Whittington hospital case shows importance of good communications: Healthcare services need to engage the public early over reforms and not wait until others have united against them.
North London's Whittington hospital provides the latest excruciating example of how not manage service reorganisations. By mishandling the communication of plans to replace wards with community facilities it has a rebellion on its hands.
What hospital managers regarded as an "estates strategy" has now been described in the Camden New Journal, which broke the story, as "a dramatic plan to dismantle the Highgate hospital." It said there had been a "hush-hush decision by the board to sell off £17m worth of public buildings … and close three wards on the main site, halve the total number of patient beds to 177 and axe 570 jobs, including around 200 nurses."
It's not hush hush now. After the plans emerged, around 500 people turned out last week to give managers a thrashing at a public meeting in the local Methodist hall, led by the Defend the Whittington Hospital Coalition. A mass lobby of a board meeting is imminent and a demonstration is taking place in Islington next month.
And in its apparent determination to alienate as many people as possible, the trust has had to make a "grovelling apology" to local MP Lynne Featherstone for misrepresenting her position.
The campaign group's chair, Shirley Franklin, explained to the newspaper the near impossibility of securing support for badly needed service reconfigurations when the starting point for the conversation with the public is making cuts.
She said: "It feels like there is an attempt to hoodwink the Whittington community into believing that we are getting a better health resource. We welcome improvements, but not a loss of hospital beds, hospital property, hospital staff. We retain our demands – no sell-off, no loss of hospital beds, no sacking of any staff."
Yet the hospital is trying to plan a better service by moving care into the community. Virtually none of the property being sold off is used for clinical work and parts have been empty for nine years.
The £17m income from the property sale is being invested in a new ambulatory care centre, which will cut admissions, an undergraduate education centre and improvements in maternity services.
Hospital stays are being shortened by better recovery management and discharge services, support at home is being improved, and integrated early intervention teams are keeping patients out of A&E.
But all this is being lost – the campaign to "save" the hospital controls the public debate. By failing to engage the public at every stage of the development of its plans, the Whittington has allowed its progressive ideas on keeping people at home rather than in hospital beds to become embroiled in fears about spending cuts and the danger of "another Mid-Staffordshire".
These debates can, and have been, won, if the starting point is talking with local people about what sort of care service we need to ensure we live as healthily and as independently as possible for as long as possible.
Selling off an empty building to improve care is not a difficult argument to win. Neither is cutting beds, if it is seen to be the inevitable consequence of better care closer to home rather than a cut.
Every time trusts and local commissioners get the communications around service changes wrong they make it more difficult for everyone else. They need to walk towards their public, not wait until MPs, councillors and local journalists have united against them because they have not been engaged from the start. That doesn't mean it will ever be easy, but it is a great easier than the alternative.
The Whittington has been on a long journey. From having a poor reputation – the Evening Standard used to publish a list of its medical errors – and inadequate buildings and equipment, it now has a good safety record, much higher standards of nursing and greatly improved facilities.
In 2011 it merged with over 30 health centres in Haringey and Islington to form Whittington Health, an integrated care organisation. Its latest plans are another step towards delivering excellent, community based care. How sad that local people now think it is going backwards. Guardian Professional.
North London's Whittington hospital provides the latest excruciating example of how not manage service reorganisations. By mishandling the communication of plans to replace wards with community facilities it has a rebellion on its hands.
What hospital managers regarded as an "estates strategy" has now been described in the Camden New Journal, which broke the story, as "a dramatic plan to dismantle the Highgate hospital." It said there had been a "hush-hush decision by the board to sell off £17m worth of public buildings … and close three wards on the main site, halve the total number of patient beds to 177 and axe 570 jobs, including around 200 nurses."
It's not hush hush now. After the plans emerged, around 500 people turned out last week to give managers a thrashing at a public meeting in the local Methodist hall, led by the Defend the Whittington Hospital Coalition. A mass lobby of a board meeting is imminent and a demonstration is taking place in Islington next month.
And in its apparent determination to alienate as many people as possible, the trust has had to make a "grovelling apology" to local MP Lynne Featherstone for misrepresenting her position.
The campaign group's chair, Shirley Franklin, explained to the newspaper the near impossibility of securing support for badly needed service reconfigurations when the starting point for the conversation with the public is making cuts.
She said: "It feels like there is an attempt to hoodwink the Whittington community into believing that we are getting a better health resource. We welcome improvements, but not a loss of hospital beds, hospital property, hospital staff. We retain our demands – no sell-off, no loss of hospital beds, no sacking of any staff."
Yet the hospital is trying to plan a better service by moving care into the community. Virtually none of the property being sold off is used for clinical work and parts have been empty for nine years.
The £17m income from the property sale is being invested in a new ambulatory care centre, which will cut admissions, an undergraduate education centre and improvements in maternity services.
Hospital stays are being shortened by better recovery management and discharge services, support at home is being improved, and integrated early intervention teams are keeping patients out of A&E.
But all this is being lost – the campaign to "save" the hospital controls the public debate. By failing to engage the public at every stage of the development of its plans, the Whittington has allowed its progressive ideas on keeping people at home rather than in hospital beds to become embroiled in fears about spending cuts and the danger of "another Mid-Staffordshire".
These debates can, and have been, won, if the starting point is talking with local people about what sort of care service we need to ensure we live as healthily and as independently as possible for as long as possible.
Selling off an empty building to improve care is not a difficult argument to win. Neither is cutting beds, if it is seen to be the inevitable consequence of better care closer to home rather than a cut.
Every time trusts and local commissioners get the communications around service changes wrong they make it more difficult for everyone else. They need to walk towards their public, not wait until MPs, councillors and local journalists have united against them because they have not been engaged from the start. That doesn't mean it will ever be easy, but it is a great easier than the alternative.
The Whittington has been on a long journey. From having a poor reputation – the Evening Standard used to publish a list of its medical errors – and inadequate buildings and equipment, it now has a good safety record, much higher standards of nursing and greatly improved facilities.
In 2011 it merged with over 30 health centres in Haringey and Islington to form Whittington Health, an integrated care organisation. Its latest plans are another step towards delivering excellent, community based care. How sad that local people now think it is going backwards. Guardian Professional.
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