Save Trafford General A&E Meeting
In a packed Community Centre in Flixton last night, the senior officials leading the reorgansitation of health services on our patch came to address the worries of local people.
Over 100 people came to listen; to find out what was planned, why it was happening, and how quality healthcare would be delivered. That was what they came for, but the presentations were so lacking in substance, that 100 people went away again clear that the full or partial closure of A&E was firmly on the agenda but with no reassurance that health provision would be protected.
Leila Williams, Head of Service Transformation NHS Gtr Manchester, spent a long time explaining that the aim was to ensure more people were treated at home which was proven to produce the best outcomes, but the audience quite rightly asked ‘what has that got to do with closing A&E?’ The audience had turned up to have specific concerns addressed about A&E and it seemed the officials were reluctant throughout to tackle those concerns head-on.
The Management Case
The key elements that I picked up in what was a frustrating dialogue:
Trafford’s A&E was the 2nd smallest in the country – to which an audience member responded quite rightly that if you close Trafford’s then another A&E will gain the distinction of being 2nd smallest, so close that and another becomes 2nd smallest. It wasn’t a sustainable argument.
The numbers coming through the doors didn’t allow for the best range of conditions to be handled. Ambulances were already diverting stroke sufferers to Salford, Trauma to MRI.
But the audience provided numerous anecdotal experiences of having faced a shortage of specialist beds at these hospitals and either enduring transfer to Macclesfield, Alderhey etc. or being in a queue out on the wards waiting for that specialist bed.
The small size of Trafford meant it was difficult to recruit the best staff – the vision for Trafford General was to provide services where it could be a centre of excellence, for instance it was developing proposals for an Orthapedic Centre.
The suscipicion of the audience was that the continuing uncertainty over Trafford General was also a factor in diminishing its ability to recruit. Provide that reassurance and confidence and you might find it easier. Additionally the acquisition by Central Manchester Foundation Trust meant that Trafford’s hospital was part of a much bigger organisation bringing opportunities to interchange.
Whilst the professionals didn’t focus on the cost, it was a recurring underlying theme. And since it wasn’t highlighted there was little audience focus on the fact the NHS was being required by this Conservative Government to make ‘savings’ (see conclusion below)
The Residents’ Case
I’ve covered much of the resident’s response in that the residents challenged most aspects of the business case. However a couple of anecdotes caught my attention.
One man had resisted obtaining medical advice over his sudden deterioration in health until he was finally persuaded to take himself to A&E at Trafford where he was quickly diagnosed as being in a critical condition as a consequence of peritonitis. Since he’d left it to the last moment to attend A&E, would he still be here had the A&E been less local?
This to me is a critical question. I’ve seen estimates that lives would be saved through the centralisation into specialist urgent care services but does that take into account instances like this. Had this man had further to travel to A&E would he have left it still later to present himself? And had he consequently died, would the remoteness of the A&E be considered a factor in the cause of death. Whilst it might even be true that specialisation and centralisation could save some lives, might it not be true that it costs others theirs.
I was also concerned by a resident from Partington. The more services are removed from Trafford General, the more isolated Partington becomes. Whilst Salford is only a couple of miles away from much of north Trafford, both it and Central Manchester are far more difficult to reach from Partington.
There was quite a lot of criticism over the fact that the investment in Altrincham General was continuing when they had nearby Wythenshawe Hospital to call upon. It was clearly voiced that Altrincham is listened to whilst Urmston and Stretford are ignored. People near me remembered the criticism expressed in the letters page of one of the local papers by a Consultant from Trafford General over the continued misplaced priority in providing a new Altrincham General.
I thought that my colleague Councillor Jo Harding, who is Save Trafford General’s campaign co-ordinator got it spot on in her very good summing up:
We are yet to be convinced that risks have been addressed.
We are yet to be convinced that the capacity is available elsewhere.
We are yet to be convinced that Trafford General’s A&E is being given a fair crack to reach its full potential.