Lewisham A&E survives – why?

Matthew Kershaw had put together recommendations for delivering safe, high quality, affordable and financially and clinically sustainable health services for people previously served by the South London Healthcare NHS Trust and across south-east London. The recommendations were not a pick-and-mix list; they were developed to be taken as a whole to stop the haemorrhaging of NHS Protestorsmoney out of the NHS and ensure the people of South East London have the best clinical care possible for years to come. Matthew could no more consider SLH NHS Trust in isolation than a doctor can consider one symptom without looking at the body as a whole.

Everyone across South East London deserves the best possible services and Jeremy has made the right decision on all but one of Matthew’s recommendations. On Lewisham Hospital A&E however, he is sadly delaying the inevitable and costing the taxpayer more. In an economy in which national debt continues to rise, to choose a solution that increases financial risk and debt is regrettable. It’s all very well intending the A&E to be smaller and focus on older people, but the reality is that people use their local A&E as an alternative to their GP and attendance across the country rises year on year. Added to this in North London commissioners are trying to close the smaller A&Es. If it remains open, people will use it as before. Unfortunately sentimentality and politics have left us with a solution that is unsustainable in the long-term and will have to be revisited yet again in the future.

That said, the other thing that will change is that local GPs are now involved in commissioning services and holding the budget. It is expensive for their patients to attend A&E so there is a strong incentive for them to ensure Lewisham A&E is used appropriately. Over time they themselves could see the benefit of reducing services at Lewisham, which they may be able to do without a major outcry. After all, it will only be by working with patients as partners that ill health can be prevented in the first place and  quality of care will improve.


About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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