SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Inequalities would continue and probably get worse: Currently people in some
parts of NW London die on average 17 years earlier than those in nearby areas. This
is neither fair nor reasonable and we need to try to reduce those differences
People would continue to die unnecessarily: A recent study showed patients
admitted at weekends and evenings in London hospitals, when fewer senior doctors
are available, stand a higher chance of dying than if they are admitted during the
week. We need a system that allows all of our hospitals to benefit from having senior
clinicians on site at all times, (including appropriate levels of consultant cover in key
specialties such as emergency surgery and obstetrics, as evidence is now directing)
Our dependency on hospital services would continue when this is not the best
use of resources: Resources which could be better used to help people to stay well in
the community. The issue of the current poor state of many of our buildings would not
be dealt with – two-thirds of our hospital buildings need upgrading
Existing hospital trusts would be under severe financial pressure: The deeper
„into the red‟ that trusts go, the more difficult it is to keep services running, to keep staff
and maintain morale, and to provide high quality patient care. Crucially, this would
happen in a disorganised way – meaning a worse effect on patients and staff
There would be problems with the NHS workforce: As it is, some services have
already had to be reduced because there are not enough clinicians to provide them
safely. Recruiting and keeping clinical staff in London is always a challenge and if we
do not offer the best places to work, and the best places to train, we will not attract the
best staff. Equally, if there is not enough senior staff, trainee doctors cannot be
supervised and are withdrawn from the hospital. All this means patients will not get the
best care, and services will be reduced.
While this may sound alarming, it is worth noting that many clinicians working for the
NHS in NW London would describe the outcome if we do nothing in even stronger terms.
Though many services are providing a good standard of care at the moment, they cannot do
so for much longer and it will be patients, and the clinicians who treat them and care for
them, who will be the first to feel the consequences.
4.4 Feedback received about the Case for Change during consultation
During consultation we sought feedback about the Case for Change. We wanted to
understand if people agreed with the case and if people had any suggestions for how it could
be improved. We asked people the following question in our consultation response form:
Q1. Do you agree or disagree that there are convincing reasons to change the way we
deliver healthcare in NW London
4,951 people answered the question. Of these:
64% of respondents who answered the question agree, including 20% who strongly
agree with the Case for Change
29% disagree, which includes 16% of respondents who strongly disagree
The remaining 6% had no views either way or were not sure/ didn‟t know.
In addition to the feedback, we received qualitative responses from organisations addressing
the need for change. Over 70 stakeholders submitted written responses to the consultation
4. The Case for Change 45