Nurses have described feeling “appalled, overwhelmed and horrified” by the impact of a major re-organisation of health services in north west London, according to feedback gathered by the Royal College of Nursing.
RCN members claim changes, including what they say will be the “downgrading” of A&E units at Central Middlesex and Hammersmith hospitals, have already damaged patient care and safety.
Meanwhile nursing staff in both hospital and community services say they have been put under an increasing amount of strain as a result of the Shaping a Healthier Future programme.
The programme, which is being taken forward by eight clinical commissioning groups, was launched in 2012 with the aim of improving care by shifting more services from hospitals into the community.
According to the RCN, the plans also include the downgrading of A&E services at Ealing and Charing Cross and the planned closure of Ealing maternity services.
However, the RCN is now calling for the programme to be suspended because it believes out of hospital services in place at the moment simply cannot cope.
“Complaint rates are increasing, as are staff sickness rates with a knock on effect for patient care”
The body asked for the views of members in its two north west London branches, comprising around 15,000 nurses and healthcare assistants, to feed into a review of the plans.
The review is being spearheaded by leading lawyer Michael Mansfield QC on behalf of Brent, Ealing, Hammersmith and Fulham under the umbrella of the North West London Health Commission.
In its submission, the RCN says there is evidence the closure of emergency departments at Central Middlesex and Hammersmith has left remaining units over-stretched with waiting times this winter “among the worst in the country”.
“The effect on nursing staff working in the area has been devastating,” says the document. “Complaint rates are increasing, as are staff sickness rates with a knock on effect for patient care.”
One RCN member who runs continuing learning courses for qualified nurses at a local university told the union her students were “burnt out, tired and frequently unable to get their time for their study days because of shortages at their departments”.
Other concerns raised by nursing staff include widespread confusion among patients about the changes, increased pressure on GPs services preventing practice nurses doing vital prevention work and an “unsafe and unmanageable strain” on district nursing teams.
As a result the RCN said it had “little choice” but to join calls for the plans to be halted.
“We have always said it would take three to five years to implement the out of hospital improvements that our residents deserve”
North West London CCGs spokesperson
RCN London regional director Bernell Bussue said it was not clear patients had seen any benefit from the changes so far.
“The case for the Shaping a Healthier Future programme was based on an increase in out of hospital care to enable more patients to be kept well or treated at home,” she said.
“In practice, little seems to have been done to boost capacity elsewhere in the system to make up for the closures.
“Proper replacement services, transition arrangements, funding and workforce plan should have been in place before the existing units were cut.
“Nursing staff working in the area have told us the closures have damaged patient care. The remainder of the Shaping a Healthier Future closures should be suspended until out of hospital capacity is properly expanded.”
A spokesperson for the eight North West London CCGs said:
“We have always said it would take three to five years to implement the out of hospital improvements that our residents deserve. We are only in year one of the implementation of Shaping a Healthier Future and we have already delivered weekend access to GP appointments, new community services to treat people closer to their homes and more joined up working with social care.
“The RCN is mistaken over our plans: We have no plans to close any hospitals. The Secretary of State made very clear in his speech, which the RCN refers to, that the A&Es at Ealing and Charing Cross would be retained. Over the next three years we will develop plans to build brand new hospitals – with A&Es – at both sites which better serve the needs of local people. “We also know that winter is a time of increased pressure for our frontline staff and we appreciate the exceptional job they do and the knowledge they have – that’s why this programme has been led by doctors and nurses from the start.”