This is a direct copy of an email we have sent to the Mid and South Essex STP to get answers about the numerous concerns we have for their proposals. Feel free to go ahead and ask these questions yourself at any of the future discussion events or just read to see why we have such grave fears about their spin that this is all in your best interests…..

Dear Sir/Madam,

At the STP Southend on sea discussion event on the 08.02.18, Dr. Ronan Fenton stated that East of England Ambulance Service (EEAS) are central to all discussions surrounding transport issues when he was questioned regarding their ability to staff and provide necessary resources for the increased level of patient transfers that would be required between the three hospitals.

Dr Fenton stated, referring to EEAS, that it is, ‘up to them whether they can provide the transfers’ and that they are, ‘fully involved and contributing to the plans’. He then stated that, ‘we can be very clear that we are developing an inter-hospital transfer service’. You are proposing transferring the sickest patients – these will need a doctor or nurse escort to do so.

As staff shortages are part of the reason you say these changes to our local health economy are required as part of the Mid and South Essex STP- how can you even consider this as part of the solution as surely this will only exacerbate staff shortages? Where are you getting these staff from? Who will train them?

Please provide written evidence of your communications with EEAS regarding their position and capacity to provide the increased inter-hospital transfers.

We also want to know at precisely what stage the Mid and South Essex STP team are in this so called, “development of an internal transfer service”, as to date, we have seen no evidence publicly that there are any written proposals in place. Please provide evidence of any discussion for the purpose of being transparent and to back up your public claims at the discussion event.

We do not feel that it is right or fair to expect the public to respond to a consultation on the re-location of acute hospital specialities when you can’t even provide a credible answer to the patient transfer aspect, the lynchpin of the whole re-configuration.

Dr. Fenton also stated that a large traffic study has already been conducted. Please provide evidence of this.

How can running a whole new transport service for relatives and patients save money. Where are the projected costs for running this service and how will this money be saved from elsewhere?

Dr. Skinner stated that it would be up to ’specialist commissioners’ to decide if there would be funding for the gold standard of stroke care at each hospital site as described by Dr. Guyler – 24.7 MRI scanning, 24/7 designated stroke Dr and nurse and the development of a regional thrombectomy service ,plus trial of the ’stroke ambulance’ containing CT scanner. Please advise if you are going to recommend to specialist commissioners that they provide the necessary funds for this provision, bearing in mind your constant claims to the public that the STP is ‘clinician led’.

With reference to the audience at the above discussion event, our opinion was that it was mainly white British representation and our campaign has liaised with numerous minority ethnic groups within our area discovered that aside from the Jewish community, there is little evidence that you have extended the STP public consultation to any of those minority groups.

Please provide evidence of any engagement you have held with our diverse population in Southend and surrounding areas.

Published lists of all the discussion events alongside information leaflets and consultation proposals should have been accessible in all key public areas throughout the community.
We have audited a large number of local GP surgeries and found that only 2 out of the 16 sites visited in the past 2 weeks have had STP materials on display for the general public. Only today, we surveyed the outpatient department in Southend Hospital and there was no STP materials on display whatsoever. This is not acceptable.

Please provide evidence of your comms plan and placement lists for public material display.

Your facebook page has less that 300 followers and half of those are Save Southend NHS campaigners who are following to see what information you are posting – which sadly is very little. You leave numerous questions unanswered on the facebook page and much is the same on your twitter account too, with members of the public ignored.

Please explain why this level of response is so poor when you have a full-time comms team and associated budget. Please express if it is your objective to achieve a meaningful public consultation and explain why IAO Margaret Hathaway stated at the discussion event when questioned if public opinion would be considered, “this is not a democracy or a referendum” – a witnessed and audio recorded insult to each and every member of the public in the room who had attempted to engage with the consultation.

Further questions

The consultation includes plans which do not have clinician approval- for example the transfer of people on NIV (non-invasive ventilation), pneumonia and pleural disease. Clinicians have specifically told us these patient will not be transferred. Why are you consulting on this and why are you stating they will have a better outcome when there is no evidence for this? If you do have evidence, please provide this in your response.

There has been no cross site consultation or agreement for some of the changes which you are consulting on (e.g. gastroenterology, orthopaedics and trauma)- why are you going ahead with this when it has not been clinically led or agreed?

Your modelling emphasises the separation of emergency and elective care for these changes to be successful. You state only a minimal number of people will be transferred between sites – how are these two statements not mutually exclusive?

Throughout the consultation, there is a huge reliance on pre hospital care and prevention of attendances. As Southend has the second highest vacancy rate for GPs in the UK at present and the second highest number of GPs due to retire within the next 5 years- why is there such reliance on primary care? What will happen when these results are not delivered?

Is it true that Pat Oakley (independent advisor to the NHS) has suggested that the only way to manage orthopaedic demand is to build a new, independent orthopaedic unit located between the three sites at the junction of the A127 and A130? How do you see orthopaedic provision at Southend if this is pursued?

We are aware that at STP meetings, staffing modelling showed that even more staff would be required to run a hub and spoke model for all services which were analysed. Why are you still claiming that this is therefore a solution to staffing issues?

What will you do if a patient refuses to be transferred? What will happen if a doctor refuses to transfer a patient as it is not in their best interests or the patient is too unwell to survive a transfer yet the specialist and facilities required are located on another site?

As most services are based around the numbers of patients being seen either in a clinic or on a procedure list, how will moving these to different places save money? The demand will still be the same and hence resources required the same?

Have you surveyed staff at the 3 sites to gauge how willing they would be to travel. There are multiple opportunities for many staff to leave the Trusts and work in the community or travel to London. How has this been quantified and risk assessed?

We look forward to formal written responses to all of the above questions in a timely manner. It is our opinion that there are far too many un-answered questions for our elected representatives to consider at present before any decision can be made.

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