Memo Describes "Awful" Finances at Imperial College Healthcare NHS Trust

Intensive care beds at Hammersmith Hospital closed along with A&E

As campaigners gathered outside Hammersmith Hospital yesterday, September 10 to protest about the closure of their A&E departments, an internal memo seen by the Evening Standard described the state of Imperial College Healthcare NHS Trust's finances as "awful".

The memo also revealed that these financial problems have led to Intensive Care Unit beds being closed along with the A&E deparment.

The Standard says that an internal memo titled "Finances — urgh!" Professor Jamil Mamet, who heads the surgery and cancer division of the Imperial College Healthcare NHS Trust, said it had overspent by £1.8 million in July alone on the back of similar overspends in April and May.

The July 15 memo threatens the scrapping of the trust’s application for self-governing "foundation" status, partially independent from the NHS, if the situation does not improve. It also outlines tough measures to curb spending including "closure of unfunded ITU (intensive care) beds at HH (Hammersmith Hospital). Three beds to close now and two beds next week".

The memo says: "I'm sorry to report that our Divisional and Trust finances are awful this month. What has become clear this month is that we don’t have adequate control of our spending."

Hammersmith and Fulham Labour Council Leader Steve Cowan said: " With one side of their mouth Imperial are telling the Care Quality Commission inspectors that they’re fit and ready to take on the new freedoms that go with foundation hospital status.

" But with the other, they’re telling clinicians and nurses that their finances are so 'awful' they will have to halt important hospital care and consider withdrawing their application for foundation status. This is further evidence of Imperial’s critical weaknesses. They now need to come clean about the true state of their finances."

A spokeswoman for the trust said no intensive care beds at Hammersmith Hospital had been closed because of cash shortages but they had been "reconfigured" so that the unit "works more efficiently".

She also claimed the Foundation Trust application was still on track saying: "The division has been working hard to bring its budget into line by careful focus on initiatives to increase efficiency while maintaining the quality of care."

Along with Hammersmith Hospital's A&E, a second unit at Central Middlesex hospital in Acton also closed yesterday.

Imperial College Healthcare NHS Trust issued a statement saying that thought the A&E department closed yesterday morning, the urgent care centre at Hammersmith Hospital has been expanded, and is now open 24 hours a day, seven days a week.

The statement continued: " More than half the patients who attend Hammersmith’s urgent or emergency services are seen at its urgent care centre, and these patients will continue to be treated there.

" Additional capacity reflecting the case mix at Hammersmith has also been created at St Mary’s. This includes extra staff and assessment bays in the A&E plus a new 15-bed elderly care ward and 4 extra surgical beds. A new, expanded ambulatory care unit will open shortly, enabling more patients to receive the specialist care they need without being admitted to hospital.

" At Hammersmith Hospital, our expanded urgent care centre can now care for more people with conditions which are urgent but not life-threatening, while ambulances will take more serious cases straight to other A&Es or specialist units where they will receive specialist emergency care.

" Anyone arriving at Hammersmith as an emergency with a serious condition will receive immediate care and be transferred to the A&E or specialist unit most suitable for their health needs.

" Patients suspected of having a heart attack will continue to be taken straight to Hammersmith Hospital which has one of London’s eight heart attack centres, providing specialist emergency care 24 hours a day, seven days a week, for people in west London suffering heart attacks or arrhythmia.

" While we anticipate that most of the patients who would previously have been treated in Hammersmith A&E will now go to St Mary’s A&E, we have also expanded our capacity at Charing Cross Hospital’s A&E as part of our preparations."

Dr Ruth Brown, chief of service and consultant in emergency medicine, Imperial College Healthcare NHS Trust, said: " These changes to urgent and emergency care are intended to ensure we have high quality specialist services where they are most needed.

" We can provide better care, more sustainably, by concentrating more resources for seriously ill and injured patients at St Mary’s Hospital and Charing Cross Hospital while ensuring good local access for those with urgent but not life-threatening conditions at our urgent care centres, including the expanded centre at Hammersmith Hospital.

" We know that we are saving more lives through this sort of approach for major trauma, strokes and heart attacks."

The Trust added: " The changes are also guided by Shaping a Healthier Future, a major programme led by clinicians  to improve health services in north west London.

" The Trust's main priority is patient care and safety and detailed planning for these changes has been put in place. The Trust has rigorously tested the new processes and services to care for patients to make sure we are always providing safe high quality care, and we will continue to closely monitor patient activity and how care is delivered after the changes have taken effect.

" A major public awareness and information campaign has taken place throughout August and will continue into September to ensure local people know where to access healthcare urgently or in an emergency. Testing has shown this campaign has done a good job of getting the message across to local people and it will continue to be rolled out after the closure date."

September 11, 2014