Lewisham Hospital to be "biggest casualty" of recommended healthcare restructure

The Draft Report of the Special Administrator appointed to sort out the mess that the South London Healthcare NHS Trust got itself into has now been published. You can download a full copy here.

UPDATE: London Tonight reports that "University Hospital Lewisham is the biggest casualty of the shake-up - set to lose both A&E and maternity."

UPDATE: Journalist James Poulter has listed the key changes for Lewisham, including:

- Full admitting accident and emergency department becomes a Non-admitting urgent care centre 
- 24/7 surgical emergency admissions end 
- Obstetric and co-located midwife led-birthing unit becomes Potential obstetric and co-located midwife led-birthing unit 
- 24/7 emergency medicine end 
- Critical care unit end 
- Inpatient padeatric service end 
- Complex inpatiant surgery end  

The key passage for residents concerned about the fate of Lewisham's A&E department appears to be this one:

The urgent care services at Guy’s Hospital and Queen Mary’s Hospital Sidcup are already well established. The draft recommendation is for University Hospital Lewisham to have a 24/7 urgent care service that will treat around 77% of the people currently attending the A&E and urgent care services there.

This is because the vast majority of patients with urgent care needs do not need to be admitted. The types of conditions the services will be able to treat include: 

- Illnesses and injuries not likely to need a stay in hospital
- X-rays and other tests
- Minor fracture (breaks)
- Stitching wounds
- Draining abscesses that do not need general anaesthetic
- Minor ear, nose, throat and eye infections.

More to come.


Tamsin said...

Sorry, Nick - where's the link?

Kate said...

the maternity issue hasn't been decided yet as I understand it

Anonymous said...

Maternity services usually close if the A&E closes because they won't have a crash team on site. I saw this happen to another hospital not too long ago...

Kate said...

true but at the meeting they said they hadn't made a decision on Maternity services

Anonymous said...

Who do we need to petition to get them to forget this ridiculous and dangerous plan?

Mezzer said...

Anon @ 13.52:

Link is on the right hand side of this page:


Anonymous said...

Who even are these TSA jokers? This is a stupid plan.

Kate said...
This comment has been removed by the author.
Pete said...

The idea that people without a car will take public transport to Sidcup, rather than going on the train to London Bridge seems particularly optimistic on the part of the TSA.

Choice A: 40 minute bus ride plus wait in the cold

Choice B 15-20 minute train ride.

What would you choose?

Mezzer said...

Think also of the sizable population increase in Lewisham as a consequence of the Lewisham Gateway building project.

Anonymous said...

Having had my son born there I am familiar with Maternity and A&E. Both of which I found to be excellent. It would be a great shame if either were to close.

Dex said...

Also, Guy's at London Bridge doesn't have an A&E - there's an urgent care centre, but the A&E is at St Thomas'.

Anonymous said...

What's really outrageous is that it's being closed as a result of the bankruptcy of the South London Trust - which it isn't part of.

Mc said...
This comment has been removed by the author.
Mc said...

The obstetric led maternity services can not work without a fully functional Intensive Care Unit. So it is an eye-wash. The maternity services will shut as well.
Making the pregnant mums wait even longer for getting admitted to hospitals far off and increasing the number of mums delivering in the cabs, ambulances and corridors. None of the surrounding hospitals (QEH woolwich, Kings, St Thomas', PRU bromley) has got any capacity to deal with the extra 4000 births/year which Lewisham Hospital is managing at the moment.

The Scorpion said...

I am very concerned, saddened and worried about this as I know that the hospital/community I work for and the patients and other people that I meet, get to know and help, throughout my shifts at Lewisham Hospital (and others I will not if it happens) WILL suffer if these closures and cuts go ahead. This includes family/friends of patients PLUS other staff members/colleagues, in many departments.
I joined the NHS as a HCA (Health Care Assistant) to (hopefully) make a difference (as did/do, many others)
I love my "job" and really care about the people who come through my ward/hospital.
If the Lewisham Hospital A&E and other much needed services are closed (through NO fault of their/our own) it will be devastating!
PLEASE sign the petition and let everyone know about it!


SAVE the services at Lewisham Hospital that are under threat!

Thank you

Sue (a proud member of Lewisham Healthcare NHS Trust)

Anonymous said...

Lewisham is an excellent hospital which hasn't run up debts and is well managed and it is being sacrificed? This is insanity. The NHS can't be run like a supermarket chain. Petition!

Anonymous said...

Wasn't it the previous Labour government that set up all these PFIs? (PFIs that are in the interest of private investor rather than the public body thats funded)

Anonymous said...

Let's not get hung up about who did what re PFIs. Let's get behind the campaign to save the hospital from cuts.

Anonymous said...

you're right, of course, but when you see the likes of Labour stooges like Alexander, Bullock and Ruddock trying to gain political points by turning out to protest against closure of A&E then I think one has a right to be a tad cynical - Ruddock would have certainly backed the PFI, if not actively then simply by being a Labour MP and not going against the party line

Anonymous said...

It's not 'restructure' it's CONDEM cuts!

Anonymous said...

Anyone see Cameron wriggling in PMQs just now? He was reminded that he had pledged to enter into a "bare knuckle fight" over Lewisham hospital. The questioner asked Cameron which side he would actually be fighting for. Cameron replied that his party stood for providing more money for the NHS whilst Labour stood for providing less money.

I believe you, Dave.

max said...

Really good quote.

Tamsin said...

Heidi Alexander has sponsored a petition here.

kolp said...

There's so much to be said about this; the history of how something so outrageous-cutting a newly installed multi million pound service- could now be rendered the sensible solution to spiralling debt but that's for another time, because as of tomorrow the 30 or so day clock starts ticking for the consultation period, before Kershaw finalises his draft recommendations and it goes to Sec of State Hunt and we (Lewisham) most likely lose our local A&E and maternity services in the name of a supposedly financially sustainable future. r

In short, petitions are fine but if we truly oppose this we have to propose alternatives.

The chief motivation of this is £££. This is what chief concern of this government, and in this case, it is somewhat understandable because the rotten Pfi deal is burning through cash.

Tamsin said...

Kershaw's recommendation includes writing off that debt - so why can't that be done without putting the skids under a relatively successful hospital in a different Trust?

But agree - a multi-lateral and intelligent approach is needed and not just the mantra of "no" to any cuts.

kolp said...

Well this is the thing Tamsin, to Kershaw it appears any area with SE in the postcode should be lumped together as part of the rationalisation.

There's a structural problem the failing hospitals which Kershaw believes the reorganisation across south London will resolve.

max said...

Indeed, and that's the spectacular fallacy this report is built upon.

But I disagree that people should come up with alternatives to where to find the money - Mr Kershaw should have come up with alternatives to put to consultation.

This is one idea only, and it ignores the inconvenients that it produces, and those inconvenients are so big that in practical terms they amount to an interruption of NHS services for many people in SE London and Lewisham particularly.

It may certainly succeed in terms of savings but at the end you'll be likely to say that the operation was successful but the patient died.

Maria said...

There is an open meeting next week to discuss on Thursday, 8th November, 6-8pm in Lessoff Auditorium at the Hosptial (Speakers: Jim Dowd MP, Heidi Alexander MP, Mayor Steve Bullock, Dr Louise Irvine, local GP and BMA council member and others.

Anonymous said...

I suggest we get as many people as possible to this and any other meetings, and all join in the ring of people around the hospital later in the month.

The Doctor is IN (for now) said...

Rather than have Lewisham NHS Trust take a hit for a mess not of their making, surely something could be done with this 'spare' billion?

david said...

It's going to be tricky to argue against becuase the main problem is a lack of a viable alternative going forward. I don't support the proposal, especially as a resident, but having read up more I kind of see what they're trying to do.

Four years ago, South London Healthcare (SLH) was three seperate Trusts, the semi-autonomous organisations that make up the NHS: Queen Mary's Sidcup (QMS) Queen Elizabeth Woolwich (QEW) and the Princess Royal (PRU). All had problems, mainly financial, and so we were disolved and merged into SLH. Because it's unusual to duplicate services across a single Trust things like the A&E and QMS were closed (that's why there's no A&E at Guy's, it's at St Thomas' for GSTT).

Now SLH has got itself into trouble again the plan is to break the Trust up - thus enabling some of the debt to be written off because the indebted organisation "no longer exists" and merge the 3 old parts with other Trusts. QMS goes to Oxleas (which is a mental health Trust, so that's strange), the PRU goes to King's (which is miles away, although there's precedence for oddly aligned hospitals in a single Trust) and QEH will merge with Lewisham.

Clearly the duplication of services at QEH and Lewisham is part of the reasoning for the closure. It's the same logic as one business doesn't need two finance departments. Flawed logic, but the same and it saves money.

So one of the routes to stopping the closure is to stop all three mergers by demonstrating flaws. It'd also be helpful if, as Kolp suggests, someone can come up with an alternative but that's easier said than done.

max said...

Why should it be difficult to argue agaist a flawed logic?
Your analysis is absolutely right, the logic used here is not applicable to the activity in question.

A duplication of finance department is a waste because they both serve the same user (the company) and therefore one should go, a duplication of an A&E or a maternity department is not a duplication at all if they serve different localities.

Should McDonald close all of its outlets round the world but one because they're duplicates?

david said...

Hi Max, but if McDonalds needed to save costs it could justify two branches in the same town as being one too many.

I don't think it's right, in a moral sense, but if you look at the London Trust set up the only multi-hospital Trusts with more than one A&E service are, ironically, South London Healthcare (QEH & PRU) and Imperial (St Mary's & Charing Cross). That's the model. It might not be a good one, but trying to change the whole architecture model will be harder than finding reasons why the merger shouldn't go ahead.

Some obvious alternatives: disolve SLH back to three local Trust's which meets the decntralised healthcare mantra coming out the DH; SLH struggles on somehow; hitch the PRU to a Kent Trust (Tunbridge perhaps) and keep QEH and QMS and logical geographic partners in a Thames-side south-eat London organisation.

max said...

Thanks a lot for all this information, it still remains that I agree with you when you say that there are other ways to go that don't involve closing down A&Es and Maternity departments.

I can think of McDonald having two branches in the same town if that would catch them customers they would otherwise lose.
And I can see the point in not duplicating specialized care units but stuff like A&E and maternity are not that.
The fact that two hospitals are in relatively close distance doesn't mean that one can have basic services scrapped if you make them share the same management.

Tamsin said...

Especially when all are apparently at full stretch* anyway, despite a recent widespread leaflet and poster campaign to direct people with non-urgent cases to more appropriate services.

* (Some of the time - someone I know who called into Lewisham late last Friday evening found it nearly empty, but I think the overall figures show otherwise.)

Tamsin said...

Sorry, "full stretch" is probably not the terminology to use about maternity services...

The Scorpion said...

Hi all, Great turnout of concerned people on Thursday (8th Nivember) night but please can we keep pushing the Campaign? Sign the petition & print out/pick up leaflets and distribute them. Attend the upcoming meetings and demonstrations. Tell everyone you know! Time is running out - 13th December deadline for the Public Consultation. Some people are saying "it's hopeless! They have made up their minds already" BUT maybe, just maybe, this once, our voices will be heard? I HOPE SO! If not, people WILL die! It's very scary!!! :(
Please forget the politics for now! Lewisham Borough residents (& those beyond) need these services to stay open! Other hospitals will NOT cope!
Thankyou so much, Sue a Lewisham Resident & Hospital Worker

Petition Watch said...

The petition is at 11,250 as 12 November

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