Why doctors were right to reject plan to axe Epsom Hospital's accident and emergency department

This Is Local London: Dr Annali Lawrenson outside Epsom Hospital's accident and emergency department Dr Annali Lawrenson outside Epsom Hospital's accident and emergency department

Surrey Downs GPs understood the needs of their patients when they turned their back on the controversial Better Services Better Value (BSBV), according to Epsom Hospital's accident and emergency staff.

Dr Annali Lawrenson, a consultant in A&E, praised Surrey Downs Clinical Commissioning Group (SDCCG) for listening to the area’s GPs - who overwhelming rejected BSBV’s proposals to axe Epsom Hospital’s A&E, maternity and children’s units - and walking out on the review in November.

Speaking to the Epsom Guardian during its visit to Epsom Hospital’s A&E department earlier this month she said she was "absolutely delighted" at the decision and endorsed SDCCG’s ideas for further integration of healthcare services at the hospital.

Dr Lawrenson said: "Epsom was tagged on to the end of BSBV which was designed to solve a London problem. It never made sense to try to solve London’s problems by causing a problem for the patients in the Epsom area.

"A huge hole with nothing else [would have been left], whereas in London there is generally something else up the road.

"The CCG took a very brave and sensible decision because they looked at it exactly from their patients’ point of view and they said ‘what is the best thing for our patients?’. They didn’t look at it as ‘can our patients help the London problem?’"

Dr Lawrenson said she disagrees with the BSBV team’s justification for the review and said it is not true to say that Epsom Hospital’s A&E is unsafe.

She added: "The justification for a lot of BSBV is that current A&Es are not safe and that’s not true and I don’t think that’s what the College of Emergency Medicine ever meant when they said the ideal is to have 16-hours-a-day consultant cover.

"That is an ideal and we should all be working towards it, and every A&E is, but it doesn’t exist in over 80 per cent of the A&Es in the country. The only ones which are providing 24 hour cover are the major trauma centres in London. "This A&E is very senior-led so the patients are already getting a very good service and it’s not unsafe. And we have very good consultant cover."

The A&E staff members interviewed by this newspaper said they had a "very good relationship" with SDCCG, which has made site visits and conducted audits within the hospital since taking over the reins in March.

Dr Lawrenson said: "That never happened with the PCTs. I don’t remember them ever visiting.

"There is probably at least a meeting a week, joint between various different people from the hospital. It’s definitely completely different to how it was and that’s bound to be more effective for the patient."

The "integrated" approach to healthcare in Epsom, which the CCG has said it is keen to foster, is already in action within its A&E.

Although any acute crises’ will be dealt with by the emergency team and its consultants, the department liaises with practitioners in any other speciality which is, or becomes, relevant to the patient, as well as the considering other care options - such as physiotherapy or social services.

Dr Mashkur Khan, an elderly care consultant, said such an approach is necessary because of the nature of the population - something which SDCCG grasped in its rejection of BSBV.

He said: "Leaving BSBV is a better solution because 85 per cent of our patients can be treated locally. They come in with elderly care-type problems. The package of care they are going to need is going to be local. The placement is going to be local. So if they go to a remote hospital it’s not going to be good for the patient or their family."

He added: "We believe in interface care where we work together, dovetail our services, and offer collaborative care because you’ve got to look at the patient as a whole."

Jeanette Ellis, deputy general manager in medicine with a focus on A&E, said so much more could be done with the site through greater integration.

She said: "We have a whole raft of partners working together - social services, pharmacy, therapists, dieticians, speech and language therapy. There’s so much which needs to come together to care for that patient and we’ve got such good links and we’ve strengthened our relationships so well it is almost like a community spirit. "And with the CCG behind us as well, we do feel like we’re going in the right direction."

Sue Cooke, a senior Older Persons Assessment and Liaison Service (OPALS) nurse, agreed: "We work as a team and we are very integrated with everyone we work with. "I’ve never had anyone turn around and say ‘that’s not my problem’. We are supported. Everybody’s there for the patients."

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