The Royal Brompton Hospital is a world-famous, world class spacialist heart and lung hospital – the latgest in the UK – based in Sydney Street Chelsea.
The Hospital has played an important role in the fight against Covid-19 as the one of only 5 centres in the UK which provides live saving EPMO treatment.
But all this sadly does not appear to be enough to stop NHS management and their asset stripping and selling it off for luxury flats and relocating setvices south of the river. We are truly appalled by this.
The fat cats tell us that there wil still be services there for a decade as they have committed to a new imaging centre in Dovehouse Street
But others in the know tell us this centre will most likely end up being sold off to private medical providers in the end.
Children’s cardiology provided at the Royal Brompton is also set to move to the Evelina Children’s Hosptial under the plans
The board is set to vote to merge with Guy’s and St Thomas’s today.
The RBKC Committtee meeting
An online meeting of the RBKC Adult Social Care and Health committee last month about the acquisition was perhaps, in some parts, special for some of the wrong reasons, partly because the Committee Chair, Labour’s Cllr Marwan Elnaghi had decided to have the bulk of the meeting devoted to presentations amd the NHS bosses making their cases, and at the very end of it, they only had time for a couple questions and statements from members of the public for a few minutes at the very end – disgraceful (we’ll say more about this later)
But we will summarise :
The first (and far largest part were the presentations.
Dr Richard Grocott-Mason: “We are glad to be given the opportunity to share what we believe are exciting plans that will benefit our patients”
First I’d like to reassure our patients, local residents and members of the committee that role is not closing. We will continue to provide specialist care for patients who need our services on the current site for at least the next decade.
Staff are very grateful for the recognition that the Council have expressed repeatedly for their excellent work, and I’m particularly proud of the outstanding care staff with both our hospital sites and delivered to patients during the last eight months.
I want to start by reminding the committee of the vision of the Royal Brompton and Harefield, which is the the UK, leading specialist center for heart and lung disease, developing services to research and clinical practice to improve the health of people globally, delivering the highest possible care to our current patients and ensuring that we can continue to do this in the future as being the driving force for the board. And we believe that the merger with Guy’s and St Thomas’s is the best way to take forward a partnership that we’ve had more than three years,”
“COVID has accelerated the transformation and models of care. Many of our respiratory patients now receive their biological treatments and intravenous drugs at home, rather than having to come up to the hospital, each time they need treatment, more patients are speaking to their clinical teams from home or work, rather than having to travel to the hospital”
Robert Craig, the Director of Development and partnership : “.We’re proposing mergers structured as an acquisition for a number of reasons. Firstly, they will bring stability and resilience to our services after many years of uncertainty about their future. We will become part of one of the largest health care organizations in the NHS, and one with a very stable history.
One of the catalysts for our collaboration was to pull our considerable resources to build a strong congenital heart disease service for patients of all ages. That could not only comfortably meet our national standards, but also and I think this part is crucial. Enable the expert teams to work together so successfully as to remain together in the same organization in the future.
Secondly, the scale of a new organization will support the development of greater sub specialization, as well as investment in the next innovations and in future technologies. And thirdly, we know that we’ll be able to sustain the important characteristics of Royal Brompton services, and that specialist care across a patient’s whole life. And the supportive, academic clinical culture, as we expand the academic opportunities that are available to our specialists.”
Helena Bridgman, a patient governor at thr Royal Brompton talked about her own experience and said this:” I started with one major problem in my lungs, but I am in fact the sum of many different parts. In fact a system of care, compassion, collaboration and coordination of care closer to home have figured large in smoothing my passage.
The staff at the Brompton have provided me with superb world-class care but the story did not end there. So what I have experienced firsthand as a patient and a nurse, is how inportant it is to be cared for by coherent and integrated teams and services that can treat many different conditions and needs at many different levels and can also provide coordinated aftercare to both local and more distant patients”.
Dr Ian Abbs, Guy’s and St Thomas’s :”This is a merger coming together of two partners, equal partners…… ”
Who does he think he is kidding here?
Dr Abbs: “The future has already been discussed and it is subject to consultation” ”
“the partnership with the other members of the NHS family n thr Royal Marsden in particular on a lung cancer pathway, with Chelsea and Westminster and other organizations of Northwest London, where we will be remaining for many years to come. as a major provider of care in northwest London, and we’re committed to engaging collaboratively with the NHS colleagues with our local authority partners, and with other stakeholders”
Charles Alexander, The Royal Marsden: “Of course we are the Royal Brompton’s most immediate neighbours as indeed is our academic department of the Institute of cancer research on the other side of th the Bromptons frontage on the Fulham Road, and not only have we been in the Fulham Road since 1870. but we intend to continue to invest throughout the whole period, both in our site in Chelsea and in our site in Sutton . The observation is that our trust has on this merger, firstly, of course, we respect, the will of the two boards of their respective trusts Guy’s and St Thomas’ and the Royal Brompton to pursue one thing, in the best interests of their patients. Our principles therefore concern the future of our patient provision on our side. And our partnership with the Royal Brompton. And indeed, with through Royal Marsden partners through the rest of the network with the Cancer Alliance, to which we provide, and have provided throughout the Covid pandemic in particular, a very joined up treatment pathway.And we wish to build on that, and invest in it.”
Hazel Fisher, NHS England ” NHS England in this role is arranging the provision of a wide range of health services to the extent that it considers necessary to meet the reasonable requirements of the people for whom it is responsible. And it does that, in large part through the commissioning stops and NHS improvement is responsible for overseeing NHS Foundation Trust and ensuring that patients receive consistently safe, high quality compassionate care within their local health systems that are financially sustainable. So those differences are important when it comes to a matter of this sort. So the NHS England is responsible for consulting on substantial service change, and variations in service, and I’m fact, our engagement responsibility is quite broad, it can go from a smaller service change which could be with a discussion with a limited group of invitations involved, or it can be full scale public consultation. And indeed, we are responsible were for those sorts of public consultations, where services move, and that is equally true if services move from one site managed by a trust to another site managed by the same trust, as it is true, if a service moves between trust. So I know that it has been a voiced concern that potentially with this transaction between the Royal Brompton and Guy’s and St Thomas’ that services will move without the right degree of scrutiny. And I think it’s really important to emphasise that that will not be the case. It was very good to hear from both Ian Abbs and Richard Grocott- Mason that that’s fully understood.”
Dr Bob Klaber” I’m a paediatrician and the director of strategy research and innovation in Imperial College healthcare and I’m going to be joined by Nicola Grinstead who is leading work across West London Children’s Health Care Alliance, and a halfway through this. So I guess just reflecting on what we’ve heard. I thought Richard’s comments around inequalities and Helena’s really important patient’s story really take us to the heart of what needs to be about and our plans. that we have been working on in collaboration with Imperial College London are very much designed to meet the health needs and address the health inequalities within our local population in northwest London, and this work has to not be about organizations, it has to be about patients residents citizens our local communities and the population we’re here to serve. And we believe that that’s best achieved by preserving and developing the long established Northwest London networks of specialists in respiratory and cardiovascular care and colleagues at the Brompton rightly talked about collaboration, being right at the heart of it, it needs to have medical education and research entwined with it. And we know from all the work we’ve done over decades, is that it led to significant improvements in adult and pediatric care but also having impact nationally. I’m just goiing to pass you to Nicola who’s goung to talk a little bit about about some of the deyails of the work we’ve been doing ”
Nicola Grinstead, managing director for West London Children’s health:
“It is important to us in northwest London in terms of meeting the health and wellbeing needs of our population, we thought it would be helpful to highlight to this meeting, very specifically through the lens of Cardiology and respiratory services which obviously is the main interface between ourselves and the Royal Brompton.
Some of the key areas of focus in collaboration across Imperial College health care, Chelsea and Westminster, and Imperial College, right now, above that line, our commitment to making sure that the needs of our population are met, our commitment to tackling health inequalities to ensuring that services are developed around patient need, and to breaking down, organizational boundaries to ensure good access to the full spectrum of health care and services including specialist provisioning and we’re doing that very specifically, and through making sure that we have a new purpose built cardiovascular and respiratory center for adults at Hammersmith hospital.
And we’ve already launched an integrated children’s health care network so the western Children’s Health Care Alliance, which focuses on making sure that children have equal access at the time they need it to the full range of healthcare services from primary care right through to the specialist services that we access through the rural producten, and also a we’ve launched this year, a new academic center for child health through Imperial College which will help us to make sure that we’re really developing clinical services, hand in hand with research and educational focus. And it’s important I think in highlighting these three examples to identify that actually we already collaborate and hugely with real volunteers and colleagues in this space, whether that be clinically or academically and I think these examples highlight the depth of the collaboration that already exists within Northwest London, I think we view the collaboration between ourselves and the world Brompton as a highly valued and hugely impactful collaboration and if I focus on children’s there’s just one example of that. I think we can say that what we have in place is a highly sophisticated and really mutually beneficial network of care provision which has genuinely evolved over time directly to meet the needs of children that we serve. Within Northwest London. Others have already commented and I wish also to emphasize on the fact that the pandemic has served, simply to amplify the importance of that collaboration, and I think both patients and our staff would lose out in the absence of that continued collaboration. I think it’s reassuring that for to hear and commitments from colleagues both the Guys and St Thomas’ under the Royal Brompton ongoing collaboration. And in this context I want them to emphasize again our ongoing commitment to the provision of excellent care in northwest London for Northwest London patients, and to collaboration with Brompton colleagues, both now and I think worth highlighting very specifically this nuance and in the future. If and when Fulham Road Services relocate in such a way that the health needs of Northwest London patients can continue to be appropriately met, both with excellence and ease of access,.”
But Professor Jonathan Weber, Dean of Imperial College had this to say:”. My concern is over the very short, medium term. And the longer term, about the nature of loss of co-location, and this loss of collaboration, and my concern is that we will lose the research stuff, which have been generating, similar to this output. I believe that there will be a real challenge in maintaining this alignment over time. I’m particularly concerned respiratory medicine , cardiovascular medicine and this research is well funded in the UK. Respitatory medicine , despite. and I urge nhse to form the transition board, which was promised along the side of this merger of organizations to look at future patient services in West London in cardiovascular and respiratory medicine, and their alignment with research and to education.”
“This move is not going to make it better. It’s going to stretch, and I suspect demoralise the researchers, particularly in response to events, because of the uncertainty over the future location or co-location, and the removal, over time, of them physically from the Imperial College environment. And this is the risk. This is the risk to respond to research. So you’ve got something that’s excellent. And that’s what’s going to be disrupted”
After presentations had gone on for over an hour, Cllr Robert Atkinson had pointed this out to Cllr Elnaghi and aaked when others would get to speak.
RBKC councillors unite and fight
Our councillors are united on this issue and many of then spoke excellently at the meeting so and this is just a brief extract of what some of them had to say and our readers can here the meeting in full at this link here:
At several points during the meeting Cllr Ian Henderson raised points of order over some of the panel, Dr Grocott-Mason Dr Abbs and Mr Craig in particular referring to the acquisition as a merger:
“It’s not a merger; it’s an acquisition”
After the fourth time Cllr Henderson had raised this, Dr Grocott-Mason replied that it was a “merger structured as a statutory acquisition”
Cllr Robert Freeman:”I just like to make three points. One is, it’s fine to say there’s a public consultation. And it’s fine to say that everybody is getting into it with an open mind. But once the Brompton has been taken over its effectively, a subsidiary of Guy’s and St Thomas’ and it’s very difficult to take that consultation with ab open mind. Just a point I’ve made. Secondly, the question of research was brushed over to really go quickly by Ian Abbs in the contribution of respiratory medicine, that the Brompton has made is absolutely enormous. And that is the. Once that has gone, it’s, gone It hass been probably the leading researcher researcher in this country. It’s really sad to say that.” Cllr Freeman also took issue with what some of the panel had said earlier appearing to be:”associating the takeover of congenital heart disease at the problem with the problems of the Bristol Royal Infirmary in the mid 90s, not too short. impression but that became neither professional or personal. Royal Infirmary was one of the most disgraceful pieces of paediatric medicine that this country has seen it was arrogant. It was careless people suffered the loss of their children lives with terminated early. If you contrast that with the Brompton with its paediatric senior team had some of the best outcomes in the country and continues to” . I believe the algorithms and the problem is as good if not , better. So, can we please make absolutely sure that that misunderstanding is put to rest. Thank you.”
Cllr Walaa Idris: “Can someone tell me how is staff morale now that they know this is going on”
Cllr Charles Williams :”In the first wave of the pandemic. The Brompton played a crucial role in supporting seriously ill patients, partly through EPMO. And I wondered what ita contribution is at the moment. If it wasn’t there where would the capacity be? ”
Dr Grocott-Mason : the Brompton is continuing to work very closely with the Northwest London ICS, in terms of provision of critical care and EPMO services. So, the, number of EPMO beds, has been expanded to an askl of 30 beds, and this is compared to our original ask of five. currently running in the second wave of about a dozen patients on EPMO in the intensive care unit. So, we are still providing, this as we’ve said that the services are not going anywhere. And we will continue to provide the collaboration with not just Guy’s and St Thomas’s Hospitals but other hospitals in northwest London”: “Around staff morale and engagement there’s been a, an awful lot of engagement with a whole load of events that have been going on for a long period of time where over the last two months we’ve been in the TUPE consultation and staff have questions, we’ve answered hundreds of questions from our staff quite appropriate questions about their employment about their job and everything. But what we have noticed is that actually there is a shift in mood to excitement around the opportunities that are provided by being part of a bigger organization that has more resilience has more support for some of the activities that are difficult to, to provide in a smaller trust. And one of the things that jointly we will be doing is to implement an electronic health record, and the investment in that will be something which again, has generated a lot of excitement from staff because that will be part of the, the enabler of transformation. ”
Dr Abbs responded : “I mean, the first thing is, is 10 years is quite a long time in healthcare. And if I reflect back 10 years on how care is organised and delivered now, compared to 10 years ago it’s cery important. I mean my own feeling is that there will be healthcare delivery of some time on the Sydney street side of the Royal Brompton hospital for many decades to come. And one of the big things that happened was is a big investment in imaging diagnostics. I mean one of the things I would expect to happen. Fortunately for patients of the future is much more concentration on early diagnostics so patients are seen earlier, particularly for complex conditions cardiac respiratory cancer particularly. And I could well see that being built up because actually much of the healthcare the future will probably be based on diagnostics and In terms of the inpatient beds, which is one only various actually small component of health care much. Just to give you an idea I think we have about 200,000 inpatients a year and at Guy’s and St Thomases we have 2 million contacts with patients a year. So actually most of the care related to an inpatient is actually coming to the hospital to test – some of that will change given the types of technology we have now. ”
Many residents in and around our borough have been patients at the Royal Brompton and Cllr Linda Wade mentioned that both herself and some members of her family have been patients there.
Cllr Malcolm Spalding was rightly keen to pick the document apart and tell it as it is : “If you want to pick this document, and the presentations that we’ve had this evening. He had a recent kind of thread, which can be unraveled, and lots of our residents are clever enough to get the theme the historical theme that’s going on here, and I’ll have to be blunt about it. And it really involves three things. It involves the state, the fiscal and the estate. It involves the acquisition or the takeover. And it involves the reason why, which, which has been given for all this to happen. And all of these have got big doubts in our residents minds, we’re bombarded with these questions, and somebody has to say it’s an important question, and I will be putting it to leadership”
These are only a few extracts but this post would go in forecer if we listed all the councillors excellent contributions in full. We’re not known for being the biggest fans of RBKC (and sometimes we’re rather ashamed of them!) but contributions from councillors of all parties on this issur have been excellent and have done us proud.
Some points from us
When some of the NHS bosses made the case from the move to South London and the acquisition of the Brompton at the meeting, they seemed to assume that as the majority of patients treated at the Brompton were from elsewhere, that this reinforced their case. But we believe that some of the panel have greatly underestimated or disregarded the local need for specialist heart and lung services locally in time to come:
First of all the health effects on the local population of huge redevelopment schemes, and densification to consider wbich will bring homes, offices, and shops of course, but also increased levels of trafffic; therefore increased levels of pollution, and the effect of a vast increase in the number of tall buildings further trapping in the pollution with them.
There is Earl’s Court and the site of the former Exhibition Centre which is set for redevelopment – this is in an area where already, some residents” health is suffering because of the levels of pollution, which are the highest in the UK and are already at three times the WHO limit.
Then to the north of our borough, the Old Oak redevelopment scheme is ongoing. bringing with it more infrastructure and a projected very large population increase and inevitably, will bring increased pollution to neighbouring areas like ours, in which the Westway runs through and which have a high level of pollution (which is, at the timebeing, at the top end of the WHO legal limit) and is likely to increase.
On a separate but still local issue, we also have to mention the effects of toxic fumes from the Grenfell Tower Fire and the possible long term health implications on local residents. Immediately after the fire, some previously healthy residents suffered from respiratory problems and some still do. The wider and long term effects suffered by residents from the toxic fumes of the fire are still largely unknown.
Also while we are encouraged that services and treatements are advanced to where a large number of patients can receive these at home, its inportant to remember that inner London boroughs like ours have a high proportion of lone residents and many who are without any support at home and also that the quality of some home environments of some of our poorest residents (ie those in HMOs, temporary accommodation or those living in accommodation – such as overcrowded housing or small may not be suited to monitoring receiving treatment and medication at home. We worry about the impact of the move on the quality of life on these residents and we think that while the move may prove helpful to residents living near Guy’s and St Thomas Hospitals;, this could become yet another case of the NHS Lottery ‘with those losing out being residents in and around our communities.
The board meeting is today and we are sad to say that this is pretty much a done deal unless the Government intervenes. We agree with Ian Henderson when he says there should be a public inquiry into the Royal Brompton and Harefield Trust and their dealings.
We also have to say that we were very disappinted with the decision of Chair Cllr Marwan Elnaghi to not allocate sufficient time for the public to ask questions at the Special RBKC Adult Social Care and Health Committee meeting . After all, that was the only real oppotunity for many residents to do so. We are thankful to many of the other Labour councillors, including Sina Lari, Pat Mason, Pat Healy and of course, Ian Henderson who all spoke very well at the meeting . We do hope that the RBKC opposition benches undergo a reshuffle this Christmas – (while we usually have a high opinion of Cllr Elnaghi, we are not convinced he is suited to chairing this particular council committee).
Later, Ian Henderson had this to say to us:
“To claim this is an acquisition by St Thomas’s means the Royal Brompton do not have to consult the public.
After the Grenfell Tower disaster, for any organisation to think they can ignore Kensington and Chelsea residents is akin to acting like the old TMO
To consider removing the number one respiratory hosptial in the world at this time is nothing sgort og a betrayal of the legacy of the NHS and the 100 year support of the hospital by our residents ”
Yesterday there was a socially distanced protest held outside the Royal Brompton Hospital with Cllr Henderson, along with Cllr Robert Atkinson and Cllr Nadia Nail, the GMB Union and members of H & F Save Our NHS in attendance:
A consultation and two petitions
Our readers can sign and share the two local petitions to save the Royal Brompton Hospital here. We recommend signing both:
Ian Henderson’s petition:
The RBKC petition:
And have your say in the RBKC planning consultation by the 30th of December here:
We end by calling on Matt Hancock and the Government to intervene in this decision and stop this asset sweating by NHS management of our legendary world-class hospital as we fear for the wellbeing of our residents if this goes ahead , especially at a time when our communities really need it more than ever.
We also say a special thanks to Ian Henderson for campaigning so strongly on this and to fellow Kensington blog From The Hornets Nest, who have reported extensively on the potential sell off and the goings on at the secretive Royal Brompton and Harefield NHS Trust for years . Check out their excellent blog here: