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GP leaders say they have been ignored in test case over Lansley ruling

By Ian Quinn

Exclusive: NHS managers have claimed success for a consultation on plans for the biggest reconfiguration of services since the new Government came to power, but GP leaders claim their opposition has been ignored.

In first major test case for health secretary Andrew Lansley's ruling on no more top down reconfigurations, a dozen PCTs and hospital trusts in London have released the results of a consultation into proposals including the closure of hospital A&E services and a shift up to 60% of the workload to primary care.

Managers in north-east London claim ‘broad support' for many of the proposals, based on Lord Darzi's original Healthcare for London plans, despite GP leaders warning the plans put patients at risk and will swamp practices.

The proposals include plans to close the A&E unit at King George Hospital in Ilford, with trusts claiming that the majority of the workload can be switched to polyclinics.

Dr Mike Gill, joint clinical director for Health for north east London, said: 'The consultation has been a great success.

'We discussed our ideas for future health services with thousands of people and the feedback shows local people and patients want to see real changes in the NHS.'

The consultation was carried out before Mr Lansley's subsequent intervention to demand that all major reconfigurations must have the backing of GPs. A summary document of the report, released by the North East London sector, fails to mention the huge concerns which had been expressed by GPs, councillors and MPs.

In their joint response to the consultation, which was carried out between November and March, LMCs in City and East London, Redbridge and Waltham Forest said the move would see thousands of patients transferred from secondary to primary care without adequate resources to treat them.

‘The LMC is unclear how the shift of work would be handled/transferred capacity wise into the primary care setting ... we are concerned about impact of moving a number of secondary care services into the community without including or developing the detail and resources to cater for these additional services,' they said.

The LMCs also accused trusts of exaggerating the ability of patients to get to other A&Es at alternative hospitals quickly enough if the King George A&E closed.

They also warned the moves could lead to privatisation of services outside of hospital.

Announcing its findings, Health for north east London did acknowledge ‘there was more disagreement than support' from respondents about plans for the closure of the A&E department and plans to close King's George's maternity unit, but said patients would 'benefit from the changes'.

But Dr Tony Grewal, medical director, Londonwide LMCs, said: 'There has been patchy communication with the LMCs about this consultation and the concerns we raised in our responses have not been addressed in the release I have seen.

'I guess the question is, which GPs and nurses have the sector worked with to develop these proposals? We certainly haven't felt at the centre of the consultation to date, and look forward to working with colleagues to ensure that any future services changes are appropriate, given the clear requirement for GPs to be fully engaged and leading such processes in the future.'

Dr Kambiz Boomla, a GP in Tower Hamlets, said he believed huge opposition from GPs and patients would stop the A&E closure plans, while he said less controversial changes to specialist hospital services included in the plans should be allowed to go ahead.

‘I can't see a Secretary of State wanting to have another Whittingdon Hospital situation breaking out in outer London,' he said. ‘This is the first test of the new Government to see whether they will back up their rhetoric with decisions.

‘They have said that all major reconfigurations must be bottom up and led by clinicians rather than by the healthcare for London report which was drawn up based on plans by McKinsey. Now we will see.'

A spokesperson for the sector said: ‘The findings from this consultation will be carefully considered by local clinicians, including GPs, hospital doctors, nurses and other health professionals as part of the review process and used to inform a final set of proposals for change. No decisions will be made on any of the proposals until this work has been undertaken and all feedback has been reviewed.'

A&E closure threat: GPs warn practices will be swamped A&E closure threat: GPs warn practices will be swamped

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