Some sobering thoughts for 2008.

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.

The Presentation to the IRP

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!

Reasons for choice of Sandwell as Emergency Surgical site.

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.

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.

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.

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

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

• 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.

CHSG Response to Interim Plans

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.

CHSG Reponse to Towards 2010

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

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?

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?

Petition in Support of City Hospital

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

How Can You Register Your Concerns?

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

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