Press release 4th April 2011
Last week we highlighted the unanimous support for Councillor Ellen Glass’s Motion deploring the clandestine re-design of chest pain services at St. John’s. This had all the hallmarks of a decision taken in haste, under cover of the Easter holidays and the election period. It was ill-conceived, ill considered, and displayed behaviour that under-pinned the longstanding lack of trust between NHS Lothian and the people of West Lothian. If NHS Lothian had any credible defence to these allegations, we would surely have heard it by now. The silence is deafening.
The nurse-led chest pain service at St John's Hospital was previously provided to West Lothian residents on a seven day a week basis, but was downgraded last month to just eight hours a day from Monday to Friday. NHS Lothian now appears to be using this as an excuse to send patients arriving at A&E with suspected heart-related pain directly to the Royal Infirmary.
This instruction is given in a letter sent to staff from the Clinical Director of Cardiology, Dr Neal Uren, dated 12th April. Nowhere in this letter is there any mention of consultation with any of the stakeholders. It would appear that consultation for the people of West Lothian is as alien a concept now, as it was in 2004 when we witnessed the wholesale degradation of emergency services. Service re-design is specifically within the remit of the St. John’s Stakeholders Group, as determined by the Cabinet Secretary, Nicola Sturgeon but that seems to carry little weight.
Jackie Sansbury, the Chief Operating Officer, asserts both in the Edinburgh Evening News and West Lothian Courier that consultation will take place. Yet Dr. Uren has instructed St John's Hospital staff to move patients directly to the Royal Infirmary from 4th April onwards-prior to any “consultation”. Despite Mrs. Sansbury's statement, Dr. Uren does not mention the word "consultation" once. Neither the staff at St John's, nor any of the stakeholders were consulted, nor was the West Lothian public. Dr. Uren has instructed the transfer of chest pain patients to start with immediate effect.
Mrs. Sansbury states that only those patients (approximately 150 per year) who would normally require specialised heart tests (cardiac catheterisation) will be transferred directly from A&E at St John's to the Royal Infirmary. But Dr. Uren clearly states in his letter that there should be no attempt to select the cardiac high risk patients. In doing so, he states they will ignore nationally and internationally recognised risk management tools. This means that anyone with chest pain, which might be heart-related, will have to be sent directly to the Royal Infirmary for assessment. This will be significantly more than the 150 patients per year currently transferred. So who is being economical with the truth?
We naturally welcome any improvements in patient outcomes. But why is this being foisted on West Lothian patients? The Borders, Fife and Forth Valley Health Boards are served by the RIE for cardiac catheterisation, but their less serious chest pain patients are still admitted and assessed locally, before only the most serious are sent to the RIE. Why the difference for St. John’s?
St. John’s Hospital is, as stated by the Cabinet Secretary, an “acute emergency hospital”. Perhaps telling is Mrs. Sansbury’s removal of the word "emergency" in describing the status of St. John's hospital. Is this a pre-curser to further covert service change? To add insult to injury, Dr, Uren has further downgraded our Acute Emergency Hospital to the status of “institution”.
We intend to table these and many other questions at the meeting of the St. John’s Hospital Stakeholders next Wednesday.
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