St John's Hospital - Reality Not Rumours

Claims that St John's Hospital in Livingston is being downgraded and that promises have been broken are completely untrue.

Listed below are just some of the recent investments and upgradings that have been made to improve and increase services.

  • A new £1.1 million renal unit has greatly enhanced the quality of life for renal patients living in the area
  • A new centre caring for mothers with severe post-natal depression from across Lothian
  • A new phototherapy unit so patients can have treatment for psoriasis at St John's rather than having to travel to Edinburgh
  • ENT services have been transferred to St John's and cardiology has been enhanced
  • The awarding of university teaching hospital status
  • On top of this, as promised, work is underway on the new centre for short-stay surgical patients, helping cut waiting times even further.

Recent years have also seen:

  • The creation of an oncology day unit
  • A £2.6 million upgrade of the A&E department
  • The replacement of outdated imaging equipment at cost of c. £300,000

In the past few years there have also been important new posts created to enhance services for patients. These have included two more paediatricians, a third A&E consultant, a 7th plastic surgeon, a second respiratory consultant and two additional anaesthetic posts.

Shown below are the main questions currently circulating about St John's and NHS Lothian's response.

Rumour: That NHS Lothian broke promises to secure long-term future of St John's.

Reality: The hospital's future is secure and always has been. This has been clearly demonstrated by our actions and investment.

Rumour: NHS Lothian promised to rezone and enhance the catchment area but no real progress has been made.

Reality: The move of ENT to St John's has been a major example of the hospital providing services for a larger catchment area. NHS Lothian committed itself to re-examining patient zones. This is proceeding in line with our timetable and is likely to report within the next 6 months.

Rumour: Surgery and trauma orthopaedics lost to Edinburgh with no public consultation.

Reality: Yes, one or two trauma orthopaedics patients a day are briefly transferred to Edinburgh for treatment and then return to St John's for rehabilitation. This had to happen because the training of junior doctors to provide the service could not be sustained. The reason for this was that, despite every effort, not enough consultants could be recruited to train them. Emergency general surgery ended in 2004 for similar reasons. In both cases the clinical safety of patients was paramount. The issues were fully detailed during NHS Lothian's 'Improving Care, Investing in Change' public consultation.

Rumour: The NHS Lothian broke promises to maintain core services at St John's.

Reality: These services have been maintained and further strengthened with the addition of orthopaedic rehabilitation and by the transfer of Lothian ENT services to St John's. This has meant a total of 1,664 ENT inpatients have been treated at St John's between April and August this year compared to 559 in the same period last year. Indeed the overall number of inpatients and day cases being treated at St John's has been increasing year on year and stood at 44,241 in 2005-06 compared to 43,598 in 2004-05.

Rumour: NHS Lothian broke promises to retain cardiology and CCU.

Reality: We are retaining the joint Cardiac Care Unit/High Dependency Unit. As stated last year the future of the coronary care unit at St John's is secure. Furthermore, the redesign of Lothian's cardiology services means that services will be enhanced with extra cardiology input at St John's. And if there is a need to expand cardiology clinics for West Lothian these will be accommodated at the hospital.

Rumour: The mortuary has been downgraded to a body store and all post mortems now done in Edinburgh.

Reality: A team of three mortuary technicians were employed at St John's. But there has been one West Lothian post-mortem since July. So yes, the service has been centralised. With the number of post-mortems required being so very low it does not make sense to use taxpayers' money to pay for different services at different hospitals.

Rumour: Families pay to repatriate the remains of loved ones to West Lothian.

Reality: Families do NOT have to bear any cost for the return of remains. NHS Lothian has made arrangements with an undertaker for this.

Rumour: A new consultant cardiologist has been appointed at the RIE.

Reality: This post is funded by four health boards to provide highly specialised electrophysiology procedures for patients from all over south-east Scotland. We hope patients will welcome this joint investment within Lothian to provide this advanced service to anyone who needs it. Indeed, we have increased access to cardiology services at St John's.

Rumour: Hospital management has been disbanded and all local decisions are being made in Edinburgh.

Reality: Quite the opposite. Local management and decision making have been strengthened and devolved to St John's. A full site management team is in place at St John's headed by a director of operations. Other senior medical directorate staff are based at St John's and a Hospital Management Group exists with staff from all disciplines. West Lothian CHCP is also closely involved with decisions.

Rumour: Cardiology clerical support has been reduced.

Reality: Clerical support is being increased not reduced.

Rumour: CCU nurses are being forced to work shifts in other wards leaving a specialised area depleted.

Reality: We practice the sensible and flexible use of staff in order to address areas of shortage in the hospital when they occur. This is not depletion. We have a modern and effective "escalation" policy so extra staff can be directed where they are needed when they are required. This also means less money is spent on hiring private agency nurses, meaning more resources are available for patient services.

Rumour: There is widespread loss of morale with many staff seeing the loss of acute services as inevitable.

Reality: This is not in line with the feedback we receive in our close working relationship with staff representatives. It is misleading claims like these that harm staff morale.

Rumour: The entire pathology department is leaving.

Reality: Certain on-site pathology services will remain at St John's but others will move. This is the only way to create the teams of experts, each with their own areas of expertise, needed for top quality services. This is already being done in cancer care and histopathological diagnosis where teams work across the whole of NHS Lothian. The result is a better service for patients. Consultation with the public shows that people are well aware of the benefits of having centres of excellence for certain services.

Rumour: A new Private Finance Initiative (PFI) hospital at Larbert threatens viability of maternity and medical units at St John's and that PFI has been widely condemned as a method of financing hospital building.

Reality: We have been closely consulted on the Larbert proposals and they will not affect the viability of St John's. The funding of the hospital is a matter for NHS Forth Valley Forth Valley and not NHS Lothian.

Rumour: West Lothian heart attack patients will be forced to go to RIE bypassing St John's.

Reality: Thanks to medical progress our ambulance crews can perform ECGs in the ambulance and send these electronically to a coronary care expert who can decide whether the patient should have the latest clot-busting drugs. Most of these patients will go to St John's. For a small number this is not the best treatment and they require urgent angioplasty - which has only ever been available in Edinburgh. Getting them straight to the RIE cardiac lab means they no longer have to be delayed in St John's before being transferred. We believe patients will welcome the swifter and more streamlined approach.

Rumour: A Hospital at Night system is being introduced meaning basic minimal medical cover for non-acute areas.

Reality: For many years there were complaints that night-time hospital medical services depended on trainee doctors who had worked very long hours and were on call even longer. Hospital at Night - which has been brought in at the RIE, the Western General Hospital and St John's - uses fully trained and dedicated teams with a whole range of skills. It is a clear upgrading of care.

Rumour: £400,000 is to be spent on upgrading the admission trolley area in the RIE to allow direct admissions of West Lothian patients.

Reality: NHS Lothian invested heavily in improving A&E at St John's. It is now investing at the RIE to make management of existing intake of patients easier at the Combined Assessment Unit. Only patients who need to, go to RIE.

Rumour: There is a downgrading of cardiac provision at the Western General Hospital.

Reality: Part of the proposed service redesign may involve relocating the cardiac lab to RIE. This would mean a better and more efficient service for patients across the whole of Lothian. Bringing the three labs together in one place allows for greater efficiency, helping cut waiting times for patients needing urgent or routine treatment.

Rumour: St John's is being destroyed, promises are being broken and that the people of West Lothian "are blissfully unaware of the damage being done".

Reality: Far from running down St John's we have kept our promises and invested in new and better services. That can be very clearly evidenced. St Johns is treating more inpatients and day cases than in the past and it is a key part of NHS Lothian's plans now and in the future.

07/03/2007