 that secretary of state praises work of clinicians on panels and then basically says Sir Bruce Keogh has had a look at it and come up with a different suggestion on A&E! The lives-saved stuff doesn’t hold up to scrutiny either.
“South London Healthcare Trust has longstanding and serious financial problems so no change is not an option. But the decision not to accept in full the Trust Special Administrator’s recommendation in relation to Lewisham A&E and the strength of local feeling about this issue show how difficult these judgements are.
12.32pm Back to Lewisham. Jeremy Hunt’s announcement has baffled local MP Heidi Alexander. “Jeremy Hunt says there will be a “smaller A&E” at Lewisham. What does that mean?!” she tweets.
The NHS Commissioning Board today announces the forthcoming departure of its chief operating officer and deputy chief executive, Ian Dalton CBE.
Ian will be moving to BT Global Services to take up the position of President of Global Health.
Ian has held a number of very senior roles within the NHS including Chief Executive of NHS North of England and chief executive of two hospital trusts, and worked on the reconstruction of civilian health services in Iraq.
“I am excited by my new role with BT, which will allow me to utilise my experience to work with health systems across the world. However, it has been a huge privilege to have contributed to the NHS in so many key roles over the years and to have worked with so many caring and dedicated NHS staff.
“I have been impressed by the NHS Commissioning Board’s passionate focus on the interests of patients and I am confident it will deliver real improvements for the future. For the next period, my focus will be on delivering what I am sure will be a successful transition for the operations directorate of the NHS Commissioning Board”.
12.24pm BREAKING - NHS Commissioning Board operations director Ian Dalton is jumping ship to become ‘president of global health’ at BT. More details soon.
12.20pm Ben Clover’s first full news story on the south London reconfiguration is now live. Read it here.
12.19pm Exactly which patients are taken and not taken by Lewisham’s new, smaller A&E is of wider significance. HSJ chief reporter Dave West has a story this week about a review of A&E provision across the country. The work is being done by none other than Bruce Keogh, who Jeremy Hunt revealed this morning advised him on the Lewisham decision.
Dave’s story suggests that two levels of A&E are under consideration - the top level would deal with the most urgent stroke, heart attack and neurological cases for instance, while the second level would take only less specialised cases.
Ben has asked the DH for Bruce Keogh’s recommendations.
12.00pm The Foundation Trust Network has broadly welcomed the Secretary of State’s decision.
11.58am The DH has announced South London Healthcare is to be dissolved by October 2013.
Its statement, released just now, says: “The most financially challenged NHS Trust in England is to be dissolved by October 2013 to address the risk it carries for ongoing patient care and the pressure it is placing on other parts of the NHS.
“Previous attempts to solve the financial problems at South London Healthcare Trust have failed. Currently, the trust is losing more than £1 million every week and by the end of this year, is expected to have an accumulated debt of more than £200m – money that is being taken away from patients elsewhere.
“It was on the advice of NHS Medical Director Professor Bruce Keogh that Mr Hunt also announced that he has decided that it is in the best interests of patients that Lewisham Hospital should retain its A&E.
The trust will be dissolved, with each of its hospitals taken over by a neighbouring hospital trust. These mergers are subject to approval from the relevant regulators.
All three hospitals within South London Healthcare NHS Trust – Queen Elizabeth Hospital in Woolwich, Queen Mary’s in Sidcup and the Princess Royal in Bromley – will be required to make the full £74.9 million of efficiencies identified by the Trust Special Administrator.
The Department will pay for the excess costs of the PFI buildings at the Queen Elizabeth and Princess Royal Hospitals and write off the accumulated debt of the Trust so that the new organisations are not saddled with historic debts. It will also negotiate an appropriate level of transitional funding to cover implementation.
“With regard to the proposed service changes within the new merged Lewisham-Greenwich provider, the Secretary of State asked Professor Sir Bruce Keogh, Medical Director of the NHS, to consider if they would improve patient care.
“On the basis of Sir Bruce’s advice, the Secretary of State has accepted the recommendation to centralise very specialist emergency care at four sites in South East London because this will significantly improve the quality of care and save the lives of up to 100 patients a year.
“The Secretary of State understood the financial rationale for downgrading Lewisham A&E, but in the interests of local patients has imposed some additional clinical safeguards proposed by Sir Bruce. Lewisham Hospital will retain its ability to admit patients with less serious conditions, and will continue to have 24/7 senior medical emergency cover, allowing it to remain open as a working A&E department treating up to 75% of the patients who currently use it.
“Patients with much more serious conditions or higher risk pregnancies will be taken to Kings, Queen Elizabeth, Bromley or St Thomas’ because they are more likely to have a better result. To get to this higher standard of care, patients across South East London will only spend on average 2 more minutes in an ambulance to access specialist emergency services and on average 2-3 minutes in a private car or public transport to access consultant led maternity services.
11.53am Responding to the decision, shadow health secretary Andy Burnham said there is now “utter confusion” on reconfiguration across England.
11.46am It seems Bruce Keogh has recommended Lewisham retains a smaller emergency unit, which deals with about 75 per cent of the traffic it currently takes.
11.41am Jeremy Hunt says he asked NHS medical director Bruce Keogh to look at the south London reconfiguration.
11.36am Jeremy Hunt is on his feet in the House of Commons. Announcement imminent.
11.18am Also on HSJ today is editor Alastair McLellan’s leader: CCGs’ financial fears resurface. “As the leaders of clinical commissioning groups begin to put their plans into action, a significant number will be nervously wondering what dormant horror lies waiting in their area’s financial foundations,” he writes. Not one for the faint hearted, this. You’ll see what we mean if you click through.
11.15am The pro-Lewisham campaign has produced a song. You can listen to it on Youtube here, if you want to while away the minutes as we wait for the secretary of state’s decision.
HSJ readers will be aware that is not really true - PFI actually only accounts for about a third of the deficit at South London Healthcare.
10.46am Here’s Bill Morgan’s blog on Jeremy Hunt’s Lewisham decision. The former special advisor to Andrew Lansley writes: “Jeremy Hunt’s decision, then, is this: does he take the harder political decision now over SLHT to make it easier to take other such decisions in the future?” Mr Morgan dismisses the argument that the south London decision is a harbinger of market forces being unleashed on the NHS by last year’s Health and Social Care act is “not just incorrect – it is the opposite of the truth.” Possibly a swipe at Andy Burnham’s point from last week (see 10.39am).
10.39am Opposition leader Ed Miliband went on ITV’s breakfast programme Daybreak this morning to call for Lewisham’s accident and emergency unit to be kept. Proposals to downgrade it are based on the “wrong priorities”, he said, arguing that reconfigurations should be based on “clinical judgements, not cost judgements”.
Last week Andy Burnham said the Lewisham recommendations were “a nonsense”. “That’s a market and finance running hospital reconfiguration, and it cannot be done like that,” he said.
10.32am Wondering why there’s no update on the Lewisham decision? It’s been put back to 11.30am, HSJ understands.
10.24am NHS medical director Bruce Keogh, deputy chief executive David Flory and Monitor chair and chief executive David Bennett have written to NHS leaders to explain changes to the reporting of quality accounts. The amendments kick in from February this year.
Independent sector providers are also encouraged to consider including these quality indicators in their accounts.
The Mandate from the Department of Health to the NHS Commissioning Board requires the NHS to measure and publish outcome data for all major services by 2015. The data should be broken down by local clinical commissioning groups where patient numbers are adequate, as well as by those teams and organisations providing care.
“The changes we are making to the reporting requirements for quality accounts, as well as any future changes we make, will support the Mandate commitment,” the letter says.
10.10am Deputy chief executive of the NHS David Flory has written to NHS trusts and foundation trusts to inform them that, in future, a trust’s criminal liability will transfer to its successor if it merges with or gets taken over by another trust.
This is because a local fire service was thwarted in its attempt to prosecute an NHS trust following a fire at a hospital in October 2011. Between the incident and