Whittington must change to go forward

THE Whittington will survive, but it must adapt to meet the challenges of the new political world of health. That’s the message from the doctor in charge of securing the hospital’s future.

At the beginning of this month, Dr Yi Mien Koh became the first chief executive of the newly-founded Whittington Health, which incorporates Haringey and Islington community services into the hospital, with the aim of making ‘‘clearer and smoother pathways for patients’’.

The move is, however, a double-edged sword. It helps secure the future of a hospital that just last year seemed destined for closure but it also means many changes are afoot.

Last week the Royal Free Hospital announced plans to cut 450 posts – more than 100 of them nurses – to help slash �40million from its budget and Dr Koh conceeds the Whittington’s staff will not be untouched.

“When we merged with Islington and Haringey community services, from day one there have been some areas where we have duplication by nature of bringing the services together,” she said.

“A management restructure is taking place right now and it’s only after I have done that, and we have tried to place the right people in the right place, that we can take a decision as to where the hospital is going.

“At the moment my focus is on developing the new team and structure and I would think if we are as efficient as we can be, we should be able to survive as an organisation.”

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As well as squeezed NHS budgets, the hospital will be affected by the government’s health and social care reforms should they survive unchanged from the current pause in the process.

Again, this will be two-sided for the hospital, with Dr Koh excited about working with commissioning GPs, but wary of the challenges the idea of “any willing provider” could present.

Asked about her views on the controversial bill, she said: “I think it’s right for clinicians to be in the driving seat because they know their patients and they should be able to provide the best care for their patients. We are hoping to work very closely with our GPs to design the care pathways that best fit with the population.

“I think the choice is a good thing, because patients want it and it also promotes people to become better.

“But this idea of ‘any willing provider’, for us that is a risk because it means that with the requirement to make significant savings, unprecedented savings, and with more players in the internal healthcare market, that could be a risk to the hospital and the range of services it provides.”

She added that the hospital could also see the services it provides deplete due to additional focuses on ‘standards’.

“Part of the changes will also be driven by standards and we have to decide if we are meeting those standards and if not, what changes can we make to meet them. There may be decisions we take to say it’s unaffordable to meet those standards,” she admitted.

One of the things that could secure the hospital’s future, she says is to become a foundation trust.

“There will be even more community ownership by having community governors, the hospital will be more independent and it means we have accountability not to the Department of Heath, but instead back to the local community,” said Dr Koh.

“In the new world, government policy dictates all NHS trusts have to be a foundation trust by 2013, so if we didn’t we would have to merge with some other organisation, so I would prefer for us to be in charge of our own destiny.”

Last year more than 5,000 people took to the streets to protect the Whittington Hospital. Will we see similar scenes in the future with the site under threat? Dr Koh hopes not.

“The Whittington has a history dating back to the 19th century and I can’t see why it would not go forward into the next, but it requires us to do things differently,” she said. “We can’t just continue the same way.”