EMERGENCY consultants quit the Alexandra Hospital because the proposed reconfiguration would leave Redditch without a safe A&E service.
The quartet – who announced they were quitting to join Warwick Hospital last month – also say their concerns about the downgrade were repeatedly ignored and bosses at Worcestershire Acute Hospitals NHS Trust told outside experts consultants universally supported the plan to downgrade the Alex when they knew this was not the case.
The details were revealed in the resignation letter penned by departing A&E consultants Richard Morrell, Sarah Crawford, Chris Hetherington and David Gemmell and published by the Trust on its website after an FOI was made by the Save the Alex campaign group.
Initially Trust bosses had refused to reveal the reasons behind the consultants’ departure.
In the letter the consultants said successive management decisions had undermined services at the Alex over the last three years leading to ‘the self-fulfilling prophecy of failing and unsustainable services.’
The Trust appeared to accept the massive overcrowding of A&E departments which was ‘a disgrace and a patient safety issue which causes serious harm to many patients and intolerable stress on all A&E staff’.
But the most damning part of the letter revealed initial claims by commissioners the proposed reconfiguration project would secure more than 90 per cent of A&E services at the Alex were widely inaccurate.
The group say the plan would create a minor injuries unit and GP service with very limited emergency care offered for adults.
There would be little or no surgical support for emergencies, trauma, paediatrics or pregnant women. Fitting children, frail elderly patients with suspected broken hips, sports enthusiasts with anything other than a minor fracture or sprain, most victims of road traffic collisions and those who injure themselves falling off ladders/horses/bicycles or any patient with abdominal pain would be directed elsewhere.
“This in our opinion is neither an A&E service nor a safe service,” the letter said.
“Junior and senior doctor training posts would need to be removed as the unit would not be providing the full breadth of A&E practice, which would reduce the available clinical cover for the service to what we consider an unacceptable level. Due to the national shortage of A&E doctors it would be difficult to recruit to such a unit and therefore in our opinion the long term future of the service would be placed in jeopardy.”
The letter adds when outside A&E specialist experts and Health Education West Midlands – responsible for training places – raised concerns about the proposals, they were ignored and considered ‘misguided’.
“The Medical Director has stated that if we do not support modified Option 1 the Alexandra Hospital would “wither on the vine””, the letter states.
The consultants say the final straw came during a review of the proposals by West Midlands Clinical Senate when on the final day they were told they were expected to support the model and take back their concerns about patient safety.
It was also discovered there were additional plans to reduce the model further so all surgical in-patient services at the
Alex would be removed as of next month without any public consultation. They say this was presented to the senate as having clinical support when it had been agreed without the knowledge of themselves and consultants in the urology and medical divisions.
When they raised written concerns the Trust management, it is claimed, seemed more concerned in finding out how the senate had obtained copies of the letters rather than addressing the concerns themselves.
It has also been revealed the Trust’s management were warned in October and December the A&E consultants were thinking of going but no notice was taken.
“Throughout this difficult period we have endeavoured to protect our clinical teams from the pressures of working in this environment. The situation has taken a heavy toll on our personal and family lives; the stress has been unbearable at times. We are battle-weary and exhausted by the continuous pressure that we have been under. We can no longer see a way forward to secure safe and sustainable A&E services at the Alexandra Hospital especially whilst the current senior management and senior clinical leadership remains in place,” the letter said.
“We of course do not want to see our unit destroyed and can only hope that common sense prevails. We regret we have not been able to secure reliable and sustainable services for our A&E staff and for our patients. We are aware that we may be handing the Trust the outcome they desire but feel that we have no other option.
“With wholesale change in the senior clinical and non-clinical management we hope that sensible discussions around emergency provision may take place and the people served by the Alexandra Hospital may yet achieve their aim to secure local, high quality health services.”