Who decides the future of liverpool Women’s Hospital?

March for Liverpool Women’s hospital 2018 4

” We must save it”. Save Liverpool Women’s Hospital  campaign has spoken with over 4,000 people this summer of campaigning.

helen and pam carrrying the bannerSome people have asked us questions about how and why  the “relocation” of the hospital is being proposed.  This then is an attempt to answer some of those questions.

In a cash strapped NHS, should £140 million pounds be spent “relocating” a perfectly good hospital less than a mile down the road?

Should we be suspicious if this is in an area being gentrified?

Should a  modern low-rise hospital in landscaped grounds, set back from the traffic, be replesley at Run event

laced by a high-rise in the middle of some of the densest traffic in the city?

Should such a move be pushed on the false basis that the move would save money?

Should we take the risk  of losing an exceptional hospital in a time and an  environment so hostile to the NHS, in a situation of crisis, spring, summer, autumn and w

inter in the NHS? Or should we  say, like the Merseyside Pensioners Association say “What we have we hold!”

mapThe

Liverpool Women’s Hospital  is explicitly safe. The CQC report indicates this and all sources confirm this. If you want more detail please see here

The day-to-day problems of funding for Liverpool Women’s Hospital  come from the underfunding of the NHS nationally, and from an inadequate maternity tariff. The idea that savings from sharing some services  at the Royal can bridge that gap or even pay for the £140 million move  is not  credible. Recruitment at Liverpool Women’s Hospital is traditionally good because it is a world-famous hospital.

The main decisions about the Liverpool Women’s Hospital are,  officially,  made by  the Board of Directors of the Liverpool Women’s Hospital and the Liverpool Clinical Commissioning Group.  Liverpool City Council Health and Wellbeing board has a say too. Liverpool City Council is working with other organisations  as part of  plans to integrate health and social care. This larger group could have a say too, though not immediately.

Just to be clear, it’s not the doctors, midwives and neo natal nurses making the decisions. Not here, not anywhere in the NHS. There are few doctors on the board. Clinical directors do not often attend the board meetings. Relationships between the hospital upper management and the staff are not always sweetness and light as the annual NHS survey indicates.

Liverpool Women’s Hospital has a regional role too. It provides services for  women, babies and some men from across the region,  into North Wales, and the Isle of Man. These services include the treatment of complex cases.  Plans  for the future of this hospital go to the other  Merseyside Councils, in a joint committee  for approval too.

neo natal 2Liverpool Women’s hospital’s role as a neonatal centre has just been  further developed by a grant of £15m funding to improve and upgrade its existing Neonatal Unit. Th re have been other improvements too in Outpatients department, and  in  the refurbished Gynaecology Unit.

Merseyside and Cheshire have an Sustainability and Transformation Plan area  that is  supposed to plan NHS provision in its area (and make further huge cuts of almost £1billion across the area), and  parallel to that is the Women and Children’s Vanguard , which nationally  answers to the Maternity Review

The Maternity Review  is pro privatisation, both in the use of for profit providers, encouraging dispersing services from hospitals  and in developing costing mechanisms through the  personalised budget system.The  safety and effectiveness of the maternity review is called into question here .

Already many women  have been charged for NHS maternity care based on their migration status even if they are living and working here, or if they are UK citizens returning here the costs are enormous.

TBirth chairhe pressure to use private providers, (one such organisation has been placed on enhanced surveillance) and to encourage home births  are also part of the maternity review. Maternity  care  should respect the mother’s wishes AND must always be safe for mother and baby. Some of the ideas that over  promoted natural child-birth by criticising provision that used interventions in childbirth, have already been rolled back since our campaign started in 2015. Home births for those who want them and for those for whom it is safe, are great, but the vast majority of women choose the safety of the hospital.

Many NHS budget crises, including that in Liverpool Women’s Hospital  are temporarily supported by what’s called Transformation or Sustainability funds; it’s not quite the same thing as the STP  areas, but came in at about the same time.

The  NHS nationally   must be  formally consulted too about major expenditure. The NHS national structure is s complex.  There is a set of slides available here but there have been changes since this was written. The laws changed in 2013 with the health and social care act and another major change is under way at present.

Consultations with the national NHS bodies are detailed and the ones about the Liverpool Women’s Hospital have been back and forth a few times,  according to  reports to the board.

£Two streams  of money go into the NHS, Revenue for day-to-day spending and capital for major projects. Capital funding is  the permission to spend money on long-term projects like new builds,  refurbishment, major equipment and the like. NHS capital funding is not doing very well, falling for three years in a row ( Capital spending does well for the big corporations making a packet from it)

A bid for capital funding needs to be made if the current plans for a “relocation” are  to go ahead. The plan is  to relocate Liverpool Women’s Hospital to the traffic island that is the new Royal site (Prescot St, Liverpool L7 8XP)

There is a  problem that this, and the last, government  wanted to keep big capital expenditure off their books. They falsely believe that borrowing for investment can lead to a financial crisis. Its plain nonsense, details here. Keeping big borrowing off the government books has given big corporations like Carillon the chance to make a fortune from Private Finance Initiative which have resulted in hugely expensive and often badly built hospitals and schools.

At present there is no  published source for the money for the Liverpool Women’s Hospital Boards plans. Unless there is a major turn in Government policy the money for this relocation will come via PFI, or possibly a loan from Liverpool City Council,. who will themselves have to borrow the money. Liverpool city council has its own major financial problem thanks to appalling austerity cuts from this government.

june 30thThe abominable chaos that is the new Royal  Liverpool  build has to be sorted out at huge cost. The full cost is not yet known, nor who will bear that  cost. Never the less we are expected to believe that this will have no impact on decisions about money to relocate Liverpool Women’s hospital at the  projected cost of  over £140million on  the same site.

Policy issues are decided by government and by their appointees in the NHS, like Simon Steven.They are not the polices the people of liverpool generally support.

There are two professional disciplines involved in planning health care, one is medicine which is the patient facing care and the other is health economics. The health economics planning in the last ten years have been disastrous, and politically committed to the privatisation and US model.

Lets look as some of the errors this group have made

1. Hospital beds numbers  have been closed down but are desperately needed.

2. The internal market introduced to make hospitals compete has been an expensive  disaster.

3. Staff shortages. Insufficient doctors , nurses and midwives have been trained. This is a planning failure, not an accident

4.  Bursaries have been  stopped.

7. Outsourcing  and commissioning private companies to deliver health care has been costly and ineffective.  Private companies made £831m profit from such contracts.

Doctors Nurses and Midwives  and the related professions correctly want to be able to co-operate across hospitals, across disciplines. What stops this is not the physical placement of the buildings, but the trust system and the internal market.

Broadgreen Hospital  and the Royal constitute one trust and are talking of merging also with Aintree . These buildings  are much further apart than Liverpool Women’s Hospital and The Royal Liverpool University Hospital. Talk of an “isolated site” in this situation is a nonsense.

Long term intensive care at level 3 is not available at Liverpool Women’s Hospital. Short term intensive care is  available at LWH. Those who need long-term intensive care are transferred to the Royal. 6 minutes away, by ambulance. This is less time than it would take to push a patient through areas of some hospitals. It would cost a lot less than £140m to upgrade the service at LWH. Services which do cause problems are ones that the hospitals already share.

Christine jonesOur campaign is very realistic about the strengths and weaknesses of Liverpool Women’s Hospital. We heard some breath-taking  stories whilst we were campaigning, some of wonder at lives started and others saved and some less happy. We met so many happy babies, and lovely children born there. Some of you we spoke to might like to share your stories on our Facebook page or in reply to this.

More than 40,00 people have voiced their opposition to these proposals. Our campaign wants

  1. to keep our  hospital focussing on women’s health, the average British woman has 19 years of ill health.
  2. to keep maternity provision safe and away from traffic fumes and particulates
  3. to obtain better funding for the NHS and especially for maternity.
  4. to pay staff well, recruit, train and retain more staff.
  5. to oppose privatisation and PF.
  6. to end the rationing of care.

main poster jpegPlease march with us on September 22nd 2018  at 12 noon to Save Liverpool Women’s Hospital and Save the NHS. This is the next stage in our campaign Fight like your grandmother did to get the NHS

 

March for Liverpool Women’s Hospital 22nd September 2018

main poster jpeg

For all our sisters, mothers, daughters, friends and lovers.

Fund maternity services properly, nationally and locally

Protect and improve health care for women.

The NHS needs you. Bring the family. March for the National Health Service:

Fully funded. Publicly provided, not for profit. Free at the point of need and providing a comprehensive service. End the PFI scandal.

Repair and finish the new Royal Liverpool Hospital. Kick out the privatisers.

Pay the staff well. Bring back bursaries Tackle work-load

Please send solidarity greetings to use on the march and in the build up to the march

Follow us on face book Save Liverpool Women’s Hospital, emailsavelwh@outlook.com twitter @ lwhstays, blog Save Liverpool Women’s Hospital

sonia's graphic

March for the

Liverpool Women’s Hospital

22nd September
12 noon Liverpool L8 7SS, to Albert Dock, through town.

Deepest Sympathy

Our hearts and thoughts go out to the  families  of babies who died at the Countess of Chester Hospital Waiting, hoping and praying that  a very sick new-born will come through leaves a permanent  memory in the minds of the whole family. Thankfully many babies do make it through and grow into healthy children and adults.

Sadly some babies don’t make it and  hearts break.  How incredibly hard it must be for parents and families who also find that their baby’s death is possibly a murder. The emotional  pain must be extreme.

Our thoughts go also to the staff who work in the hospital who have worked hard and professionally.

This has been a long chain of investigations some of which we have reported. We do not know and cannot comment on the guilt or otherwise of the case against the arrested nurse. That must go through the courts.

We do know that the NHS needs to reduce workload and increase the democracy in the management  of staff, making more staff more confident  to raise concerns.

The chain of events looks something like this. The numbers of deaths  looked wrong. A report was commissioned. Then there was a follow up report, admissions  of the most complex cases were restricted,  the police were involved and now an arrest has been made. What happens now will be decided in the courts.

A year ago the Countess Of Chester Hospital published the following statement here

 “The Countess of Chester Hospital has requested the input of Cheshire Police into its ongoing review of neonatal services.
In February this year we published the findings from an independent, clinical review into neonatal services at the Countess carried out by the Royal College of Paediatrics and Child Health. This report pointed to 24 recommendations for improvement which are now underway. It included a further detailed case note review by an independent neonatologist that has been unable to answer all of the questions regarding the cause of death for a number of babies.
The Trust and its doctors have continuing concerns about the unexplained deaths and are very keen to understand that everything possible has been done to help determine the causes of death in our neonatal unit between June 2015 and June 2016.
As a hospital we have taken the clinical review as far as we can. We have now asked for the input of Cheshire Police to seek assurances that enable us to rule out unnatural causes of death.”
 Since the 2017 report  Chester stopped providing for these most complex cases until the concerns had been addressed.
A major report by MBRACE  started the chain of investigation. From this there has been a chain of events that lead to the arrest.
Neo natal care is a  very skilled, very intense and caring part of hospital life. It is also very high-tech and involves cutting edge science. Babies  are alive today who just a few years ago would have died. It is an important service and most of us know very dedicated staff involved in this care.
The deaths in Countess of Chester is a terrible story especially as the care offered to these babies matters so much to everyone and especially to the mums, dads and  families.
Our campaign sends sympathy to all who mourn.
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Will medicine banks join the food banks and the clothes banks?

G.P.s  have been told not to write  prescriptions for some conditions. This is a cost cutting project. It will save £100million pounds,  or so the NHS national management claim.  This £100 million will only hurt the poor, and we have plenty of  poor people amongst us.

The NHS national management have made some  damaging decisions in the past, like cutting  far too many hospital beds and privatising many mental health beds. This is another bit of  nastiness.

This policy will be fine for people with money to spare, as the prescription charge  could well cost more than buying medicine over the counter. However  in Britain this year 4 million people used food banks, 4.1 million children are now living in relative poverty  accounting for more than 30 per cent of children. Liverpool and Merseyside  have  high rates of child poverty. Most of these children come from families with at least  one working parent. A fifth of the UK workers earn less than the living wage. Families headed by working mothers  can be hardest hit because mothers on average are the worst-paid. In Liverpool last summer thousands of schools uniforms were collected and donated to those who could not afford them.

food banksSo how are people who can’t afford food or school uniform, or to keep the house really warm in winter,  going to afford these medicines?

Knowing the medicine might not be available might stop people going to  the doctors and serious illnesses not being spotted. Better 10 trips to the doctor for minor ailaments than  one serious illnesses not being spotted.Haemorrhoids and Diarrhoea are minor problems  but can be symptoms of worse.

Are we going to be having to ask football fans to bring medicines to the match to put in collections? Who  would  be responsible for keeping medicines safe?  The idea is ridiculous. In a city with a street drugs problem, this would be  dangerous.

sun burn 2 Without these simple treatments  people with little money will get more ill, will have longer off work and will long-term cost the NHS more.A mum with conjunctivitis will find it hard to go to work. Children should wear sun screen. Is it ok for poor kids to get sun burnt? What does a mum do if her child has awful colic or  bad  nappy rash or oral thrush?  Do they not understand just how carefully many mums have to budget?

It’s not just the people directly affected. Imagine children in a class where some mums can’t get hold of head lice treatments, or  Verrucae treatments.

The NHS needs decent funding and the money is there to pay that funding. Only the United States of America and China are home to more billionaires than the UK, while the combined wealth of the (very rich) list has increased 10% since 2017.  We are lucky if we get a 2% pay increase. This is the fifth largest national economy in the world. Our government can fund the NHS properly but we must make it  louyd and clear that  a fully funded NHS is essential

The NHS protects us from  some  ill health caused by poverty and most  poverty caused by ill health, but we  need to stop the rot, stop policies that only hurt the poor.

The World Bank says ” Poverty is a major cause of ill-health and a barrier to accessing health care when needed. This relationship is financial: the poor cannot afford to purchase those things that are needed for good health, including sufficient quantities of quality food and health care.

and

“Ill health, in turn, is a major cause of poverty. This is partly due to the costs of seeking health care, which include not only out-of-pocket spending on care (such as consultations, tests and medicine), but also transportation costs and any informal payments to providers.

 

Pulse a GP newspaper commented “The guidance also does not apply to long-term or more complex conditions who will continue to get their usual prescriptions”

But it does point out that “people who receive free prescriptions will not automatically be excluded from the new guidance” So the poorest will be hit.

“Conditions for which over the counter items should not routinely be prescribed in primary care:

The conditions are these

  • Acute sore throat
  • Infequent cold sores of the lip
  • Conjunctivitis
  • Coughs, colds and nasal congestion
  • Cradle cap (seborrhoeic dermatitis – infants)
  • Haemorrhoids
  • Infant colic
  • Mild cystitis
  • Mild irritant dermatitis
  • Dandruff
  • Diarrhoea in adults
  • Dry eyes/sore tired eyes
  • Earwax
  • Excessive sweating (hyperhidrosis)
  • Head lice
  • Indigestion and heartburn
  • Infrequent constipation
  • Infrequent migraine
  • Insect bites and stings
  • Mild acne
  • Mild dry skin
  • Sunburn due to excessive sun exposure
  • Sun protection
  • Mild to moderate hayfever/seasonal rhinitis
  • Minor burns and scalds
  • Minor conditions associated with pain, discomfort and fever
  • Mouth ulcers
  • Nappy rash
  • Oral thrush
  • Prevention of dental caries
  • Ringworm/athlete’s foot
  • Teething/mild toothache
  • Threadworms
  • Travel sickness
  • Warts and verrucae

The British Medical Association has said”‘However as there has been no change to the regulations that govern GP prescribing, this guidance cannot be used by CCGs to ban all such treatments. GPs must continue to treat patients according to their individual circumstances and needs, and that includes issuing prescriptions where there are reasons why self-care is inappropriate. This guidance does make it clear that such requirements continue to apply in individual situations.”

and RCGP chair Professor Helen Stokes-Lampard said 

‘We are very pleased that NHS England have listened to our concerns and that GPs will retain the ability to use our expert medical judgement and clinical skills to prescribe medicines that are also available to buy over the counter in certain circumstances. It is also welcome that limitations will not affect patients living with longer-term and more complex conditions.’

So if you need  these medicines and can’t afford them, ask for  them , and quote that advice. Tell your GP what the BMA says

And please tell your MP what you think of this.

If you are keen to help the NHS come to London on June 30th to join our ceklebrate and

june 30th

defend the NHS demo. Contact our facebook page for details of tickets. £20 waged £10 unwaged. Further concessions in cases of need.

 

Don’t let the vultures in.

The NHS must not go the way of the Care Home sector.

A CQC report on Liverpool’s Health Care is advising the NHS and the Liverpool Council to work in financial and planning partnership with the private nursing home sector, and other private providers. Haven’t we had enough with Carillon? This is to be discussed at the Health and Wellbeing Board. The Liverpool Integrated Care Partnership Group, would include this sector and other private providers in an integrated planning organisation. Further details of the whole plan canbe found here

old people crossingThe elderly care home sector is very seriously flawed. The system is dominated by big business including hedge funds. A hedge fund is “an offshore investment fund, typically formed as a private limited partnership, that engages in speculation using credit or borrowed capital”. Football fans will have heard of them.

Private sector homes for the elderly now have a combined market value of £11.9 billion; five times that of Local Authority Homes. About half of residents get some Local Authority funding, and some get NHS funding, but most residents have to pay a lot themselves.

The system is run for profit by Big Business and has a poor record.

There are four major companies, owning what often appear to be independent care homes.  Companies that appear independent can be owned by other companies. Three of the big four, HC-ONE, Four Seasons and Care UK, are owned by private equity companies, complete with debts, according to the Financial Times. Private nursing homes are  owned by big business out to make a profit

Four Seasons Health Care has been in deep financial crisis, of its own making, resulting in a crisis in Widnes last year. This is not a crisis from lack of funding from the Government or local authority but from the financial model they use. Many of them are owned by hedge funds, are financially insecure, and can close because of bad debt arising from speculation.

In Widnes, the Millbrow Home had to be rescued from a near financial collapse by the public sector at the end of 2017. This model of care takes a profit, but does not take responsibility. The responsibility seems always to drop back onto the public sector.

Remember Southern Cross?

“Southern Cross Healthcare (Group plc) was a private provider of health and social care services, predominantly through the provision of care centres for elderly and some younger people. The group was the largest provider of care homes and long-term care beds in the United Kingdom, operating over 750 care homes, 37,000+ beds and employing around 41,000 staff. Following rapid expansion financed by the sale of leases of its homes, its shares fell 98% from early 2008 to early 2011, reducing its market value from £1.1bn to around £12m. The company had severe financial problems in 2011 and declared insolvency the following year”. (wikipedia.org).

 

This sector could be voting on plans and allocation of our Local Authority and NHS resources

This is out of order…

Image: Yui Mok/PA WireThe men and women in the homes have the right to respect and the best available care, including medical care. The law and organisation of the Care Home System is not fit for purpose.  It shows all the very worst elements of privatisation.

The staff working in social care can be fantastic, kind and loving but are overworked and underpaid. Many are so overworked they are leaving or having breakdowns. Care on the cheap does not work.

Unison quoted a worker”I have seen many good workers leave frustrated at the poor pay and the way zero hours contracts are used by way of punishment and reward. If you turn down a shift, hours you were depending on can be taken and given to others, sometimes with only hours’ notice. I have seen how many use this as a way to simply force out staff who may have complained about quality of care. Is this acceptable? Duty of care means that we have to raise concerns, yet many are too scared of the implications financially if they do.” https://strongerunions.org/2016/01/14/time-to-care-homecare-workers-speak-out/

unison nurseWe need residential and nursing home care for  some our growing numbers of older and ill people. No one wants people kept in hospital for longer than they need to be there. Although if  so many  hospital beds had not been closed it would be less difficult to keep people in hospital a little longer.

The profit driven private care home sector though, must not have a say in Liverpool’s Health Service or in Council funding decisions. No to an integrated system!

The CQC report lists three sets of local social care providers as part of the local system:

“Adult social care”

49 active residential care homes:

  • One rated outstanding
  • 35 rated good
  • 10 rated requires improvement
  • One rated inadequate
  • Two currently unrated

41 active nursing care homes:

  • 16 rated good
  • 15 rated requires improvement
  • Six rated inadequate
  • Four currently unrated

72 active domiciliary care agencies:

  • Two rated outstanding
  • 34 rated good
  • 11 rated requires improvement
  • 25 currently unrated

This sector, with this local and national record, should have a say in our NHS, our Local Authority Care. Really? What about due diligence?

board2We need good social care

Hospitals negotiate daily with the private sector to accommodate people in need of a care home placement. It is  both routine and difficult because there is not a comprehensive universal service as there should be. What we have is a patchwork of services, some good, and some bad. Significant parts of the service are owned by big companies there to make a profit.

The care home system is inadequate, run for profit, and privately owned and should have no say in how the NHS or Local Authorities are run.

The market does not work in public service. It is inefficient and ineffective. The problems in the sector are not to do with shortage of cash, but to do with maximizing profit through hedge funds.  The needs of our elders come second to profit. The sector needs to be reformed. We have to use the system until the next government acts or Local Government finds a way to take it back in-house.  Do not let them take charge. This system must not be allowed to taint our NHS.

Care homes were one of the first sectors to be privatised

“In the 1980s a significant shift from the public sector provision of elderly care to private sector homes occurred, with the proportion of private facilities increasing from just 18% in 1980 to 85% by the end of the century.[2]

We need to nationalize the care home service, cut out the hedge funds and their speculation, and set some decent standards.

We need publicly owned, publicly provided care homes, with reliable funding and good levels of investment, effective monitoring and good planning, like the NHS used to have.

We need a full regulatory and training system. We need staff with secure jobs, who go home fit to raise a family, to enjoy their leisure, not tired to the bone.

Cruel and disgusting Government cuts

Liverpool City Councils funding has been mercilessly slashed and this has damaged funding for social care. Out sourcing and reducing the working conditions for staff has solved nothing. It has made things worse. The private sector is not efficient at providing public services.

Liverpool Echo reported in 2017 “Since the coalition Government came to power in 2010 and began an era of austerity and swingeing cuts to local councils, Liverpool’s authority has had to make total budget reductions of £330 million.

In 2010, the council received £523.72 m in Government funding, compared with the £243.90m it will receive this (2016) year. That figure will drop even further to less than £215m by 2019/20 meaning the council will have to find more ways to make savings and raise vital cash

We urgently need a better care system. A detailed report in 2015 described some of the difficulties vulnerable patients faced when discharged without good care. Delayed discharge figures were at the forefront of NHS managers’ minds during the winter/spring beds crisis in the NHS. Patients can be discharged only to come back into hospital shortly afterwards. There is a need to improve medical care in the care home sector.The private sector must not be given any kind of decision-making role, whatsoever, let alone sharing risk and gain.

Labour is committed to a national care service. A Labour Council should not be dancing with the devil, but should be preparing to implement its party policy.

 

 

 

 

Response to One Liverpool Operational Plan for Liverpool Women’s Hospital

These are the key points made about the future of the Liverpool Women’s Hospital, as set out in the One-Liverpool-Operational-Plan, published by Liverpool Clinical Commissioning Group in May 2018.

In the document, these points are set out as a table. We have extracted and answered each point in text form.

Introduction to their document

The reconfiguration of women’s and neonatal services currently delivered by LWH at the Crown street site to address issues with clinical standards and service co-dependencies  This phase of the project is to conduct a public consultation on proposals and to develop and gain approval for  Decision making business case.”

This sentence omits the word “maternity” yet this crucial to the role of the Liverpool Women’s Hospital. Let us hope that maternity is included in the overall term of “women’s services”

20151204_094642

Each of the points in the document from the CCG refers to the idea that the Crown Street site should close and another building be put on the Royal Liverpool Site. (The number of beds involved is not mentioned, nor are the plans to persuade mothers to give birth at home). Read more

Marching to save Liverpool Women’s Hospital – Join us

 

On 22nd September 2018 we are marching, again, two years after our first march.

Sadly  plans are being put forward, again, to fundamentally change our hospital which sees 8,000 babies born there each year and over 50,000 appointments for a whole range of  health services for  women and babies and some specialist services for men too.

At 12 noon on September 22nd 2018 there will be a march from the Liverpool Women’s Hospital to demonstrate against these plans which are little different from earlier ideas.. We will continue our campaign across the summer to let people know what is happening and how to help defend  services for the women and babies of Liverpool and beyond. We really do need as much help as we can get. We can win if the people of Liverpool get behind this camapign. Don’t forget Huddersfield Royal infirmary was saved  in May 2018 by a brilliant campaign.

Capture

The Clinical Commissioning Group (CCG) intends to put consultation in place this Autumn with action in 2019. The details are in the One Liverpool Operational Plan. We will report on the plan as a whole in another post .

The document is quite hard to read as it is presented in narrow columns so we will copy each column separately.  (It’s quite funny to find the worst examples of management speak “Rationalisation of optimisation of corporate workforce” being one such. We think it means cutting admin  and manual staff. The NHS has been doing that to lower grades for a generation and it has not helped, not one bit.)

We will repond to each of these points in another post

The rest of the section about Liverpool Women’s Hospital is as follows

  1. Liverpool Women’s Hospital
  2. The reconfiguration of women’s and neonatal services currently delivered by LWH at the Crown street site to address issues with clinical standards and service co-dependencies  This phase of the project is to conduct a public consultation on proposals and to develop and gain approval for  Decision making business case.”
  3. 1. Complete NHSE assurance process
    2. Complete approval process
    3. Complete Public consultation
    4. Development and approval of Decision Making Business Case
  4. 30-Jun-18
    01-Sep-18
    31-Dec-18
    31-Mar-19
  5. The safety of women’s and neonatal services provided by the Trust will be improved, via:
    Services which meet national and local clinical guidelines Reduction in clinical risk Reduction in over-occupancy in the neonatal unit Improved staff satisfaction regarding the delivery of services Improved clinical outcomes for patients Reduction in staffing and transport costs relating to patient transfers Reduction in backlog maintenance risks
    The quality of women’s and neonatal services provided by the Trust will be improved, via:
    Increased patient satisfaction
    Increased staff satisfaction
    A reduction in regulatory oversight and intervention
    Improvements in the CQC rating at the Trust
    Improved diagnostic capabilities
    Improved ward facilities which meet national standards
    Increased parental accommodation
    Optimised patient flows
    The financial sustainability of the Trust will be improved, via:
    Rationalisation of optimisation of corporate workforce
    Avoidance of an increase in CNST premiums required to be paid by the Trust
    Reduction in facilities management costs
    More efficient use of space within the hospital

Please come and join the fight to save our hospital.

Snip od the plans for the hospital

March on 22nd September 2018. Save Liverpool Women’s Hospital, Save Maternity Services, Save the NHS.

On 22nd  September 2018 Save Liverpool Women’s Hospital Campaign will march from Liverpool Women’s Hospital  to the Albert Dock and Labour’s Annual Conference

hands off our NHSOur slogans are

Save Liverpool Women’s Hospital, Save all Maternity Services and Save the NHS

We are campaigning for  a fully funded, fully staffed, publicly provided NHS.

End the crisis in the NHS now

Invest in our mothers, in our babies, in our people

Invest in our hospital, on site.

Reinstate all breast-feeding support services

Invest in mental health

For decent pay, bursaries and lower workloads for all NHS staff.

For an end to privatisation and for services to be brought back in house

For a full reinstatement of the NHS

For an end to rip off  PFI building finance in the NHS and public service

Not one more winter crisis; fix the NHS. This winter there were 10,000 “additional deaths” in England and Wales in the first few weeks of 2018. “This rise of 12.4 per cent, or 10,375 additional deaths, was not due to the ageing of the population” These policies are costing lives

Not one Doctor or Nurse who wants to work in the NHS and is fit to do so,and has a job offer to face deportation.

Health care for every mother and baby and health care for all, 

Not one more  contract to go to for profit organisations. These companies are there to make profit and public services are suffering from this

Campaigners have to encourage NHS Staff that together we can change this mess

The fight for our hospital is part of the struggle for the NHS. We face the largest corporate interests who see it as a business opportunity. Remember Carillion and the Royal Liverpool Hospital rip off. The NHS was founded as a public service for the people

£ The NHS as a national service is fully affordable, when it gets the same proportion of public expenditure as other western European countries pay for their health care, the same proportion as the UK used to pay before 2010.This is less than the appalling US system

Good health care is good investment in the population and prevents much human pain and grief.

Privatisation just makes money for the shareholders.The whole model is flawed as a method of delivering public service

please helpHow you can help

Spread the word.

Distribute leaflets,

set up small meetings to discuss it, donate.

Set set up a stall,

Sign the petition, take it door to door

Keep us informed,

Come to meetings

Follow us on Facebook Save Liverpool Women’s hospital, and in our blog, Save Liverpool Women’s hospital. Join NHS  campaigns

Donate to the campaign

Raise it in your toddler groups, in your unions, in your community groups

Bring your banners, bring your friends and family on the  demonstration on the 22nd September

 

April 2018 Update

Update: We want to keep our hospital on site, fully funded and up graded.
(Whilst reading this please keep in mind:

  • Carillon, that wonderful bankrupt monstrosity,
  • The much needed, though flawed and long delayed new building for the Liverpool Royal,
  • The terrible debt that comes from the PFI funding of that building,
  • The overwhelming evidence of danger to babies from exposure to traffic pollution,
  • The chequered history of the leadership of the CCG.
  • The huge STP changes nationally and locally going through the NHS…oh and
  • The Maternity Review and the Merseyside Women and Children’s Vanguard plans,
  • Personal maternity budgets
  • A few of the Mayor’s grand plans and even more.


Got all that?)
Well
Liverpool Womens Hospital is still here, still safe, still solvent, still providing care to women, babies and some men.Still (as far as we know) providing it’s full range of services.
Great that Liverpool Womens Hospital is doing much needed improvement to the neo natal unit, though this seems a little slow to get off the starting blocks. It’s some months since the money was allocated for the upgrade to the neo natal unit
It is far from perfect but it’s a good hospital.
So what next?
The local NHS “commissioning” body still intends to go to consultation on its proposals to reduce, and move the hospital after these local elections.
Their plans remains to use a PFI (!!!) funding scheme to “rebuild” a smaller service on the same site as the benighted New Royal Liverpool Hospital with fewer beds.
So we pay more, to get less, and, as a bonus, put massive pollution into the lungs of 8,000+ babies a year.
And they could well pay thousands to PR people to make enough people think it’s all a good idea.
So we begin again our campaign to defend Liverpool Womens Hospital.
We need you to help.
Please message us if you want to know how to help.
john-and-judy

Seacombe Pop Up Worries

Speech for the Pop up Maternity Unit public meeting 28 03 18
Thank you for coming
Nearly three years ago I read of the threat of closure over Liverpool Women’s Hospital, I set up a Facebook page and an electronic petition which got and still gets thousands of signatures and page likes. For all or mothers, sisters, daughters, friends and lovers and the babies

So why are we worried? We totally endorse the right of women to choose the kind of setting where they will give birth. We also support their right to keep and improve existing services. It is crucial that such choices are based on safety of mother and baby. We also support the choice of hospital birth either in an obstetric lead unit or an alongside unit, the choice the overwhelming number of mothers make in 2018, and a choice which is denigrated in many reports.

There are four kinds of birth settings used in England; the hospital, an alongside maternity unit which is co-located at a hospital and a Free Standing maternity unit which is located some way away from a hospital. Then there is home births. They are all currently considered safe for low risk mothers having a second or subsequent baby, but access to an obstetric hospital in an emergency is crucial for all. A Pop up maternity unit is one that has been set up as an experiment, a pilot without the normal capital investment and planning. The pop up in Seacombe is in a room in a children’s centre that housed a Sure Start centre before the cuts.

We campaign in a tradition of women fighting for decent care at birth that goes back, here on Merseyside, to the early 20th century. The Women’s Cooperative Guild published a bookbanner called Maternity. Letters from Working Women
The petition and Facebook page started a journey in understanding and becoming truly angry about what was happening to the NHS, to women’s services and to maternity services. I have children and grandchildren so had seen the NHS in action, good and bad.
A short while later I had a phone call from junior paediatric doctors asking for help in their campaigns and found out about the shortage of such doctors, nurses and related professionals and lack of investment.
We were joined in our campaign by longer-term campaigners who had fought (and failed) to stop the 2013 Health and Social care act and the spread of PFI. They did though raise real awareness of the issues Across the UK tens of thousands of people are fighting to defend the NHS and their numbers are growing.
So why are so many NHS campaigns worried?
• Because the NHS is starved of funds and much of those funds are diverted to profit making contractors who make £871 million profits
• Because the national health service is being fundamentally changed though accountable care programmes now renamed integrated partnerships
• Because this regime has resulted in an appalling crisis this winter, but next year’s will be worse and it is not accidental. It is fully avoidable. We will have avoidable deaths next winter if policies continue as they are now.
• Because this crisis is being used to pave the way for privatisation
• Government policies have been linked to 120, OOO unnecessary deaths of deaths especially following cuts to health and social care in UK since 2010
https://fullfact.org/health/austerity-120000-unnecessary-deaths/
The additional deaths are not just in hospital. There were Ten Thousand additional deaths not caused by flu or any other measured indicator.
The hospitals are inadequate to cope with the population. The number of beds per head has been consistently reduced, to the lowest in comparable countries, deliberately and by policy. The number of doctors is inadequate, and that is the result of government training numbers. Are these NHS gurus now saying they got it wrong? Are they apologising? Are they resigning? Far from it. It is part of Conservative long-term plans
Before I turn to maternity and paediatrics let me look briefly at the worst hit service, mental health.
Mental health

baby

has been starved of resources. You may have heard of the 2 million pound damages awarded to parents whose adult children had died from neglect in mental hospitals but now the situation is worse.
“Mental health trusts left with less funding than 2012 due to government cuts, new analysis reveals
Income for mental health trusts £105m lower in 2016-17 than five years earlier in real terms”
Many in patients are now sent to private providers one of whom boasted how they did well out of NHS shortages
“Cuts to mental health services have led to a situation where there is enormous demand, with little capacity to meet the need. In the five years up to 2016, mental health trusts in England had £600 million (US$751 million) slashed from their budgets. Meanwhile the number of people seeking mental health community help has jumped by almost 500,000 a year, to 1.7 million, since 2010”.
Therefore, we have every reason, when we consider maternity, to be worried.
Maternity is the most common reason to use the NHS. The current administration want to see that change and for more mothers to give birth at home. Since the introduction of the NHS, giving birth has become much safer. Maternal Deaths dropped from 500 per 100,000 births to less than one in 7,000
Nine out of 10 mothers give birth in Hospitals and for many that is their choice but it is a choice the current admins of the NHS want to change
Costs by planned location of birth
Home – £1,066
Freestanding midwifery unit – £1,435
Alongside midwifery unit – £1,461
Obstetric units – £1,631
They are also preparing for personal budgets for maternity, which could adapt to patients buying care from private contractors or the US model of population based funding.
Funding good care in pregnancy, at birth and in the first two years of life is an investment well worthwhile and one that pays off in economic as well as health and happiness. Investment in good maternity care makes the whole country better off.
– Published factors that raise the risk of maternal death include:
Being over 35
• Obesity
• High blood pressure or heart disease
• Anaemia
• Foetal abnormalities
We add to this list the great risk of poverty. The still birth rate doubles for poor mums and we live in a poor area. This pop up is in a poor area, it is in the bottom 2% of areas for wealth in the country
https://www.npeu.ox.ac.uk/birthplace

We have followed the maternity Review, the Merseyside, Cheshire Women, and Children’s Vanguard
We know the following
They want to reduce the number of hospital births
The NHS is short of midwives, midwives are over worked. Staff stress has become a risk factor Maternity units had to close their doors to women on 382 occasions last year.
The maternity tariff is inadequate
An NHS spokesperson said it was ok to travel for four hours in labour.
There is a push to close maternity facilities“ to regionalise obstetric care because of the shortage of obstetricians, from 147 to as few as 118,
The NHS focus of “choice” not safety in their publications though good work on safety goes on through MBRACE
The Maternity Review favours including private providers. It also favours giving women a choice of four versions of place of births but not which city they give birth in if the NHS decides to close a maternity facility
We have a private contractor working here in the Wirral, and there are concerns from CQC reports. But according to the internet, it runs a clinic, Bidston and St James children’s Centre in Birkenhead already. So we were especially concerned when we heard that the local CCG were intending to set up an accountable care system using this private company
The purpose of a company is to make a profit. The purpose of the NHS is to provide health care
NHS spending on care provided by private companies has jumped by £700m to £3.1bn with non-NHS firms winning almost 70 per cent of tendered contracts in England last year.
Private care providers were awarded 267 out of a total of 386 contracts made available in 2016-17, including the seven highest value opportunities, worth £2.4bn.
Richard Branson’s Virgin Care scooped a record £1bn worth of contracts last year, meaning the company now has over 400 separate NHS contracts, making it the dominant private provider in the NHS market
https://www.independent.co.uk/news/health/nhs-privatisation-contracts-virgin-care-richard-branson-jeremy-hunt-a8134386.html

On Wednesday 7th March 2018 we raised our concerns about the pop up maternity unit and plans to create an accountable care maternity model using One to One midwives, a private company, with Catherine McClellann and Simon Banks of Wirral CCG
We asked about the section from the minutes of the CCG

“The implementation of the National maternity services review is on track and continues to progress with putting into place the recommendations of the report. Wirral is in the process of piloting an Accountable Care Maternity model with the acute provider subcontracting to ONE to One Midwives to deliver the full range of services included in the Better Births report. The Improving Me team (Vanguard site) has chosen Wirral to also pilot a “pop up” midwifery led unit within the community”

Mr Banks at first denied this had been said but we were able to show him the document.
He said that accountable care is parked/stalled because of the legal challenges
He said that the pop up would be run by Wirral University Hospital Trust (Arrowe Park)
It would not be a run by the company One To One Midwives
The midwives will be using a “case load model”. These are not extra midwives. It is a “redesign” of the Community Midwife team providing “continuity of care”. We think caseload model this is difficult in a situation where there is a shortage of midwives. It will remain an aspiration until resources are provided, and training midwives can take years
The pop up will he said be covered by the Clinical negligence scheme for trusts
Mr Banks reported on improvement in stillbirth figures (These figures really do need to improve)
Mr Banks said there were arrangements for rapid transfer as used for home births. We asked about Ambulance response times, which we have seen as problematic. He did not see this as a problem.
We asked about lone working for the midwives. Mr Banks said there would be other staff there during the day. The team will do antenatal and post-natal care from the Seacombe centre.
There is only space for one mother at a time in the pop up unit
It will be accessible 24/7, open 12 hours a day
There will be a loop system to divert cases to the hospital if the midwife is not available at the pop up or it is already in use.
We asked what would happen when the mother goes into labour. The mother will phone the midwife. The midwife will go down to the pop up (this has since been changed to the midwife will go to the home initially and see if transfer to the birth centre will be feasible)
We asked about the central phone information system mentioned in the vanguard video
https://www.youtube.com/watch?v=-5Yj_jxDByI
(See about one minute 22 seconds in) We were told the single point of access booking in system would not function at present. We are concerned that this system could direct women to options that they would otherwise not consider. Choice of birth setting is highly influenced by initial advice.
We asked to see the consultation they had undertaken, they said they would forward it.
We asked about personalised budgets, which are a feature of the Maternity Review? Catherine Mc Clellan replied that they do not want midwives involved in such calculations, in costing each intervention and procedure.

We asked about the One to One company. We were informed the company were under High surveillance ((or something similar), they can provide ante natal and post-natal care.
He said they have to work to national agendas
Mr Banks suggested we looked at this
We had seen this previously and consider it to be methodologically questionable and without a solid evidence base.
We asked where the capital money had come from for this pop up unit. He said none had been spent apart from a small grant for decorating. The council had provided the building, equipment was from the hospital. If there was a call for this kind of a service then perhaps, the NHS might do some capital investment but the NHS had no capital to invest, (this was his meaning if not his exact words)

We asked could the pop up do instrumental delivery or ventouse? The answer was no.
We asked could they do pain relief or epidurals? The answer was no.
We then visited the children’s centre and met the midwives, who are lovely, as expected.
We do not think that the size of the team is realistic for the service advertised, even with all the good will in the world is applied by the midwives. Sleep, self and family care, holidays and sickness mean this is a very small team to provide 24-hour cover.
So what is the situation This expresses some major concerns.

We do support women’s choice in child birth but it needs to be a well informed personal choice not one pushed by appalling policies as listed above.

We will continue to monitor the situation locally and nationally.

Birth chair

Why no extra staff for an extra service?

We will continue to question the situation
We suggest those who want to know more nationally read this also