President Tony Falconer FRCOG 018RCOG President Dr Tony Falconer writes…

We are anticipating a busy few months ahead of us.

A week ago, the Special Trust Administrator for South London Healthcare NHS Trust published their report. The recommendations made for uncomfortable reading. The RCOG submitted evidence to the consultation but rather than recommend specific actions on whether to close or maintain a unit, we provided advice on the minimum clinical standards needed to ensure high quality maternity services.

Clearly, to have several hospitals within a Trust haemorrhaging over a million pounds a week is untenable, especially during these stricken times. It makes good sense to organise our services in such a manner as to offer the best available care as close as possible to the needs of the community.

The closure of local A&E and maternity units will always be vociferously opposed and there is a certain injustice in the proposal to shut a well-run unit, especially for the healthcare professionals who have served their local communities tirelessly over years. However, the challenges to concentrating medical resources and support services will inevitably mean that new configurations must emerge with some units increasing in size and others changing their service provision.

Then, there is the final report of the Francis Inquiry due next month. The news stories in the media recently have given us a hint of what is to come and the ramifications have excised us all, from medical leaders to front-end professionals.

It is clear that this report will make distressing reading but we cannot afford to bury our heads in the sand. It is a wake-up call for all of us to improve our NHS. We must accept that mistakes have been made in the past, learn those lessons and move forward.

Acting in the best interests of our patients must come first. It is clear that the culture of bureaucracy and performance targets in the NHS was damaging. Though useful as indicators in some areas, other targets, when pursued for their own sake, become a barrier. Political meddling has been responsible for the slavish adherence in some cases which led to micro-management at the expense of clinical need and this must never be allowed to happen again.

As the old adage goes: “When one door closes, another opens”. We are now presented with new challenges under the aegis of reform. The present shift in the way we work, towards disease prevention by adopting the life-course approach, will not only improve the nation’s health and wellbeing, it should also help us to work smarter. The aspirations toward better sharing of information and co-ordination between healthcare and social services must be made a reality. The development of strategic clinical networks in women’s services and the appointment of a national clinical director bodes well for women’s health.

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