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Lewisham decision ‘delaying the inevitable’ – 2020health

Healthcare policy professionals have responded with concern to the announcement that Lewisham will retain its A&E department.

Health secretary Jeremy Hunt has accepted the broad recommendations of Special Trust Administrator Matthew Kershaw and South London Healthcare NHS Trust is to be dissolved by October.

There is some consensus on the view that the failure process did not take long enough to consider local people’s views on the reconfiguration, but others warn of the damage that could be inflicted by failing to implement Kershaw’s recommendations in full.

2020health suggested that the recommendations were “not a pick-and-mix list” that Hunt could implement in part.

Julia Manning, chief executive of the think tank 2020health said: “They were developed to be taken as a whole to stop the haemorrhaging of money out of the NHS and ensure the people of South East London have the best clinical care possible for years to come.”

She added that Hunt was “sadly delaying the inevitable” with Lewisham A&E, which could increase costs.

“Unfortunately sentimentality and politics have left us with a solution that is unsustainable in the long term and will have to be revisited yet again in the future.”

NHS Confederation chief executive Mike Farrar said that discussion and clinical advice on such large scale reorganisations could avoid “trench warfare” and added: “Where the evidence shows that change will save lives or improve experience and outcomes for the population, we should expect political support.

“Quality needs to be the main driving force behind any change. Delivering long-term improvements requires a joined-up, whole-system solution rather than looking at one organisation in isolation.”

Chris Ham, chief executive of The King’s Fund, agreed that change was necessary for the failing trust but warned that “the failure regime should be used as a last resort and must not become a back-door route for reconfiguring hospital services”.

He said: “With a number of other trusts also facing serious financial challenges, it is vital that, wherever possible, these problems are resolved before it becomes necessary to invoke the failure process – this will require stronger political leadership than we have seen in the past.”

The current timetable for the failure process was not long enough to properly consult local people, Ham added.

Rehana Azam, GMB National Office for NHS warned: “This Government is now presiding over the downfall, break up and privatisation of the NHS. As people will have to travel further to access services, particularly urgent care in built up areas with congested roads, lives will be put at risk.”

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