Was dividing Chorley A&E a marketing ploy gone wrong

Marketing plans to fragment A&E departments continue.

In 2017, Warrington & Halton hospital trust board setup a detailed marketing plan for people who opted to pay privately [PDF]  for surgical operations that were previously banned by commissioners (Clinical Commissioning Groups).

The marketing plan was relaunched in 2018 where it was revealed the trust had actually established the pay private scheme five years earlier in 2013, immediately after the 2012 Health & Social care act came into effect.

[1] Other 'changes' to how the NHS functions also came into effect such as 'fragmenting' A&E departments into two parts (emergent & urgent) then selling off the 'urgent care' contract to the private sector later.

Can anyone think of where [1] above has already happened?  I'm sure you can, just think local..

In their marketing material, the trust said they were "prepared to rebut ‘privatisation’ messaging via interest groups and media". 

It didn't work, and a clear message was sent from the public that all treatment under the NHS must remain universal and this is merely for those what had the ability to pay - and potentially jump any queues.

NHS patients were being charged as much as £8,500 for operations at the Warrington hospital trust, sparking outrage and claims "privatisation is already here".

Patients raised concerns over the cost of surgeries under the My Choice programme at NHS Warrington and Halton Hospitals Trust.

Since the introduction of the H&SC act in 2013, commissioning groups, also setup under the act, began to ration and ban NHS medicines and treatment, a list of which can be viewed here.

Barbaric and 'immoral'

One NHS campaigner said "So no knee/hip replacements for those that genuinely need them? No D&C (dilation and curettage) for those unfortunate to miscarry? Barbaric."

Another patient wrote on social media "Several of the operations I've had are listed including a knee arthroscopy I had a few years ago when I couldn't work for months."

She wrote that she was "horrified" to see treatment for heavy menstrual bleeding on the list, describing the whole move as "immoral"

The trust claim the self-pay scheme provided convenient access for patients, which many patients rightly translated as paying to jump the queue.

Since the outcry the trust have suspended the scheme. 

However, clinical commissioning groups (CCGs) continue to ration and ban medicines and treatment so be very vigilant and join an NHS campaign group near you.

Links/Related

NHS hospital stops plan to charge patients almost £20k for operations after outcry

History shows closing Chorley A&E results in worse outcomes, not better

History shows closing Chorley A&E results in worse outcomes, not better

When opposing closures by CCG and LTHTr don't look too closely at their reasons for closing Chorley District Hospital (CDH) A&E but look at historical data as reasons for RETAINING CDH A&E, and even 'expanding' these services.

The evidence for opening CDH A&E full time is compounding; as closing it permanently would result in worst outcomes for patients due to many factors including:

Overlcrowding at surrounding A&E hospitals - this includes Wigan WWL as their Chief exec has already stated the WWL could not manage additional patients in 2016/17 when CDH A&E was closed.

Perhaps the most compelling evidence to keep A&E services in Chorley is what's called' ambulance handover breaches'.

Handover breaches are a 'clear indication' of a failed system.

Paramedics are left waiting to handover their patients to a hospital A&E department. If that department is overcrowded and does not have enough beds then the handover times shoot up. The result is seriously ill patients waiting in corridors or backs of ambulance and thus fewer ambulances on the road.

When Chorley A&E closed in 2016 Ambulances began queuing up at Preston hospital so couldn't  get back on the road to reach emergencies. Subsequently it emerged in Jan 2018 a local man died of a suspected heart attack after waiting over 90 minutes for an ambulance to arrive.

If they close Chorley A&E, this could become commonplace, particularly as the Ambulance service comes under more pressure.

Now how much evidence do you want?

Well, let's have a quick look at another disaster that happened over at Blackburn hospital when it started taking patients when their Trust closed Burnley hospital A&E.

Let's do a comparison of ambulance handover breaches.

The figures for 2015/2016 show a huge increase in serious Ambulance handover breaches (> 60mins) when Chorley A&E closed. 

Patients had to be taken to the Royal Preston hospital and any hospital nearby. Wigan saw a huge increase in patients arriving by Ambulance of almost 500% when Chorley & South Ribble hospital A&E shut it's doors in April 2016.

The ambulance handover times trebled and as the table above shows there was a huge increase in serious ambulance handover breaches resulting in patients lives' being put at risk.

Now take a look at the table where it shows the Royal Blackburn [hospital] where they shut Burnley A&E taking patients to Blackburn.

The increase in handover and serious handover breaches at the Blackburn hospital is HUGE going from 191 handover breaches in Apr 2015 to 366 breaches a year later in May 2016.

Is this what we want for Chorley & South Ribble hospital?

and Remember, before Burnley A&E was closed the hospital trust claimed the Royal Blackburn hospital could accommodate patients from the Burnley area - including Burnley, Rossendale, Pendle and many other towns.

So how can that be deemed 'better outcomes' for patients as we're led to believe?

When it comes to the crunch, and public consultation arises, those wishing to close Chorley A&E need to prove alternative provision is already in place in the community and that any bed closures can accommodate patients elsewhere. They also need to prove there will be no overcrowding at surrounding hospitals pushing their resources and placing patients at risk.

I say it can't be done, and along with my fellow NHS campaigners intend to continue to fight tooth and nail to KEEP and EXPAND our life-saving services at Chorley & South Ribble hospital.