Save Newark Hospital

Protecting Newark Healthcare Jobs and Services

Those of us who oppose the downgrading of Newark Hospital suffered a double disappointment on Tuesday when the Health Minister, Simon Burns and NHS Nottinghamshire County said the decision to downgrade Newark Hospital fulfilled the Health Secretary’s four criteria for changes to NHS services.

Nottinghamshire County Council’s Overview and Scrutiny Committee gave their support to NHS Nottinghamshire County’s proposals to remove services from the hospital.

Responding at a Westminster Hall debate called by Newark’s MP, Patrick Mercer, the Health Minister, Simon Burns announced that NHS Nottinghamshire County would not be referring its decison Nottinghamshire County Council’s Overview and Scrutiny committee. Mr Burns went on to say that he was unable to intervene in the matter or the decision to rename the Accident & Emergency department to a Minor Injuries Unit.

Commenting after the debate Mr Mercer told the Nottingham Post “We’ve got to have something better than that which is being proposed. Most will accept that A&E has been closed, but most believe and most have indicated during the consultation process that what we do need is an ‘urgent care centre’.”

The Save Newark Hospital Campaign has submitted evidence to both the Health Secretary and the Health Minister showing that NHS Nottinghamshire County does not meet the four criteria. Chair, Dr Ian Campbell, said “It’s clear the Health Minister was only prepared to listen to one side of the story and this in itself is very worrying. We are now considering what to do next in a battle that is clearly far from over.”

Health Minister Simon Burns has agreed to speak at a Westminster Hall debate to be hosted by the Newark MP Patrick Mercer next Tuesday (6th July).

The debate will centre around the future of Newark hospital and last for half an hour (1300-1330). A stakeholders meeting involving NHS Nottinghamshire County, Sherwood Forest Hospitals Trust, Mr Mercer, Save Newark Hospital Campaign and GPs will then follow locally on a date to be decided – probably within the next two weeks.

Commenting Mr Mercer said:

‘I’m delighted the Health Minister is taking such an interest in our hospital. Today’s visit was his first ministerial visit and he spoke with many members of staff during his tour of the hospital. The fight for the future of our hospital is not over. But at last we are getting somewhere.’

The Minister’s visit to Newark followed NHS Nottinghamshire Trust’s decision to rename the hospital’s A&E ‘minor injuries unit plus’ on 17th June and close beds.

Save Newark Hospital Campaign Chair, Dr Ian Campbell said:

 “The Minister reiterated Government policy that local public opinion should be at the heart of NHS decision making. The issue over A&E in Newark is a perfect opportunity for that policy to start. Now that we have political involvement at the highest level perhaps NHS Nottighamshire County will listen to the majority of people in Newark, and to our MP, who are opposed to their plans.”

The Health Minister will not meet with the Save Newark Hospital Campaign when he visits Newark hospital today (1st July). And hospital staff have been banned from discussing the future of their hospital with Simon Burns.

Newark MP Patrick Mercer will hand Mr Burns the following letter from the Campaign:

Dear Mr Burns

I’m sorry I was prevented from meeting you in person and I hope this letter will enable the Secretary of State, Andrew Lansley, to overturn NHS Nottinghamshire’s decision of 19th June to downgrade Newark hospital’s A&E to a minor injuries unit, re-route ‘blue light’ ambulances to Lincoln or Mansfield, some 20 miles away, and close a medical ward.

NHS Nottinghamshire County conducted a flawed and misleading consultation. The public were asked what name they wished to call their A&E and the hours it should open. The Consultation said it would continue to offer the same level of care that is currently available (p15 NHS Nottinghamshire County’s consultation document). The resultant business case makes substantial changes in the range of conditions the hospital will accept and the closure of a medical ward to the reduced number of admissions. Patients and the public have not been offered a choice.

As Appendix 1 explains in detail, the Consultation also fails to meet the Secretary of State’s strengthened criteria he expects decisions on NHS services changes to meet:

  • Focus on improving patient outcomes – Dr Foster data shows that United Lincolnshire Hospital’s outcomes are worse than Sherwood Forest’s and Sherwood Forest’s mortality rates are lower than ULHT’s (NHS Nottinghamshire County’s wants blue light ambulances re-routed to Lincoln)
  • Consider patient choice – NHS Nottinghamshire County conducted a flawed and misleading Consultation, as explained above.
  • Have support from GP commissioners – the Newark Healthcare Review Steering Group Terms of Reference shows a GP Advisor Forum, but there is no mention of their support in either the Newark Healthcare Strategy or the Business Case for Newark, and it is clear that clinical opinion is divided.
  • Be based on sound clinical evidence – In their business case, NHS Nottinghamshire County repeatedly cite the Academy of Medical Royal Colleges’ 2007 report into Acute Health Care Services[1]. The report actually says “Big is not necessarily better” (p.v). The evidence for improved outcomes by transferring all acute medical admissions to other sites is not there.

Also, the Consultation failed to meet government guidance on consultation in five key areas:

  • Criterion 1: When to consult – proposals for options 1 & 2 of the consultancy document were developed prior to any form of consultation; that is without consultation
  • Criterion 3: Clarity of scope and impact – whilst the consultation document is clear about what is being proposed, the consultation is biased and misleading, as explained in Appendix 2 ‘Your Hospital, Your Choice’
  • Criterion 4: Accessibility of consultation exercises – the consultation failed to reach its target population as indicated by the low response rate, and the consultation has excluded GPs and around 30,000 people who live 10 miles of Newark
  • Criterion 6: Responsiveness of consultation exercises – due to the poor response (263 out of a population of 43,000) NHS Nottinghamshire County then carried out a telephone survey to gather another 500 responses – by definition this group are ‘non-respondents’ and should therefore not be included in the consultation
  • Criterion 7: Capacity to consult – NHS Nottinghamshire County failed to state it would abide by the government guidelines on consultation

Finally, the consultation was carried out prior to your Government coming to power, and prior to the policy on GP commissioning. In delivering patient choice, local GPs will be met with requests from the bulk of their patients to be treated in Newark. The loss of the A&E department and the failure to reopen Friary Ward also means the loss or downgrading of other services such as surgical cover, physiotherapy, medical beds, carer support and the pharmacy. This will undoubtedly result in a reduction in patient choice.

If properly considered could Newark Hospital and Newark and District GPs become a pilot for Practice Level Commissioning?

I look forward to hearing from you.

Yours sincerely

Dr Ian Campbell

Chair, Save Newark Hospital Campaign

 


[1] www.aomrc.org.uk/publications/reports-guidance/doc_download/67-acute-health-care-services-report-of-a-working-party.html

The Health Minister Simon Burns, who visits Newark hospital today (Thursday 1st July), will be told two million extra miles are likely to be travelled as a result of NHS Nottinghamshire County’s decision to downgrade Newark Hospital’s A&E, re-route ‘blue light’ ambulances to Lincoln or Mansfield and close a medical ward.

A return trip between Newark and the proposed alternatives (Lincoln and/or Mansfield) would clock up a round trip of around 46 miles. With up to 50 patients or more at any time bedded at distant hospitals and assuming the average patient receives two vehicle visits a day, then we might calculate, the number of miles travelled to visit per annum at an astonishing 1,679,000 miles. If we were then to add the ambulance mileage for transporting to and from Newark this figure would be close to two million miles.

The decision by NHS Nottinghamshire County flies in the face of what Nottingham Energy Partnership is trying to achieve locally as part of the NHS Sustainable Development Unit’s remit to reduce the 18 million tones of carbon created by the health service every year.

Newark MP Patrick Mercer said this is just another reason why NHS Nottinghamshire should come to its senses and reverse its decision of 17th June:

‘We are all committed to reducing the carbon footprint and this is another factor that NHS Nottinghamshire County will need to explain in their decision to downgrade services at Newark Hospital. I wait their explanation with great interest.’

Dr Ian Campbell
Chair, Save Newark Hospital Campaign
 

28th June 2010

Dear Secretary of State

REQUEST FOR A REVERSAL OF DECISIONS MADE AFTER A FLAWED CONSULTATION BY THE PRIMARY CARE TRUST

I write as Chair of the Save Newark Hospital Campaign (SNHC). The campaign group was formed in response to the publication by NHS Nottinghamshire County, in November 2009, of a consultation document, which detailed proposed options for changing services at Newark Hospital.

The SNHC ask you to reverse the decision announced by NHS Nottinghamshire County on 17 June 2010 to downgrade the A&E department, re-route all ‘blue light’ ambulances to Lincoln or Mansfield, some 20 miles away, and close a medical ward.

The Campaign was encouraged to read that in your first speech made as Health Secretary you said you: ‘would put your heart and soul into the improvement of health outcomes by making patients the driving force of improvements to the NHS’. And the Campaign welcomes the publication of last week’s four criteria that need to be met for all NHS service changes (see Appendix 1).

The people of Newark have not been engaged over NHS Nottinghamshire County’s plans, and are bitterly opposed to the downgrading of their local hospital. The consultation has not followed government guidance and misled the town’s MP, Patrick Mercer, and his constituents (see Appendix 2). As such, the process was flawed and the Campaign is considering referring the case to a judicial review.

The population of the greater Newark area is in excess of 60,000. NHS Nottinghamshire County only received 243 responses to their proposals, which did not include retaining the current A&E department. A rushed telephone poll was carried out just before the consultation process finished to increase the number of responses.

The Government has recently announced that it is committed to taking action on climate change. The Climate Change Act has been published, together with a target to cut carbon emissions by at least 80% by 2050.

The NHS has a carbon footprint of 18 million tones of CO2 per year and according to David Nicholson, NHS Chief Executive, the health service has a ‘responsibility to tackle its carbon footprint’. The NHS Sustainable Development Unit has been set up to reduce the NHS’ carbon footprint and here in the East Midlands the Nottingham Energy Partnership is driving forward the climate change agenda locally.

With a medical ward closing and patients who require urgent care being taken more than 20 miles away from their home town it would seem that the green agenda has not been fully considered by NHS Nottinghamshire County.

A return trip between Newark and the proposed alternatives (Lincoln and/or Mansfield) would clock up a round trip of around 46 miles. With up to 50 patients or more at any time bedded at distant hospitals and assuming the average patient receives two vehicle visits a day, then we might calculate, the number of miles travelled to visit per annum at an astonishing 1,679,000 miles. If we were then to add the ambulance mileage for transporting to and from Newark this figure would be close to two million miles.

I look forward to hearing from you.

Yours sincerely

Dr Ian Campbell

Chair, Save Newark Hospital Campaign

The Health Minister, Simon Burns, visits Newark hospital tomorrow (1st July). However, he is apparently insistent that his visit is not in a mediatory capacity.

It is therefore crucial as many people as possible write to the Health Secretary, Andrew Lansley, if we are to overturn NHS Nottinghamshire County’s decision of 17th June.

Mr Lansley can either be contacted via his email by clicking HERE or through Royal Mail by downloading the suggested letter HERE and sending it to:

Rt Hon Andrew Lansley MP,
Secretary of State for Health,
Department of Health,
Richmond House,
79 Whitehall,
London SW1A 2NS

Photographs from our hugely successful market stall on Saturday 26th June can be accessed from our Photo Gallery by clicking here. Thanks to everyone who contributed to making the day a success, especially those of you (almost 600) who completed a ballot paper.

In response to the Secretary of State’s four criteria for when NHS organisations make changes to services (http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_116290), the Save Newark Hospital Campaign claims NHS Nottinghamshire County does indeed provide insufficient assurance that the four tests have been properly applied.

Commenting Newark MP Patrick Mercer said:

There is little doubt that the consultation process must be urgently reviewed by the Government. It is crucial that services are not reduced in a town whose population is expanding. It’s clear to me that the whole process leading to NHS Nottinghamshire’s decision to downgrade Newark’s A&E department, close a medical ward and re-route blue light ambulance services away from the towns hospital must be properly scrutinised.’

- ends –

Editors Notes

NHS Nottinghamshire County’s Decision  

NHS Nottinghamshire County decided last week (Thursday 17 June):

  • A 24 hour Minor Injuries Unit ‘plus’ (option 1 above) by 1st October 2010[1]
  • Reduction in medical beds to be agreed approximately 56 to 32 with effect from 1st April 2011 meaning ‘Newark Hospital will have two wards vacant’[2]
  • The hospital will now not accept medical emergencies – all blue-light emergencies will go to Lincoln (first) or King’s Mill (if previous history)[3]

What the Proposal Means in Reality

In the consultation document NHS Nottinghamshire County says under option one ‘this means that we could provide the same level of care that is currently available at Newark’[4]. NHS Nottinghamshire County claims it is merely changing the name from A&E to a minor injuries unit. Yet the hospital has been operating an A&E department because, until now, it has accepted blue light ambulance services and is staffed with specialist A&E consultants.

NHS Nottinghamshire County only collected 700 responses to its Consultation, and 500 of those followed a rushed telephone poll just before the consultation had closed due to the poor response. Local people were never given a chance to vote for retaining the A&E department, because the ‘missing option 3’ wasn’t included within the Consultation Document. 

The ‘Missing Option 3’

Retain Newark Hospital’s fully operational Emergency Care Centre where an integrated emergency service will provide comprehensive care to all but the most seriously ill, or those requiring immediate and direct access to specialist centres, far in excess of the 85% of potential patients currently proposed by NHS Nottinghamshire County.

 What the Consultation Document Offered for Comment

Option 1: Minor Injuries Unit ‘Plus’ 24/7 – a minor injuries unit (MIU) staffed by doctors and specially trained nurses to treat people with minor injuries such as broken bones and minor illnesses. There would be access to x-ray and other testing equipment. A direct online link to other centres would allow the results to be read by experts who would give immediate advice if necessary. An out of hours GP service would also be available. This service would treat 85% of patients with the other 15% taken directly to another hospital by ambulance.

Option 2: Minor Injuries Unit ‘Plus’ 7am-midnight – this would be the same as Option 1, but only open between 7am and midnight, with out-of-hours GP cover enhanced (local GPs prefer this option, but there is a conflict of interest because they would gain financially – the cost of patients visiting A&E comes out of their budget).

 


[1] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15797 (page 5)

[2] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15799 (page 73) and http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15802 (Transition & Implementation Plan 2010 page 1)

[3] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15799 (page 53)

[4] http://www.nottspct.nhs.uk/images/stories/My_Voice/newarkconsult_1109.pdf page 15

The Newark MP Patrick Mercer is this morning (Friday 25th June) to ask the Health Secretary to ‘call in’ the whole consultation process over the town’s A&E department. Mr Mercer said he is ‘thoroughly fed up’ with the PCT, NHS Nottinghamshire County, for misleading him and his constituents over the plans for Newark Hospital.

NHS Nottinghamshire County claimed in its consultation document that the changes ‘could provide the same level of care that is currently available at Newark’[1].

Mr Mercer said:  

‘NHS Nottinghamshire County assured me it was merely changing the name of Newark hospital’s A&E department. Clearly the re-routing of all ‘blue light’ emergencies away from Newark, and the closure of a surgical ward is a fundamental change of services. I can no longer trust NHS Nottinghamshire County and it’s therefore time for the whole process to be scrutinised by the Health Secretary.’

 Sherwood Forest Hospitals Trust, which provides services at Newark, issued a memo to staff on the changes (attached). The memo hints at the fact that the Trust is at loggerheads with NHS Nottinghamshire County, which commissions services, over what should be provided at Newark.

                                       – Ends - 

 Editors Notes

NHS Nottinghamshire County’s Decision  

NHS Nottinghamshire County decided last week (Thursday 17 June):

  • A 24 hour Minor Injuries Unit ‘plus’ (option 1 above) by 1st October 2010[2]
  • Reduction in medical beds to be agreed approximately 56 to 32 with effect from 1st April 2011 meaning ‘Newark Hospital will have two wards vacant’[3]
  • The hospital will now not accept medical emergencies – all blue-light emergencies will go to Lincoln (first) or King’s Mill (if previous history)[4]

What the Proposal Means in Reality

In the consultation document NHS Nottinghamshire County says under option one ‘this means that we could provide the same level of care that is currently available at Newark’[5]. NHS Nottinghamshire County claims it is merely changing the name from A&E to a minor injuries unit. Yet the hospital has been operating an A&E department because, until now, it has accepted blue light ambulance services and is staffed with specialist A&E consultants.

NHS Nottinghamshire County only collected 700 responses to its Consultation, and 500 of those followed a rushed telephone poll just before the consultation had closed due to the poor response. Local people were never given a chance to vote for retaining the A&E department, because the ‘missing option 3’ wasn’t included within the Consultation Document. 

The ‘Missing Option 3’

Retain Newark Hospital’s fully operational Emergency Care Centre where an integrated emergency service will provide comprehensive care to all but the most seriously ill, or those requiring immediate and direct access to specialist centres, far in excess of the 85% of potential patients currently proposed by NHS Nottinghamshire County.

 What the Consultation Document Offered for Comment

Option 1: Minor Injuries Unit ‘Plus’ 24/7 – a minor injuries unit (MIU) staffed by doctors and specially trained nurses to treat people with minor injuries such as broken bones and minor illnesses. There would be access to x-ray and other testing equipment. A direct online link to other centres would allow the results to be read by experts who would give immediate advice if necessary. An out of hours GP service would also be available. This service would treat 85% of patients with the other 15% taken directly to another hospital by ambulance.

Option 2: Minor Injuries Unit ‘Plus’ 7am-midnight – this would be the same as Option 1, but only open between 7am and midnight, with out-of-hours GP cover enhanced (local GPs prefer this option, but there is a conflict of interest because they would gain financially – the cost of patients visiting A&E comes out of their budget).

 


[1] http://www.nottspct.nhs.uk/images/stories/My_Voice/newarkconsult_1109.pdf page 15

[2] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15797 (page 5)

[3] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15799 (page 73) and http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15802 (Transition & Implementation Plan 2010 page 1)

[4] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15799 (page 53)

[5] http://www.nottspct.nhs.uk/images/stories/My_Voice/newarkconsult_1109.pdf page 15

The health minister Simon Burns is to intervene in what is being seen as a test case for the Coalition Government over the future of A&E departments. It follows NHS Nottinghamshire County’s decision last week to downgrade Newark’s Accident and Emergency Department, close a medical ward, and re-route ‘blue light’ ambulances to Lincoln or Mansfield some 20 miles away.

The Health Secretary, Andrew Lansley, on taking office said A&E departments should not be forced to close against the will of local doctors and patients[1]. Yet NHS Nottinghamshire County’s consultation document did not include the option to retain current A&E services[2].

Newark MP, Patrick Mercer, says NHS Nottinghamshire County has misled both him and the general public:

‘The Health Minister has responded with such speed to my request to step in that it indicates the urgency of the problem. I have no doubt his visit (on 1st July) will help to resolve the new difficulties we face with the consultation process and its good to see a minister rolling his sleeves up and getting involved.’ 

Mr Mercer says he will demand the Department of Health pull in the consultation unless the hospital’s emergency department and associated services are retained, the proposed medical ward closure is withdrawn, and ‘blue light’ emergency services are reinstated to Newark.

                                      – ends - 

 

Editors Notes

NHS Nottinghamshire County’s Decision  

NHS Nottinghamshire County decided last week (Thursday 17 June):

  • A 24 hour Minor Injuries Unit ‘plus’ (option 1 above) by 1st October 2010[3]
  • Reduction in medical beds to be agreed approximately 56 to 32 with effect from 1st April 2011 meaning ‘Newark Hospital will have two wards vacant’[4]
  • The hospital will now not accept medical emergencies – all blue-light emergencies will go to Lincoln (first) or King’s Mill (if previous history)[5]

What the Proposal Means in Reality

In the consultation document NHS Nottinghamshire County says under option one ‘this means that we could provide the same level of care that is currently available at Newark’[6]. NHS Nottinghamshire County claims it is merely changing the name from A&E to a minor injuries unit. Yet the hospital has been operating an A&E department because, until now, it has accepted blue light ambulance services and is staffed with specialist A&E consultants.

NHS Nottinghamshire County only collected 700 responses to its Consultation, and 500 of those followed a rushed telephone poll just before the consultation had closed due to the poor response. Local people were never given a chance to vote for retaining the A&E department, because the ‘missing option 3’ wasn’t included within the Consultation Document. 

The ‘Missing Option 3’

Retain Newark Hospital’s fully operational Emergency Care Centre where an integrated emergency service will provide comprehensive care to all but the most seriously ill, or those requiring immediate and direct access to specialist centres, far in excess of the 85% of potential patients currently proposed by NHS Nottinghamshire County.

What the Consultation Document Offered for Comment

Option 1: Minor Injuries Unit ‘Plus’ 24/7 – a minor injuries unit (MIU) staffed by doctors and specially trained nurses to treat people with minor injuries such as broken bones and minor illnesses. There would be access to x-ray and other testing equipment. A direct online link to other centres would allow the results to be read by experts who would give immediate advice if necessary. An out of hours GP service would also be available. This service would treat 85% of patients with the other 15% taken directly to another hospital by ambulance.

Option 2: Minor Injuries Unit ‘Plus’ 7am-midnight – this would be the same as Option 1, but only open between 7am and midnight, with out-of-hours GP cover enhanced (local GPs prefer this option, but there is a conflict of interest because they would gain financially – the cost of patients visiting A&E comes out of their budget).

 


[1] http://www.savenewarkhospital.org.uk/?p=210

[2] http://www.nottspct.nhs.uk/images/stories/My_Voice/newarkconsult_1109.pdf

[3] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15797 (page 5)

[4] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15799 (page 73) and http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15802 (Transition & Implementation Plan 2010 page 1)

[5] http://www.nnotts.nhs.uk/content/showcontent.aspx?contentid=15799 (page 53)

[6] http://www.nottspct.nhs.uk/images/stories/My_Voice/newarkconsult_1109.pdf page 15