal Officer of Birmingham City Council Health Scrutiny Committee. The Trust have been invited to send a representative but they have declined. The list of names will be sealed away before the envelopes are opened and I will store them safely just in case an independent review were demanded. I would ensure that no member of Trust management ever had sight of these lists.

Trust Board Decide to Engage Consultants

2007-06-17T10:37:00.000+01:00

Ken Taylor's ballot of the Consultants at City regarding the interim reconfiguration plans really seems to have got the wind up the Trust board. The following letter went out to all consultants on the 13th June 2007 (click here for original copy).

Sandwell & West Birmingham Hospitals NHS
NHS Trust

Chief Executive
': 0121 507 4847
Fax: 0121 507 5636
Email: john.adler@swbh.nhs.uk

To: All SWBH Consultants
cc: Executive Team, DGMs

13 June 2007

Dear Colleague

Shaping Hospital Services for the Future

Those of you based at City Hospital may have received a letter from Ken Taylor proposing a ballot of City consultants on the Trust’s plans for service configuration change in advance of the “Towards 2010” plans for a new hospital. In the light of this I am writing to remind all consultants whether based at City or Sandwell where we are in the process with these important plans.

Our plans for change in pathology, paediatrics, neo-natal care and surgery have been developed over the last 18 months following extensive discussion with clinicians from the services involved. As this work has proceeded there have also been many opportunities for the wider clinical body to contribute to the discussion which many of you have taken. Finally, as you will be aware, we carried out a four month formal public consultation on the plans that concluded in mid-March 2007.

As a result of ongoing work with clinicians and in the light of the outcome of the consultation the final proposals recommended to the Trust Board incorporated a number of important changes:

· the Paediatric Assessment Unit at City Hospital will be open for 24 hours a day;

· there will be a 24 hour Surgical Assessment Unit at City to increase support for A&E and reduce the numbers of patients needing transfer to Sandwell;

· elective colorectal surgery will be retained on both sites to ensure there is support for gynae-oncology at City Hospital.

The Trust Board approved the plans for change at its meeting in May. The Birmingham local authority scrutiny committee referred the proposals for emergency surgery only to the Secretary of State and we are waiting for confirmation of the next steps in this process. The rest of our proposals were not referred and can therefore proceed. The ballot that Dr Taylor is seeking to organise does not have any formal status as part of the Trust’s decision making on these plans.

For those of you who have received Dr Taylor’s letter, there are two particular points that I would like to stress.

Firstly, the Trust has strong support for the plans for a new hospital and is moving rapidly in developing these further. In addition to longstanding support from our PCTs, and public support shown through the consultation, we have also recently had renewed confirmation of SHA and DoH support for the programme at their latest review of the plans. I am also pleased to be able to tell you that the Trust Board approved the business case for the purchase of the land on which the new hospital is to be built at its meeting last week. This business case will now go to the SHA for their approval. Work on the detail of the plans for the new hospital is also well underway as part of the process of preparing the hospital outline business case for submission in March 2008.

Secondly, the steering groups and the executive team carefully considered the range of possible options for change in both paediatrics and neo-natal care and in surgery before deciding to proceed with these plans. We are clear that we have identified the best options available to us. The plans for a single paediatric inpatient unit at Sandwell have been developed alongside the plans for developing the neo-natal unit at City and taken together include significant capital and revenue investment in these services. The plans for emergency surgery were developed alongside plans for bringing elective surgical services together and are designed to make the best use of the theatre capacity available to us at each of our sites. We believe that the proposals approved by the Board provide the best way forward for our services and now want to focus on planning for implementation so that we can get on with developing our services for the future.

The proposition on the ballot is essentially for the status quo. It is of course entirely up to each consultant whether you wish to participate in the ballot at all and if you do, which way to vote. I trust, however, that this letter has helped ensure that you remain up to date with our progress on these plans and are presented with a full and accurate statement of the position. As always throughout this process, if you have any questions or wish to discuss further please do not hesitate to contact me,

With best wishes.

Yours sincerely,

John Adler
Chief Executive

Isn't it amazing what it takes for a Trust Board to engage its consultants?
*******************************
I am going to respond to some points in John Adler's letter:

In his second paragraph the Chief Exec. talks about extensive discussion with clinicians from the services involved. He is presumably referring to the Sandwell-based Medical Director and Sandwell-based Clinical Directors in Paediatrics and Sandwell-based surgeons? I have been getting a very different message from the City-based clinicians. At no time has the Trust balloted the senior medical staff at City on their proposals.

The consultation was fundamentally flawed. It did not address the multi-ethnic population served by City Hospital. It did not tell the community that if they had an ill child or a surgically ill adult although they would be assessed at City Hospital, if they needed to stay in hospital longer than 24 hours they would need to be moved by ambulance to Sandwell Hospital. This would be the only population in Birmingham subject to this inferior form of care, and it would not be suffered by people going to Sandwell Hospital with the same problems. Are these plans really tenable expressed in this way?

However in spite of consulting the wrong population and not providing them with the full facts, the proposals were still resoundingly rejected.

The Chief Exec. omits to mention that the Commission for Racial Equality are now involved in the reconfiguration plans.

How the Executive Team have concluded that they have the best options for Paediatrics and Emergency Surgery is a complete mystery. The best options for whom? Not for the poor people of West Birmingham. Not for City Hospital.
I think it means the Trust has a very different agenda. and the sooner we understand what that agenda is the better.

There has to be a very real concern after what has happened in Coventry with the Walsgrave PFI. The local health economy is going to have to find many millions of pounds and there will be severe cutbacks at the hospital. One has to ask the question well what about the new University Trust PFI here in Birmingham? It is a bigger project than Walsgrave. How will that black hole be financed? Could it be at the expense of City Hospital and the population it serves? What chance of another big PFI happening in the near future in the Birmingham area? Can anybody answer these questions please? Would it not be sensible to maintain the status quo at City Hospital until that new PFI happens as the Executive Team try to assure us it will?

Ken Taylor. Posted 00.15hrs 19th June.

Vote, Vote, Vote!

2007-06-14T10:16:00.000+01:00

This is a timely reminder to all the senior doctors at City Hospital to make sure that they vote in the secret ballot and return their voting papers by next Wednesday 20th June.

The Motion is lengthy for good reasons but the message is very simple:

We are FOR investment in a nice new hospital on the Grove Lane site.
We are AGAINST moving the Children's beds and the Emergency Surgical and Trauma beds from City to Sandwell Hospital while we wait for the new hospital.

There is a simple choice for voters, IN FAVOUR or AGAINST.
There is no option for those who are undecided except perhaps not to vote. I would like ALL those eligible to vote. Naturally I would prefer them to vote in support of the motion. However actually voting is the most important thing. Disagreement among human beings is essential for progress. We learn from different views being expressed. It is a great strength of the human race. It is how we resolve our disagreements that is important. Letting people decide at the ballot box recognises that the majority must determine what happens in a fair and free vote.

Why a secret ballot? It takes all outside pressures off the voters. Each individual can follow his/her conscience without fear of peer pressure or reprisals from any quarter. No names are required just a cross on the paper.

The ballot papers are numbered to ensure no duplicates. The sealed envelopes are numbered so they can be ticked off from the list to ensure people have voted. These lists will not be available when the sealed envelopes are opened and will be destroyed when our independent assessor from outside the Trust is content all is in order.

DO MAKE SURE YOU VOTE!!!

Adler Anger at (Genuine) Consultation

2007-06-12T20:23:00.000+01:00

Ken Taylor has been organising a ballot for the Consultants at City on whether or not they support the Trust's interim reconfiguration plans. This seem to have put the wind up the Trust Board a little, as can be seen in the following letter to Ken Taylor from the Chief Executive (click on the letter to enlarge).

Ken has responded to the letter in the following fashion (a printable copy is available here):

Mr. John Adler,
Chief Executive,
Sandwell and West Birmingham Hospitals NHS Trust,
Trust Headquarters,
City Hospital,
Dudley Road,
Birmingham B18 7QH. 11th June 2007.

Dear Mr. Adler, Re: Ballot of City Hospital Consultants.

I was really disappointed to receive your letter today, both with regard to its content and its tone. In organising the ballot, City Hospital Supporters are giving the consultant medical staff at City Hospital the opportunity to express their opinion on the plans for the new hospital and the service reconfiguration in a truly democratic, fair, private and time-honoured way. We have done our best to make sure the doctors are aware of all the new developments such as Race Equality issues and the matter of the Birmingham City Council Health Scrutiny Committee’s response to your proposals, as well as the resounding rejection of the reconfiguration plans by the consultation process flawed as it was. There are ethical issues here for doctors who do have a wider responsibility to all members of the community served by the hospital. We also pointed out to them that apparently the West Midlands Strategic Health Authority is already under the impression that your proposals have clinical support, although admittedly they do not state where that support is based, and how it was obtained. Surely some clarification now would be most timely?

I would like to reassure you that Trust resources are not being squandered by City Hospital Supporters. The cost of materials such as paper and envelopes is being borne by Unison or City Hospital Supporters. This was made clear to ***** at the start of the campaign. I am sure ***** has only done things for us in her own time, because I know she comes into the hospital very early at around 7am. If we owe any money to the Trust, it will be reimbursed.

This ballot could go either way. We have given the consultants a choice. It was our intention to ask you to nominate a person to represent the Trust at the count to ensure that all was in order. This offer still stands. However if you do decline to nominate somebody we shall identify an impartial and respected individual to perform this task.

Your letter to me is very clear indeed. In response to your final paragraph I would simply say that when the Trust produces plans that address the health care needs of all of the populations of both City and Sandwell Hospitals in a fair and equitable manner, we will be able to campaign for the Trust and not against it. I look forward to that time.

Yours sincerely,

Dr.K.G.Taylor MD.,FRCP
On behalf of City Hospital Supporters Group

Ken and I would be very interested to here your opinion on these matters. The use of the comments facility below is positively encouraged.

Information or Propaganda?

2007-06-08T12:08:00.000+01:00

I have just been reading the June copy of Heartbeat which is apparently the pulse of Sandwell, City and Rowley Regis Hospitals. The editorial team are certainly not short on hyperbole when it comes to reporting progress on Towards 2010 and the Interim Reconfiguration proposals. The story is only from one side, with no reference to opposition or indeed facts that inconveniently do not fit the party line.

Would staff have been interested in a few pertinent facts? I can think of a few examples: Such as how does the population affected by the Interim Reconfiguration relate to the population responding to the Shaping Hospital Services for the Future paper that sets out how services would change in the interim. Well only 15.6% of respondents were from the ethnic minorities, whereas the inpatient ethnic minority population at City from the Trust's own data on its website is running at 45.9%, a threefold difference! No comfort for the Trust here. The best way to have targeted these people would have been to consult them as patients on the wards, in outpatients, and in their general practitioner's surgeries. This did not happen.

Interpreters would have been needed and instead of talking about concentrating inpatient Children's services and Emergency Surgery services at Sandwell Hospital they should have explained that if they had needed to remain in hospital more than 24 hours they would face being moved by ambulance to Sandwell Hospital or elsewhere. I cannot visualise them lining up to say yes to that proposal!

How about one or two more consultation facts. When people were asked about whether they agreed with the proposed changes for surgery 47.2% said NO and 31.4% said YES. The NOs have it in spite of consulting the wrong population. Interestingly there were very similar figures for the proposed changes to children's services, 45.6% said NO and 29% said YES. Do you think it is just remotely possible that if they had consulted the right population even more would have said NO?

I looked very hard in Heartbeat to see if they had included a mention of the Birmingham City Council Health Scrutiny Committee decision on the Interim Reconfiguration plans, and the fact that the committee had referred the Emergency Surgery proposals to the Secretary of State and proposed that an Independent Reconfiguration Panel is convened. No that has not reached consciousness either, or if it has, it has been conveniently airbrushed away.

Heartbeat cannot claim to have the pulse of City Hospital until it accurately presents the facts whether they are palatable or unpalatable. I suspect an independently minded editorial team is needed. I would welcome the opportunity to write the front page for the July edition? Is anybody listening out there?

Finally I received another glossy brochure about Towards 2010. today. It presents an analysis of the public consultation, (I wonder how much this little lot has cost?) There were some additional papers entitled Public Consultation on the 2010 Proposals. There is a section "Service Transition" and it states and I quote "It has been a longstanding principle for the 2010 Partnership that the proposed new acute hospital needs to be almost the final element of the system to be put in place . This is based on the recognition that any other sequencing could mean that the new hospital was too small to cope with demand in the absence of the proposed community services."

Well what do you make of that? I am trying to get my mind around the timescales. Presumably the idea is that all the health centres, community facilities and community hospitals will be built and up and running by 2010 giving 3 years to build the new hospital so that it could be open by 2013??? Does this sound realistic? It sounds as if the money for the new hospital will be raised later, as you would not want to raise PFI money until you actually need to spend it. What happens if we cannot afford the last stage at all, or can only afford half a hospital??

Why not keep what we've got, ensure that the developments in the community go together with the new hospital build simultaneously, and work our socks off to achieve this as soon as possible?
I suspect people would feel that this a plan we could all get behind!

Medical Director Misleading Everyone?

2007-06-05T17:03:00.000+01:00

When Dr Hugh Bradby was being interviewed on The Politics Show on Sunday 3rd June I believe that he misled the viewers. The piece opened with a brief interview with a gunshot victim that had been successfully treated at City Hospital. The patient made the point that City Hospital had saved his life. It moved on to a view of the A&E Department at City as the commentator said the management wanted to move the main Emergency Surgery Service to Sandwell Hospital while establishing a 24 Hour Surgical Assessment Unit and management maintain that this is an improvement. They then cut to Dr. Bradby being interviewed at Sandwell. He said "I would want treating where the best facilities were and all the evidence shows that you are far better off travelling further away to the best resourced department than you are to a local department that perhaps does not provide you with as good a service."

This is an outrageously misleading statement. What better resourced department is he talking about? Is he talking about the A&E Department at Sandwell? He cannot be because the patients referred to would be sorted out in City Hospital's A&E Department and the 24Hour Surgical Assessment Unit. If the plans go through they would then move to a ward bed at Sandwell if they needed longer than 24 hours in hospital. Currently patients are admitted to a bed at City. Is he telling us that Sandwell Hospital has better wards, more and better nurses, more and better doctors, less infection on the wards than City Hospital? If he is where is the evidence?

In fact patients moved to Sandwell Hospital will receive similar care to that delivered at City but they will have suffered the risks and inconvenience of an additional ambulance journey with all the attendant problems for their relatives. This extra journey would be occurring because the Trust has decided to make changes to emergency services that are not in the best interests of patients. This will not be better care but worse care that is why City Hospital Supporters are so opposed to it.

SWBH Plans Featured on The Politics Show

2007-06-03T22:07:00.000+01:00

The Politics Show had a piece today about the controversial plans being considered at Sandwell & West Birmingham Hospitals NHS Trust. If you missed the program do not worry; you can watch the programme by clicking on this link and pressing the latest programme button on the right hand side (this should be available for the next week). The article starts 10 minutes 20 seconds in, although you may be interested in the piece on euthanasia which precedes it.

The programme started by interviewing an anonymous man who had been treated at City A&E for gunshot wounds, underlining the point that we are moving away emergency general & trauma surgery beds from an area with a high gun crime and stab wound incidence rate. When added to the fact mentioned by Councillor Deirdre Alden that when the General Hospital closed, Dudley Road Hospital was renamed City Hospital and we were told it would be the hospital for Birmingham City Centre, we have the main reasons why the interim reconfiguration proposals are so ridiculous. We reiterate again that we are not against the building of the new hospital and the investment outlined in Towards ~~2013/14~~ 2010. We simply want to ensure that until the new hospital is built, and we have some proper plans for it instead of just spin and conjecture, services should remain at the same high quality they are now.

When Sue Davies, Trust Chair, responded to this point she said that Birmingham had three hospitals and so there was a choice where you can go. This completely misses the point. If you are being admitted for emergency surgery, you do not choose where you go. The Ambulance service takes you to the most appropriate local hospital. At the moment they can take you to City, which is roughly 10 minutes away from the City Centre. In future, they may decide to spend another 15 minutes taking you further down the road to Sandwell Hospital, or more likely take you to Heartlands or University Hospital. Either way, whether you are the victim of gun crime in Winson Green or have an accident in Birmingham City Centre, it will take the Ambulance longer to get you there.

Hugh Bradby, the medical director at SWBH, again used the argument that one is better off travelling further away to the best services rather than being treated locally in poorer facilities!!!! I have pointed out on this blog before in a previous post that I believe this statement is misleading. Currently we have acceptable facilities at both sites to manage emergency surgical and paediatric patients. It is the Trust that want to reduce these facilities at City and concentrate them at Sandwell, so the choice is really between being able to keep the patient at the same site where everything can be done or then having to move them to a new site after an arbitrary period of time.

Another quote, this time from the programme was by Marie Welch, a mother of four who has two children with special needs. In response to the replacement of emergency paediatric beds with a 24 hour PAU at City she said to the Trust:

"If you lived my life, walked in my shoes you wouldn't do what you're doing. It would stay."

Sue Davies' response to this was that more and more children are now being treated in the community rather than in hospital beds. However, there is currently a shortage of paediatric beds in Birmingham which will be made worse by these proposals. We already see children being transferred to hospitals outside the City due to paediatric beds being at full capacity.

I must be honest that I felt a bit sorry for Sue Davies. The lady did not look comfortable defending the indefensible.

The presenter finished by pointing out that there is another Dr Taylor in the region who is an MP as a result of plans to change the local hospital services. Would Ken consider running for MP, he asked? Dr Ken Taylor replied that he was ruling nothing out!

I guess we will have to see what the outcome is of the referral of the surgical plans to the Secretary of State and the overall proposals to the Commission for Racial Equality.

The Politics Show

2007-05-31T17:26:00.000+01:00

Make a date with BBC1 on Sunday 3rd June between 12 noon and 1pm. City Hospital will be featuring during the hour so turn down the oven, put your feet up and see what you make of it. Alternatively don't forget to record it so you can watch it later. I believe that there will be a longer slot than is normally available on TV News.

Surgery Plans Referred to Secretary of State

2007-05-29T20:08:00.000+01:00

Councillor Alden and the Birmingham Council Health Scrutiny Committee have given their judgement on the Trust’s proposals for Emergency Surgery and Trauma. It is a resounding rejection in no uncertain terms. The case for the people local to City Hospital continuing to have access to the same level of emergency care without having to face additional ambulance journeys while they wait for a new hospital has been upheld, and quite rightly so. Why should those with the greatest health care need have to put up with the worst service?

Now it’s over to the Secretary of State for Health. We must all hope and pray that Mrs. Hewitt convenes the Independent Reconfiguration Panel which she is empowered to do. We can then present our evidence to this Panel which is increasing in quality and quantity by the day. Of course there is always the possibility that the Trust might decide to “review the situation” and choose an option that preserves the emergency services for the people. Wouldn’t that be the most sensible way forward for all concerned? Let’s get on and make 2010 happen as soon as possible. Surely that would be best for everyone!

Ken Taylor, City Hospital Supporters Group, 29/05/2007

Chairman
Health Overview & Scrutiny Committee
Birmingham City Council
The Council House
Victoria Square
Birmingham B1 1BB
Tel: 0121 464 7457
Fax: 0121 303 4555
E-mail: deirdre.alden@birmingham.gov.uk

Right Honourable Patricia Hewitt MP
Secretary of State
Department of Health
Richmond House
79 Whitehall
London SW1A 2NS

18/05/07

Our Ref: DW/DA/SWBHREF
(Please quote in your reply)

Dear Minister

Referral of Sandwell and West Birmingham Hospitals NHS Trust Shaping Hospital Services for the Future Consultation

I write to inform you that the Birmingham City Council Health Overview and Scrutiny Committee is referring the decision by Sandwell and West Birmingham Hospitals NHS Trust’s proposals to consolidate all of the Trusts emergency surgery provision at its Sandwell hospital site. This referral is made under Section 4(7) of The Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulations 2002.

The Committee feels that the part of the Shaping Hospital Services for the Future Consultation relating to the provision of Emergency Surgery will result in a reduction of service for the people of Birmingham and is not premised on clinical need. In evidence provided to Birmingham and Sandwell Joint Health Overview and Scrutiny Committee the Trust stated that currently the greatest need for emergency surgery is located on the City Hospital site. The Committee does not believe that the decision to consolidate emergency surgery on the Sandwell Hospital site has been taken with patient safety as the prime concern.

The consultation process carried out by the Trust clearly demonstrates that the proposals for surgery set out in the consultation document were opposed by the majority of respondents. The Committee does not believe that the twenty four hour surgical assessment unit announced by the Trust as a result of the consultation is a sufficient variance of the original proposal and will still result in a substantial diminution of service for one of the most deprived areas of Birmingham.

In addition the Committee believes that Sandwell and West Birmingham Hospital NHS Trust have not demonstrated a clear case as to why emergency surgery could not instead be consolidated on the City Hospital site. We feel this option should now be considered as a matter of urgency in order to safeguard the welfare of Birmingham patients. The Committee also believes that any decision taken by the Trust should be based on demographic and geographic indicators.

The Committee is extremely concerned that the decision to proceed with the proposals is not in the interest of patients in Birmingham and is contrary to the views expressed in the consultation process. The Birmingham City Council Health Overview and Scrutiny Committee requests that the decision is referred to the Independent Reconfiguration Panel as soon as possible.

I look forward to your response in this matter.

Yours sincerely

Councillor Deirdre Alden
Chairman of Health Overview and Scrutiny Committee

CC Cynthia Bower - Chief Executive – NHS West Midlands
CC John Adler - Chief Executive - Sandwell & West Birmingham Hospitals TrustCC Tony Shaw – Chief Executive – Independent Reconfiguration Panel

NB: A printable version of this document is available at the following address:

http://docs.google.com/Doc?id=dr2jf65_11hfr6wp

An Open Letter to the SHA

2007-05-23T22:39:00.000+01:00

The following letter regarding moving Paediatric and Emergency Surgery and Trauma beds from City to Sandwell Hospital as part of the interim reconfiguration plans was sent to the Strategic Health Authority, the Birmingham Mail and to all staff at City Hospital. A copy was also sent to the Commission for Racial Equality today. The document referred to in the letter can be found here. The Birmingham Mail's coverage of the letter is available here.

Ms. Elisabeth Buggins,
Chairman West Midlands Strategic Health Authority,
St. Chad’s Court,
213, Hagley Road,
Birmingham B16 9RG. 20th May 2007.

Dear Ms. Buggins,

Re: Sandwell and West Birmingham Hospitals NHS Trust’s Interim Reconfiguration Proposals - Shaping Hospital Services for the Future.

I am writing to you on behalf of the City Hospital Supporters Group and this is an open letter that is being simultaneously passed to the Birmingham Mail. You may know that we are a group composed of members of the community served by City Hospital and also members of staff from across all the staff groups of the hospital. The one commitment we all share is to ensure that local people can rely on continuing to receive a high quality hospital service. We support the 2010 proposals for the new hospital combining both City Hospital and Sandwell Hospital on the Grove Lane site. We are only too well aware that this exciting new development is still only at the very early planning stage, and many things could happen in the next few years that could jeopardise or delay its opening. At the moment it is not projected to open before 2013/14.

City Hospital Supporters feel very strongly that patients at both City and Sandwell Hospitals should continue to receive the same quality of service while they await the new build. The Trust’s Interim Reconfiguration Proposals do not threaten the services provided for the population of Sandwell Hospital, but unfortunately they do threaten those services for the population served by City Hospital. The Trust’s initial proposals that went out to consultation would have moved Emergency Surgery and Trauma beds to Sandwell and Paediatric beds providing only a 12 hour Paediatric Assessment Unit at City Hospital. As a result of our campaign on behalf of local people the consultation period was increased by a month, the 12 hour Paediatric Assessment Unit became a 24 hour unit and finally they decided to provide a 24 hour Surgical Assessment Unit. However these proposals are still fundamentally flawed.
I believe you will find that the Trust’s Reconfiguration Proposals conflict with their own Race Equality Scheme May 2005-April 2008 which is easily accessible on their website. The following data have come from this source. It states that 20% of Sandwell residents and 30% of Birmingham residents are from Black and Minority Ethnic groups. Ladywood, Handsworth, Soho and Aston have significantly higher proportions of Minority Ethnic residents: 49%, 81.5%, 76.2% and 70.6% respectively. They go on to look at the percentage of Black and Minority Ethnic inpatients by hospital in 2004-2005. The figures for Sandwell Hospital are Black and Ethnic Minorities 13.4%, White 70.5% , Unknown 16.1%. For City Hospital the figures are very different: Black and Ethnic Minorities 45.9%, White 45.4% and Unknown 8.7%. They admit that Sandwell’s data is not as good but even if we were to assume that all the unknowns at Sandwell were Black and from the Ethnic Minorities there total figure would only be 29.5% compared to 45.9% for City. If we exclude the Unknowns it is Black and Ethnic Minorities at City Hospital 45.9% against 13.4% at Sandwell Hospital! A more than threefold difference!

In paragraph 4.1 the policy states and I quote “Equality for Sandwell and West Birmingham Hospitals NHS Trust means that all members of our community and workforce must have equal access to the services and opportunities offered by the Trust regardless of gender, race, ethnic background, disability, religion, sexual orientation or age.” In the paragraph under Meeting the Specific Duties it states in 6.1 “To assess its existing policies and service delivery for any adverse impact on the promotion of race equality. Crucially under paragraph 6.2.3 it says and I quote “if impact assessments show that a current policy, service or function results in greater adverse impact, or if opportunities arise which allow for greater equality of opportunity to be promoted, the Trust will ensure that the policy, service or function is revised and targets are set to reduce or eliminate disadvantage.”

Now I can hear you asking where is this all leading? Well it is very simple. If the Trust were to implement its plans for moving inpatient Paediatric and Emergency Surgery and Trauma beds from City Hospital to Sandwell Hospital and establishing 24 Hour Assessment Units in Paediatrics and Surgery at City, we would argue that they would be treating the City Hospital patients that have a different ethnic balance to Sandwell in a different way. In particular they would be exposing two thirds of the Emergency Surgical patients and two thirds of the children brought to City Hospital A&E and needing admission, to transfer by ambulance to Sandwell Hospital or if no bed were available there, to another hospital. The ambulance journey would not be to better care i.e. an ITU or HDU bed, but simply for managerial and financial convenience. It would be an ambulance journey not for the benefit of the patient but for the benefit of the Trust and would undoubtedly put City Hospital patients with their higher Black and Minority Ethnic mix at greater risk than the patients with a different ethnic mix admitted to Sandwell Hospital. We believe that this conflicts with the Trust’s Racial Equality Policy and we presume the Commission for Racial Equality would be of the same view. The Trust did consider five options before selecting one that impacted on Emergency Services producing a differential effect on the two hospital populations. City Hospital Supporters believe that now is the time for the Trust to choose an option that does not impact upon Emergency Services at all, and does not involve moving significant numbers of ill patients, children or adults unnecessarily.

Needless to say this will form part of the evidence we will be giving to the Independent Reconfiguration Panel. Under the circumstances we feel that there should be no move of Inpatient Paediatrics from City Hospital to Sandwell Hospital while the situation is being satisfactorily resolved. I would appreciate an early reply on this most worrying situation.
With kind regards,

Yours sincerely,

DR. K.G.TAYLOR

City Hospital Supporters Group.

cc. Cynthia Bower
Sue Davis
John Adler

The Achievements of City Hospital Supporters

2007-05-20T11:23:00.000+01:00

Since it came into being during the second half of 2006 we have made a number of achievements of which we can be proud:

1. The consultation period was increased by one month.

2. The proposed 12 Hour Children's Assessment Unit at City Hospital was increased to a 24 Hour Unit.

3. A 24 Hour Surgical Assessment Unit was introduced towards the end of the consultation.

4. We have achieved a referral to the Secretary of State for Health by the Birmingham Council Health Overview and Scrutiny Committee of the Emergency Surgery proposals (to move the inpatient beds from City to Sandwell)

This represents good progress but we need to achieve more. City Hospital Supporters cannot rest until we have ensured equality of service provision to patients across the Trust especially when it comes to Emergency Services.

You can show your solidarity with us now! Visit the website every day as the story is very fast moving. Pass details of the website to friends and colleagues. Get contact details of those who want to join our great enterprise and let me have them.

Good News and Bad News.

2007-05-18T18:12:00.000+01:00

The combined Health Overview and Scrutiny Committees for Birmingham and Sandwell Councils met at the Sandwell Council House at 10am today with representatives of the Sandwell and West Birmingham Hospitals NHS Trust.

The Trust had arranged for their appointed medical experts all Sandwell based doctors to be there with one very notable exception, Mr. Peter Ahee the Director of A&E at City Hospital. Dr. Ken Taylor was present representing City Hospital Supporters and he was permitted to contribute to the meeting.

The QUAD team again presented their data on the consultation. There was some discussion on the Towards 2010 proposals but there was general support for the new hospital but concern about how the proposals for the community component would function with the hospital.
The reconfiguration proposals were then discussed after the QUAD team had again presented the consultation results demonstrating very significant opposition to the Trust's proposals on Emergency Surgery and Paediatrics at City Hospital. Great concern was expressed that the data indicated that there had been inadequate participation by the ethnic minorities in the consultation process. It was appreciated that had more of this population expressed their views it would have made opposition to the proposals even more overwhelming.

The debate that followed on reconfiguration was extremely lively with the Chair of the Birmingham Committee Deirdre Alden expressing the very great concerns her councillors had about both Emergency Surgery and Paediatrics. Peter Ahee the Director of A&E at City once again made clear to Councillors that two thirds of the children, and two thirds of adults with surgical illnesses brought to City Hospital A&E would have to move by ambulance to Sandwell or elsewhere because they needed to stay in hospital longer than 24 hours. This is a key point as these patients would be subject to unnecessary ambulance journeys that would put them at increased risk.

I spoke briefly at the end of the meeting making clear City Hospital Supporters were fully supportive of the new hospital on the Grove Lane site. Our concern was to ensure no deterioration to emergency service provision at either hospital while we awaited the new hospital which was no more than a preliminary plan at present. I made clear that unnecessarily moving patients in ambulances and exposing them to increased risks was not acceptable especially as the Trust had rejected options that would preserve fully supported emergency services on both sites. I pointed out that however flawed, the consultation had roundly rejected the Trust's plans. I also mentioned that our petition had supported 24 hour Assessment Units in Paediatrics and Surgery and opposed moving beds in these specialties from City to Sandwell.
This meeting ended shortly afterwards at about 12.10pm.

The Birmingham Councillors then met until about 1.10pm and I was fortunate to be present when Councillor Alden announced the results of their deliberations. Emergency Surgery was to be referred to the Secretary of State for Health. The Scrutiny Committee were very concerned about the proposals for Paediatrics and she would be writing to West Midlands Strategic Health Authority to express her concerns. I believe there was mention of some monitoring and also some conditions. I will be seeking early clarification on these issues.

We now have a further great opportunity to influence the debate in the interests of patients. We will make sure that we present evidence to the Independent Reconfiguration Panel that will presumably be convened by the Secretary of State. The decision on Paediatrics is a setback but there are several avenues to be explored in this area, and this you can rest assured, we will be doing. Watch this space!

Tomorrow a Day of Decision for the Health Scrutiny Committees of Birmingham and Sandwell

2007-05-17T11:35:00.000+01:00

City Hospital Supporters are not against modernisation and change but it must not increase risks to patients living in Birmingham or Sandwell. The Sandwell and West Birmingham Hospitals NHS Trust made public a letter from the Chief Executive of the West Midlands Strategic Health Authority to the Chief Executive of the Trust dated 3rd May 2007 at its Trust Board Meeting last week. In that letter the Strategic Health Authority list nine tests that must be satisfied in their minds in order to gain their support for the Trust proceeding with its reconfiguration proposals. They are of the view that these tests have been satisfactorily met. We would argue about tests 3,5,6.

Test 3 asks "Do they deliver real patient benefits in terms of quality and safety?"
We would simply ask is it safer to move sick children and adults after they have been "stabilised" at City Hospital or safer to care for them completely on one site? We believe the answer is self-evident.

Test 5 asks "Are the risks of implementing changes clearly identified and clearly mitigated?"
The Trust has not made this information public. Where is the data on ambulance travel times between City and Sandwell hospitals at different times of day? Have they done a full risk assessment? What are the risks for patients? What other hospitals in the country have such an arrangement and what has been their experience? The Strategic Health Authority needs answers to these questions as do we all.

Test 6 asks"Do they have clear support from the clinical workforce and do they respond to the future challenges of maintaining high quality clinical rotas etc under increasingly restrictive regulations?"

City Hospital Supporters KNOW that the Trust does not have the support of the Paediatricians and General Surgeons directly involved in losing inpatient services from City Hospital. We doubt that the rest of the medical staff at City Hospital truly support the Trust's reconfiguration plans. There has not been a ballot of City Hospital medical staff. The Trust has listened mainly to its appointed medical leaders not based at City Hospital. They have not listened to those directly involved.

So our hope for tomorrow is that the plans to move inpatient Emergency Surgery and inpatient Paediatrics will be referred to the Secretary of State so that the Independent Reconfiguration Panel can review the plans and listen to our concerns presented as evidence.

The Five Options For Reconfiguration Considered by the Trust

2007-05-16T11:55:00.000+01:00

Status Quo:
Option 1: Centralise inpatient elective general surgical specialties only:
Option 2: Main inpatient emergency service at Sandwell Hospital and main inpatient elective service at City Hospital (consultation proposals):
Option 3: Main inpatient emergency service at Sandwell Hospital and main inpatient elective service plus a 24 hour SAU at City Hospital:
Option 4: Centralise inpatient elective general surgery and orthopaedics but retain inpatient emergencies at both sites.

City Hospital Supporters point out that the Status Quo and Option 4 both leave fully supported A&E Services at both hospitals and would be acceptable. Option 4 would allow reconfiguration and also guarantee both A&E Departments. We believe that fully supported A&E Departments for both hospitals at least ensure a good emergency service for local people which should be an absolute core requirement of the NHS and this view was expressed in the Yvette Cooper letter reproduced below.

A Very Important Letter

2007-05-13T22:02:00.000+01:00

The following is a copy of the letter from Yvette Cooper, Parliamentary Under-Secretary of State for Health at the time of the merger between Sandwell Healthcare Trust and City Hospital NHS Trust, to Richard Steer who was Chairman of City Hospital NHS Trust at the time. It sets out conditions of the merger and I think it is quite clear in respect to the current interim reconfiguration plans for Sandwell & West Birmingham Hospitals NHS Trust - in particular

"A key feature of the merger proposals... is that the two hospitals... will continue to provide the full range of clinical services to support local Accident and Emergency Services."

Please click on the image to enlarge it.

Trust Board Meeting Review (10th May 2007)

2007-05-13T21:16:00.000+01:00

The following is an account of the public Trust Board Meeting on Thursday at which the Trust decided to ratify the interim reconfiguration plans for Sandwell & West Birmingham Hospitals NHS Trust, which plans to replace the current emergency inpatient paediatric and general and trauma surgery beds at City Hospital, Birmingham with a 24-hour Paediatric Assessment Unit, and a 24-hour Surgical Assessment Unit.

The Trust Board met at 2.30pm on Thursday 10th May with the public present in order to ratify proposals arising from both Towards 2010 and the Reconfiguration of Services. At the start of the meeting the Chair announced that the public could speak at the start of proceedings, but after that they would have no opportunity to ask questions, comment or seek clarification. Effectively they were being asked to comment on material that had not been presented to the meeting. Several members of City Hospital Supporters were present and took the opportunity to complain about this most unorthodox and undemocratic method of conducting business, and made their views on the proposals before the Board known. It seemed from what was said at the meeting that there had been a previous private meeting of the Board.

QUAD the organisation based at Warwick University were asked to present their findings on the two consultations. We then had a pseudo-scientific presentation of methodology and results. There was no mention of how they checked the questions for their suitability and validity. There was no mention of the reading age required and if it matched the reading age of the population under study. It was accepted that the ethnic mix of the respondents to the questions in the two booklets did not match the ethnic mix of the population served by City Hospital, consequently ethnic minorities were significantly under-represented. However although the process was flawed one message emerged very clearly that the population resoundingly rejected losing inpatient Paediatrics and inpatient Emergency Surgery from City Hospital. A more carefully performed study accurately representing the ethnic mix of the actual patient population is likely to have made these results even more spectacular.
The Board went on to receive a paper on Paediatrics creating a sub-regional Neonatal Unit at City for complex cases, and a more basic unit at Sandwell. Inpatient Paediatrics were to move to Sandwell with a 24 Hour Paediatric Assessment Unit at City. Two Sandwell Consultant Paediatricians told the Board that this was the way to go. There are three General Paediatricians at City Hospital plus Neonatologists but not one of them attended the meeting. Were they invited to attend and give their views? The Board accepted what they were told virtually without question and the paper was passed unanimously.

They then considered Emergency Surgery. Another paper was produced setting out the plans to move inpatient Emergency Surgery from City to Sandwell and establish a 24 Hour Surgical Assessment Unit at City. This paper was introduced by Dr. Hugh Bradby the Medical Director and Sandwell-based Gastroenterologist. He went on to ask Mr. Peter Ahee Director of A&E at City to outline the differences patients would observe if the Trust’s paper were implemented. Mr. Ahee told it as it is. If you were a sick child admitted to the Paediatric Assessment Unit or an adult admitted to the Surgical Assessment Unit, if it became clear that you needed to stay in hospital longer than 24 hours you would be moved to Sandwell. This would amount to two thirds of the children and two thirds of the adults admitted to these units. No questions were asked by the Board on what would happen if Sandwell beds were full although the hope was expressed that Birmingham Children’s Hospital might help out and I believe someone is going to have a word with them. Mr. Ahee also pointed out that the Specialist Surgical Registrar would be allowed to reside at home overnight provided he could return in 20 minutes. The Chief Executive thought that the Surgical Registrar should be required to remain resident in the hospital while the situation is risk assessed possibly up until 2009.
The Director of Surgery at City who is a Trauma and Orthopaedic consultant was called and he recommended the proposals to the Board, although he clearly stated that he was only speaking on behalf of Trauma and Orthopaedics. Then a Sandwell General Surgeon was asked to speak and he told the Board why they should vote for the proposals with great enthusiasm. An Anaesthetist, I believe from City Hospital also seemed content with the arrangements. No General Surgeon emergency or otherwise based at City Hospital was called by the Trust to speak about the subject in which they have the expertise, and which directly concerned them. The Board passed the second paper unanimously.

It is for the public to decide on the evidence presented, which I believe I have recollected correctly, if the fateful decisions taken by the Trust Board are sound. Was it a reliably designed consultation that was robust and accurately reflected the views of all the population affected? Do the decisions take due account of the very clear views expressed by the consultation data available flawed as it is? Why did we not hear from at least one Paediatrician and one General Surgeon based at City giving their honest professional views? Add to this the fact that two thirds of children and two thirds of surgical patients admitted to the respective 24 hour Assessment Units will be moved to Sandwell or elsewhere within 24 hours these decisions have got to be unacceptable. The emergency care provided for the people of Birmingham will not be as good as at present as a result of these decisions. There were four other options that were rejected in favour of the current option, and we believe that two of those options would have met the aspirations of the local community and the results of the consultation.

City Hospital Supporters would welcome a reconfiguration that would improve services to patients, and we believe this can be achieved. The Trust’s current reconfiguration will involve a diminution of existing emergency services at City Hospital.

Consequently City Hospital Supporters are calling on the Birmingham Health Overview and Scrutiny Committee at their meeting next Friday 18th May to reject the Board’s plans and refer them to the Secretary of State for Health who in turn would arrange for them to be reviewed by the Independent Reconfiguration Panel. This arrangement formed part of the conditions for approving the merger of City and Sandwell Hospitals set out in the letter shown above sent to the Chairman of City Hospital NHS Trust Richard Steer by the the Parliamentary Under-Secretary for Health at that time Yvette Cooper.
City Hospital Supporters would wish to present evidence to this Panel.

Ken Taylor on behalf of City Hospital Supporters 15/05/07

Trust Make Decision on Interim Plans

2007-05-07T12:44:00.000+01:00

On an e-mail sent to staff on Friday, the Chief Executive announced that as a result of the consultation exercises held earlier this year there will be a 24-hour Surgical Assessment Unit (SAU) and a 24-hour Paediatric Assessment Unit (PAU) at city to support the A&E department on this site. This means that the petition we submitted to Birmingham City Council's Health Scrutiny Committee has been successful. However, it also means that emergency inpatient paediatric and general and trauma surgery beds will be removed from the city site. In other words, after 24 hours after being admitted in an emergency, children will have to be transferred to either Sandwell General or Birmingham Children's Hospital, and general and trauma surgery patients will be moved to Sandwell Hospital.

If you have issues with this I suggest you turn up to the public Trust Board Meeting at the Wolfson Lecture Theatre in the Postgraduate Centre at City on Thursday 10th May 2007 at 2.30pm and make your feelings known.

CHSG Expands Campaign

2007-05-03T22:42:00.000+01:00

At the meeting of the City Hospital Supporters Group on the 24th April 2007, it was unanimously agreed that the scope of the group should be extended to include the effects of the reconfiguration plans on Sandwell Hospital and the community it serves. There are many concerns among the Sandwell staff and community about the provision of acute healthcare in the borough when the two current acute sites are merged onto a single site, which will be close to the present City location.

The main role of the City Hospital Supporters Group until now has been to increase awareness and participation in the consultation process, and to present a petition opposing the interim reconfiguration plans to Birmingham City Council's Health Scrutiny Committee. This month the Trust will announce the results of the consultations and its plans for the interim reconfiguration plans and the Towards 2010 project. It will be doing this on Thursday 10th May 2007 at 2.30pm in the Wolfson Lecture Theatre in the Post Graduate Centre at City Hospital. We would urge everyone who can make it to be present at this meeting, because it is important that the Trust is reminded of the strength of opposition to these proposals should they decide to proceed with them. A large turnout from those of us opposed to the Trust's reconfiguration plans will be a timely reminder to the Trust board that they exist to serve us, the staff and community, and not the other way round. In the recent past, it is clear that the Trust board has expected the local community to change to accommodate their plans. This was unacceptable, and although some movement has been made towards more acceptable outcomes, we still need to remind them of our concerns to ensure that we maintain the best possible acute healthcare services for the local community in the short to medium term.

Letter to CHSG Members 11/04/07

2007-04-19T19:37:00.000+01:00

The following letter was sent to City Hospital Supporters Group Members on 11th April 2007. If you wish to attend the meeting on the 24th April 2007 you would be more than welcome, even if you are not currently a member.

Dear Member,

The consultation period for the reconfiguration of services within the Trust ended on the 15th March. We marked this important milestone by presenting a petition of 1150 signatures opposing the Trust's proposals to Councillor Deirdre Alden the Chair of the Birmingham City Council's Health Overview and Scrutiny Committee. As you may know this important committee has rejected the reconfiguration proposals. As a result of public pressure so far, the Trust has changed its stance on Paediatrics and we believe they have opted for a 24 hour Children's Assessment Unit. This is better than nothing but it will not be as good as the present service. Ill children needing more than 24 hours in hospital will still have to be shipped elsewhere and ambulances may take seriously ill children elsewhere right from the start.
We await progress in surgery, and understand that the Trust is considering either a 24 hour Surgical Assessment Unit or maintaining the status quo. The latter would be infinitely preferable as the former would again mean that seriously ill people would have to be moved after 24 hours or once again the ambulance service may decide to take them elsewhere. Our goal has always been to ensure that local people do not suffer a worse service while they await the new hospital which at the moment is at least 6 or 7 years away. We are also concerned that if the new hospital either never happened, or was seriously reduced in size, services lost from the present City Hospital would never be regained for the people of Birmingham.
I believe that people within City Hospital and in the community realise that City Hospital Supporters have had an important influence on the consultation to date. I also believe that there is still a major job of work to be done (1) to ensure we get the best possible result announced in May (2) to ensure that all services continue at both City and Sandwell while we await the new hospital and (3) to ensure that the new hospital is delivered as promised. We have exclusively represented the interests of City Hospital over the reconfiguration because broadly it is the services at City Hospital that are in jeopardy. However now is the time for us to consider the full picture and I would like to see a City and Sandwell Hospitals Supporters Group. I know that many others at both hospitals share this view. In our small way we have demonstrated that ordinary people on the staff and in the community can influence events. Working together is the key. Do come to our next meeting when we will be very much considering the future.

TUESDAY 24 APRIL 12.30P.M. ANNE GIBSON ROOM CITY HOSPITAL, NEAR POSTGRADUATE CENTRE.
Yours sincerely,

Ken Taylor

Can Primary Care Reduce OP Demand?

2007-04-03T21:47:00.000+01:00

Can primary care reform reduce demand on hospital outpatient departments?

Moving care into the community and closer to people’s homes is very much the mantra of the present government. It is profoundly influencing national thinking and is an important factor in the downsizing and merging of hospitals so that they are serving larger catchment areas. There seems to be a widespread belief held with evangelical zeal in some quarters that treatment in the community clinic, or at the health centre must be in some way superior to care in hospital.

The key question that must be asked is: Where is the evidence? In fact the evidence does not exist so it is refreshing to see that the NHS Service Delivery and Organisation Research Development Programme commissioned research by Professor Martin Roland at the National Primary Care Research and Development Centre at the University of Manchester and he published the results in March 2007 in a paper entitled “Can primary care reform reduce demand on hospital outpatient departments?” The results of this research make essential reading for everybody but especially planners who are thinking of moving more outpatient services into the community. Four different approaches were examined. Transfer of outpatient services to primary care, relocating specialists into community settings, liaison between primary care and specialists and professional behaviour change.

Transfer:
· Transferring Minor Surgery to Primary Care: The Research Findings show little impact on hospital waiting times and some studies show a reduction in the quality of care.

· Transferring Primary Care clinics for chronic conditions: Health outcomes are at least as good in primary care as in hospital outpatients; well-structured GP clinics can reduce outpatient visits while improving access to care. The cost of transferring care in this way is largely unknown.

· Intermediate Care: General Practitioners with Special Interests (GPSIs): Evidence suggests that GPSI clinics provide high quality care with good health outcomes that is more accessible than hospital outpatients and involves shorter waiting times. However, the lack of uniformity in the GPSI model and in arrangements for monitoring GPSI services means that these findings are not robust. The cost of GPSI services varies widely and appears to be generally higher than the cost of specialist services. Some hospital consultants are hostile to the GPSI concept. GPSI services running without local consultant support may be unsafe.

Relocation:
Moving secondary services or specialists to primary care settings: Relocation improves access to specialist care and increases patient satisfaction. With the exception of the attachment of physiotherapists to primary care teams, this strategy has proved ineffective in reducing demand on outpatient services. It has brought no improvement in GP skills or reduction in GP workload. Due to economies of scale, specialists appear to be generally more efficient when working in hospital settings. Relocation may improve equity in care provision in remote rural areas.

Telemedicine consultations between GP and specialist: Liaison models of working may improve the quality of primary care but have little impact on health outcomes. Reduction in outpatient attendances is occasionally, but not consistently achieved. Successful delivery depends heavily on good communication between individual primary and secondary care clinicians.

Liaison:
· Liaison models of working may improve the quality of primary care but have little impact on health outcomes. Reduction in outpatient attendances is occasionally but not consistently achieved. Successful delivery depends heavily on good communication between individual primary and secondary care clinicians.

Conclusions:

“A number of potentially effective strategies have been identified that may: reduce outpatient attendance, maintain or improve quality of care, increase convenience for patients. However the evidence does not support some of the assumptions about hospital and community care made within the NHS.”

· Assumption: Care can safely be transferred from specialists to primary care practitioners.
Comment: Not true of minor surgery and not necessarily true of GPSI services.

· Assumption: Care in the community is cheaper than care in hospitals.
Comment: Often not the case. Cost evaluation should not focus purely on NHS costs but also on prices charged by providers.

· Assumption: Transferring care into the community will not increase overall demand.
Comment: There is a serious risk that increasing provision may increase demand either because of increased demand from patients or increased referral from GPs.

· Assumption: Care in the community is popular with patients and should be encouraged.
Comment: The general popularity of this policy would not necessarily survive loss of quality and efficiency.

Commentary from City Hospital Supporters:

This is an important piece of work commissioned by the NHS and performed by the National Primary Care Research and Development Centre, an organisation impeccably qualified to objectively investigate moving work done in secondary care to the primary care sector. City Hospital Supporters congratulate Professor Roland. This work does not support the wholesale move of secondary care outpatient services to primary care. There are serious reservations and uncertainties concerning the quality of care and cost.It is to be hoped that the Sandwell and West Birmingham Hospitals NHS Trust, the Heart of Birmingham Primary Care Trust and the Sandwell Primary Care Trust take note of this work. We are providing them with copies of the paper. Their Towards 2010 plan envisages moving a lot of the hospital services into the community. This would include a lot of work currently being seen in the A&E Department at City and Sandwell Hospitals. This subject was not covered in Professor Roland’s paper but presumably these bodies will be providing published evidence that such changes are justified? However this may prove difficult as City Hospital Supporters do not believe this work has been done. Doctors are quite rightly not permitted to treat patients with untried and untested medicines, so why are government and health care organisations permitted to introduce untried, untested and unproven schemes that could prove excessively expensive to taxpayers and provide less efficient and poorer quality health care?

The original full paper is available here.

Petition Submitted to Health Scrutiny Comittee

2007-03-22T11:07:00.000Z

The City Hospital Supporters Group handed over a 1145 signature petition to Councillor Deirdre Alden, Chairman of Birmingham City Council's Health Scrutiny committee on Monday at the Council House in Birmingham. There was coverage in the Birmingham Mail, as well as on Saga radio, Drive Time on Radio WM and a piece on Midlands Today at tea time and in the evening.

The signatures were collected by members of the City Hospital Supporters Group by knocking on doors in the local area, leaving petitions in local community centres and places of worship and an online petition. On our Day of Action, local resident Rageev Hassan told us about how he spent a couple of hours one day knocking on doors trying to get signatures for the petition. One door was opened by an elderly gentleman who knew nothing of the plans. He took the petition, disappeared for a couple of minutes, and came back with seven signatures from his household.

Many thanks to everyone involved for all their efforts. Hopefully this will show the Health Scrutiny Committee the strength of feeling against the proposals. They have already been critical of the plans, and have the power to refer this to the Secretary of State if they believe the proposals are not in the public interest or the consultation has not been carried out properly.

Thanks to the efforts of the members of the City Hospital Supporters Group, the Birmingham Mail (and their big debate), and media coverage on Radio WM, Saga and Midlands Today, I guess it would be difficult to claim the consultation has not been carried out properly. However, as our campaign has highlighted since December last year, the proposals are not in the public interest and there is still work to be done.

Petition Presentation Press Release

2007-03-21T22:58:00.000Z

A number of representatives from this 200 strong Group of hospital staff and members of the local community will be presenting petitions to Councillor Deidre Alden Chair of Birmingham City Council’s Health Scrutiny and Overview Committee on Monday 19th March at 12 noon at the Council House in Birmingham.

The Group have been campaigning against Sandwell and West Birmingham Hospital Trust’s proposals to move Emergency Surgical, Trauma and Children’s Beds from City Hospital to Sandwell Hospital as part of their reconfiguration proposals while a new hospital is awaited in 2013.

The petitions opposed moving the Emergency Surgical, Trauma and Children’s Beds from City Hospital with the inevitable downgrading of the Accident and Emergency Department at that hospital and supported the development of 24 hour Assessment Units for both Children and Surgery.

1145 SIGNATURES WERE COLLECTED

“The Trust went out to consultation with fundamentally flawed proposals that would if they were implemented lead to worse Accident and Emergency Services for the people of Central and West Birmingham while they await a new hospital that will not open its doors before 2013 at the earliest. They have sought the views of the people and they have been given a resounding NO to their proposals” say City Hospital Supporters.

“This is only the tip of the iceberg and a major issue of this campaign has been making the community aware of what is at stake. Once they have appreciated what it will mean to them they have had no difficulty in voicing their opposition” said Dr. Ken Taylor a spokesman for the Group.

“This is not the end of the campaign. It is the beginning of the next phase. Even though the consultation ended on the 15th March the Trust will not be unveiling its final plan until May. Now is the time for people to contact their local Councillors and MPs if they have not already done so.”

“In addition to this petition the Health Scrutiny and Overview Committee of Birmingham City Council have resoundingly rejected the Trust’s proposals on changing their services and so have Mr. Khalid Mahmood’s constituents in Perry Barr after he had thoughtfully circulated them with a questionnaire.”

“The only sensible course of action for the Trust is to drop their plan and leave the beds at City Hospital while trying to shorten the time to the opening of the new hospital. Will it really take until 2010 to reach the stage of signing contracts?” asks Dr. Taylor.

Mahmood to Raise Concerns in Westminster

2007-03-14T20:36:00.000Z

It is rare for politicians these days to get of the fence, but according to a report in the Birmingham Mail Khalid Mahmood has done just that over the interim proposals at Sandwell & West Birmingham Hospitals NHS Trust. In the Birmingham Mail Big Debate in January he promised to send a consultation document to each of the households in his constituency and abide by the response. According to the Mail report, 200 people responded with 67% opposing the proposals to cut emergency paediatric and general & trauma surgery at City Hospital.

Mr Mahmood says he is "looking at raising this issue with the most senior people in Parliament, whether in private or on the floor of the house". Whether he will get an intelligent response is a different matter altogether.

Interim Consultation Ends Tomorrow

2007-03-14T20:07:00.000Z

Just a reminder that Shaping Hospital Services for the Future, the consultation regarding the interim proposals for City and Sandwell Hospitals, ends tomorrow (March 15th 2007). It is a bit late to request a consultation document if you have not already filled one in but you can still fill it in online via the following link:

http://www.sunion.warwick.ac.uk/onlinesurvey/interim2010/

What does City Hospital Supporters Group consider to be the best answers to these questions?

Q1 No

Q2 Do not change until the new hospital is ready to open.

Q3 No

Q4 The proposals will result in a worse service for people living locally to City Hospital.

Q5 No

Q6 You would want urgent treatment including surgery at City Hospital. You would be fearful of the risks of transfer to another hospital.

Q7 No

Q8 Urgent care for a sick child should not be delayed by travelling to a hospital further away.

Q9 Ask why they want to make changes that will give you a worse service before the new hospital opens.

The other Questions are self-explanatory.

As well as completing your consultation form and returning it before the 16th February you can complete our petition form and return it to us and you can also choose if you wish to enrol with the City Hospital Supporters Group. For further information please see the post entitled Petition in Support of City Hospital.

Health Scrutiny Committee Criticise Proposals

2007-03-08T20:11:00.000Z

The front cover of the Birmingham Mail is not pleasant reading for Sandwell & West Birmingham Hospitals NHS Trust. It reports that Birmingham City Council's Health Scrutiny Committee, chaired by councillor Deirdre Alden, has published a report on the interim reconfiguration proposals which call for the plans to be scrapped. The full story is here.

While checking the story on Deirdre Alden's own blog, it appears the report is based on a draft letter written by Councillor Alden which is "attached to the Committee papers and is therefore a public document". The final wording of the letter still needs to be agreed at the Health Scrutiny meeting next Wednesday.

NHS Day of Action @ BTC

2007-03-04T18:18:00.000Z

As part of the NHS Day of Action there was a small meet-up outside the Birmingham Treatment Centre to protest against the reconfiguration plans proposed by the Trust in the document Shaping Hospital Services for the Future. A small group turned out to hear from Chris Rickards (UNISON Branch Secretary, City), Esther Lowe (UNISON regional organiser), our very own Ken Taylor (Spokesman, City Hospital Supporters Group) and Malcolm Cantello (President, UNISON), as well as an impromptu speech by local resident Rageev Hassan on his successful efforts at door-to-door petition signing on behalf of the group. Ken Taylor claimed it was the first time he had ever got on a soapbox (which given the number of the campaigns he has been in over the years sounds quite surprising) and this indicated the seriousness of the current proposals. Entertainment was provided by a marvellous steel band, and there was some media coverage including a reporter from the Birmingham Post and a Midlands Today camera crew as well as yours truly of course.

A coach took most of the people on to the main rally in Victoria square that was part of the national day of action. I left with a copy of Socialist Worker, a RESPECT leaflet and a flyer for a trade union meeting. It was just like being a student again...

NHS Day of Action at City Hospital

2007-02-24T19:59:00.000Z

Next Saturday (3rd March 2007) the City Hospital Supporters Group are holding a Day of Action at the front of the hospital on Trust property with the permission of the Chief Executive. There will be a marquee and at about 10am we will be joined by TUC members from around the Midlands on their way to the big Save our NHS Rally in the City Centre. Starting at 10.15am there will be some speeches, and we hope to have Khalid Mahmood MP among the speakers. There will be an opportunity for people who have not done so already to complete their consultation forms and the petition.

City Hospital needs you there to demonstrate your solidarity with our cause. The people who work there and the members of the community it serves have to be the ones that stand up and support it. Please come, even if it is for just a short time and bring your family, friends and anybody else that wants to support a great hospital doing a great job. The bigger our demonstration the more publicity our cause will receive giving us the best chance of being heard (you might even get a chance to be on TV!). Come and support City Hospital. You are needed now.

Ed Doolan Debate Proves Fruitful

2007-02-23T23:48:00.000Z

There was an excellent debate on Friday's Ed Doolan show regarding the healthcare plans for Sandwell and the West of Birmingham. The panel was made up of six people, John Adler (Chairman Sandwell & West Bimingham Hospitals), Di Reeves (Sandwell Primary Care Trust) and Denise McKlellan(Heart of Birmingham PCT) who made the case for the proposals while Ken Taylor (Spokesman Ciy Hospital Supporters Group), Chris Rickards (Unison) and Judith Whalley (Royal College of Nursing) raised objections and concerns on the proposals. The panel was chaired by Ed Doolan himself and supplemented by an audience, many of whom were staff at the hospital and also some familiar faces from the Birmingham Mail debate which took place earlier this year.

Surprisingly the show started by discussing the longer term Towards 2010 proposals whose consultation finished last Friday, although John Adler assured Ed that points made today would be taken on board. As usual there was a general consensus among the panel that these proposals were a good idea although some concerns were raised over the number of beds and the standard of service that would be found in the planned community hospitals. This was unsurprising given that the debate took place at City because as mentioned before on this blog most of the opposition to the Towards 2010 proposals come from Sandwell residents who feel they are losing a hospital.

The debate then went onto the shorter term Shaping Hospital Services for the Future plans where I am glad to announce a victory for the City Hospital Supporters Group. For the first time John Adler gave a public commitment for a 24 hour Paediatric Assessment Unit, which was one of the main aims of the petition. He also said that the Trust were examining proposals for a 24 Surgical Assessment Unit, another aim of the petition, and would implement this if it was financially and logistically feasible.

A recurring theme in the debate was the climate of fear that exists in the NHS at the moment.
These accusations were not aimed at the senior management, but at "bullies at lower levels" as Judith Whalley put it. Ken Taylor pointed out that staff in the NHS are line managed, and are expected to follow the Trust line. Many doctors were frightened to speak up in opposition to these proposal because they were afraid of the consequences he said. Ed Doolan, who used to sit on the Trust board of the Children's Hospital, noted that this has been a problem in the NHS for years. In particular, Ken claimed that some doctors were even afraid to attend a meeting arranged with a local MP. John Adler stated that he was happy for this meeting to take place, and was happy for staff to say whatever they wanted about these proposals. I understand that since the programme a productive meeting between the group of doctors and the local MP has taken place.

A write-up on a debate like this would not be complete without me picking up Hugh Bradby on not one but two points he made on this show. The first one regarded his favourite excuse for the interim proposals, the European Working Time Directive (whose affect Ken Taylor assures us is being exaggerated). After spending a few minutes explaining how much more junior doctors we would have to employ to comply with this piece of legislation, and telling us how much it would cost if changes were not made, he concluded by claiming that the interim plans were being driven by clinical motivations and were not due to financial concerns thus contradicting everything he had just said! His other boo boo was as he pontificated that it would be better to stabilise a patient and move him to the correct facility rather than keep him at the wrong facility and try to manage the patient there. He seemed to completely ignore the point that currently we have acceptable facilities at both sites to manage emergency surgical and paediatric patients. It is the Trust that want to reduce these facilities at City and concentrate them at Sandwell, so the choice is really between being able to keep the patient at the same site where everything can be done or than having to move them to a new site after an arbitrary period of time. You do not need be medically qualified to realise that the former case here is preferable.

Some excellent points were made by the former chairman of City Hospital NHS Trust, Richard Steer, about the fact that whenever two Trusts merge the plan will always be to reconfigure services regardless of guarantees by the management and the Department of Health that services will stay the same during consultations on the merger. This was the case during the merger of Sandwell Healthcare NHS Trust with City Hospital NHS Trust five years ago, and is currently the case in the proposed takeover of Good Hope Hospital by Heart of England NHS Foundation Trust (if you want to take part in this entirely separate consultation, please click here). He also made an excellent point that since Birmingham Health Authority was split into four (now three) separate PCT's, there is no pan-Birmingham healthcare strategy, which is to the detriment of heathcare planning for the city.

Deidre Alden, chair of the Health Overview and Scrutiny committee on Birmingham City Council, made another good point that the healthcare proposals may affect people outside the Sandwell and West Birmingham area. If under the new plans the Trust fails to cope, ambulances could be diverted to Heartlands or Selly Oak which will have a knock-on effect on the services at these hospitals. Do not say you have not been warned - make sure wherever you live that you take part in the remaining consultation, Shaping Hospital Services for the Future.

Finally, on a lighter note I did chuckle at Dr Connolly's claim (did you know you have a 1-in-5 chance of seeing him if you have a heart attack in Sandwell or Birmingham City Centre?) that it took him 11 minutes to get from City to Sandwell. Not 15 minutes. Not 10 minutes. 11 minutes. Now I have done this route a lot and I would estimate it takes me a minimum of 15. Does anyone know what car he drives (in particular what is the size of the engine) and how on earth he managed so accurately to calculate this time?

Reminder on Doolan Debate

2007-02-21T20:30:00.000Z

Just a reminder that the Ed Doolan show is going to host a debate on Shaping Hospital Services for the Future at City Hospital this Friday (23^rd February 2007) at 10am. It will be in the Wolfson Lecture Theatre of the Postgraduate Centre at City. Tickets can be obtained by phoning 08453 030 030. I believe you may be required to have a question to ask the panel.

Normally I would include a link to the City Hospital site map here but as you can see it does not work. The Trust paid a private firm £6000 develop this website to help advertise their services and compete for patients in the new patient-centred NHS, but they cannot even be bothered to check what they paid for works. We can only imagine what will happen when we give them £700 million for the new hospital and community facilities.

The Towards 2010 consultation that concentrates on the proposals to build a new hospital finished on Friday, but the consultation regarding the interim reconfiguration plans outlined in Shaping Hospital Services for the Future has been extended for another month until March 15th 2007. While it is great to be able to concentrate on the reconfiguration plans in this debate (which is after all the way the consultations should have been done, i.e. separately), it is very convenient for the Trust to not have to face the public again over the plans to build a new hospital in Smethwick. Despite what the Trust says, these plans are very unpopular in Sandwell and the only reason the opposition to Towards 2010 has not been taken seriously is that there is not an organised campaign highlighting these plans in the way the City Hospital Supporters Group has done for the other consultation. As I have mentioned on this blog before, the Trust has not even waited for the end of the consultation before putting the wheels in motion for the building of the new hospital.

On Friday, we have an opportunity to prevent the same thing happening with the interim reconfiguration plans.

CHSG Response to Interim Plans

2007-02-17T17:07:00.000Z

CITY HOSPITAL SUPPORTERS GROUP RESPONSE TO:
SHAPING HOSPITAL SERVICES FOR THE FUTURE.

INTRODUCTION:

This document has attracted our greatest attention because it is about reducing services especially at City Hospital which is the much larger hospital serving the most deprived population. It is also the City Centre Hospital and its A&E Department has a fine reputation with some 100,000 plus referrals per year. Indeed the merger of City and Sandwell Hospitals was only approved on the 8th March 2002 by the Parliamentary Under Secretary of State for Health Yvette Cooper after Birmingham MPs had met with her presenting a paper about the importance of ensuring the continuance of City Hospital’s A&E Department in its present form. A letter was written by Ms. Cooper to the then Chairman of City Hospital NHS Trust Mr. Richard Steer and a copy is appended to this response. It is noted that the first condition in her letter states “will continue to provide the full range of clinical services to support local Accident and Emergency Services.” The second condition states “neither of them is under threat of closure nor is either expected to become under threat as a direct or indirect result of merger.” The third condition states “should there be proposals for service reconfiguration these will be the subject of feasibility studies involving key stakeholders, public consultation and national independent scrutiny. Furthermore in the future all NHS organisations will be required to consult local authority overview and scrutiny committees on proposals for service reconfigurations. These committees will have the statutory powers to refer those proposals to the Secretary of State if the consultation process is inadequate or the merits of the proposal are not in the interests of local people.”

OUR CONCERNS:

· Moving inpatient emergency general surgery, trauma and children’s beds from City Hospital to Sandwell will adversely affect the service provided by City Hospital’s A&E Department.

· At present if a patient is seriously injured or has a serious surgical problem he or she may be brought to hospital in an ambulance or by relatives in a car. The patient is brought into A&E and is seen assessed and treated by the A&E Team. If surgery is required it can be performed as speedily as required on site by the duty surgeon and then the patient can move seamlessly to a Critical Care or High Dependency bed and hopefully on to an appropriate ward for full recovery. This is ideal patient care in the local hospital all under one roof. The community can depend on receiving high quality care speedily in their local hospital.

· If the emergency surgical and trauma beds were moved from City Hospital patients arriving there would have to face being patched up and then transported elsewhere which is not coherent medical care. How would they be transported and with what type of escort? Would doctors and nurses be required and if so how feasible would that be? How would that effect their risk of survival and recovery? Indeed the Trust state in their document that ambulances and GP referrals will be directed to Sandwell and presumably if they do not have beds to other hospitals further away. Although some of the geographical distances to these other hospitals may not be great the speed of access depends on having roads that are not blocked with traffic. Having blues and twos on does not mean that ambulances can fly over traffic jams. Again the relatives would have to travel further afield with many of them using a rather poor public transport system, or if they are more affluent in cars. The cost of travel on public transport is another important issue. If there were no duty surgeon at City with a support team then patients could not even be operated on there so would have to be exported to other surrounding hospitals Furthermore this would put patients with upper gastro-intestinal bleeding that may need surgical intervention at risk. This would mean the gastroenterological service moving to Sandwell with knock on consequences for medical patients coming to City Hospital as emergencies.

· What has been said in the point above also applies to children if their beds were moved from City to Sandwell. Can this be sensible for a hospital seeing nearly 20,000 paediatric referrals a year? Remember Birmingham is already short of general paediatric beds. Although we have the Birmingham Children’s Hospital this is a regional specialty hospital on a site constrained for space. There is great pressure on its beds and often patients are referred to City from BCH because they are short of beds. Indeed the shortage of children’s beds in the city has meant City Hospital has had to send children needing admission to New Cross Hospital Wolverhampton and Worcester. Is this good care for local people? Does it make sense to reduce beds in Birmingham further? Why are they offering a Part-Time 12 Hour Paediatric Assessment Unit when currently children can be seen at any time of the day or night and be fully sorted out? Could the planners be saying well at certain times of the day we see relatively small numbers of children so why provide a full service? We believe the people of West Birmingham would say every single child is precious and deserves the same level of care as every other so give us a 24 hour service with every child being treated equally. No doubt planners have children. Would they be happy for them to receive an inferior service because the child became ill at an inconvenient time? How many of these planners actually live in West Birmingham? The Trust are proposing an inequitable service for which there is absolutely no justification. City Hospital Supporters believe equity of care must be afforded. In fact it is our understanding that cost is not really the issue so why are they proposing a Part-Time Paediatric Assessment Unit????

· What will the changes give us asks the Trust in its consultation document?
Maintain local access they say but surely the true facts point to the very reverse being the case.

Tackle the urgent problems in some specialties. They refer elsewhere in the document to the European Working Time Directive for junior doctors, they also mention elsewhere Modernising Medical Careers and recruitment and retention.
In fact the doctors working in the relevant specialties at City Hospital assure us that recruitment of consultants, junior doctors and nurses is not a problem. They also state that concerns about the EWTD and MMC have been over-played by the Trust.

Change services to help deliver the vision for improved NHS care.
If services are being reduced as described above how can this relate to a vision of improved NHS care?

Apparently the main benefits of the proposals are to:

Improve clinical services and make sure they are safe and can meet modern day requirements..
This just does not square with the reality of what they are proposing.

Help attract and keep the best staff.
The only reason the Trust has lost staff is that they have deliberately reduced the staff complement by 540 including medical and nursing posts in an effort to reduce the financial deficit of circa £15 million. Furthermore when the Trust advertised for a qualified Children’s nurse at City recently there were 70 suitable applicants. I am reliably assured that there is keen interest in the consultant surgical posts becoming available in the Trust. There are plenty of men and women of great quality who relish working in the very challenging and worthwhile environment of City Hospital.

Enable services to develop and support the long-term vision for health services.
They are repeating themselves.

Let junior doctors work fewer hours and meet European Regulations.
Not an issue according to informed sources.

Make better use of resources including investment in new equipment.
Not supported by any evidence presented.

We now need to turn to the consultation process itself which is vexatious. In effect we have had two consultation processes rolled into one which is very confusing for the public. They were both launched on the 20th November closing on the 15th February. As a result of public pressure the consultation on reconfiguration has been extended until the 15th March.

In order for this consultation to be meaningful the people in the community not only need to appreciate what is proposed but understand the implications for their healthcare. We believe that expecting them to phone up for two booklets or try and download them or complete them online is just asking too much. On the 3rd February the Trust were approached by City Hospital Supporters Group and asked to place the green booklets “Shaping Hospital Services for the Future” on every ward and in every outpatient clinic. The response was an interesting one, they thought “the suggestion was a good one and they would check if there were enough copies left.” This response says it all? The people attending the hospital as patients and their relatives are the very people that will be most affected by the changes. Surely those are the people the Trust want to hear from? Many of the people around City Hospital do not have access to computers and the key reasons for them having poorer health than more affluent areas will seriously impair their ability to respond to this confused, poorly thought out and executed consultation process. The truth of the matter is that if they knew about, and understood what is proposed, it is very unlikely that they would approve it.

IN CONCLUSION:

City Hospital Supporters Group believe that the Trust has not produced any convincing evidence for the proposed changes that would effectively downgrade services at City Hospital and undermine its A&E Department. We are firmly of the view that services should remain as presently configured, and then when the new hospital is built, provided it is of an adequate size both City and Sandwell Hospitals can move into it. This may take significantly longer than the six years forecast by the Trust. While the people of West Birmingham and Sandwell await their new hospital they deserve at the very least to continue to receive the current level of service
We believe that we have shown that this consultation process has been inadequate, and there are no merits in this proposal for the local people and it is certainly not in their interests. We believe that it would not stand up to national independent scrutiny and unless it is significantly modified it should be referred to the Secretary of State for Health.

More Details on Doolan Debate

2007-02-15T20:50:00.000Z

As I have mentioned on this site before, the Ed Doolan programme is going to bring a debate on the reconfiguration plans to City Hospital on the morning of Friday 23^rd February starting at 10am. It will be in the Wolfson Lecture Theatre of the Postgraduate Centre at City. Tickets can be obtained by phoning 08453 030 030 and the lines opened at 10am this morning. I believe you may be required to have a question to ask the panel.

If you disagree with the reconfiguration plans and are able to attend we would urge you to take part in this debate. It is very likely that the Trust and PCT management will be out in force to show a united front from the managements, with plenty of "experts" defending their view. Those of us who have studied these proposals independently know that they are not telling the full story, but the listeners of the Ed Doolan show will not be aware of this unless you let them know.

CHSG Reponse to Towards 2010

2007-02-15T20:42:00.000Z

CITY HOSPITAL SUPPORTERS GROUP RESPONSE TO:
TOWARDS 2010 – INVESTING IN A HEALTHY FUTURE.

INTRODUCTION:

The West Birmingham and Sandwell catchment areas are both extremely deprived especially West Birmingham, and they both have a great diversity of ethnic groups. These factors mean the population has more small for dates babies, more congenitally abnormal babies, a higher perinatal mortality rate, more hypertension, more diabetes, ischaemic heart disease, more strokes, more chronic lung disease, more cancer, more violent injuries, more self-harm, alcohol and drug abuse than more affluent and less ethnically diverse areas.

It makes sense for the areas with the greatest health care needs to have the best access to and provision of health care services both primary and secondary. To date there has been remarkably little investment in the health care infrastructure of the area.
City Hospital Supporters Group welcomes the proposed investment of £695 million in buildings but is concerned at the possible fragmentation of the investment and questions the impact this will have on the delivery of services especially in the secondary care sector.

OUR CONCERNS:

· £200 million of the above figure will be invested in new and refurbished health centres which is good for primary care and this leaves £495 million for a new specialist hospital fit for the 21st century plus new community hospitals and community treatment centres on the current Sandwell General Hospital site, Rowley Regis Hospital, on the current City Hospital site and also at Aston / Perry Barr and at Sparkbrook / Springfield.

· The question is how much money does this leave for a proper hospital? A major concern is that it will not be enough.

· Will people still need to be admitted to a proper hospital in 2013? The very simple medical answer is yes of course they will. If you are seriously ill you need care in a proper hospital bed looked after by an adequate number of staff not too far from home. At the moment City Hospital has 700 beds when they are all open, and Sandwell has 400 beds giving 1100 beds in total. In the Trust’s summary consultation document they do not mention bed numbers. I understand there will be something over 600 beds which means a cut of about 500 on the present total of the two hospitals. This is a swingeing cut. However I believe there will be 200 to 300 beds in community hospitals. The bed numbers need to be explicit.

· Bed occupancy has to be a major issue. Currently in this Trust like others throughout the country we are practising industrial production line medicine. It is all about high turnover with low production costs in the best business tradition. The aim is to put the most patients through the least number of beds requiring the lowest number of nurses possible. It means bed occupancy figures of over 95% and even over 100% have been tolerated. This has led to all the problems that are now an every day occurrence. Patients pushed into any available bed, some patients admitted to a ward of the other sex, the need for draconian target times for patients to be admitted, with the Chief Executive’s P45 depending on meeting the targets, patients with infections being admitted inappropriately. The question is what is bed occupancy going to be in the new specialist hospital? If we had an occupancy of 80% and certainly not more than 85% like some of our continental friends we could avoid the awful problems mentioned above. Bed occupancy in the new hospital needs to be explicit.

· What about community hospitals? What is the record on these institutions in the UK?. Well surprisingly during the last 30 years or so every effort has been made to close down community hospitals. Why? They were found to be places where patients languished without a very good quality of care. The patients were transferred to acute hospitals so they could receive a full range of integrated care. Why are we revisiting the past?

· Fragmentation of the clinical service and lack of joined up care could be real problems with the new system being proposed. The more separate institutions that you have the more barriers there will be to the smooth journey of the patient from illness to health, the more travelling time for the health care professionals. Do we need so many community hospitals? It makes sense to have intermediate care or community beds on the City Hospital, Sandwell Hospital and Rowley Regis sites but do we need the others? Why not facilitate a lower bed occupancy at the new hospital by increasing at least potential bed numbers and sacrificing two of the community hospitals?

· Another very real worry not touched upon in the consultation document is to move more and more of acute illness into the community setting to be carried out by General Practitioners and Nurse Practitioners leaving the hospital to look after the seriously ill. This is a development which does not have a sound evidence base. It is in reality third world medicine chosen for its perceived cheapness rather than its suitability to a first world country and England’s second city. If it has not been chosen for the residents of Edgbaston, Sutton Coldfield and Solihull who are in far better shape why have it in poverty stricken West Birmingham? We need to remember that today’s mild or moderately severe illness effectively diagnosed and treated in secondary care with early discharge if appropriate will avoid a number of serious pitfalls.

· If the Birmingham Treatment Centre and the Sheldon Block are all that is eventually left of City Hospital it will leave the BTC with no on site support. If a patient presents with an illness requiring immediate admission, if another specialty is required urgently, or if a day case operation becomes complicated requiring more complex intervention and admission, presumably urgent transfer elsewhere will be the only option? Is this 21st century care?

· Lastly we do not believe the local community has been fairly consulted on what is proposed. They have only been presented with one option and the full implications of what has been proposed have not been explained. This is a community where more time and effort needs to be committed to ensure a truly meaningful consultation. What proportion of the population even know about the changes proposed? Furthermore the Trust have had two consultations running at the same time making it difficult to do justice to either.

IN CONCLUSION:

The new capital investment proposed is welcome and desperately needed. The people of West Birmingham and Sandwell deserve and should demand a proper secondary care hospital with a full range of services on one site. This should have an adequate number of beds designed for an occupancy of 80-85%. Even if all the beds did not open from day one there should be space to open wards as they may be needed It should have a comprehensive A&E Department that at the very least can handle the emergencies currently seen at City and Sandwell Hospitals combined. It will serve 500,000 people and it should be able to do them justice. If the staff of that hospital have the right conditions they will deliver a magnificent service.

A nightmare situation that must not be allowed to happen is as follows. An unsupported Birmingham Treatment Centre on the Dudley Road site with a community hospital in the Sheldon Block. The rest of the hospital is demolished and the land sold for the rich pickings of developers. Sandwell Hospital suffers a similar fate. We are left with some inadequately sized hospital at a venue to be decided with several community hospitals that will be filled with those who have nowhere else to go. The dedicated staff providing a great service today, who are far more important than buildings will have long since left for greener, more sensible and coherent pastures.

A really good secondary care hospital with excellent health centres and primary care facilities and three community hospitals has surely got to be the way to go providing seamless care that is cost efficient. The development of primary care by the destruction of secondary care must not be allowed to happen.

CHSG Press Release 13th Feb 2007

2007-02-14T20:59:00.000Z

City Hospital Supporters Group of about 200 and growing comprises members of the community local to City Hospital and its staff. It has submitted its response to the document Shaping Hospital Services for the Future to the Health Scrutiny and Overview Committee of Birmingham City Council.

They say “moving inpatient emergency general surgery, trauma and children’s beds from City Hospital to Sandwell Hospital will adversely affect the service provided by City Hospital’s A&E Department to its local community.” The Trust deny any adverse effects. One senior respected consultant at the hospital states “the Trust’s plans make no sense.”

At the moment patients needing the above services can get them 24/7 at City Hospital. If that is no longer to be the case it is a worse service for local people. Worse means being taken to a hospital further away, maybe Sandwell but it could be a lot further. They point out that this will hardly improve the outlook of those seriously in need of care.

They are very critical of the proposal for a Part-Time Children’s Assessment Unit pointing out that this would deny equity of access to local children. If the child presented during opening hours presumably it would be able to stay at City, but if not it would be off to Sandwell or further afield. The quality of care would depend on what time the child was ill “Are they planning a shop or a hospital?” say City Hospital Supporters.

They go on to point out that claims made by the Trust that their proposals are necessary because of problems with junior doctors hours and recruitment and retention of staff have no substance. There does not even appear to be a financial case for the Part-Time Children’s Assessment Unit.

They are very critical of the consultation process, in effect two consultations at the same time. It has been difficult to inform the community about what is going on. Getting the green consultation booklets is not easy especially if you do not have access to the internet and e-mail. The Trust has not seized the opportunity to hand out booklets to those most affected namely inpatients, outpatients and their relatives

The City Hospital Supporters believe that the proposals are not in the best interests of local people and the consultation process has been inadequate. These are the essential criteria for Birmingham City Council Health Scrutiny and Overview Committee to refer the proposals to the Secretary of State for Health unless the Trust modifies its position.

The mantra of City Hospital Supporters is that the people of West Birmingham continue to have 24-hour access to high quality emergency care for adults and children on the City Hospital site, until a new hospital which can provide this service opens its doors.

If people would like to find out more about City Hospital Supporters Group, obtain the booklet Shaping Hospital Services for the Future with advice about completing the consultation form and signing our petition visit: www.supportcityhospital.blogspot.com

New Hospital a Done Deal?

2007-02-13T20:56:00.000Z

Graham Seager, Director of Facilities has just been appointed Director of the New Hospital Project according to an e-mail sent to Trust staff on Friday 9th February 2007.

In anticipation of the large workload involved in the new role, many of his current responsibilities have been taken over by Pauline Werhun, the Director of Nursing.

Graham Seager's new role is particularly interesting, given that the consultation regarding the new hospital Towards 2010, does not finish until this Friday (16th February 2007), and a "decision" will not be taken until May.

John Adler has previously said that the Towards 2010 proposals are not as controversial as Shaping Hospital Services for the Future, the interim proposals that the City Hospital Supporters Group has concentrated its campaign on. This simply is not true. Many people in Sandwell are very angry at losing a hospital to what they consider to be a new hospital just around the corner from the City site, as was apparent on the Ed Doolan show John Adler was on. Just because they have not got an organised campaign, they are being ignored.

Is this what they mean by consultation?

CHSG Releases New Campaign Documents

2007-02-13T20:50:00.000Z

Three more documents have been released by the City Hospital Supporters Group regarding the two current consultations about healthcare in the Sandwell and West Birmingham region. They are available in the bar on the right hand side under the heading Key Documents (Printable Versions) and are called Press Release 13th February, Response to 2010 and Response to Shaping Hospital Services

I appreciate not everyone can access documents stored via Google documents and spreadsheets so I will post them as part of the blog over the next three days, as they are quite a lot to take in one go.

Ken back on Phil Upton

2007-02-12T20:27:00.000Z

Ken Taylor was back on the Phil Upton show this morning for the second time to give an update on the campaign. You had to be up early to hear him as he was on just after 7am, but the early bird catches the worm. Compare this to the Trust, who amble in just after 11am on the Ed Doolan show although to be fair some of them do live a bit further away...

Good job Ken, only another month to go!

Ed Doolan to Host Debate on Reconfiguration

2007-02-08T15:40:00.000Z

The Ed Doolan programme is going to bring a debate on the reconfiguration plans to City Hospital on the morning of Friday 23^rd February starting at 10am (update 14/02/2007: originally the start time was planned for 11am but it has been brought forward an hour). It will be in the Wolfson Lecture Theatre of the Postgraduate Centre at City. From what I understand at the moment, a telephone number will be put out nearer the time for people to ring for a ticket. People may be asked to have a question and they may get tickets on the basis of the question they are asking.

I will put further details on here as and when they become available, so please check back if you are interested in participating in this debate and you are not a regular listener of the Ed Doolan show.

Why did the Trust Extend the Consultation?

2007-02-06T20:49:00.000Z

While browsing the links on the left hand side, I came across a video report of the Big Debate held at the Afro-Caribbean Millennium Centre on January 16th as part of the Birmingham Mail's big Hospital Debate which is well worth watching:

http://videos.icnetwork.co.uk/icbirmingham/birminghammail.wmv

What strikes me is that at the end Steve Dyson warns the Trust that if they do not have a proper consultation on these proposals (which he defines a "taking advice and conferring with" the people, and "not just ticking bureaucratic boxes"), the Birmingham Mail would join in and oppose the Trust's plans.

A day later the Trust extended the deadline on Shaping Hospital Services for the Future, to March 15th 2007 from February 16th 2007.

On the Ed Doolan show last week, John Adler used the extended deadline as an example of the Trust trying to engage with the people and as proof they were not trying to hide the plans. The comment by Steve Dyson puts this claim in a slightly different context.

Health Plans Defended on Doolan Show

2007-01-28T10:31:00.000Z

On Friday at 11am, Ed Doolan welcomed John Adler (Chief Executive of Sandwell & West Birmingham Hospitals NHS Trust), Hugh Bradby (Medical Director SWBH), Jackie Chambers (Heart of Birmingham PCT) and Di Reeves (Sandwell PCT) into his studio to explain the two consultations currently going on to the listeners of his show.

The four guests were given some time to explain the proposals. When Jackie Chambers was asked to explain the interim proposals, she said she wanted to talk about the Towards 2010 proposals and was allowed to unopposed. After Hugh Bradby said the proposals would allow the Trust to recruit and retain staff, Ed picked up on the fact that the Trust had recently just lost a lot of staff presumably referring to the 560 posts removed by the Trust in the Autumn. Hugh Bradby's reply was that there was a lot of turnover in staff in the NHS and astonishingly Ed let this statement go without question. (Incidentally later Ed asked John Adler again whether or not a lot of nursing posts had been removed. John replied that it was mainly administration, managerial and support staff whose posts had been removed. If Ed had been on the ball, he would have asked how they managed to close so many wards and reduce so many bed days without sacking a single nurse or doctor). Di Reeves managed to explain that as a mother she supported the proposals on paediatrics; she would as she represents Sandwell PCT, and the interim proposals are a bad deal for City. The only time she even attempted to acknowlege the other side of the argument was when she spoke about Michel Platini's election as UEFA president, an issue she regarded as "very important" (even when compared to childrens health in the heart of Birmingham?).

Before the show, Ken Taylor (spokesman for the City Hospital Supporters Group) had campaigned hard to get an equal footing on the show and have a proper debate on the interim plans. He was told (as was mentioned twice on the show) that there would be a full debate at a later date, but was invited on to this show by the editor Robyn Dangerfield. According to the e-mail I have seen, she hoped to call Ken at the "beginning of the phone in... so that the key issues and concerns are flagged up early".

Over ten minutes into the show, Ken was introduced by Ed and brusquely asked "What's your question". Ken started to explain how the City Hospital Supporters Group was formed but was cut short by Ed who insisted "Ken, do me a favour, instead of making a point ask a question"

Ken pointed out he had been invited onto the show with the understanding that he would be able to make points pertinent to the debate, but was continually interrupted by Ed who pushed him to make a question. He did finally get a minute or two to make a point after which the Trust was able to respond. Hugh Bradby replied with the following:

"Ken has illustrated quite well that he doesn't understand the case for change"

and

"things have moved on quite a lot from when Ken retired"

He then goes on to explain why the European working time directive (EWTD) has forced the Trust to reconfigure its services in the medium term. Ed does not intervene, but asks Ken to respond. Ken points out that he still works for the Trust and that the has been told by the relevant doctors that the EWTD is not a problem and is being used as a smokescreen by the Trust. Hugh dismisses the point that Ken has not retired by saying he only works in one outpatient clinic and again claims he does not understand how a modern general acute hospital works. Ed again lets this personal attack go and asks Ken to respond. Ken again points out what he has heard from his fellow medical professionals and calls Hugh Bradby's attempts to rubbish their views "very, very poor". Ed now decides to intervene and tells Ken there is no need for any personal attacks from him, or anyone in the panel.

After this exchange, John Adler acts as peacemaker and says there are no personal issues, that the Trust has talked to Ken and understand his concerns. Some more points are made and responded to by both sides. Ken, who was invited onto and called by the show is then cut off.

Even in Ken's absence we still got some choice soundbites from the studio. John Adler complains near the start of the show that the term "downgrading the A&E" with reference to the plans for removing emergency general & trauma surgery and paediatrics at City is very misleading. Is this any more misleading than many of the statements made by the Trust regarding both the interim and Towards 2010 proposals on the Birmingham Mail's Big Debate or on the Radio Five Live debate? Why don't you click on the links and decide for yourself.

While the City Hospital Supporters Group is concerned in particular with the interim proposals for City A&E, it would be fair to say we do not represent all the opposition to the Trust plans. Time and time again on this show people from Sandwell rang questioning the location of the new hospital, which would be just a stone's throw away from the current City site just inside the border of Smethwick with Birmingham.

John Adler spent a lot of time justifying the location of the new hospital, and I must admit despite spending a lot of time pouring over the Towards 2010 proposals, he came out with a lot of reasons I had not heard before. The main reason for the location of the new hospital I had heard previously was that it was the most central location to the population being served. On this show he added that it was on the dual-carriageway Black Country spine route so it would be easy for ambulances to access, it would help regenerate an economically deprived area, and that there would be minimal disruption to the surrounding area as it is not a residential area. He did not mention the other (and arguably main) reason for the location of the new hospital; that its location was a political decision based on the fact that it will still serve Birmingham City Centre, but is just inside the Sandwell boundary so that technically it can be said that Sandwell will not be losing a hospital.

A couple of callers picked up on the point that the traffic on these dual carriageways leading onto junction 1 of the M6 can get pretty crowded, particularly on Friday afternoons or when West Bromwich Albion are playing. These were dismissed by the Trust, and on the second occasion Ed actually fielded the question, saying that when ambulances had the blue lights flashing and the siren on it would not pose a problem. Unfortunately the caller did mention ambulances, but perhaps instead of answering the question Ed should have asked the studio how people with a sick loved one in the back of their car were supposed to get to A&E in such circumstances.

Another caller made a point that Sandwell would be losing an A&E. John Adler's response was that "it was a statement of fact that there will still be an A&E in Smethwick, which is in Sandwell". This completely ignores the point that it is not as central a location in Sandwell as the current A&E, and that when the new hospital is built, many people in Sandwell will find it easier to get to Manor Hospital in Walsall. If John Adler knew anything about the population he was serving, he would realise that it fair to say that for most people in Sandwell a hospital in Smethwick might as well be a hospital in Birmingham as far as they are concerned.

Another listener sent a comment to Ed asking why the people of West Brom do not matter. Sandwell residents may have been heartened when Hugh Bradby later mentioned that he "supports West Brom". To avoid Trust accusations against us of misleading the public, I must point out however that he was referring to the football team and not the town.

The ugly question of whether the consultation really is a consultation was again asked. It is not a referendum warned Mr Adler, but denied the Trust was trying to keep people in the dark after someone mentioned they knew nothing about these plans. Mr Adler replied the Express & Star had covered this, there had been almost saturation coverage in the Birmingham Mail, they were having 100 public meetings and the consultation on the interim plans had been extended, as well as coverage on programmes such as the Ed Doolan show proved the Trust was not trying to hide this from the public. While the Trust have made some moves to involve the public further, I think it is fair to say a lot of this coverage (in particular the Birmingham Mail's) has been a result of campaigning by the City Hospital Supporters Group and other opponents of the plans, and the Trust have been pushed into extending the consultation on the interim plans after an outcry by the local community.

The most telling statement on the consultation was by John Adler when he said

"before we went out to consultation we looked at a number of options"

Perhaps this is the point. If this was a genuine consultation the Trust would have presented a number of options and let the public decide. When the Trust presented these proposals to the staff over a year-and-a-half ago, they were supposed to be consulting on four options, two of which kept the general acute hospitals we have now. In the time it actually took the Trust to go public with the consultation it changed and is now being presented as the building of a new hospital, which further is being used as a Trojan horse to get through some decidedly questionable interim plans.

The reality is that if even if the spokesman for many staff and patients at City Hospital is being dismissed by the medical director with ad-hominem personal attacks, someone who is part of the medical profession and who has worked at City Hospital for many years, who knows the issues involved and has asked for some sensible compromises, what chance has the community got to make its point heard in this consultation?

Consultation taken to Birmingham News

2007-01-25T21:59:00.000Z

It appears that the Trust has taken out a two-page advert in the Birmingham News, the free newspaper that is dropped through doors across Birmingham on Thursdays, regarding the proposed changes to healthcare in Sandwell and the West of Birmingham. The article gives a brief explanation of the two consultations that are currently taking place, Towards 2010: Investing in a Healthy Future and Shaping Hospital Services for the Future on the first page (page 24), with the actual consultation documents printed on page 25.

Whilst these efforts to raise awareness of the proposed changes should be applauded, it is worth noting that at the meeting organised by the Birmingham Mail many people said they had seen the consultation documents before but were unsure what the implications were.

Those of us who are concerned in particular with the interim plans proposed in Shaping Hospital Services for the Future should consider writing to the Birmingham News outlining the potential problems with the plans to remove emergency general & trauma surgery and paediatric beds from the City site. Their e-mail address is birmingham_news@mrn.co.uk, or they can be snail mailed at The Birmingham News, Letters, Weaman Street, Birmingham, B4 6AT.

E-mail to CHSG Members

2007-01-24T22:07:00.000Z

The following letter was sent out today to members of the City Hospital Supporters Group via e-mail with details of the next meeting.

CITY HOSPITAL SUPPORTERS GROUP

Dear Member

There will be a meeting of the City Hospital Supporters Group next Wednesday 31st January from 1245-1345 in the Coffee Lounge, Postgraduate Centre. Tea and Coffee will be provided.

Come and hear of the progress made so far, the positive feedback, and plans for future events.

Come and share in the brainstorming session to offer your ideas of ways to reach more people in the hospital and the community, to inform them of the plans, and invite them to make a response.

One suggestion is for a leaflet drop in the area. Could you spare half an hour to push some Green booklets through the doors in a road where you live, or work? You may have other ideas. Every little helps and your contribution is important. The plans are not set in stone; if enough people stand together, the Trust will be forced to listen. We can make a difference – come along and show your support for City Hospital.

Ken Taylor, City Hospital Supporters Group

City Hospital Needs You Now

2007-01-24T19:56:00.000Z

The following flyer is being distributed by the City Hospital Supporters Group. It contains a brief summary of the aims of the group and how you can help us achieve those aims. On the left hand side there are links on how to obtain a consultation document (see the link entitled How Can You Register Your Concerns), and links to either download a printable version of the petition or sign it online. There is an option on the petition to join the City Hospital Supporters Group.

C i t y H o s p i t a l N e e d s Y o u N o w

Keep the ambulances bringing the children, the seriously injured and those needing surgical care, to City Hospital

· What we want is:-

A 24 hour Children's Assessment Unit

A 24 hour Surgical Assessment Unit

· What you can do is:-

1. Complete and return a Shaping Hospital Services for the Future (green booklet) form now (consultation period extended until 15 March 2007)

2. Sign our Petition

3. Join the City Hospital Supporters Group

TOGETHER WE CAN MAKE A DIFFERENCE

Ed Doolan Show to Cover Health Plans

2007-01-23T22:33:00.000Z

John Adler will be appearing on the Ed Doolan show this Friday (26th January 2007) just after 11am to discuss the plans for the future of healthcare provision in Sandwell and the West of Birmingham. Our very own Ken Taylor should also feature on the programme.

This is another great opportunity for the community to ask the Chief Executive of Sandwell and West Birmingham Hospitals NHS Trust important questions about the planned changes on a respected local forum. We urge you to phone-in or alternatively e-mail your questions to Ed and tell your friends to watch out for the show.

You can e-mail questions to Ed at ed.doolan@bbc.co.uk, or alternatively phone in on the number given out during the programme.

Campaign Goes National

2007-01-21T17:16:00.000Z

On Friday, John Adler and Ken Taylor crossed swords again, this time on a national platform on the Matthew Bannister show on Radio Five Live.

The show should be available until Friday 26th January via the following link. The item starts 1 hour 19 minutes into the programme and lasts just over 10 minutes.

www.bbc.co.uk/radio/aod/fivelive_aod.shtml?fivelive/morning_fri

A particular highlight is when John Adler accuses Ken of intentional misrepresentation after it is claimed the doctors are not involved in the planned changes. Intentional misrepresentation? Why then have so many doctors from the affected departments joined the City Hospital Supporters Group? I have personally heard doctors say to me that they have told the Trust management of their concerns and have not been given acceptable answers. If by involved you mean asking them what they need and then ignoring what they say then I guess John is right.

Is this what the Trust plans to do with the public consultation?

Public Backlash at Interim Plans

2007-01-18T20:09:00.000Z

If you were not present at the Birmingham Mail's Big Debate at the Afro Caribbean millennium Centre on Tuesday Evening you missed a treat. The public and staff who are served by and who serve City Hospital united to give the health managers responsible for the interim plans a grilling - so much so that yesterday the public consultation on Shaping Hospital Services for the Future has now been extended by a month to the 15th March 2007. Let us hope this is the first of many victories for those of us who oppose these plans.

A broad section of the public asked John Adler, Chief Executive of Sandwell and West Birmingham Hospitals NHS Trust some serious questions which he answered in true civil service fashion. For full coverage see the Birmingham Mail's coverage here - I understand they will be publishing answers to further questions asked at the end of the meeting over the coming days and weeks.

The opening question was a very sensible one about whether it is better for badly- injured trauma patients to be stabilised at City and then transferred to another hospital, or for them to be treated under one roof. This was followed up later on in the evening by an excellent point made by a nurse from City Hospital who said that the City A&E department would be crucial if there was a terrorist attack on the second biggest city in Britain. The fact that stabbings and shootings are common in the area surrounding City hospital has not been lost on anyone, except the Trust management, who have been deluded by their own spin. The answers of the representatives of the Trust seemed to be based on the idea that doing nothing was bad and not an option. The problem with this is the corollary - doing something must be good - does not hold either. We should only make changes which improve the situation and the problem is we do not believe the interim solutions offered by the Trust at present are good enough.

A point was then raised about the cost of travelling to visit patients transferred to Sandwell. A taxi would cost around £10, and the trip would involve changing two or three buses. Would the Trust be liasing with Centro? Of course we would implied John Adler, and let us remember low income patients can be reimbursed for their travel expenses.

Come off it! replied the crowd. It is not as easy in practice to reclaim these expenses because you often need receipts, not exactly the first thing you remember in an emergency. In any case, relatives visiting their children would not be reimbursed, pointed out one man. And does anyone really believe the Trust has enough sway over Centro to get the transport network overhauled to suit their own plans? I doubt it. Services may follow hospitals as the Chief Executive pointed out, but as he also pointed out earlier that 90% of patients would still be using the same hospital, will there be enough demand to make such services financially viable for the Transport Executive?

Someone then asked if the newly built Birmingham Treatment Centre would still be used if the new hospital was built. This and the new Emergency Services Centre (ESC) at Sandwell would continue to be used replied Mr Adler. What he failed to point out is that the ESC was designed to be used as an A&E. When the new hospital is built the A&E will move with it and the ESC will presumably be used in a way it not designed to as a planned operation centre, a fact pointed out previously by the Express and Star.

When asked if the plans would lead to further job losses John Adler's answer was (and I quote the Birmingham Mail):

"We have no job losses in the long term plans"

An astonishing answer given that the new hospital will only have half as many acute beds as the two it is replacing. Unless SWBH NHS Trust plans to become less efficient, it is a natural consequence that staff will have to go. Some of the clinical staff may be employed instead by Heart of Birmingham or Sandwell PCT, but there is no guarantee that support staff will have their jobs transferred to these organisations when the new hospital is built in 2013.

Some interesting points about community services were raised by Conservative councillor Deidre Alden, Midlands Today health correspondent Michele Paduano and local GP Niti Pall. The latter was rather unfairly heckled for apparently supporting Trust plans. I think she slightly missed the point of the City Hospital Suppporters Group campaign. Everyone in the room agrees that community facilities need to be improved so that stays in acute hospitals are reduced, but the problem many of us have is that the PCT's have failed to do this over the last eight years. Where is the evidence that things will improve in the next eight? Sandwell PCT is heavily in debt (although Heart of Birmingham PCT is sitting on a large surplus carried over from previous years); this will surely impact on the level of community provision they can provide even with a £700 million investment.

Khalid Mahmood, Labour MP for Birmingham Perry Barr, promised to send a consultation document to every household in his constituency and said he would stand by what his constituents think. It would be nice to see some of the other local MP's make this commitment - why not use the link in the bar on the left hand side to find out who your MP is and see whether they can help in a similar fashion.

The final question was the one that I think most of us have been thinking; is this consultation going to take on board the publics concerns, or is this a done deal, a bureaucratic box to be ticked before they can get on with the next stage. John Adler was asked this three time during the evening and his answer left us none the wiser.

The point is this. We have two consultations going on at the same time, in a three month period over the Christmas period. One is about whether a new hospital should be built. The other assumes we will be building a new hospital and asks how we should reconfigure services in the meantime. This hardly reassures us this is not a consultation in the sense "We will give the public their say, and then do what we were going to do anyway".

However, Shaping Hospital Services for the Future does now have an extended deadline as mentioned above. Towards 2010 will end on 16th February 2007 as before, because it is believed by the Trust that the public are broadly in favour of building a new hospital. At this meeting both sides of the panel were in favour of it but there was some discontent on the floor.

Have the Trust shot themselves in the foot by not heeding the warnings of the clinicians over the interim plans? Their arrogance over this issue could end up costing the community a new hospital if they are not careful. This is the reason the two consultations should have been done separately in the first place.

Trust Response to Question on Seriously Injured Patients Inadequate

2007-01-08T22:01:00.000Z

Who is the Trust kidding? In this article in the Birmingham Mail 8th Jan. a Trust spokeswoman states:

"a surgeon would be on standby for City A&E who could be called in if anyone walked in needing immediate surgery"

How many patients who have been shot or knifed or have surgical emergencies are able to walk in?? Do these people live in the real world? We have one of the most experienced teams at dealing with surgically ill emergencies in the country at the moment. Having it downgraded will not improve the service to our patients.

The Birmingham Mail's Big Debate

2007-01-08T19:55:00.000Z

The Birmingham Mail is organising a public meeting to debate the planned changes at City and Sandwell Hospitals. It will take place at 6pm on Tuesday 16th January 2006 at the Afro-Carribean Centre, 339 Dudley Road, Winson Green, Birmingham, B18 4HB (for a map of the area, please click here). This is a fantastic opportunity to quiz the healthcare bosses about the planned changes at City and Sandwell hospitals, and we would urge as many people as possible to turn up and make your views known in the presence of the local media (Midlands Today will probably also be covering this story).

To see an online version of the Evening Mail article, please click here.

The Website of the Afro Carribean Millenium Centre is http://www.acmccentre.com/acmc.shtml

About this Campaign

2006-12-28T19:13:00.000Z

On the 20th November 2006 the Sandwell and West Birmingham Hospitals NHS Trust went out to consultation on two sets of proposals; Towards 2010 and Shaping Hospital Services for the Future.

The Towards 2010 proposals can be welcomed although they will not become a reality before 2013 at the earliest assuming they actually go ahead. The Shaping Hospital Services for the Future proposals are bad news for the people of West Birmingham because the Trust is proposing to move the inpatient beds for Emergency and Trauma Surgery and for children from City Hospital to Sandwell Hospital. Effectively this will mean ambulances will be taking Surgical and Trauma patients from West Birmingham likely to need admission, to Sandwell Hospital. The same will apply to children during the 12 hours the proposed Children’s Assessment Unit is closed at City Hospital. This will mean worse access to emergency hospital care for the people of West Birmingham until at least 2013 when the new hospital is planned to open. These changes would have undesirable effects on other services provided at City Hospital with the loss of emergency surgical and children’s expertise.

As a result of the grave concern felt by the staff of all working groups at City Hospital over 100 people expressed their support for establishing the City Hospital Supporters Group. The key objective of this Group is that the people of West Birmingham continue to have 24-hour access to high quality emergency care for adults and children on the City Hospital site, until a new hospital, which can provide this service opens its doors.

The people organising this Group are Dr. Ken Taylor a consultant physician who has worked at City Hospital in various capacities over 26 years, a very senior nurse, and Christine Rickards, branch secretary of UNISON, who have both worked many years at City Hospital and between them they represent all the staff groups. The Group are advised by the relevant medical experts at City Hospital who have all contributed to and approved the two documents Support City Hospital which gives advice from our Group on answering the questions on the Shaping Hospital Services for the Future consultation document, and Petition in Support of City Hospital which you can also be downloaded from the links in the bar on the right hand side. You can also join the City Hospital Supporters Group. We are striving to get as many people as possible to complete consultation forms, join the petition and join the Supporters Group. It would also be good if people attended the consultation meetings organised by the Trust and expressed their concerns about the proposals on moving services from City Hospital. The dates and times of these meetings are available via the following link: www.swbh.nhs.uk/latest_news/documents/Consultationmeetings.pdf

Lastly all consultation forms and petitions have to be in by the 16th February 2007 at the latest. Make sure you express your view.

Update 18/01/07: The consultation deadline for Shaping Hospital Sevices for the Future has now been extended to 15th March 2007, so there is really no excuse to make your voice heard!

Petition in Support of City Hospital

2006-12-28T19:12:00.000Z

The following is the text of the petition opposing the loss of emergency Inpatient Surgical and Paediatric beds at City Hospital. A printable version is available here:

http://docs.google.com/View?docid=dr2jf65_4dd92wm

This can be printed out and sent to the address at the bottom of this post, or alternatively copy and paste into Word, fill in and e-mail to supportcityhospital@googlemail.com (If you would prefer a version in Word e-mailed to you as an attached file, please request it via the same e-mail address).

The petition can also be signed online using the following link: http://www.ipetitions.com/petition/supportcityhospital/

Whichever method you decide to sign this petition by, please ensure you only sign it once.

Petition in Support of City Hospital

I oppose moving beds for Emergency Surgical Patients and Emergency Trauma Patients from City Hospital to Sandwell Hospital.

I support a 24 hour Surgical Assessment Unit at City Hospital as proposed by the surgeons and A&E doctors at City Hospital.

I oppose moving Children’s beds from City Hospital to Sandwell Hospital.

I support a Children’s Assessment Unit that remains open 24 hours a day, at City Hospital.

Name

Home Address

Contact Number

Email Address

Signature

I AM / AM NOT employed by Sandwell and West Birmingham NHS Trust (Delete as appropriate)

If you are employed by the Trust which Department do you work in?

I wish to be enrolled as a member of The City Hospital Supporters Group. YES /NO (Delete as necessary)

Membership subscription: Medical Staff £5
Non-medical Staff £1
General Public Free

NO PERSONAL DETAILS ON THIS FORM WILL BE SHARED WITH THE TRUST.

(NB: If you are signing our online petition, please ensure you tick the box entitled "Display my name as anonymous on the signatures list" if you do NOT want your name to be publicly associated with the petition)

PLEASE PUT THIS FORM IN AN ENVELOPE ADDRESSED TO:

CITY HOSPITAL SUPPORTERS GROUP
POSTGRADUATE CENTRE
CITY HOSPITAL
DUDLEY ROAD
BIRMINGHAM
B18 7QH

Public Meetings

2006-12-19T21:38:00.000Z

Below is a link to a pdf document which contains times and dates of public meetings that are being attended by the the two public consultation teams. We encourage you to attend these meetings and make known your opinions regarding the interim reconfiguration plans for City Hospital.

www.swbh.nhs.uk/latest_news/documents/Consultationmeetings.pdf

How Can You Register Your Concerns?

2006-12-12T20:42:00.000Z

Get the document with the green front cover and the picture of the child “Shaping Hospital Services for the Future’’ which is the really important document about services together with the accompanying questionnaire by doing one of the following:

1) Phoning the Hospital on 0121 507 5940

2) E-mailing consultation@swbh.nhs.uk

3) Go to the Sandwell and West Birmingham NHS Trust website http://www.swbh.nhs.uk/ Details are currently available via the latest news link
(http://www.swbh.nhs.uk/latest_news/index.html).
Alternatively, the consultation document can be filled in online via the following direct link http://www.sunion.warwick.ac.uk/onlinesurvey/interim2010/

Your response needs to be sent back to the Hospital or completed online before 15th March 2007 (this has been extended from the previous deadline which was 16th February 2007).

What does City Hospital Supporters Group consider to be the best answers to these questions?

Q1 No

Q2 Do not change until the new hospital is ready to open.

Q3 No

Q4 The proposals will result in a worse service for people living locally to City Hospital.

Q5 No

Q6 You would want urgent treatment including surgery at City Hospital. You would be fearful of the risks of transfer to another hospital.

Q7 No

Q8 Urgent care for a sick child should not be delayed by travelling to a hospital further away.

Q9 Ask why they want to make changes that will give you a worse service before the new hospital opens.

The other Questions are self-explanatory.

As well as completing your consultation form and returning it before the 16th February you can complete our petition form and return it to us and you can also choose if you wish to enrol with the City Hospital Supporters Group. For further information please see the post entitled Petition in Support of City Hospital (click here).

Support City Hospital

2006-12-11T21:14:00.000Z

The City Hospital Supporters Group was established on Saturday 9th December 2006 when over 100 members of the staff from all branches of the workforce expressed their support for its objective…

That the people of West Birmingham continue to have 24-hour access to high quality emergency care for adults and children on the City Hospital site, until a new hospital, which can provide this service, opens its doors.

What is being planned by the hospital management?

1. Moving Inpatient Emergency General and Trauma Surgery from City Hospital to Sandwell Hospital.

2. Moving overnight-stay Children’s Beds from City Hospital to Sandwell Hospital and only offering a 12 hour Children’s Assessment Unit at City Hospital

Why should we be concerned?

City Hospital’s Emergency Department, the nearest to the City Centre, sees over 100,000 referrals per year with more stabbings and shootings than any other hospital in the Midlands and probably in the UK.

City Hospital sees almost twice as many emergency surgery patients as Sandwell Hospital.

These two facts mean that moving Emergency General and Trauma Surgery from City Hospital to Sandwell Hospital makes no sense!

Moving these services will also affect the training of the doctors and the reputation of City Hospital, making it less likely to be able to attract the best staff in the future.

This will mean a second-rate service for the people of West Birmingham.

City Hospital currently sees any child that is brought to the hospital, whether by the family (to the emergency department) or because they have been referred by a general practitioner (GP). If the hospital management decide not to have children’s doctors (paediatricians) at City Hospital 24 hours a day, such children will need to be transferred to Sandwell Hospital for assessment.

This will mean a second-rate service for the children of West Birmingham.

What can you do about it?

Click here to find out