Monday, 15 July 2013

BSBV must cease misinformation campaign!

To All; Please note that this e mail is sent to NHS England, (kindly forward to David Nicholson), Jeremy Hunt, BSBV (kindly forward to Marian Plant and Mike Bailey ) SCC Health Scrutiny Committee members BBC Radio, National Journalists, local journalists, our Member of Parliament, Chris Grayling, Save St Helier campaign who requested our FOI figures after seeing Marian Plant's Myth Busters page, the CEO of Epsom St Helier Trust and the medical director of St Helier NHS Trust and all members of Surrey Downs CCG.

Please would Dawn forward this to Agatha Nortley-Meshe as latter is mentioned here.

Dear Surrey Downs CCG Board members, David Nicholson. Marilyn Plant, Mike Bailey, BSBV staff, Matthew, Ruth, Chris, SCC Health Scrutiny Committee members, members of the press and campaign members.

For those of you who are disinclined to bother to listen to the publicwe would ask you to at least look at the attached FOI answers re ambulance blue light times, in 
conjunction with Marilyn Plant's last ' Myth Buster ' page copied at footing of e mail  below. Astonishing 

The public have engaged with the information campaign BSBV have been involved in for the last few weeks on Twitter and in the media, giving evidence of facts we have collected regarding BSBV in relation to Surrey residents and their needs. We would have preferred that these members of staff had used the pause in BSBV to collect this information themselves. This culminated in Marilyn and Mike's 'myth busting" daily web-site posting!!  Is this a good use of doctors' time, which we, the public, pay for??

Included in the twitter exchange, which preceded the web site nonsense, were details of the type of FOI facts we have collected, these was given to Agatha and Marilyn, via twitter, earlier this week.

There is NO excuse, therefore, for the misrepresentation that has taken place! It is time that this shambolic process is laid to rest and the staff dealt with appropriately!

We hope NHS England will take note of how even recorded blue light ambulance times are dismissed as untrue.

In view of this, no members of the public can have any confidence that any genuine consultation will be possible.

It may be that many of you expect the public to be cynical about NHS presentation of information but we continue to insist that the public voice should be heard and that FACTS should be the basis upon which any changes are made. Increased safety for some patients should not be an excuse for increased risk for others.

'So, to BSBV's so called Myth Busting week!!
Most of the points made relate to Epsom's objections (unsurprising as there are so many flaws with the process relating to Epsom, hence so many objections.)

8th July. Mike Bailey states 10 % patients in London more likely to die at weekends. Once again leaves out Epsom and St Helier's below average mortality rate at weekends, shown in the information they used.

9th July. Mike attempts to 'Bust' his next myth
That BSBV did have all evidence!

An E mail sent to Epsom and St Helier staff asking for very basic information, on same day our CCG was supposed to vote on the BSBV proposals, dismissed as "up dating".   If one doesn't have basic information available how is one recommending a process to CCGs?
10th July
Mike Bailey knows the London 168 hours cover for maternity is unaffordable- if Royal Colleges are happy with what we do, don't pretend an unaffordable alternative will be put in place, -is this so Epsom staff can be removed in the meantime?

11th July
Mike makes up own myths!!
We had pointed to NHS England's evidence re OOH GP only led units being unsafe for children- not quoting NHS England opinion on BSBV.
Whether it's a minor injuries unit or an urgent care centre, if GPs cannot treat /diagnose/cater for very sick children, as in the NHS England evidence, that is surely what BSBV should be taking into account- Our area must have acute paediatric help, very specialised cases are already taken elsewhere, but having medical staff available to travel with paramedics is obviously not an affordable option for all children who fall ill.

Dr Marilyn Plant. Denies that a "terrible" thing like gagging has ever happened!!
Please see attached media protocol- if doctors have to get BSBV approval before speaking out, what does this amount to??

If there was real freedom, why were medical directors of all 5 hospitals asked to sign a pro forma letter approving all BSBV work? Medical Directors should have been asked to comments on all areas, under subjects required, so they could express their real opinions based on the facts. 

The following is cut and paste from Marilyn's web page. Bear in mind that we
 had explained, via twitter, that our ambulance times were, in fact all blue
 light times. See the letter from SECAM attached which shows they are giving
 all category A blue light times for the dates requested and they actually
 couldn't give the other ambulance times , as requested in the 3rd question,
 owing to time that would be required for collecting such information 

Dr Marilyn Plant 12th July 2013
We have used the recognised best practice method available when calculating all travel times. Our times are drawn from satellite navigation data based on millions of actual journeys.
Both the London Ambulance Service and the South East Coast Ambulance Service (SECAmb) have examined and supported our methodology and we are in continuous dialogue with both about the likely impact on their services.

SECAmb data released following a Freedom of Information request relates to all journeys by ambulance, and not
 just ‘blue light’ travel times.  We know from conversations with.....
end of M Plant's quote

We think it is outrageous that not only do the public have to collect information for this process but that, instead of using the pause time to do the work properly, the actual facts are disputed in this way.

The child mentioned in NHS England's reports deteriorated when 999 calls didn't result in an ambulance attending in 30 minutes. 
We know, from our time in LINks, that sick children have suffered from long transfer times both for surgery and during transfer back from a London Hospital.

The Darzi report shows 24 minutes maximum transfer time in Labour before an "adverse" occurs. The birthplace study cited by BSBV shows 40% of first time mothers need transfer in or just after labour so a midwife only led unit would not be safe because of our ambulance times

We show the link below so you can assess the way the main BSBV staff think public concern should be addressed!!

The debacle we have witnessed since Epsom was thrust into the already flawed BSBV should be a lesson to the NHS - changes must be based on facts-

Kind regards,
Jane Race (who provided all data via twitter to BSBV, in last few weeks)
Rosemary Najim

Epsom Hospital campaign Former LINks members. No vested interest, unlike some mentioned above, 
in any private or NHS service, except as patients! 

Monday, 8 July 2013

Latest on BSBV from the Rt Hon. Chris Grayling MP.

GPs in Epsom and Ewell, Mole Valley, Reigate and Banstead and Elmbridge have voted overwhelmingly against the Better Services Better Value proposals to remove acute services from Epsom Hospital. An even larger proportion said they wanted the future of Epsom Hospital decided in a Surrey context and not part of a London review.

The secret ballot, instigated by local MPs Chris Grayling, Sir Paul Beresford, Dominic Raab and Crispin Blunt, was sent to all GPs practicing in the new Surrey Downs commissioning area, and the result was independently counted and verified by the Returning Officer at Mole Valley District Council.

The new Surrey Downs Clinical Commissioning Group and the Better Services Better Value review team had previously said that local GPs were behind the scheme. But doctors voted by two to one against the plans for Epsom hospital to be downgraded and by more than four to one in favour of decisions about Epsom being taken in a Surrey context.

Chris Grayling said:

"We organised this ballot because we did not believe that local doctors really agreed with what is going on, and the result clearly shows that we were right. This vote was carried out in secret, was independently verified, and it shows that the controversial plans for Epsom are not just opposed by the public but by the doctors as well. I think this result marks the death knell of Better Services Better Value, and I hope that all involved will now call a halt and stop wasting public money on a review that, in the context of Epsom and Surrey, has never added up."

The questions to the GP's and voting results were:

Are you in favour of the BSBV proposals to remove A & E and Maternity Services from Epsom Hospital?

Yes 32%
No  68%

Would you support a separate process to consider the future of Epsom Hospital as part of the Surrey and not SW London health economy?

Yes 82%
No  18%

Thursday, 4 July 2013

HOSPITAL UPDATE: Latest letter sent to the Surrey Downs Clinical Commissioning Group (SDCCG)

Dear Surrey Downs Board Members,

It was very disappointing for the public, given the halt in BSBV, which would have given you time to look properly at the needs of the people of Epsom and the surrounding area, to find that you passed on plans, at a meeting with clinicians last week, suggesting that at present you do not want to have paediatric in patient beds at Epsom and that you plan to have an urgent care centre led by GPs only.

It is also gives rise to concern that the meeting, which was supposed to be a clinical paediatric meeting was attended by only one paediatrician from the CCG, two BSBV employees, the operating officer, and a GP, whose interests are not paediatrics related and  who is from outside the area concerned.

It is very clear that rather than looking at what needs to be commissioned for the local population, you are continuing to be led by BSBV interests which will, it is true, achieve better outcomes for London residents, but considerably worse outcomes for our area-  because of the dangers which will results from the increased travel times and the lack of access to stabilisation by secondary care physicians where needed.

I copy below an extract from the recent research on urgent care, issued by NHS England for consultation and  you will see evidence of exactly the scenarios we have outlined when putting the case to you for retaining paediatrics and maternity and stabilisation facilities at Epsom.

We would also point to the expenditure implications of losing the paediatric service which serves the acute and community needs at present.Consultants have provided both services in an integrated way and you will have to pay for community replacements and for acutely ill children elsewhere under your plans.

It is of great concern also that so many of our CCG members do not seem interested in providing services for the whole area and that some seem content as long as their own area is provided for. This is not what a commissioning board is supposed to do and we will challenge this!!

For those of you who have not had time to look at the ambulance blue light figures we sent recently, the journey times to both London and Surrey alternative centres are far too long for women in trouble in labour or sick children.

Please look at the latest evidence re urgent care centres below.

It would be good to hear that you decide to reverse your plans and will keep paediatrics and maternity and an urgent care centre with secondary care facilities when required, but until then we are determined to put these issues into both the local and national public domain 

Best wishes.
Rosemary Najim and Jane Race.
Epsom Hospital Campaign.

Extracted from NHS England Review of Urgent Care Evidence. June 2013

National reporting and Learning System (NRLS) data illustrates there are significant patient safety issues for children who attends minor injury units where the medical cover is run by out of hours GP. The incidents suggest that staff at minor injury units were sometimes unable to direct or transfer patients to the care service most appropriate to their need. Examples of incidents reported can be summarized under themes including; lack of equipment, inability to deal with child’s presenting condition, delay in ambulance transfer out of the minor injury unit for children, children presenting although the minor injury unit is closed, failure to recognize safeguarding issues and critically ill children.
Extracts from NRLS data
A poorly child arrived at a minor injury with unidentified rash on both legs and body- emergency ambulance still hadn’t arrived after 30 minutes and child was deteriorating
Asthmatic teenager presents – difficulty breathing,- nurse unable to assess seriousness- happens a lot at night
NHS England document advises children needing specialist paeds. Bypass local hospital.
Very sick children from our area already are taken straight to St Thomas’ or St Georges’ so Epsom is fully compliant-