Are better savings always better value? A nurse takes a perspective of this question regarding the NHS of South West London pioneering the Better Savings Better Value (BSBV) 'review [process which] has been set up to look at ways to drive up the quality of patient care and health services in south west London and to make sure the local NHS spends its money as effectively as possible' - due to government funding cuts.
However, the ongoing review has been a cause for concern with many communities surrounding Croydon, Epsom, Kingston, and in recent news, Carshalton (St. Helier) with many 'save St. Helier' demonstrations taking place since as early as 2007 when the decision was less eminent. On the 19th of February 2013, The chief executive of the Epsom and St Helier University Hospitals NHS trust, Matthew Hopkins assures: "...whilst this is of course an unsettling time for our doctors, nurses, midwives and other staff, they continue to provide the very best possible care" in addition to local government implementing plans to save the NHS Trust which annually delivers broadly ranging treatment to 700, 000 patients including emergency services.
As an (anonymous) health professional who has worked in one of the suggested hospitals for two sets of A&E and Maternity (emergency services) closure, a number of difficulties regarding the decision are highlighted in the following interview:
What is your role in the NHS?
"I am nurse and ward manager. My role is supervisory, to implement policies and also meet hospital objectives."
Describe your initial response to hearing that the hospital you work for was one of those in the question for the BSBV review?
"Insecure...undervalued. I felt unsupported by the government who we work with after the cuts. Many people are also going to lose their jobs. There is no reason why our community should move out from our own area when they are ill. Every branch of the community has the right of equal access rights to healthcare services, not suffering due to postcode lottery."
Would you feel positively or negatively about the decision if it were the case that the hospital you work for is selected for emergency department closure?
"It would feel it's the wrong decision to make. If our A&E department and maternity is closed, St. Georges - the next closest hospital - will overflow [as they gestured up and outwards with both hands]. There is no point closing district hospitals like St. Georges, Croydon and St. Helier because these are the ones which filter patients (always after first contact in an emergency) to the smaller tertiary hospitals in the area such as the Sutton hospital, The Royal Marsden. We are always the first point of care for so many patients and deal with the most varied and complex presentations. It would be unfair to put such pressure on tertiary hospitals after closing two whole, different emergency departments."
How would you summarise your views on the BSBV review 2013?
"Sometimes at work, when there are few staff members working, the risk is increased of lower patient care. Just look at hospitals. I work in a multidisciplinary team so taking a central A&E department means because of overflowing patients, departments like at St. Georges will have more breeches [In NHS hospitals' A&E a breech is when patients are admitted to the department for over 4 hours, which the government sets as a limit] and failing to meet their targets. I hope for the best so that patients' quality of care is not compromised."
