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Independents' Day

CCG chair warns Hunt A&E closure threatens ‘whole ethos of clinical commissioning’

The proposed closure of Lewisham A&E affects the ‘whole ethos of clinical commissioning’, the chair of Lewisham CCG has warned in a letter to the health secretary.

Dr Helen Tattersfield wrote to Jeremy Hunt this week to say the proposals as part of the trust special administration (TSA) will fragment the provision of care for Lewisham residents.

She said: ‘If the TSA proceeds as currently planned it is my belief that not only will this result in a reduction of quality and provision of health services for Lewisham residents with huge risks to health outcomes but also the effective end of clinical commissioning in Lewisham.’

The consultation produced as part of the TSA, which ends today, recommended that ‘a 24 hours a day, 7 day a week urgent care centre at University Hospital Lewisham’ would replace the A&E department.

The consultation said it was not about ‘closing’ the department but reforming it.

It added: ‘Those who did require more specialist emergency services would not have to make the decision about where to go. They would be taken direct to the right place having called an ambulance because of the severity of their health problem, or they would be transferred by ambulance if assessed at University Hospital Lewisham’s urgent care centre as needing further care.’

But Dr Tattersfield said: ‘In all of the arguments and outrage against the planned changes at Lewisham Health are as proposed by the TSA, which are compelling in themselves, there is one aspect of the effect of the proposals that has so far not been mentioned, namely the impact on the whole ethos of clinical commissioning.’

‘The Health and Social Care Act advocates a process of local decision making and of partnership between healthcare, local government and the local population, “No decision about you without you” being a central and overriding theme of the act.’

‘The TSA proposals will fragment the provision of care for Lewisham residents and sever these established relationships as patients are cared for in one of four out of borough providers.’

‘The close co-operation and shared aims demonstrated by Lewisham Healthcare will be impossible to maintain with four providers due both to local workload capacity within commissioning and local government but also to the dilution of influence on the remaining providers for whom Lewisham residents represent only a small proportion of their work and with whom they have no natural affinity.’

Readers' comments (6)

  • Vinci Ho

    One thing the government has done very well is creating all these political sound bites ,'no decision about you without you', 'efficiency saving', 'pathfinders'....
    And the reality is....
    We all know the answer

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  • Come on, nobody fell for that local decisions by local clinicians claptrap! 'No decision about me without me' ranks in there alongside 'I am passionate about the NHS' and 'Substantive changes' as the epitaphs applied to the NHS by the Coalition of Broken Promises.
    Let's watch Camerons 5 pledges fall off cliff edges - he has a personal accountability deficit that he hopes others will pay-off!

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  • Sounds like Dr Tattersfield has just realised the reality of commissioning. The NCB will impose things on you and unless you can show how you can do it better and stay within your ressource limit then you will have no choice.

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  • I think you've missed a few words there chaps:

    "No decision about you without (your CCG manager's funding approval)"
    "I am passionate about (cutting) NHS (services)"
    "Substantive (funding) changes"
    "Efficiency savings (to reduce GP income)"
    "Pathfinders (to privatization)"

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  • Dr Tattersfield's letter seems a very sound analysis, she puts her finger on important issues as you might expect of a good clinician with her patient's interests at heart; the ostensible reason you might suppose for involving GPs in commissioning work in the first place.

    If her reasoning is totally ignored, side-lined and even considered hostile then it's business as usual in the NHS commissioning cloud.

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  • The Commissioning Board ignored a 71% vote by the NHS Assembly in Doncaster supporting a sensible move towards allocation of CCG budgets closer to a fair share of resources. It would have involved moving some money out of London. Is it any wonder that the majority of CCGs still suspect that the Commissioning board is still run by the politicians?

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