Answers to our questions for the Epsom-St Helier Trust uncensored!

The election campaign is over but the fight to ensure the future of St Helier Hospital and all other vital healthcare services in South-West London continues. While the KOSHH Party didn't win any seats on Merton or Sutton councils, the candidates all did well in the polls, campaigned hard, raised awareness about our health services among countless people and made St Helier Hospital and the role local councillors can play in ensuring its future a bona fide election issue.

During the campaign, we put a series of questions to the Epsom-St Helier Trust after we felt this interview in the Wimbledon Guardian with the trust's new Chief Executive raised more questions than it answered. At last, we have answers to our questions. Here they are, posted without futher comment and completely uncensored.

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Firstly, I would like to say thank you for submitting these questions to us. We know that you are passionate about St Helier Hospital, and – having met some of your candidates at the public listening event we held in Merton earlier in the year – we hope that you can already see how committed we are to openness and transparency, as well as the day job of providing high quality care to our patients. 

Our absolute priority is to provide great care to every patient, every day – and over the last three years we have performed very strongly against the standards the government expects of us. At the same time, we have made great headway in overcoming a significant deficit of almost £20 million and we plan to break even this year. That is an incredible achievement, and something that we as a Trust are very proud of.

However, we also understand that our estate is of great importance to local people, including our patients, visitors and staff. As such, we have provided detailed answers to your questions below. 

In addition, once the local elections are completed later this month, we would like to invite you to visit St Helier, meet with our Chief Executive and go through any of the detail.

Has the calculation of £78 million for upgrades to St Helier Hospital allowed for inflation over the next five years?

The proposed investment of £78 million will be used across our hospitals, and is based on what our analysis shows we can afford during the next five years, whilst still meeting our financial obligations (such as paying staff and purchasing equipment). 

As such, within this proposed figure we will need to allow for VAT (where we cannot reclaim it), 
professional fees, and any inflation to the costs involved in construction. As always, we will make sure that we are getting the best value for money, so that our patients and the taxpayer will receive maximum benefit from any investment that we make.

Given that 12m has already been spent, can we please be told what this money has funded?

Every year, we spend approximately £9 million on improving and maintaining our hospital buildings as well as funding new state-of-the-art equipment.

In the last year alone, we saw benefits at all of our sites from improvements to the roof at Epsom Hospital, to new equipment in the operating theatre at St Helier. 

You can see a full breakdown of previous plans at www.epsom-sthelier.nhs.uk/investments.

In addition to the £9 million of improvements we funded last year, we were also awarded £4.5  million from the NHS Trust Development Authority to fund service transfers from Sutton Hospital to our two main sites (including the necessary improvement works at Epsom and St Helier). This has allowed us to create a combined outpatient department in Ferguson House and a new state of the art urology centre at Epsom, while improving the existing facilities at Sutton for blood-testing clinics, pain and chronic fatigue clinics and increasing the capacity of our car parks at both of the main sites.

The major refurbishment projects included:

• Completion of the urgent care centre at St Helier;

• £450,000 on general ward upgrades, including refurbishing the coronary care unit and the 
kitchen on Buckley ward at Epsom Hospital; 

• £250,000 creating additional single rooms for patients at both Epsom and St Helier, which offer increased privacy and help to protect our sickest patients from spreading or contracting infections; 

• £1.1 million on general maintenance at St Helier Hospital, including replacing old windows 
and roof maintenance across the hospital buildings;

• £100,000 on improving the system for piping gases (such as oxygen) to patients across 
Epsom.

Can we please have a detailed breakdown of how the remaining £78 million will be spent? Is it a loan?

Early plans for how we will spend the proposed £78 million are currently going through the process of being approved by our Trust Board as part of our five-year business planning process. As you would expect, we are working closely with our clinical commissioning groups and the NHS Trust Development Authority during this process.

Investing such a significant amount of money into NHS services over a number of years requires a rigorous process for individual business cases, including external approval when required. It is likely that over the coming five years, there will be times when we will need to go through further approval processes (particularly for the larger projects we undertake). As such, we are not in a position to release a detailed breakdown at this stage. 

However, please be assured that – as in previous years – our plans will be targeted at improving patient care either through new equipment, upgraded wards and facilities or specific projects such as the creation of a new eye-unit at St Helier. We will keep the public informed of all major upgrades as they progress.

Why is there no mention in the Sutton Guardian article of the role of Clinical Commissioning Groups (CCGs) in hospital spending? Given the CCGs have been assigned the task of reducing spending across multiple hospitals in SW London, it seems curious that they are conspicuous by their absence from the Sutton Guardian article.

As an acute Trust, we work really closely with all of our clinical commissioning groups and healthcare partners, and our Chief Executive certainly did make reference to their important role in her interview with the Sutton Guardian. We are always happy to talk to the Sutton Guardian though, so if there are burning questions you think they should be asking, please do let them know.

Twas the night before election day...

L to R: David Murray (Wallington South), Frances Cornford (Sutton West), Sandra Ash (Wimbledon Park), 

Dr Tiz North (Sutton South), David Ash (Raynes Park), Dave Ash (Cheam)

Twas the night before election day, and all over the borough

Candidates are being incredibly thorough.

And the KOSHH Party is no exception

Still campaigning until dawn's inception.

Our candidates wish they were snug in their beds

But St Helier Hospital thoughts fill their heads.

For they'll not rest until it is secure

As a result, they've had much to endure.

Their feet are aching, they all need hot baths

After walking the wards' endless footpaths.

Thousands of homes got leaflets through doors

Explaining why healthcare is a councillor's cause.

Our work has been hard thanks to many a Tory

Whose letters to residents tell a different story.

How do they know St Helier Hospital isn't under threat?

The strategy announcement hasn't happened yet.

We still waiting on that, at least until June.

Will the CCGs change their tune?

Cuts to services are "very likely", they say.

Imagine if St Helier's A&E went away.

And kids' services and renal and maternity.

Gone from south London for all eternity.

Because of this, we can't stand idly by.

The KOSHH Party urges all councillors to try

And fight for our hospital's survival.

We want unity here, we don't need a rival.

Lib Dem, Labour, Tory, UKIP or Green

Or any political stripe in between,

Every councillor can play their part.

Don't tell us you don't know where to start.

You can lobby the CCGs - it's our money they spend.

We will fight for our hospital to the end.

If you have a party colleague who's an MP

Lobby them too. Have them over for tea!

Tell them about the concerns of people near you

Who need the NHS, as we all do.

The KOSHH Party is committed to healthcare for all.

We will not take our eye off the ball.

Without our hospitals, there's a hole in the community.

But with loud voices and cross-party unity,

Councils can play a vital role

In ensuring there isn't a hospital-sized hole.

Without St Helier Hospital, life becomes rougher.

And, on top of all that, local businesses suffer.

Ambulances will spend longer in traffic.

For women in labour, this will cause havoc.

The hospital issue remains a hot button

For all the good people of Merton and Sutton.

If we can save the hospital, there will be jubilation.

See you tomorrow at the polling station!

Photography by Paul McMillan

Clinical Commissioning Groups: Local bodies that need to be held to account by local people

Clinical Commissioning Groups (CCGs) control how our money is spent in our local hospitals but few people know what they do or how they can be held accountable. This concerns Keep Our St Helier Hospital Party (KOSHH Party) candidates for Merton and Sutton enormously.

“The future of St Helier Hospital is not in its own hands - it is South West London CCGs who make the big decisions,” says Frances Cornford, who is running as a KOSHH Party candidate in the Sutton West ward. “The CCGs have to make £370m in cuts across SW London and their strategy won’t be revealed until June or July - after the local elections.”

Does anyone know what CCGs are supposed to do?

CCGs are local bodies tasked with spending our money on our hospitals. This system can only be effective if the CCGs are transparent, the members of CCGs have no conflicts of interest, such as financial interests in private healthcare providers, and if their meetings are held in public, times, dates and agendas widely publicised and they are held at times which allow large numbers to attend.

Click here for a link to the SW London CCG's website, representing CCGs from Merton, Sutton, Croydon, Kingston, Richmond and Wandsworth. If you scroll down to the bottom of the homepage, you can find links to the six CCG's websites and from there, you will then have to go through each individual website to find dates and times. Why does the SW London CCG website not act as a one-stop shop with a calendar of events for all its CCGs? 

The SW London CCG response to this is: "CCGs are independent statutory bodies and advertise their own meetings on their own sites." But the SW London CCG website is used to share information on behalf of all CCGs on other matters. So why not CCG meeting times? Curiouser and curiouser...

Meeting times and dates seldom, if ever, appear in the local press, let alone on the SW London CCG website. This simply isn't good enough.

Does anyone know when their local CCG is next meeting?

The Sutton CCG was meant to be meeting today, Wednesday 7 May, at 2pm. However, this has been postponed until June 18. As far as we know, the location will still be Priory Crescent, Sutton SM3 8LR and it will still be held at 2pm but it is difficult to find out information about any CCG meeting. 

KOSHH Party candidates are dismayed that meetings are poorly publicised by CCGs and the timings are inconvenient.

“Holding a meeting at 2pm on a weekday means many people will be unable to attend, such as those who work full time or are looking after their young children during the day,” says David Murray, KOSHH Party candidate for Wallington South.  

So how come Surrey Downs CCG manages to be more accessible?

KOSHH Party candidates were interested to learn that Surrey Downs CCG, which publicly broke away from the failed Better Service, Better Value review, will be holding a public event in conjunction with Epsom and Ewell Conservatives on Tuesday 10 June at 7.30pm.

“This shows it is possible for CCGs to hold events in the evening when more people can attend,” says Dave Ash, KOSHH Party candidate for Cheam. “Why won’t our local CCGs learn from Surrey Downs and hold meetings at times when people are likely to be able to attend? Why would they make it difficult for so many people to attend?”.

What can local councillors do about all this?

There is no reason why local councillors cannot play an important part in lobbying CCGs in defence of our local health services. 

If elected, KOSHH Party councillors will lobby local CCGs to better publicise their meeting times and venues and encourage more meetings in evenings and on weekends so that a broader cross-section of the community can attend. 

We will lobby for CCG meeting times to be advertised in all GP surgeries across Merton and Sutton.

We will also continuously lobby CCGs for greater transparency, constantly remind them of the importance of preserving all vital services at St Helier Hospital, attend CCG meetings and publicly report on the meetings' outcomes. 

We urge all candidates to join us in these promises.

Photography by Petr Kratochvil

Some important questions for the Epsom-St Helier Trust

World Press Freedom Day has been observed for another year. And, thanks to the internet, the good news is that it is getting easier to be part of the free press in Britain. While we were disappointed that the Sutton Guardian profile of Chrisha Alagaratnam, new Chief Executive of the Epsom-St Helier Trust did not include answers to important questions, we were heartened to see that people were keen to jump on board in the comments section and challenge the information in the article.

Over on Twitter, the KOSHH Party Twitter account (@KOSHHParty) asked Ms Alagaratnam a few questions in relation to the Sutton Guardian article. Originally £219m had been earmarked to fund improvements at St Helier and then it was announced that this would be reduced to £90m over five years. In the Sutton Guardian article, it said that £78m would be spent. So our first question was, quite simply, what's going on?

Ms Alagaratnam responded promptly thus: "£90m was at Feb 13/14. £78m is from the new financial year 14/15 for the next five years as we have already begun investing."

So that would mean that £12m has already been spent on upgrades to St Helier Hospital. Thus, we asked additional questions over Twitter. We received a tweet from the trust's communications department account requesting that we ask any further questions via email. Certainly over email, nobody is not limited to the 140-character format of Twitter for questions and answers but we prefer a more transparent approach.

With the principle of transparency as our guiding light, we publicly ask the following questions of the Epsom-St Helier Trust.

1. Has the calculation of £78m for upgrades to St Helier Hospital allowed for inflation over the next five years?

2. Given that 12m has already been spent, can we please be told what this money has funded?

3. Can we please have a detailed breakdown of how the remaining £78m will be spent?

4. Is this £78m in the form of a loan that will have to be paid back?

5. Why is there no mention in the Sutton Guardian article of the role of Clinical Commissioning Groups (CCGs) in hospital spending? Given the CCGs have been assigned the task of reducing spending across multiple hospitals in SW London, it seems curious that they are conspicuous by their absence from the Sutton Guardian article.

We look forward to answers to these questions from the Epsom-St Helier Trust. Unlike Twitter, there is plenty of room for extensive responses in the comments section of this blog post.

If elected to Merton and Sutton Councils, KOSHH Party candidates promise to publicly hold all decision-makers to account in relation to the future of St Helier Hospital and urge all candidates to promise to do the same. We want to see a future in which Merton and Sutton councillors from across the political spectrum unite in support of our hospital.  

Dr Tiz North tells why she stands for St Helier Hospital

The KOSHH Party Sutton candidates at St Helier Hospital. 

L to R: Frances Cornford, David Murray, Dave Ash and Dr Tiz North

Dr Tiz North, a consultant radiologist at St Helier Hospital shares her statement of purpose about why she is running on the KOSHH Party ticket in the May 22 local elections.

I believe that the population surrounding Epsom and St Helier Hospitals deserve to be treated by a local hospital trust which has all the secondary services of an Acute District General Hospital.

First, some background to the current situation facing St Helier Hospital... Over the past 30 years, there have been constant attempts by politicians to close St Helier, an excellent hospital with a good reputation. This has sprung out of the belief that there are too many hospital beds in London and therefore several of the outer London District General Hospitals should close.

Indeed, there has been an overall reduction in the number of beds throughout the capital thanks mainly to modern technology which allows day case surgery and intervention by minimal techniques. These advances result in shorter hospital stays. This shift has been led by the clinicians performing these services. It has not been led by politicians. Likewise, the shift of tertiary services, such as transplantation, cardiac and vascular surgery, major trauma, neurosurgery, acute stroke services and paediatric surgery, have all been shifted out of Epsom and St Helier Hospitals. These services are now performed at St George's in Tooting. Again, this was all with the agreement of grassroots physicians.

But what about the present situation? Our two local hospitals, Epsom and St Helier, have been pared down to the essential core services. This includes busy A&E departments, Paediatrics, Maternity, General Surgery (including cancer surgery), Eye Surgery, Urology, Orthopaedics, General Medicine (including diabetes, renal services, palliative care, care of the elderly and dermatology). Because of this wide spread of specialties, both hospitals can cater for the majority of common surgical and medical conditions. This attracts high calibre junior doctors into the surgical and medical rotation schemes as well as students from St George's Medical School.

What could happen in the future? If any of the specialties, especially A&E, Paediatrics or Maternity, were removed from either Epsom or St Helier, a domino situation would arise. If there are no patients admitted to the wards for acute medical or surgical treatment via A&E, this means the hospital loses training recognition by the Royal Colleges and the withdrawal of junior doctors. These doctors would be replaced by doctors in non-training posts, mostly from abroad. A lack of patients means a lack of teaching cases and this would have a negative effect on the presence of medical students. The general downgrading of the hospital means it would not attract top quality consultants and overall patient care could suffer.

Where would the patients be treated if St Helier Hospital was downgraded? The Better Service, Better Value (BSBV) programme may be defunct in name but the SW London Collaborative Commissioning Groups (SWLCCG) is simply the programme's latest incarnation. This group believes that much of the work can be done locally in patients' homes and by GPs. This is despite the fact that GPs are already under too much pressure and more than 50% of GPs are women, many of whom want to work part-time. On top of this, there is not the back-up in the community because there is a shortage of district nurses. 

So, what would be the new reality for patients in our community? In reality, what would happen is that more patients than ever would descend on St George's A&E in Tooting. The physicians there have been quite vocal about not wanting this to happen. This is understandable as they would like to concentrate on the tertiary services they already provide, as well as providing secondary services to their own local population. Like the area surrounding St Helier Hospital, the population around St George's Hospital is increasing.

Are there any solutions? Epsom and St Helier Hospitals should not be subject to any further reconfigurations. Doctors should work with local Clinical Commissioning Groups (CCGs) to ensure that across the patch every attempt is made to reduce hospital admissions and shorten hospital stays by improving health and social care outside the hospital. In turn, CCGs should support their local hospitals and not reduce funding by such an amount that they become unviable.

Both hospitals should look at their own practice to see how treatments can be improved by rapid investigation and timely intervention.

About Dr Tiz North: Dr North moved from Epsom to Sutton in 1982 and has lived in the same house in South Sutton since then. Both her children went to schools in the local area. She has been a consultant radiologist at St Helier Hospital since 1977 and was previously the Clinical Director of Diagnostic Imaging for Epsom and St Helier. Dr North was also chair of the Local Negotiating Committee. Currently, she is the Honorary Secretary of the SW London Division of the BMA and a member of Keep Our NHS Public.

Photography by Paul McMillan 

Sharing information in a few tweets? Not good enough!

This week, the KOSHH Party called out the SW London Collaborative Commissioning Group (SWLCCG)on letting slip some alarming information via Twitter and a link buried in their website.

It was generally thought that in June, there would be an announcement about plans for local hospitals, including St Helier Hospital. This followed on from the disastrously wasteful Better Service, Better Value (BSBV) programme in which the "preferred option" was for St Helier to lose A&E, maternity, renal and paediatric intensive care departments.

But via their Twitter account, SWLCCG revealed that in June they will release a "five-year strategy to set the standards and outcomes commissioners want to achieve" and that "details of how they achieve them will be the next step."

Dr Tiz North, KOSHH Party candidate for Sutton South challenges SWLCCG, saying that these tweets raise more questions than they answer.

She asks SWLCCG: "Is this a case of BSBV in a new guise? Will the CCGs come up with the same strategy via slightly different means, such as applying the unrealistic London Quality Standards?".

In short, St Helier Hospital is not safe. It may seem on the surface that this sort of delay and obfuscation by the SWLCCG is helpful. After all, it delays any definite announcements about closing vital services and no Coalition MP wants to go into the 2015 General Election with the threat of a massive hospital closure hanging over their heads.

But it's not that simple. There have already been cuts to services at St Helier - there is just one paediatric ward with others moved to Epsom General Hospital and Ferguson House, which was to be the winner with the now-abandoned £219m refurbishment is a shell of its former self. Add to this creeping privatisation at St Helier, such as G4S winning a £3.5m contract for driving the hospital's non-emergency ambulances, despite one of their ambulances being involved in a patient losing his life, and it is clear to see we have a death by 1,000 cuts on our hands before any major cuts even happen or are announced.

As Dr Tiz North said, "unrealistic" standards could be applied to St Helier Hospital in the future which could potentially be used to justify a downgrading or, worse still, result in a closure under Clause 119 which gives the Health Secretary the power to close hospitals within 40 days.

This may seem like a rather lofty Westminster-level issue for a local election campaign but we need grassroots activism and action from concerned residents and from Merton and Sutton councillors from all the major parties. We call on Conservative and Liberal-Democrat candidates to challenge their colleagues in the House of Commons who voted for Clause 119 and to point out to them how it could potentially threaten hospitals across England, including St Helier Hospital.

Many thanks to Radio Jackie for breaking the news. Click here to read the story.

Photography by Paul McMillan

Introducing Britain’s newest political party!

The future of St Helier Hospital is the biggest issue facing residents of Merton and Sutton and this has motivated six residents to declare they are prospective candidates in the May 22 local elections representing the Keep Our St Helier Hospital Party (KOSHH Party).

Meet the KOSHH Party team:

Dr Tiz North (Sutton South Ward, Sutton): Tiz has worked as a Consultant Radiologist at St Helier Hospital since 1977 and was previously the Clinical Director for Diagnostic Imaging for Epsom and St Helier. She has lived in Sutton since 1982.

Tiz says: “It is so important that we defend all the services at St Helier Hospital - A&E, maternity, children’s services, renal, everything. It would be a disaster for all patients and for the local community.”

David Murray (Wallington South Ward, Sutton): David has clocked up more than 25 years for IBM and as a local school governor. Married with three daughters, he now volunteers for St Raphael's Hospice, Age UK and CAFOD. He has lived in Wallington with his wife Anne for more than 40 years.

David says: "St Helier A&E were fantastic when I needed them recently and I want them there for future generations."

Frances Cornford (Sutton West Ward, Sutton): Frances has lived in Sutton for more than seven years and really appreciates the value of having a good local hospital. She believes that local politicians in Sutton are not doing nearly enough to protect St Helier.

Frances says: “Local politicians are full of warm words but little in the way of action. Being part of the Keep Our St Helier Hospital Party is a way to put pressure on politicians of all parties and make them realise how important our hospital and the NHS are to local people.”

David Ash: (Raynes Park Ward, Merton): David is a father and grandfather and he has lived in the borough for 34 years. Now retired, he had a varied career in public service which included running a textile laboratory, training managers, drafting central policy and dealing with Parliamentary business.

David says: “I have lived during the best times the UK has ever known, in which the finest achievement was the creation of the most cost-effective health service in the world, paid for according to means and free according to need. I am determined to fight the attack on St Helier Hospital, which is part of the current giveaway of the NHS to private companies who will care nothing for the health and wellbeing of the nation.”

Sandra Ash (WImbledon Park Ward, Merton): Sandra is a wife, mother and grandmother, and a retired tutor. She has lived in the borough for more than 30 years. She believes that the threat to vital services at St Helier Hospital, such as A&E, maternity, the children’s hospital and the renal unit, is the biggest single issue facing SW London.

Sandra says: “We want to raise public awareness of this threat to St Helier Hospital and the whole community - it needs to stay on the political agenda. It is for that reason that I have decided to stand as a candidate for the Keep Our St Helier Hospital Party.”

Dave Ash (Cheam, Sutton): Dave has a young family, has lived in borough of Sutton for seven years, and has lived in the area for most of his life. Whenever members of his family have used St Helier Hospital, they have always had excellent care, and he knows that they are not alone in this regard.

Dave says: “I believe that the high quality care at St Helier Hospital represents great value to the taxpayer - the whole community will suffer if we lose any of these services. I oppose any privatisation of NHS services - it is a national asset worth fighting for.”

Photography by Paul McMillan