Medical directors at the hospitals involved in the Better Services Better Value (BSBV) review have been asked to sign pre-written letters drafted by the BSBV team saying they support the changes outlined in its controversial proposals, it has emerged.

Health campaigner Jane Race tipped this newspaper off about the "pre-written letter in support of the BSBV review" of acute hospital services which she said has been sent out to the medical and nursing directors at hospitals involved, by BSBV.

The affected hospitals are Epsom and St Helier, Croydon, St George’s and Kingston.

It is understood that the letters outline support for the changes proposed in the review and for the level of involvement of the directors in the process.

It is believed that some individuals, who have serious concerns about the process, feel they have been put in an "uncomfortable" position being asked to sign, fearing their future careers may be jeopardised if they do not.

A BSBV spokesman confirmed today that the letters have been sent out.

He said: "The standard Department of Health assurance process requires written evidence of clinical support as part of the ‘four tests’ for NHS service change.

"We have been asked to provide letters to demonstrate that there has been clinical engagement and support for the case for change and the proposed models of care.

"These letters were discussed at our clinical strategy group and programme board and it was agreed that the BSBV programme team would draft outline letters for trusts to consider.

"We are awaiting their responses and will publish these letters in due course."

The letter sent by the BSBV team to the medical and nursing directors at Epsom, St Helier, Kingston, Croydon and St George's hospitals:

23rd May 2013
 
We, the Medical and Nursing Directors of the five hospitals involved in the Better Services Better Valueprogramme and members of the Clinical Strategy Group (CSG), can verify that there has been wide-ranging active involvement of clinicians and clinician support for the programme’s aims and processes.

We have collectively and individually nominated medical and nursing colleagues as members of the CWGs, and have provided leadership and challenge throughout course of the programme.  Two of the CWGs have been co-chaired by Medical Directors, and we have been involved in nominating co-chairs of the other CWGs, either from the outset of BSBV or as vacancies have arisen.

Specifically, our role as members of the CSG has been to:

•         Provide ongoing advice and support on BSBV’s strategic direction through our expertise as clinicians and clinical managers

•         Agreed the clinical quality standards for BSBV which underpin the development of the BSBV models of care – these are informed by the London Quality Standards and guidance of various Royal Colleges and equivalent organisations

•         Provide clinical leadership in the design of models of care through the work undertaken by the CWGs, all of which report to the CSG for approval

We understand and are supportive of the case for change.  We believe that the proposed clinical standards will deliver better quality care and outcomes, and we understand that implementing the standards may require reconfiguration of services as they are currently provided.  We understand the process that has been undertaken to develop the reconfiguration options and we participated in the non-financial evaluation of these.  There now remain three options which are considered to be viable and we give our support to go out to public consultation on these.

Rosalind Given-Wilson and Alison Robertson
St George’s Healthcare NHS Trust

Jane Wilson and Duncan Burton
Kingston Hospital NHS Foundation Trust

Tony Newman Sanders and Zoe Packman
Croydon Health Services NHS Trust

Martin Stockwell
Epsom and St Helier University Hospitals NHS Trust

Ruth Charlton
Epsom and St Helier University Hospitals NHS Trust

Pippa Hart
Epsom and St Helier University Hospitals NHS Trust