Future of the Battledown Ward Discussed Today

Cheltenham MP Martin Horwood is this morning meeting with Dr Philip Milner, the independent reviewer of children’s inpatient services. Martin first signed the petition against the loss of inpatient services at Battledown ward before he was even a parliamentary candidate and he took up the issue on the first day after his election in May 2005. After an ‘options appraisal’ in May 2005 it seemed as though the battle had been won when the local NHS responded to a huge local campaign by agreeing to pilot a nurse-led ward that would have kept overnight inpatient beds in Cheltenham. But in March 2006 drastic cuts were announced in the NHS in Gloucestershire to help neighbouring Primary Care Trusts clear multi-million deficits. Battledown ward’s promised nurse-led unit was axed weeks before it was due to start and the ward closed to overnight inpatient admissions in May 2006.

In September last year, Martin asked to meet NHS Gloucestershire chief executive Jan Stubbings to discuss their new situation of financial surplus and the re-examination of the case for overnight children’s beds in Cheltenham.

‘Given that the only reason the plan was scrapped in 2006 was financial, it’s right that we should re-open the case now that the NHS is in surplus. Given the economic situation, this could be our only chance’ said Martin

‘Many of the people who weren’t here in 2005 – including Dr Milner I would guess – may not realise just how comprehensively we won the argument back then’ he said. ‘The options appraisal accepted the huge opposition to the loss of inpatient services amongst stakeholders and recommended a rescue package in the form of a nurse-led unit. Crucially, it identified a clinical need, saying that a nurse-led ward could have helped hundreds of sick children every year to stay closer to their families. These would have included minor respiratory cases, minor orthopaedic emergency cases such as fractures needing traction and minor surgery cases needing overnight observation. That’s just as true today. All the local NHS trusts had signed up to the idea. The plans were in place and ready to go. It was only the government’s financial mismanagement that scuppered the plan at the very last minute. I think Dr Milner needs to understand the strength of opposition there was to the original plan and the bitter sense of betrayal we all felt when the rescue plan for a nurse-led ward was so abruptly dropped without consultation. We argued, we marched and we signed petitions in our tens of thousands but the NHS and the government let us down. But I have never given up. This is a real opportunity for the local NHS at least to rebuild some of that trust with local people. ’


BATTLEDOWN WARD TIMELINE
July 2003
Cotswold & Vale PCT (one of NHS Gloucestershire’s three predecessor PCTs) launch countywide review of children’s and maternity services.

Local clinicians identify children’s and maternity services at Cheltenham as at risk. The Save Battledown Ward campaign launch petition to save ward in response.

June 2004
PCTs agree draft plan for consultation on changes, to be led by Children’s Health Planning Group (CHPG)

Save Battledown petition reaches 12,000 signatures, backed by the Gloucestershire Echo’s Save Our Children’s Ward campaign and all three political parties.

11 September 2004
6,000 protesters march through Cheltenham in support of Battledown ward to mark opening of consultation. Richard James of Cotswold & Vale PCT and chair of CHPG proposes location of children’s services and neonatal intensive care in either Cheltenham General or Gloucestershire Royal. But a clear proposal to move inpatients to Gloucester to inpatients is buried on p16 of his consultation document. The document makes no recommendation for change in broader maternity services but accepts its proposals ‘will limit the choice of location for a future change’.

December 2004
Save Battledown petition reaches 22,000 signatures.
Six Foundation Trust governors including three clinicians oppose changes but call for the examination of nurse-led children’s ward.

Loss of inpatient services is opposed by all three political parties.

January 2005
Consultation outcome report acknowledges the 22,000 petition signatures and reveals 98% of correspondence opposed the proposals. The top four most frequently made points all relate to Battledown ward.

Save Battledown petition reaches 24,000 signatures.

A joint sub-committee of the Gloucestershire PCTs agree to commission an options appraisal of a nurse-led ward and ‘hospital at home’ alongside inpatient closure. Reassurances are given about the future of Cheltenham’s maternity ward.

6 May 2005
General Election result announced in Cheltenham. All seven parliamentary candidates oppose loss of inpatient services, including paediatrician Dr Bob Hodges standing as a Save Battledown candidate, and poll 43,621 votes between them. Lib Dem Martin Horwood is elected with 18,122 votes and writes to the NHS the same day fulfilling his election pledge that Battledown ward inpatient services will be his first priority. It is also the key issue in his maiden speech to Parliament.

Save Battledown petition reaches final total of 27,000 signatures.

17 May 2005
Options appraisal final report by Shona Arora and Ada Bennett recommends piloting a nurse-led ward, retaining inpatient beds on Battledown ward. Key findings included:
Following group discussions, 71% of stakeholders support a nurse-led unit, only 10% the move of overnight services to Gloucestershire Royal.
There was a clinical case for overnight care in Cheltenham. It was estimated that between 3 and 10 children a night – a minimum of 950 bed days per year or more than 300 children - could be appropriately cared for in a nurse-led ward, including mild respiratory cases, orthopaedic minor emergency cases such as fractures needing traction and surgical day cases needing overnight observation such as ophthalmology, maxillo-facial and urology.

A joint PCTs sub-committee accepts the recommendation for a nurse-led ward pilot on 23 May, ‘to assist in meeting the needs of children currently admitted to hospital and to help avoid the need to transfer them to Gloucestershire Royal Hospital’.

June 2005
The proposal to pilot a nurse-led ward is explicitly accepted by all three Primary Care Trust boards in turn.

Planning begins for the implementation of the nurse-led ward.

February 2006
Opening of nurse-led ward scheduled for March 2006.

Government announce need for NHS to clear its deficit within one year. Cheltenham & Tewkesbury PCT is in surplus but Cotswold & Vale and West Gloucestershire have a combined deficit of £10m for 2005-06. Total savings required in Gloucestershire are £30m.

Cheltenham & Tewkesbury PCT and Gloucestershire Hospitals NHS Foundation Trust agree to stand by their commitment to fund nurse-led ward. Cotswold & Vale and West Gloucestershire PCTs begin to cast doubt on decision.

28 March 2006
Joint meetings of three PCTs cancel plans for nurse-led ward. Closure of overnight services is to begin on 19 April without further consultation.

April 2006
All elected governors of Foundation Trust condemn ‘absolute farce’ of national consultation requirement, saying ‘Governors, Members and local people have worked tirelessly in order to maintain overnight Children’s Services at Cheltenham General Hospital.’
Closedown of inpatient services at Battledown ward begins. Despite urging from Martin Horwood MP, Overview & Scrutiny Committee declines to ‘call in’ proposal.

June 2006
Formal consultation begins on proposed cuts across NHS in Gloucestershire. Battledown ward is not included. The closure of Cheltenham’s maternity ward is proposed despite all previous assurances.

22 July 2006
10,000 people march through Cheltenham in protest at the NHS cuts. Many placards and banners support Battledown ward.

30 September 2008
Martin Horwood MP meets with PCT Chief Executive Jan Stubbings to discuss re-examination of case for overnight inpatient beds at Battledown ward, given new PCT’s financial surplus.