A petition to the government to save the Min. 

 

A petition on 38degrees collected over 2.400 signatures 

 

Response from Monitor, 24 January 2014

 

Re: Royal National Hospital for Rheumatic Diseases NHS Foundation Trust (“the Trust”)

 

Dear Professor Odam,

 

Thank you for your letter to David Bennett dated 1 January, which has been passed to me to respond on his behalf. I have also shared your letter with the team in Monitor that are working with the Trust. I apologise for the delay in responding.

 

As you are aware, the Trust is facing a large financial challenge for its size and we are working hard with the Trust and other key local stakeholders, including local commissioners and the NHS England local area team, to find a solution which will ensure the continuity of services for patients.

 

Your petition clearly reflects the strong level of feeling in the local area about the future of the Trust and the need to maintain high quality services for patients.

 

We note your views regarding the importance of the Trust’s brand, mission, and clinical research to the quality of services provided, and quality of services is a key part of the consideration of options for ensuring continuity of services for patients.

 

Although the work being undertaken to develop a sustainable solution remains on-going, we appreciate the need to agree the future of the Trust and services as quickly as possible to provide certainty to staff, patients and the local community.

 

Thank you for taking the time to contact us and share your concerns with us.

 

Yours sincerely

 

Tom Grimes

 

Enquiries & Complaints Manager

 

 

 

My letter to the TDA and Monitor:

 

I closed our 38Degrees campaign in December 2013 after 5,011 people had signed the petition. I then sent the following letter to both David Flory CBE, CEO of the TDA and Dr David Bennett CEO of Monitor. A separate letter (here) has been sent to the Chairman of Bath and North East Somerset District Council.

 

January 01 2014

 

In a letter I recently received from Paul Swiderski, Ministerial Correspondence and Public Enquiries, Department of Health on 07 November 2013 in reply to our petition, started in April 2013 and sent when 3,483 signatures had been collected concerning the future of the Royal National Hospital for Rheumatic Diseases (RNHRD), he stated:

 

"I note your concerns, and Departmental officials have contacted Monitor, the regulator of foundation trusts in England, and the NHS Trust Development Authority (TDA) with regard to this issue."

 

Since I sent the petition in October 2013, many people have continued to sign the petition and write their reasons and supportive comments. In closing the petition at 5,011 signatures, and in the light of Mr Swiderski’s letter, I am sending you the complete petition so that you may fully experience the number of concerns held by so many people. Indecision over several years about the fate of the RNHRD has led to major concern and considerable disquiet both locally and nationally as can be seen in the wide distribution of support. We are told that the intention is that patient services and the brand and mission of the RNHRD will all be protected, but no strategy has so far appeared that will properly deliver this outcome and maintain and protect it. The only plan so far is for the Royal United Hospital (RUH) to purchase and disenfranchise the RNHRD.

 

The current proposal that the RUH should buy the RNHRD appears to be the only plan and does not bear out Mr Swiderski’s assurances that "a number of options are being reviewed, and it is hoped that suitable methods will be identified in the coming months".

 

No other plans have ever been tabled to Governors or reported to Members and we were told by the Chair recently that there is no alternative strategy.  This was confirmed at the Annual Members Day of the RNHRD on December 12th 2013 when this question was asked and when we also heard the RUH representative make fine statements about respecting and preserving the brand and reputation of RNHRD, but confirmed that there are no plans for the future governing body of the RUH, if and when it becomes a Foundation Trust, to include any representation of RNHRD.

 

No one can yet explain how the brand, quality and reputation of RNHRD can actually be preserved, protected and managed by RUH in these conditions. This is why we believe that a new trust to embrace both institutions should be formed. From the outset it has been clear that the RNHRD is far too small to be a viable foundation trust. It makes complete sense that local hospitals should share many common administrative functions and this alone would save significant funding. The extra financial burden of the government and administration of a foundation trust has been a significant factor in the financial distress of the RNHRD and it was recently further compromised by changes in the new Health Act which took time to bed in.

 

Preserving the integrity of the imaginative and forward-thinking research-led clinical practices, so well integrated with a dedicated therapist team, that functions so well at RNHRD and that has delivered and continues to deliver the highest quality of patient services throughout this long unstable time as evidenced by CQC, must be the aim. The high reputation of the RNHRD has taken many years to build and can be destroyed in moments by dismembering delicate and symbiotic clinical and research practices and relocating and disenfranchising them. In the long term it makes far greater sense to refurbish, reconstruct and redevelop what is, rather than to risk losing the impetus and creativity of what now functions so well through new build, relocation and new directorial and management responsibility.

 

Over the last financial year the RNHRD has made considerable savings and this is a positive signal. The new Refresh initiative to reconstruct and refurbish outpatients, using charitable funds collected over the last two years shows confidence in the building and what it can provide. The joining of charitable funds, national heritage funds and a large local and national initiative to preserve, reconstruct and develop could and should be the way forward. Had the hospital been failing in any significant medical way, the story would be different, but it cannot be a wise and cost-effective strategy, in the longer term, to dismantle excellent services that patients trust and value, and risk losing such excellence and reputation through redistribution, relocation and fundamentally detrimental management changes.

 

George Odam

 

former patient-governor

 

 

 

My letter to the Chairman of B&NES:

 

January 01, 2014

 

Dear Councillor Neil Butters,

 

I am submitting to you a copy of my petition in support of the Royal National Hospital for Rheumatic Diseases, Bath (RNHRD). It carries 5011 signatures. At 3,483 signatures I sent it to Rt Hon. Jeremy Hunt MP and received a reply from the Department of Health that was inaccurate and did not address our concerns. (See attached) Since then many more people have signed the petition and left very supportive comments.

 

I have recently been told by the new Chairman of the RNHRD, Eugene Sullivan, that the fate of The Min (RNHRD) is a local issue and will and should be addressed locally. So, having closed the petition at 5,011 signatures, I am sending this to Bath and North East Somerset County Council with the request that this matter of increasing concern affecting the health and well-being of many local patients and employees is raised in full council.

 

The reply I recently received from Paul Swiderski, Ministerial Correspondence and Public Enquiries, Department of Health on 07 November 2013 stated:

 

"I note your concerns, and Departmental officials have contacted Monitor, the regulator of foundation trusts in England, and the NHS Trust Development Authority (TDA) with regard to this issue ...a number of options are being reviewed, and it is hoped that suitable methods will be identified in the coming months".

 

The current proposal that the Royal United Hospital (RUH) should acquire the RNHRD is the only plan and does not bear out Mr Swiderski’s assurances. Because of the inaccuracy and imprecision of the statement from the Department of Health, I am submitting the fuller petition to my local county council for your consideration.

 

Despite the pressures of the last troubled years since Monitor intervened at RNHRD, the hospital has continued to offer services repeatedly gaining the highest accolades from the Care and Quality Commission (CQC) following their inspections. The same cannot be said of the RUH over the same period.

 

The acquisition by the RUH of the RNHRD provides no guarantees that any of the current services will either continue or function as efficiently as they currently do. We believe that the aim must be to preserve the integrity of current imaginative and forward-thinking research-led clinical practices, so well integrated with a dedicated therapist team, that functions so well at RNHRD and delivers the highest quality of patient services throughout this long unstable time as evidenced by CQC.

 

At the recent Annual Members Day of the RNHRD on December 12th 2013 it was confirmed that there is only one tabled plan – that of acquisition by the RUH. Members heard the RUH management make fine statements about respecting and preserving the brand and reputation of RNHRD, but then they confirmed that there are no plans for the future governing body of the RUH, if and when it becomes a foundation trust, to include any representation of RNHRD.  No one can yet explain how the brand, quality and reputation of RNHRD can actually be preserved, protected and managed in these conditions.

 

This is why we believe that a new trust to embrace both institutions should be formed. It makes complete sense that local hospitals should share many common administrative functions and this alone would save significant funding. The extra financial burden of the government and administration of a foundation trust has been a significant factor in the financial distress of the RNHRD and it was recently further compromised by changes in the new Health Act which took time to bed in.

 

Over the last financial year the RNHRD has made considerable savings and this is a positive signal. Another is that starting in February 2014 the new Refresh initiative to reconstruct and refurbish outpatients, using charitable funds collected over the last two years, shows confidence in the building and what it can provide. The joining of charitable funds, national heritage funds and a large local and national initiative to preserve, reconstruct and develop could and should be the way forward rather than any relocation and new-build. Had the hospital been failing in any significant medical way, the story would be different, but it cannot be a wise and cost-effective strategy, in the longer term, to dismantle excellent services and risk losing such excellence and international reputation through redistribution and fundamentally detrimental management changes.

 

The threatened removal and atomisation of the RNHRD from its historic central site into some new-build, somewhere on the Combe Park RUH site as yet unspecified, could be catastrophic. The supporting physiotherapy team, if merged into a larger team, could lose its specialist knowledge and unusually sensitive respect for and liaison with senior medical staff that currently exists. The inevitably more impersonal and ‘treat it and beat it’ policy, necessary in a general hospital, is not appropriate to support long-term rehabilitation of those with complex chronic disorders. The fears of patients are exacerbated by the many years of uncertainty and unfulfilled assurances that all patient services will be preserved. Such assurances have been made by people who will have absolutely no say in the final outcome. The recent demise of the high quality Neuro-Rehabilitation Unit stands as a stark warning.

 

To summarise what may be lost:

 

A small specialist hospital with a long-standing national remit for rehabilitation of patients with complex chronic conditions;

A close-knit team of practitioners in interrelated and associated research-led disciplines;

A highly successful team of clinicians, therapists and researchers who work in a symbiotic manner;

An international reputation for diagnosis and treatment of complex chronic cases;

An international reputation for the training of rheumatologists and other clinicians;

Representation in the government of the RUH if and when it becomes a foundation trust;

The close alliance with Bath Institute for Rheumatic Diseases, the well-reputed independent medical research charity that also has a symbiotic relationship with the RNHRD;

A small patient-friendly hospital easy to access by those patients with loco-motor problems;

The city centre location that has aided and enhanced the rehabilitation of many patients over decades;

The trust of patients that the excellent quality of their care will be down-graded and that services will not be preserved functioning as well as they currently do.

Since the RNHRD is a national hospital, some signatories of our petition come from many different parts of the country, and all hope that the services upon which so many have relied and continue to do so will remain. But the local issue is paramount and it is becoming clear that final decision will be made as such, and that it will be determined by one factor only, that of short-term economics. The high reputation built at RNHRD has taken many years to build and can be destroyed in moments by dismembering delicately integrated clinical and research practices and relocating and disenfranchising them. In the long term it makes far greater sense to refurbish, reconstruct and redevelop what is, rather than to risk losing the impetus and creativity of what now functions so well through new-build, relocation and new and more remote directorial and management responsibility.  

 

Yours faithfully

 

George Odam

 

Emeritus Professor: Bath Spa University, Fellow of the Guildhall School