We’re Not Going Away!

To their lasting shame Surrey County Council (SCC), NHS England South (NHSE(S)), Ashford & St Peter’s NHS Foundation Trust (ASPH) and Central & North West London NHS Foundation Trust (CNWL) presided over the closure of Blanche Heriot Unit (BHU) on Friday 29 September. ASPH proclaim on their website and corporate literature – “Patients First; Passion for Excellence – so let’s take these fine words and apply them to what has happened to Blanche Heriot. Patients First – BHU patients have not been consulted. They were not informed, let alone given the opportunity to raise objections, when the threat to the BHU first became apparent on the award of the Surrey-wide contract to CNWL. There have been two ‘Information and Discussion Events’ in August and September when hamfisted attempts were made to promote the “new service” to patients whose distress at the threatened closure of BHU was only too obvious and questions raised were met with bland assertions and obfuscation. A webinar held at the third attempt last week turned out in fact to be a conference telephone call with only three people dialling in. We await the results of the online patient survey that closed on 22 September. The BHU Patient Group made representations to the SCC Adults & Health Select Committee on 4 September arguing for a further six months extension of the BHU contract as there were still so many unresolved issues around CNWL’s and ASPH’s future service plans for BHU patients. At the same meeting Healthwatch Surrey argued for more time to be allowed in view of the inadequacy of consultation. The Councillors did not support an extension to the BHU contract but did agree to set up a task group to explore the adequacy of the consultation and implementation arrangements. The Chairman then went on holiday and we are still waiting to hear how the task group will operate and when we will have the opportunity to present evidence to the task group on the failure to consult in any meaningful, formative way with BHU patients. There are 2,850 signatures on the BHU campaign petition (and the petition will continue - to reopen BHU). Time and again we have drawn the attention of the decision makers to the comments posted on the petition site from patients who attest to the excellence and lifesaving impact of the service they have received from the BHU. If “Patients First” meant anything, BHU would not have closed on Friday. Passion for Excellence – BHU has been a centre of excellence for 25 years serving a large population in North West Surrey principally from Woking, Runnymede and Spelthorne, although patients also attended from further afield given the Unit’s accessibility and expert, discreet service. It was seeing some 15,000 patient attendances per annum, with opening hours that stretched into the evening during the week and Saturday mornings. A great many of the patients attending the BHU had longstanding conditions requiring regular review and attention – a detail which appears to have been overlooked by the commissioners and CNWL. Patient feedback (The Friends and Family Test) was always at the highest levels of satisfaction. BHU was fully integrated with St Peter’s Hospital with clinical inter-connectivity with maternity, obstetrics & gynaecology, A&E, pathology, dermatology, pain management, physiotherapy and - for inpatient admissions - general medicine and intensive care. It was a training resource for junior doctors, GPs, nursing staff and other health care professionals. As the many comments posted on the petition site by GPs and other health care professionals demonstrate, it was a hugely valued local clinical resource. Here is just one of many comments on the petition site – “The BHU, is an essential part of the local community, the staff are excellent and extremely welcoming, they have helped me tremendously over many years, some 21 years ago they supported and nursed my partner and kept him alive and with a good quality of life for 11 years. Had the unit not been there I am in no doubt that our time together would have been vastly reduced. The care and education that they provide to the wider area would be lost if the unit were to close.” If “Passion for Excellence” meant anything, the BHU would not have closed on Friday. Personal Responsibility – we propose to interpret this as holding to account the elected representatives and senior officers from SCC, NHS England, CNWL and ASPH who together have caused the BHU to close. That is why we are not going away. There is growing disquiet across the country about the cuts in sexual health services and the fragmentation of those services. This was first signalled in the report of the All-Party Parliamentary Group on HIV/AIDS (December 2016) and has been reiterated in subsequent reports from the King’s Fund and Public Health England (PHE). The PHE review of the commissioning of sexual health and HIV services since responsibility for public health passed to local authorities in 2013 revealed widespread decreased investment ranging from 5% to 25% and a mean average of 14%. The 33% disinvestment imposed by Surrey County Council in the contract awarded to CNWL was therefore over twice as much as the average level of disinvestment. In August, the Local Government Association described sexual health services as “at a tipping point” due to cuts in local authority public health budgets. The recent report from the Royal College of General Practitioners – Sexual & Reproductive Health: Time to Act – states that “that RCGP members have reported that a perfect storm of factors is reversing previous positive advances made in promoting sexual and reproductive health”. The British Association for Sexual Health and HIV - whose members seek to promote, encourage and improve the study and practice of diagnosing, treating and managing sexually transmitted infections, HIV and other sexual health problems - are understood to be monitoring the impact of reduced funding and accessibility to sexual health and HIV services closely. The BHU Patients Group will play its part in monitoring the impact on individual patients, and service users generally, of the new service arrangements in Surrey. We have already heard from one patient who was not given the option of being examined at Buryfields by a female doctor. We shall enable patients to report specific concerns to us and we shall seek access to, and publish activity and performance data for CNWL’s Surrey service. We have set up a website which we shall be developing as a vehicle for monitoring the CNWL service. The SCC Adults & Health Select Committee will be reviewing the CNWL contract in nine months’ time and we shall collate information for submission to that review as well as contributing to the Committee’s task group (once it is set up!). In the meantime we shall continue to advocate for individual BHU patients especially those who cannot reasonably be expected to travel to Buryfields Clinic, for whom continuing provision must be made at St Peter’s. And we will campaign for the reopening of the Blanche Heriot Unit as a shining example of a health care facility that gives true meaning to the words – Patients First and Passion for Excellence.