Dr Angus Wood – I have read the recent assessment from Dorset clinicians with regard to the impact of longer ambulance journeys on patient survival, as reported in Bournemouth Echo, today and in BBC News. And also I have read similar assessment and review from Dr Forbes Watson, front page the “I” newspaper last Friday.
I have followed the whole issue for three months now, and that includes reading several major DCCG papers that have been published. All references are in emails below.
It is understood that, as you emphasise, medical treatment starts as soon as the ambulance arrives at an incident. But for the rest Dr Wood – and Dr Forbes Watson – you are not giving a full and comprehensive account of the whole issue and in that sweeping over hugely critical issues.
1. Stabalisation. In many cases the most critical issue above all issues is to get patients to the nearest A&E department to stabalise, with then further medical diagnosis, and as needed further transport onwards to a specialist hospital.
2. DCCG/SWAST analysis. You have looked at 34 cases – out of 650 cited cases over four months of life threatening conditions. And this in the context of 36,000 admissions to Poole hospital A&E in 2017. Analysis of 34 cases is then a glimpse – not a thorough, peer reviewed, in-depth, statistical survey.
3. Arrival of ambulance at the incident. You say treatment starts as soon as the ambulance arrives. All well and good – but then when will the arrival be doctor when it will take possibly/ probably well over an hour for an ambulance to arrive in western areas? Ambulances inevitably stacking up at RBH on the eastern most edge of the county.
4. Two snapshot cases of so many in Dorset – people waiting hours for ambulance as matters stand, with two A&E departments – and you are telling us it will all “miraculously” improve when we go down to one A&E for the 460,000 conburbation : More than 14,000 patients left waiting four hours or more in A&E as hospitals miss targets : Disabled man left lying on driveway for two hours waiting for ambulance.
5. Coronary attacks, strokes, sepsis, pre-natal complications, burst appendicitis, meningitis, choking, concussion, severe burns, loss of consciousness, internal bleeding, road traffic accidents, broken limbs – all these cases and you are telling us Dr Wood, and Dr Watson, distance to the nearest A&E hospital is not the most critical of critical issues to alleviate suffering and save life?
7. Sorry doctors but this does not stack up. That is why we have overwhelming opposition to these changes with petitions of over 50,000 in our towns. On your “logic” distance to nearest hospital is not of highest concern, but then only because you pit this critical factor against “getting to the appropriate A&E”. And the answer there of course is that ALL A&E departments need to offer, as far as possible, full range of common A&E services.
8. You are using centralisation at one major A&E to justify closing down a second A&E in the conurbation when the truth is in a conurbation of our size we should have and need to develop both A&Es for full services : A&E and Urgent Care Centre. No factor is more important than getting to a medical team in an A&E department in the shortest time. Specialist cases, such as brain trauma to Southampton, a very small fraction of all the many hundreds of A&E cases every week.
9. Operational budgets are being cut back doctors by some £147 million. That is the truth isn’t it. The mandate of DCCG from DHSS. The consequence then of this enormous Beeching II cut-back in funding, the grand centralisation plan. We lose Poole A&E which then, along with Poole maternity, gets moved to the grand centralised site at RBH.
10. And that is access to RBH along the notoriously overloaded often gridlocked A338. And RBH on the river Stour flood plain with flooding every year in the area such as Ilford. And of course with climate warming increased flash flooding. And we end with no backup major A&E in the conurbation.
11. Sheffield Research. Repeatedly Tim Goodson and DCCG have cited this research (always non-specifically) as evidence base to downgrade from A&E to an urgent care unit when the truth is the professor leading the reseach, Professor Jon Nicholl, makes clear there is no evidence of improved outcomes from downgrading.
12. Close down of Poole A&E is without precedence in the UK. Sheffield study looked at down-grading A&E in towns between 18,000 and 110,000. Adding up all five towns in the study did not add up to the population of our conurbation. Never before has a major A&E been closed down in a conurbation of our size, with then the next nearest A&E ten miles away (30 miles from Purbecks) – along the overloaded A338.
13. In all doctors I do not accept what you are selling. Time and again considerable inconsistencies in DHCC claims, with worse again downright false information, Cllrs telling the public an urgent care unit is “all but in name” the same as an A&E department when there is no comparison : A&E with consultants, surgeons, theatres, and admission wards – none of which we will have in a GP led outpatient urgent care centre.
14. Doctors – and doctors. I could not have a higher regard for the medical profession and for all working in the National Health Service. However, I realise now there are doctors, and there are politicised doctors. Those as yourselves who become managers of NHS policy and as such make the decision on funding, and in that it seems inevitably committed to packaging government policies, even when as in this case for Poole it is clear there are going to be serious adverse consequences.
15. However, I might have a solution, a colleague who might like to donate £200 million to Dorset NHS. But you are saying this is not needed? We are better off with one A&E on the eastern edge of the county? Longer journey times are not relevant? You are saying the whole situation is fine? These enormous changes are nothing to do with enormous funding cuts?
In a word doctors, I do not believe you. You are grossly misleading the public in Dorset. Time – as with the lies that launched Brexit – will show up the truth. It always does. In coming years seriously ill people from the western side of our catchment area will die on-route in ambulances. There will then no doubt follow court cases citing all the evidence and outrage in Dorset for three years fiercely opposing these changes.
Tim Goodson – Dr Forbes Watson – Debbie Flemming – Tony Spotwood. What is your real agenda?
Yours sincerely,
Jeff Williams
Resident
Poole
