COMMERCIAL: The health secretary has approved the closure of services at King George Hospital in Ilford.

The Independent Reconfiguration Panel this afternoon issued its report on the north east London health economy and services at Barking, Havering and Redbridge University Hospitals Trust in particular.

It recommended the plan put forward by commissioners to close emergency and maternity services at King George Hospital and bolster those at Queen’s in Romford.

The IRP’s report said: “Attempting to provide safe, high quality A&E and maternity services at all six hospitals in north east London is not sustainable and the development of a major acute hospital at Queen’s Hospital will bring real benefits to patients.”

Andrew Lansley received the report on 22 July. He said this afternoon that he “accepted” its conclusions but that “no changes will take place until the Care Quality Commission has assured the Secretary of State that the services provided by Queen’s Hospital and other local health services are of a high standard.”

The care regulator this morning issued a report listing a variety of problems at Queen’s regarding maternity, radiology and emergency care.

Care problems at King George Hospital were noted but most of the problems had been at Queen’s.

Chief executive of the CQC Cynthia Bower said the organisation was recommending BHR received external support, reduced its activity and made its maternity services safe “immediately”.

In a statement, Mr Lansley said:”I support the CQC’s findings, and the decisions taken by the local NHS to support safe care at the trust. When we can be sure that those decisions have resulted in sustainable improvements in the quality of services for local people, the next set of decisions – to provide the right care in the right place – will be implemented. This must include a vision for the future of services at King George Hospital.

“Both Queen’s Hospital and King George will have a great future ahead of it when the right measures have been put in place to make sure that patients are going to the right place for their care. As I have made clear, where hospital trusts show that they are facing up to their issues, and taking recovery decisions, we will support them. The CQC identified the positive response to new leadership at the trust. NHS London, and I, will support them in delivering the improvements in quality and sustainability of services required.”

Last month, Mr Lansley approved the closure of services at Chase Farm, allowing a reconfiguration that was largely welcomed by NHS managers.

The King’s Fund, NHS Confederation and Foundation Trust Network have all publicly called for the government to support reconfiguration, even where that involves closing services.

Earlier this month, Barking, Havering and Redbridge declared to the SHA and the DH that it was not “clinically or financially viable” in its current organisational form.

Heather Mullin, chief executive of NHS outer north east London, said: “An independent panel looked at our proposals in great detail and met with clinicians, GPs, managers, patients and campaigners before submitting their report to the Secretary of State. The panel agreed that our proposals will enable the provision of safe, sustainable and accessible services and offer real benefits in terms of clinical and service quality. Andrew Lansley supports the panel’s advice in full.”

The IRP said the future of King George Hospital “had not been discussed adequately with patients and local people”.

The CQC began its full investigation of care at the trust in July after issuing warning notices in June and July on standards of care and emergency treatment.

In its report, the regulator said: “Despite some signs of improvement in recent months, patients remain at risk of poor care in this trust, particularly in maternity services. We have identified ongoing concerns in emergency care and in radiology. Widespread improvement is needed in patients’ experiences, patient flows, the management of complaints, staff recruitment and governance.

“Long standing concerns in maternity services have progressively worsened.”

Inspectors found a “lack of learning from maternal deaths”, Ms Bower said, and that “patient flows still aren’t good enough”.

While noting “past and present poor leadership”, Ms Bower also said new chief executive Averil Dongworth and her team were “getting hold of it”.

Ms Dongworth started at BHR in February this year, replacing John Goulston who moved to NHS London to look after the progress of other non-foundation trusts as head of provider development.

A recurring point in the CQC report is the problems caused by the five-year-old PFI hospital’s design.

The document said: “We have a number of present concerns about the safety and suitability of premises at Queen’s Hospital, supported by accounts given by staff and patients during our investigation. It can be dificult to navigate and signage is poor, some wards and clinical departments do not have natural light, and there are line of sight problems in the emergency department and general wards.

“There is a lack of waiting space in the urgent care centre and poor facilities in the theatre recovery unit for patients who are cared for in that facility for up to 23 hours.

“The design of the emergency department at Queen’s Hospital also contributed to problems with equipment which staff raised during our investigation.”

Acknowledging the problems with the circular design of Queen’s, Ms Dongworth said: “In many ways it is a modern PFI hospital. What I would want to see go back to the centre of the NHS is that there are many hospitals now built on this circular model. Our public [raised the design as a problem] of it at the AGM.”

The Secretary of State for health has approved the closure of services at King George Hospital In Ilford.

The Independent Reconfiguration Panel this afternoon issued its report on the north east London health economy and services at Barking, Havering and Redbridge University Hospitals Trust in particular.

It recommended the plan put forward by commissioners to close emergency and maternity services at King George Hospital and bolster those at Queen’s in Romford go ahead.

The IRP’s report said: “Attempting to provide safe, high quality A&E and maternity services at all six hospitals in north east London is not sustainable and the development of a major acute hospital at Queen’s Hospital will bring real benefits to patients.”

Andrew Lansley received the report on July 22 and said this afternoon that he “accepted” its conclusions but that “no changes will take place until the Care Quality Commission has assured the Secretary of State that the services provided by Queen’s Hospital and other local health services are of a high standard.”

The care regulator this morning issued a report listing a variety of problems at Queen’s around maternity, radiology and emergency care.

Care problems at King George Hospital were noted but most of the problems had been at Queen’s.

Chief executive of the CQC Dame Cynthia Bower said the organisation was recommending BHR recieve external support, that it reduces its activity and that it makes its maternity services safe “immediately”.

In a statement the health secretary said:”I support the Care Quality Commission’s findings, and the decisions taken by the local NHS to support safe care at the trust. When we can be sure that those decisions have resulted in sustainable improvements in the quality of services for local people, the next set of decisions – to provide the right care in the right place – will be implemented. This must include a vision for the future of services at King George Hospital.

“Both Queen’s Hospital and King George will have a great future ahead of it when the right measures have been put in place to make sure that patients are going to the right place for their care. As I have made clear, where hospital trusts show that they are facing up to their issues, and taking recovery decisions, we will support them. The CQC identify the positive response to new leadership at the trust. NHS London, and I, will support them in delivering the improvements in quality and sustainability of services required.”

Last month Mr Lansley approved the closure of services at Chase Farm, allowing a reconfiguration that was largely welcomed by NHS managers.

The King’s Fund, NHS Confederation and Foundation Trust Network have all publicly called for the government to support reconfiguration, even where that involves closing services.

Earlier this month the trust declared to the SHA and the DH that it was not “clinically or financially viable” in its current organisational form.

Heather Mullin, chief executive of NHS outer north east London, said: “An independent panel looked at our proposals in great detail and met with clinicians, GPs, managers, patients and campaigners before submitting their report to the Secretary of State.The panel agreed that our proposals will enable the provision of safe, sustainable and accessible services and offer real benefits in terms of clinical and service quality. Andrew Lansley supports the panel’s advice in full.”

The IRP said the future of King George Hospital: “Had not been discussed adequately with patients and local people”.

The CQC began its full investigation of care at the trust in July after issuing warning notices in June and July on standards of care and emergency treatment.

In its report the regulator said: “Despite some signs of improvement in recent months, patients remain at risk of poor care in this trust, particularly in maternity services. We have identified ongoing concerns in emergency care and in radioogy. Widespread improvement is needed in patients’ experiences, patient flows, the management of complaints, staff recruitment and governance.

“Long standing concerns in maternity services have progressively worsened.”

The regulator’s report found a “lack of learning from maternal deaths”, Dame Cynthia said, and that “patient flows still aren’t good enough.”

While noting “past and present poor leadership” Dame Cynthia did say that new chief executive Averil Dongworth and her team were “getting hold of it”.

Ms Dongworth started at BHR in February this year, replacing John Goulston who moved to NHS London to look after the progress of other non-foundation trusts as head of provider development.

A recurring point in the CQC report is the problems caused by the five-year-old PFI hospital’s design.

The document said: “We have a number of present concerns about the safety and suitability of premises at Queen’s Hospital, supported by accounts given by staff and patients during our investigation. It can be dificult to navigate and signage is poor, some wards and clinical departments do not have natural light, and there are line of sight problems in the emergency department and general wards.

“There is a lack of waiting space in the urgent care centre and poor facilities in the theatre recovery unit for patients who are cared for in that facility for up to 23 hours.

“The design of the emergency department at Queen’s Hospital also contributed to problems with equipment which staff raised during our investigation.”

Acknowledging the problems with the circular design of Queen’s, Ms Dongworth said many recent PFI hospitals had been built using a circular design, and patients had raised some of the issues it caused at the last AGM.