A couple of weeks ago I published a story about the future of Charing Cross hospital, based on an interview given by Dr Mark Spencer, clinical lead of the Shaping A Healthier Future programme in north-west London.
There were two main story lines from the interview: an inquiry had been requested to check whether recent A&E delays were a result of the closure of Hammersmith and Central Middlesex A&Es on September 10; and Dr Spencer’s revelation that a property developer had suggested redeveloping the tower building at Charing Cross hospital as residential flats.
Full versions of the stories are here:
In response to the story about Charing Cross hospital, Imperial College NHS Trust issued the following statement:
“We are still some way off clarifying what our new models of care should look like in practice on the Charing Cross site in order to meet changing needs. That has to be the priority before we begin to consider in detail, the design of the proposed new facilities and the sale of surplus land. And we have committed to involving patients, local communities and other stakeholders in that process too.
“As such, we can confirm that we are not in any discussions about the disposal of land at Charing Cross Hospital or about alternative uses for the tower block. We can also confirm that no decisions have been made about the future of A&E services at Charing Cross – we are still awaiting the outcome of the England-wide review of urgent and emergency care by Sir Bruce Keogh and Professor Keith Willett to inform our proposals for the future. Again, we are committed to involving local stakeholders in helping to shape these proposals.”
To me, the statement seemed to be puzzling – a bit of a “non-denial denial” by not specifically addressing points raised in the story. It also appeared to suggest a difference of opinion between the senior management team at Imperial and Shaping A Healthier Future.
I asked a series of follow-up questions for clarification. For the sake of completeness, here’s how Imperial responded:
1. Do you disagree with what Dr Spencer outlined in terms of the “emergency centre” at Charing Cross – namely, that it will be run by GPs specialising in emergency medicine and emergency nurse practitioners, not have an intensive care unit, not receive “blue light” ambulances and will be part of an “emergency network” linking in with St Mary’s (and the four other major A&E units in west London), with emergency consultants available by phone or videoconferencing? If so, please can you outline your vision of the changes to the Charing Cross A&E?
• We are still awaiting the outcome of the England-wide review of urgent and emergency care by Sir Bruce Keogh and Professor Keith Willett to inform what A&E should offer at Charing Cross. We are working closely with the CCGs on this and we are also committed to involving local stakeholders in helping to shape proposals.
2. You say that “we” (ie Imperial College NHS Trust) are not in discussions about the disposal of land at Charing Cross or alternative uses for the tower block. Was Dr Spencer wrong to say that a developer had approached GPs/SaHF to suggest retaining the tower block and converting it into flats? Has Imperial ruled out converting part or all of the tower block into residential properties?
• Dr Spencer is of course free to share information about any discussions that he has had. The Trust, with oversight by the NHS Trust Development Authority, is responsible for the Trust estate and we have not had any discussions about alternative uses of the tower block at Charing Cross. The Trust is working closely with the CCGs on clarifying what our new models of care should look like in practice on the Charing Cross site in order to meet changing needs. That has to be the priority before we begin to consider in detail, the design of the proposed new facilities and the sale of surplus land. And a vital part of this will be involving patients, local communities and other stakeholders in that process.
3. Is Imperial unhappy and/or in disagreement with the SaHF vision of Charing Cross having its A&E replaced with an “emergency centre”, as outlined by Dr Spencer?
• We are still some way off clarifying what our new models of care should look like in practice at Charing Cross Hospital, including the A&E service there. We are working closely with the CCGs on this and the outcome of Sir Bruce Keogh and Professor Keith Willett’s review of urgent and emergency care will guide our proposals.
4. Is Imperial keen to take greater control of the future services provided in its hospitals under Shaping a Healthier Future? Has it now decided that it is less willing to accept the suggestions/recommendations/vision of SaHF and is effectively challenging the next stage of the programme?
• The Shaping a healthier future programme is the regional strategic framework for the Trust’s own clinical strategy and vision for the future. The clinical strategy that we set out in July is fully in line with SaHF’s principles and the role it set out for our three main sites. When we published our clinical strategy, we also recognised that we needed to do more to engage our stakeholders, including patients and the public, in shaping and implementing our clinical changes.