Health services in south east London have been thrown into turmoil again, as health chiefs order a suspension of the A Picture of Health changes and staff face more uncertainty. LINDA PIPER reports.

THE chief executive of the South London Healthcare Trust has issued a dire warning of the consequences if the announced review of health service changes is not done quickly.

Dr Chris Streather claimed any significant delay could result in premature deaths, the forced sale of one of the hospital sites, escalating financial problems and an exodus of staff.

He was speaking to Bexley Council’s health scrutiny committee in the wake of the announcement by London health chiefs of a review of the A Picture of Health (APOH) plans in Bexley, Bromley and Greenwich.

Ahead of the review Ruth Carnall, chief executive of NHS London, has also called a halt to any changes due to be made under APOH.

Dr Streather told the committee: “Elements which are controversial will need to be reviewed.”

He claimed APOH had already met three of Health Secretary Andrew Lansley’s four new criteria for health service changes.

Dr Streather said the fourth, consultation with GP commissioners, had not been possible when APOH was done.

But there is disquiet that the man chosen to leader the review is Bromley Care Trust chief executive Simon Robbins, the same man who led the decision-making on APOH.

Dr Streather told Bexley councillors the clinical problems which APOH set out to solve, still exist.

He said South London Healthcare Trust (SLHT) did not have the necessary number of staff or the volume of emergency patients for the A&E departments at its three hospitals, Princess Royal, Queen Elizabeth and Queen Mary’s.

Dr Streather said A&E patients, particularly the elderly, were being exposed to risk and premature death.

He said it was vital to separate emergency surgery from planned surgery, adding: “The clinical issues are still live and some are getting worse.”

In paediatrics, staff were having to deal with general paediatric problems as well as very premature babies.

The maternity services could not deliver the required 98 per cent consultant presence nor reproduce it across three sites and neither could it achieve the midwife-to-mother ratios.

Dr Streather revealed his trust was “the most financially challenged in the NHS”.

The trust had an agreed overspend of £43m last year and has agreed another overspend this year of £36m.

Dr Streather said because of movement of treatment out of acute hospitals into the community, the trust would be undertaking £50m less work this year.

He explained APOH would also have a positive impact on the trust’s finances, with shorter hospital stays, more use of operating theatres and more day care cases, while reducing the number of beds and staff.

Dr Streather said APOH was set to save the trust £9m this year and added: “We won’t now get all that benefit”.

He warned: “Patience is running out with our organisation in its present form.

“I think there is a serious danger of any delays impacting on the future viability of having three sites.”

Despite the suspension of the APOH changes, Dr Streather revealed work will continue to expand facilities at all three hospitals.

He said both maternity and A&E services were at clinical risk.

Dr Streather claimed winter capacity in A&E at both the Princess Royal and Queen Elizabeth needed “propping up”.

When the Queen Elizabeth opened in 2000, it handled 70,000 A&E patients but now it treats 104,000.

He added: “Its resuscitation is not fit for that volume of patients.

“We will be doing building work there and on a smaller scale at Princess Royal.

Dr Streather also revealed the trust would be moving planned orthopaedic surgery temporarily to Queen Mary’s to separate it from emergency surgery and may also do the same with planned gynaecological cases.

The expansion of A&E facilities at Princess Royal and Queen Elizabeth and moving elective surgery to Queen Mary’s all form part of the planned APOH changes.

But Dr Streather claimed the moves were purely for patient safety and would not prejudice the upcoming review.

Meanwhile, unions involved in redundancies and reorganisation at the South London Healthcare Trust have slammed the treatment of staff as “abysmally shoddy”.

A number of unions are working together to help hundreds of staff across the trust’s three hospitals who face losing their jobs or reapplying for them.

They have lodged a collective grievance over the trust’s attempts to shortcut the statutory 90 day consultation on job losses by trying the change the numbers to less than 100 so the 90 day rule would not apply.

In reality up to 800 people are affected.

Staff, including senior consultants, who are 65 or over found a letter on their desks informing them of their retirement date.

Staff sources said the letter contained no thanks or appreciation for their work.

Some of them had been in their jobs for more than 30 years.

Unison regional organiser, Carol Shorter said staff were being expected to apply for jobs without having any job description.

She said she had written to Dr Streather twice asking why the trust was not consulting staff in a meaningful way and had yet to receive a reply.

She said: “The trust seems to feel it doesn’t need to listen to the unions.

“They are treating the staff in an abysmally shoddy way.”

Ted Purcell, GMB regional organiser described the situation at the trust as “a very sorry state of atffairs”.

He claimed the trust was rushing the redundancy consultation meetings but was not listening to anyone.

Mr Purcell added: “The trust has handled this appallingly.

"Morale is at rock bottom. The whole thing is a sham.”

At the health scrutiny committee, Dr Streather said he had spent a lot of time “propping up staff morale”.

He added: “I accept there have been imperfections in the way we have communicated with staff and we have tried to put that right.”

Later, a spokeswoman for the trust added: "In line with statutory requirements, the trust is obliged to write to all staff members six months before they reach retirement age and offer them an opportunity to discuss their future at the trust.

"We recently did this, however we recognise that we failed to explain properly the options available for staff to continue working at the trust.

"We are sorry for any concern this may have caused staff and have written again to staff members to express this."