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The King’s submission (for full text, click link on the left) describes a lack of capacity at Camberwell against rising demand and a need to increase capacity. It describes advantages in transferring surgery to Orpington Hospital, Princess Royal University Hospital (Orpington) and Queen Mary’s Hospital (Sidcup) including: zero delays for elective surgery caused by emergency admissions (as currently occurs at King’s); reduction in waiting times; release of elective beds at King’s for emergency admissions which in turn releases emergency cubicles for faster A&E turnover. There is also an undertaking for elective surgery to continue at Camberwell for those unwilling to go to Orpington or Sidcup; however (the one admitted downside) – it does state that this may require a longer wait than for Orpington or Sidcup (it does not say whether longer than at present). They also state that no services are being withdrawn and that pre and post-operative outpatients’ appointments will remain at Camberwell.
King’s summarise: We do not consider this to be a substantial variation. The service of three specialties being moved will be improved, specifically around reduction in waiting times and non-cancellation of procedures. In addition, these three service moves will help address emergency and RTT [Referral to Treatment] performance at both Denmark Hill & PRUH.
Also: Transport will be provided free of charge to all Lambeth, Southwark and Lewisham patients to ensure the change in location of the service does not impact financially on the patient.
The Overview & Scrutiny Committee took statements from various interested parties including NAG represented by Irene Kimm and Norwood Forum by Noshir Patel. Whilst King’s representatives were given ample time to defend their business plan, time for others was restricted.
It became apparent that there seems to be ambiguity in their submission so that the right to choose to have elective surgery at the hospital of your choice may be curtailed. However, at Overview & Scrutiny it was verbally confirmed that the statement on page 4 of the King's submission stands: "If a patient is unwilling or does not choose to have their procedure undertaken at the Trust’s preferred site for all three proposed service moves, arrangements will be made to make bed and theatre capacity available to enable the patient to remain at their initial site where there will still be an element of elective work undertaken". The word 'initial' in this context may be significant, and is one of the ambiguities.
The issue of patient transit is vexed by admitted transport difficulties; also this will not necessarily allow carers or relatives to travel with the patient; also visitors will have to make their own arrangements to visit patients. The Orpington / Sidcup area is not easily reached from King’s traditional catchment area.
It also was disclosed that some of the medical staff are critical of these changes with some ‘going public’ – not something to be taken lightly.
The Overview & Scrutiny Committee have no executive powers to enforce a change in King’s business plan but can exert pressure. It now requires King’s to monitor outcomes over the coming months and report back. The Evening Standard picked-up on the story (click link on the left).
In summary: no changes to King’s plans have been realised but there is now a level of council and public scrutiny that may achieve a higher service level than otherwise.
There is still the right of ‘patient choice’ – you can choose where to undergo surgery at any hospital offering the procedure you need whether at any of the King’s controlled sites or indeed anywhere else in the NHS. However, there is strong attachment by many to King’s and if the outcome is that patient choice to insist on Camberwell in reality requires a long wait or any other sub-standard issues, then these would be of major concern. And we still do not know what the situation is for urology.
Update - 26th October 2014: Healthwatch is hosting a "conversation" and "workshop" into this issue on 14th November at Brixton - click here. Meanwhile we ask anyone who is awaiting surgery to tell us of their experience in patient choice of where the operation will be conducted. Please use the contact button top left of the home page.
Update - 16th November 2014: The public “conversation” on 14th December about King’s Hospital reorganisation has been reported as a gesture without any outcome. King’s will do what it wants and we need to know the result. We welcome reports of patient experience from those awaiting surgery and the choices offered. Do tell us your experience, good or bad via the link on the home page.
Update - 2nd March 2015: Complaints have been received that King's are not properly explaining patient chaoices with regards to where their surgery might take place. It's also understood that some kind of confidential investigation is ongling at King's.