Top doctors warn of hospital closures in NHS shake-up
Consultants warn that job losses and service cuts will hit patient care
Almost two in three senior doctors fear a controversial NHS shake-up that will downgrade or close dozens of hospital units will damage the care patients receive. The hospital consultants fear the sustainability and transformation plans (STPs) will lead to staff losing their jobs, will exacerbate workforce shortages and will act as a cover for cuts to services.
Of 450 hospital clinicians surveyed by the Hospital Consultants and Specialists Association (HCSA), 42% believe that STPs will have a “negative impact” on patient care. Barely one in 10 consultants who belong to the union expect a “positive impact”.
Three in four (77%) fear STPs are a way of making cuts to the NHS, while just over half (56%) fear they will lead to job losses and worse understaffing.
NHS England chief executive Simon Stevens views STPs as local plans that will modernise the way patients are cared for, reduce the pressure hospitals are under, and help plug the £22bn gap in the service’s budget expected to have opened up by 2020.
Patients will be cared for more often in or close to their homes to avoid unnecessary stays in hospital. Stevens has divided England into 44 “footprints”, many of which are facing big changes to how clinical services in the area are organised, including the downgrading or closure of units.
But plans to cut the number of hospitals, shrink the supply of beds and centralise key services have sparked protest campaigns in many parts of England. Theresa May relayed her anxiety about the political fallout from a series of A&E, stroke, maternity and other units being downgraded or closed when she met Stevens for the first time last September.
Last week Rishi Sunak, the Conservative MP for Richmond, and Darlington’s Labour MP Jenny Chapman put aside party allegiances to write to Stevens and voice their concerns about possible bias in the STP process that has raised doubts about the future of services at Darlington Memorial Hospital, which could see its A&E and other departments taken away and transferred to the North Tees Hospital, 12 miles away in Stockton-on-Tees.
“Many hospital doctors see STPs as a managerially driven process with no real clinical basis, and fear that a mix of underfunding, under-resourcing and service rationalisation can only damage patient care,” said Eddie Saville, the HCSA’s chief executive.
“This is, in effect, yet again an NHS reorganisation, but region by region, with management trying to plug the financial gaps rather than putting highquality care of patients at the forefront. The fact that STPs are being planned against a backdrop of underfunding and cuts has led many doctors to conclude that this transformation programme is purely an attempt to mask further cutbacks.”
Although a majority of the HSCA members surveyed are undecided on STPs, almost all (95%) said they had not been involved in drawing up their local plan, prompting Saville to claim that they have been “shut out and systematically excluded” from the process.
The King’s Fund health thinktank
‘This is yet again an NHS reorganisation, region by region, with managers trying to plug financial gaps’ Eddie Saville, doctors’ leader
says STPs “offer the best hope of delivering essential reforms to NHS services”, that concentrating specialist services will improve patient care, but that the NHS needs more money to ensure success. The British Medical Association, meanwhile, has dubbed STPs “a cover to deliver £26bn in cuts to health and social care [in which] millions of patients will be affected by hospital and bed closures”.
The Local Government Association, which represents local councils, criticised STPs as “secretive, opaque and top- down” reforms that would fail patients.
Campaigners in Huddersfield against the closure of its hospital’s A&E unit decided last week to seek a judicial review of the lawfulness of the plan, drawn up by the local NHS clinical commissioning group. They fear lives could be lost if people from the town are forced to travel the 15 miles to Halifax for urgent and emergency care. The plan has been referred to the Independent Reconfiguration Panel, an expert group that advises Jeremy Hunt, the health secretary, on which hospital units should be allowed to close.
Rosie Duffield’s vigorous defence of the hospital in Canterbury played a key role in her being returned as the Kent town’s first ever Labour MP at the general election in June, ousting the Tory incumbent, Sir Julian Brazier, in the process. Fears raised by the NHS deciding that patients from the Canterbury area needing urgent treatment for a heart attack, stroke or pneumonia should instead go to Ashford or Margate led to claims that people would die because of the change.
Hundreds of people protested last weekend in Louth, Lincolnshire, against plans that could see the hospital close or be downgraded through a merger with Skegness hospital. However, Louth’s Tory MP, Victoria Atkins, has accused campaigners of “scaremongering” over the hospital’s future.
Protesters in Huddersfield march in an attempt to save their casualty unit.