Key figures demand independent review of Burnley casualty care
A WAY should be found to restore a proper accident and emergency department in Burnley, say two prominent local figures who have called for an independent inquiry into the A&E fiasco.
Ex-Burnley MP Peter Pike and former health boss Ian Woolley held prominent positions within the hospital trust until July as shadow hospital governors. Now they are demanding an independent inquiry to decide once and for all whether Burnley and Blackburn should have their own casualty departments.
They say the hospital trust must recognise that it is not meeting public expectations and the A&E fiasco is the number one matter of political concern in the Burnley area.
They have gone public about the controversial arrangements saying that promises on A&E were deliberately broken by new management at the combined hospitals' trust shortly after it was set up.
They say: "We serious believe our suggestion offers a way out of the hole Mrs Kirk and Mrs Cubbon (the then chairman and chief executive) dug for the Trust when they arrogantly ignored public opinion and did not even apologise for breaking the promise."
The men have delivered their demands in a scathing letter to Mark Walkingshaw, the trust's director of planning, and want them brought to its new chairman, Hazel Harding.
They want East Lancashire Health Trust to undertake the inquiry – preferably by commissioning an agreed independent expert organisation to carry it out. The independent experts would be asked to compare the Burnley/Blackburn set up, which has just one full accident and emergency department at the Royal Blackburn Hospital, and the arrangements for patients in the Preston area, where there are accident and emergency facilities at Preston and Chorley.
They tell Mr Walkingshaw they expect the findings of the inquiry to be binding, saying: "However, if after this proposed review – the terms of which will we hope be agreed with all parties – it is found it is not feasible to have two A&E Departments in Burnley and Blackburn then all parties would abide by such a finding.
"On the other hand, if it was found it is practical to have two A&Es then ELHT would be expected to use best endeavours to implement such a finding as soon as was practical.
"This wording makes it clear to all concerned that the results of this study should be more or less binding on all concerned. There are many reasons for making this request.
"Before merger very serious promises were made that A&E facilities would remain in both Burnley and Blackburn. As a result of that and other assurances merger proceeded with the full backing of all concerned.
"But fairly soon after merger the ELHT Board under the chairmanship of Mrs Kirk and the new chief executive Jo Cubbon deliberately broke the promise on A&E — even though they were well aware this was strongly opposed particularly by various representative organisations in the Burnley area. No satisfactory explanation has ever been given as to why it was so essential to make that move.
"It is clear that in Preston and Chorley local people appear to be fully satisfied with having two A&Es, and there is no move to close the smaller A&E in Chorley."
Mr Woolley and Mr Pike emphasise the A&E at Blackburn was never designed to handle the volume of cases it faces now as there is no A&E department in Burnley.
"It is beyond belief how it was felt to be a good idea to fit a quart into a pint pot. And that is quite apart from the local feeling about all the needless extra ambulance journeys. And there are real difficulties of access from the motorway, particularly at peak times.
"The creation of the Urgent Care Centre in what looks like temporary buildings next to A&E at Blackburn is hardly in keeping and has not solved the problem."
They also point out that the performance of the A&E at Blackburn is falling way below the national target and public opinion in Burnley, and further afield in Nelson and Colne, has been dismissed.
"It is almost laughable that in the last few days that ELHT has chosen to highlight the fact that on one day in early August, when the case load was said to be low, the national target was met. What did that prove?
"Failure to meet A&E targets has been going on too long. The recent flurry of initiatives is all well and good. And we respect the fact a very senior trust executive with a formidable reputation for getting things done is totally involved.
"But nowhere is there any mention that what is being done will satisfy public opinion in the Burnley, Nelson, Colne area. Those people have just been told what is going to be done. More or less told to take it or leave it – that this is all that is on offer – Professor Alberti says its good – it is saving lives – etc. So stop moaning - sort of attitude.
"There has been absolutely no effort made to discuss the position constructively, to compromise and agree a way forward. So there is no ownership by local people of the current efforts. Just more distrust."
The two former governors also point out the hospital trust's failure to meet A&E targets has meant it has been forced to abandon its much-heralded application to become a Foundation Trust hospital, and will not rethink the situation until November.
"Failure to gain FT status could have the most serious implications for the future of retaining the independence of hospital services across East Lancashire, as well as having a most serious impact on recruitment especially of the best clinical staff," they say.
"It is essential to scrutinise the present situation. Although we are no longer legally Shadow Governors since the ELHT Board abandoned its FT application in July, we believe we have both been involved long enough locally to realise that what is being done is not good enough for local people.
"In fact because of the service failures at Royal Blackburn Hospital the whole population of East Lancashire is getting a much poorer A&E service than it should be receiving."
Mr Pike and Mr Woolley say they have no objection to the current new initiatives which try to improve the service continuing.
"There are sure to be some improvements when the service is so bad at the moment. But with respect we seriously suggest there also needs to be the twin track approach to compare the ELHT model of care with the Preston/Chorley model. And see what can be learnt.
"To appease local feelings and repair the damage done by the broken promise and restore public confidence it is essential that this is taken seriously.
"In fact we would go further and say that if at all possible a way should be found to restore a proper A&E facility in Burnley – even if it does not have quite all the full facilities at Blackburn. Chorley does not have all that Preston has, but it meets with full local approval. And that is really important. The Health Service does not belong to the ELHT Board to do just what they like regardless of local opinion."
"This needs very careful thought to be sure all relevant factors are compared. And the final terms of the comparison need to be agreed with local people – so local people will own and trust what is being done. Re-establishing local trust will be the key to this whole exercise."
In response the Trust's deputy chief executive Lynn Wissett said: "The Trust invited independent reviewers Dr Simon Walford, a former senior medical adviser to the Department of Health, and Jeremy Pease, who works with NHS North West, to investigate unscheduled care in East Lancashire's Hospitals.
"The Trust is already acting on their recommendations through the new 24/7 programme, which focuses on ensuring a round-the-clock services for our patients.
"Since the programme was introduced at the beginning of August, the Trust has consistently met its target for 98% of all Emergency Department and Urgent Care Centre patients to be treated within four hours of arrival.
"We are committed to providing world-class care for all our patients, and the Meeting Patients' Needs model has allowed East Lancashire Hospitals NHS Trust to develop excellent services.
"Cardiac death rates have halved, diagnosis for patients both in the hospital and the community has accelerated with a state-of-the-art, single-site pathology lab, and a new 30 million women's and newborn's centre will open at Burnley General Hospital next year.
"It is also important to remember death rates among emergency patients have fallen significantly since the Emergency Department was centralised at the Royal Blackburn Hospital.
"The Trust understands the concerns of Mr Woolley and Mr Pike and recognises there are real challenges in emergency care, but I am confident the 24/7 programme will bring sustainable, strong performance and improved experiences for patients."
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Friday 24 May 2013
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