Earlier today I saw a letter that one of the Support Stafford Stafford campaigners had from the Department of Health attempting to explain the administration process. It appeared a bit confusing, so I thought I would have another go at explaining what I think is going on.
In September Monitor raised concerns that the hospital may not be sustainable, and they sent in the Contingency Planning team to check this out.
The CPT did loads of work into looking at the whole health economy of the area, but they then had to follow their remit, which was to make a judgement about whether Mid Staffs in isolation and in its current form is “sustainable”. They came to the conclusion that it is not.
As part of the CPT process they had to define what was at that time called “protected services” but is now called “location specific services”. This means the services that really do have to be delivered locally. It is not the same as the services that we feel that we want. There was informal consultation on this, but in the end it was the Clinical Commissioning Group who determined the very limited list of Location Specific Services. This exercise seemed important at the time, but will probably not be in the end.
The CPT prepared a report to monitor, which concluded that the trust is not Clinically or Financially sustainable (we dispute some of the reasoning behind this) and that an administrator should be sent in. Their recommendations, based on Mid Staffs alone, were to close A&E, ICU and maternity, and essentially take away all acute services. I am not sure if anyone expected us to meekly accept this, but of course we did not.
It may have taken 50,000 people on the streets, and a unanimous motion from the borough council to convince the administrators, but they now see the wisdom of finding a more acceptable alternative.
The Administrators do not have to accept the CPT recommendations.. They are now looking for solutions that are right in terms of the whole health economy. This is necessary because all the neighbouring hospitals have trouble of their own. None of them have the capacity to take on the acute patients form Mid Staffs. The expressions of interest are in, and as I write this I know that the administration team is working through the night to scrutinise the bids.
I believe that what the administrators are looking for is a proposal that gives the option of bringing together at least two hospitals, which will allow cost sharing and skill exchange, but would allow acute services, maybe at different levels, to be delivered on both sites.
The Administrators will be coming up with their proposals and presenting them to the community within the next couple of weeks, and this will then form the basis for the consultation process.
Up to now it has been very difficult for the public to work out how best to communicate with the administrators. When the proposals are made public then there will be a great deal of engagement.
Speaking personally I have always been very clear that this must be genuine consultation, with the public being given very good quality information on what is being proposed and why. I also think it can become the start of a much longer process where the public becomes an active player in designing the services we need for the future.
In Stafford we have been learning a thing or two about ourselves over the last few months, or years, and I think it is now very important to us that we are not seen to be passive recipients of what someone else tells us is “good for us”.
Speaking personally, I am very very weary with Stafford being seen as a problem. I want the country to start seeing Stafford as the forerunner. Somewhere that is getting things right against the odds, and somewhere where we can set out to build a positive future for the NHS.
I think we can do this!