Stafford hospital’s fate will be announced at 2pm this afternoon. In spite of the incredible efforts of the Support Stafford Hospital (SSH) campaign group and the massive support from local residents, 51,000 of whom marched out of a town population of only around 65,000 and a borough of about 122,000, the word is that the news will be bad: acute and emergency services will be closed or downgraded, with local people expected to travel miles for emergency care and already-overstretched neighbouring services expected to cope.
The bitter irony in all of this is, of course, that Stafford has been opportunistically targeted by the government for closure because completely false media headlines about ‘hundreds of needless deaths’ meant that an attack on the Trust was unlikely to upset the wider public.
Within days of the publication of the Francis report – even though Francis said there was no evidence to support the mortality claims – the government and it’s executioner Monitor had begun the process of putting the Trust into administration, even though it was ahead of the financial targets it had agreed with the Department of Health and Monitor only a year earlier.
The process has stunk to the heavens, with various conflicts of interest and meddling from a Health Secretary who has claimed not to be responsible for the decision. There’s never been any real doubt that the downgrading of Stafford was a foregone, political conclusion.
The even more bitter irony is that Stafford is now one of the best hospitals of its type in the country. Even the government’s ridiculous ‘friends and family’ test (FFT) puts the hospital well into the upper echelons of England’s hospitals.
The FFT ranks hospitals according to two categories – in-patient treatment and A&E – and also combines the two scores into an overall one. Scores are given out of 100. Here’s how Stafford hospital is performing:
In-patient
UK average score: 72
Stafford score: 77
Stafford ranking: 64th of 170
A&E (the area for which Stafford was most condemned)
UK average score: 54
Stafford score: 82 (!!)
Stafford ranking: 31st of 170
Overall
UK average score: 64
Stafford score: 78
Stafford ranking: 37th of 170
Stafford is now a very good hospital, according to the people who use it, and their relatives.
Closing it now is the equivalent of taking antibiotics to cure gangrene – then deciding to cut off the limb once it’s back in good health. Could there be any clearer portrayal of the absolute insanity of the government’s campaign to close hospitals, or of the absolute nonsense of Hunt and co’s supposed ‘logic’ in depicting hospitals as ‘failed’ and claiming we’ll somehow be better off without them?
If you need it and it’s broken, you fix it. You don’t smash it to pieces after its fixed and then use that as an excuse to go around breaking other appliances in your house.
The fight won’t end today, of course. SSH are already looking at options for legal recourse and have some funding in place to start the fight, but will need everyone’s support and generosity to see it through. I urge you to give yours.
We have been in rehearsal for months if the news is bad the real fight will beginng today, it will be a fierce one, we will defend out hospital and our staff all the way! Thanks Steve for your continued belief in us and our hospital xxx
Oh well said Steve.
If A&E is removed there will not only be inconvenience and expense all round for hospitals, ambulance services and patients but THE EVIDENCE (as previously posted) suggests that mortality of unsorted ill patients going to hospital will rise.
What an irony – false allegations of avoidable deaths lead to solutions that will actually produce avoidable deaths!
Even though the academics that have looked at this fairly recently are quite adamant about it, I suppose the men in suits think that it can’t be true because the hospital you travel to is super excellent (though this effect ought to be absent if the one you are closing is also very good). Think of this example.
2 men aged 23 have a fever and the worst headache they’ve ever had and can’t move their necks very well. Both have a worried wife and a 10 month old baby. Neither can see their GP for 3 days. One lives in a city with an A&E. The other lives 20 miles away in a town where the A&E was closed a year ago.
The former thinks he’ll nip to A&E just in case, where he is rapidly diagnosed with meningococcal meningitis on account of the tell-tale rash the junior doctor would have been looking for in this type of case. Antibiotics are started but he becomes sicker and goes to critical care. He is stabilised and goes home a week later after a traumatic but ultimately successful experience of serious infection.
The other patient delays, not wanting to travel 20 miles with a baby in the back of the van only to be told it’s a virus, worried about the expense, parking, traffic etc but an hour or two later is taken anyway by his wife and her mother-in-law as he’s looking terrible and isn’t quite “with it”. She loses her way at some traffic lights but eventually gets there. She can’t seem to get attention quickly as a pub fight and it’s casualties have spilled over into the large A&E. He is in a semi-coma by the time he is seen. He is again rapidly taken to critical care but after a month in a coma and 2 leg amputations and kidney, then liver, then heart failure is deemed irretrievable and the ventilator is switched off. The widow and her extended family have travelled the 40 mile round trip twice a day for a month.
When the academics say the mortality of unsorted acutely unwell patients rises by 1% for every 10 Km to the A&E that is still open, this is what they mean.
It’s a brilliant example. Fancy writing it up into a guest blog?
Very kind but I have nothing to add – I think it just puts flesh on the academic evidence. Feel free to use it (or anything else I contribute) in any way you like.
Thanks, I will! 🙂
Yes, strange how some people don’t factor in accessibility of care into the resulting quality of care. A brilliant hospital that’s difficult to get to is no use.
This is an entirely credible scenario. The small A&E I worked in back in the early 1990’s was closed by Thatcher’s re-organisation of the NHS despite a very strong local campaign to keep it open. Although the hospital was small and didn’t have intensive care facilities (just a high dependency unit) its location very close to a busy major road well known for traffic accidents meant that often victims of such accidents were brought there rather than transport them the 15 miles further on the other side of the city to a bigger hospital. This meant seriously injured patients could be stabilised quickly and given the surgery they urgently needed then if needed safely transferred to the ICU at the bigger hospital. After the A&E closed the deaths from traffic accidents on that road increased.
Its essential that Stafford A&E stays open.
Well according to Sky:
“Sky News Newsdesk @SkyNewsBreak 24m
Emergency surgery, maternity & paediatric services at Stafford Hospital to be cut after inquiry found many patients died due to maltreatment”
I just listened to the Press conference and what I heard was they are breaking off the lucrative parts and then eventually “other” providers will take over some of whats left .. well that’s what I read into it. I think I will wait for Steve to break it all down.
You’ve pretty much nailed it, I’m afraid 🙁
I couldn’t agree more with your comments, particularly:
‘There’s never been any real doubt that the downgrading of Stafford was a foregone, political conclusion.’
The whole situation would be farcical if it wasn’t so outrageous.
So we now have an A&E which will remain ‘part time’ but which scores very highly in the FFT (82) meaning patients will have to travel miles to attend the A&E in Wolverhampton which has one of the lowest FFT scores in the country (30)!
Waiting for the administrators to explain that one!
Great point – hadn’t made that comparison yet, but worth highlighting!
2 interesting facets of the TSA spiel on their website.
A raft of proposed changes (mostly cuts) with “the real prospect of the overspend reducing to zero” and the Trust not merging with one other but with two. So – 1) which staff go in which direction (or will there be a smorgasbord of provision of various services by various departments from various hospitals in various locations)? and 2) how will we know if the financial target has been met if the overspending (I prefer the concept of an underfund myself) organisation will no longer exist? A dog’s breakfast would be too precise a term for all this.
“Creative destruction” – from the pen of exreme right-wing nutcase Ayn Rand, coming to usvia right-wing American think-tanks. Part of the tacticsseems to be -to attack rustic oo-ar places first, where there is very little in the way of political activism, and save places like East London and Liverpool until the privatisation is almost complete. SB
Reblogged this on eclectictaste18 and commented:
This government are determined to destroy the whole NHS. Truth and justice is left to the few. People have their own little busy lives nobody wants to listen, until it affects them and it will, but by that time the damage will have been done.
Is there no way that the High Court ruling yesterday regarding Lewisham hospital can be used to help Stafford. I realise that Stafford Hospital is still regarded by many as the lowest of the low – the BBC, Channel 4 news and Sky have all referred to the large number of “avoidable deaths” in the last 2 days even though there is so much evidence that this was not the case. When will we ever see a serious news programme reporting the truth about Stafford? Is there no-one brave enough to swim against the tide?
They’re two very different situations, but I’m trying to get full details of the decision so the Stafford group can look for useful hooks!
I am wondering if there is some way Stafford can be supported via 38degrees the same as Lewisham has been. Volume of support and potential fund raising for legal challenges were both important aspects of 38degrees supporting Lewisham. I am also wondering if getting the Stafford ‘truth’ out via 38degrees might generally help the cause. I think too many people are still sucked in by the flagrantly false ‘thousands of needless deaths’ rubbish frequently repeated by the media, govt sources etc
I have a couple of contacts. Not optimistic as I suspect they’ll see it as a risk to their ‘capital’ to try to push the story as hard as it needs to be (they’ve published a couple of mine in edited form), but let’s see!
With regard to the last 2 comments, although there is a huge mismatch in what local campaigns can afford to spend compared to government and it’s agencies, they can still be effective or hard to ignore. I think this has already been the case as the mood of the public was mis-read to a huge degree in Mid Staffs. Far from being ambivalent, they know what a valuable community resource the hospital(s) are and can spot the bullshit very quickly. The most important message of these campaigns is 1) we have infinite energy and 2) we are not going away. Whilst some very bad changes to access to NHS secondary care around the UK have been forced through, there have also been some notable successes or partial successes; Lewisham being (for now at least) being one of them. One additional factor stoking the anger in Mid Staffordshire is the feeling that the population has been conned – and they know it. For various historical reasons, the people in Staffordshire are generally fairly phlegmatic in their dealings with the men in suits – but this may be an exception.
So …. according to the Express and Star the full cost of implementing the TSAs proposals will be somewhere between £220m and £300m and after that the “deficit” (an artificial construct as you recall) will drop from £20m to £8.5m per year. Err .. but:
1) Didn’t Monitor send in the Administrators because the Mid Staffs Trust’s “financial recovery plan”, though being achieved, did not end at zero in 4 years – but hey – neither does this one?
2) Isn’t the TSA’s remit to consider a 10 year horizon (fair enough; who knows what the background will be then) – if so, a far cheaper option is to stick with the Mid Staffs plan AND as a bonus, access to services will continue (with necessary tweaks of course)?
3) Does this mean that HMG are being invited to invest our money in a system that will have Stafford women travelling past an empty/recycled maternity facility to give birth in distant, unfamiliar hospitals assisted and cared for by midwives who have themselves travelled from Stafford – well from where else are you going to recruit them?
A question for the floor.
Am I being thick?
or
Has the world gone mad?
Not thick … just assuming that the stated “aims” that are to be achieved by “suggested measures” are actually the true aims of those measures. Given that nothing this government does in any respect actually achieves the aims we are told they are supposed to, simply means we have not been told the true aims. I am quite sure the likes of Hunt, Osbourne, Cameron et al are more than happy that the wider public just think they are incompetent as that is far less politically damaging than the wider public knowing what they are actually doing.
Er .. you mean they are avoiding the need to say – “we want to privatise the NHS so that we can wash our hands of it (even if it costs more) and to that end it would be handy to close/downgrade a large number of hospital sites – vote for us!!”
In relation to my comment above it turns out that the 14 hour A&E may be retained. This is, of course, good but it appears critical care is proposed to be downgraded to high dependency. This is probably not sensible and won’t save any money. Maybe the actual plan is to leave the two carve-up Trusts (Stoke and Wolverhampton) to finish the job when they “discover” in 2-3 years time that they can’t quite manage to provide services locally in Mid Staffs and further cuts will have to happen (evidence – most previous Trust mergers – which as you recall from the long term study by the Bristol group – do not improve clinical outcomes and don’t save money).
One aspect in which mergers might help Stafford is recruitment of suitable medical staff, if that’s a problem.
I believe it’s a problem in some departments but not others, where jobs have been filled OK. Lack of competent manpower/training in all professions/specialites within those professions in the NHS over decades hasn’t helped, of course.
I mean manpower/training PLANNING. Apologies if it didn’t quite make sense.
I don’t know if you are aware but R4 More or Less is covering the mid Staffs stats in today’s programme.
http://www.bbc.co.uk/programmes/b038zhb7
Thanks for the pointer – I’ll take a look!