A letter landed on our doorstep last week inviting consulation on the re-arrangement of services with our local NHS Trust. It was mostly focussed on the possible downgrading of Lewisham Hospital. Option 3 of the proposals is the closure of A&E in Lewisham. Consultation ends April 7th giving very little time for considered thought and measured response.
It is the A&E closure that has grabbed the headlines. This may mask many other concerning proposals in the package. We heartily urge all to read the NHS report to get the full picture
What is the justification for closure?
- Money. The Trust has a £400,000/week overspend
- Too many A&E departments with not enough resources
- Danger of cross contamination at Lewisham
It is important to understand who uses A&E and why. It is not all speeding ambulances from the scene of an accident for life saving care. Quite the contrary for anyone who has sat for many hours in Lewisham’s A&E. There are the walking wounded, bleeding, maybe a bit concussed who need sorting. And a fair number actually walk in … more arrive by public transport or by car or taxi with a concerned friend or relative.
The lack of ‘out of hours’ health cover by many GPs has put more pressure on Accident & Emergency as offering the only practical way of seeing a doctor for some people. It also picks up people whose pain or concern is more than their position on the waiting list.
What is the impact for Lewisham?
Approximately 80% of emergency admissions in the borough go to University Hospital Lewisham. Under ‘Option 3’ they are all going to go further.
For life risk patients – the further you go, the more likely you are to die.
For non-life risk – the further you go, the less likely you are to get there under your own steam. Putting a significant greater pressure on an already hard pressed London Ambulance Service, both on their budget and their ability to maintain services for the high risk patients.
In both cases you are more likely to be admitted to the hospital with the A&E which means friends and relatives will find it harder to visit. A not insignificant factor in patient morale and recovery.
Lewisham has the greatest concentration of people and transport systems of all four boroughs in the Trust. Hence the one most likely to have a major disaster – remember the Lewisham Train Crash? There would be no local facility for the most severely injured.
What is the impact for Sydenham?
If it is bad for Lewisham, it is worse for Sydenham. The Trust’s objective is to bring care nearer to the patient. Until 20 years ago A&E for children was in Sydenham itself. My daughter had meningitis and only just survived. She would now have to go to Lewisham. Under option 3 – where? On the 176 to Kings College? By car to Orpington … both choices probably fatal.
For adults the situation is not much better. Guys Hospital by train seems a good option unless you have an ambulance. That’s of course if its not at night or a Sunday or …
Both Kings, Guys & Thomas’ are pretty inaccesible by car. Which again means if you can’t wait for an ambulance its Orpington or Greenwich. On second thoughts it will be better to wait for the long ride. Just at the time Lewisham is thinking of making most of its roads 20 mph with ‘calming’ – not very ‘calming’ if you are inside an ambulance trying to get to a distant hospital fast without smashing the patient to bits!
This is not good news for Sydenham. On the edge of Lewisham we have to travel far for many services. On the edge of the Trust territory we get a double Whammy. Unless we can find a better way.