Concern remains over lack of commitment to designated end-of-life unit in Whipps Cross rebuild

Campaigners are concerned over what they say is a lack of support for a dedicated end-of-life care centre in Waltham Forest.

End-of-life care is currently provided at the Margaret Centre, which is due to be demolished as part of the £13.7million rebuild of Whipps Cross Hospital in Leytonstone.

It is the only dedicated service in the borough and has been open to patients in Waltham Forest, Redbridge and Essex since 1987.

Though specialist palliative and end-of-life care will continue at the Leytonstone medical centre, Barts Health NHS Trust – which manages the hospital and three others – has not said for certain whether the rebuild will include a designated unit.

It has instead talked about ‘enhancing’ dedicated end-of-life care in care homes, extending specialist palliative care provision from five days a week to seven, and improving coordination between services.

Clinicians have also recommended improving ‘hospice at home’ care in Waltham Forest, which is currently non-existent. It would allow patients with advanced illnesses to be cared for at home and to die there, if they so wished.

The two types of care differ substantially: palliative care focuses on symptom management in people who have a ‘life-limiting’ illness, where end-of-life care is provided to terminally ill patients who are near death.

Local campaign group Action 4 Whipps has attacked the trust for being “evasive” on the topic of the Margaret Centre, instead making a “wide range of loose, largely aspirational statements about improving end of life care in general”.

Barts Health previously said the Margaret Centre was “not fit for purpose,” earning the ire of campaigners and councillors.

A spokesperson for the trust later clarified the comment was made in the context of an “open, lengthy and wide-ranging discussion” of where improvements could be made in “fulfilling the aspiration that everyone should be able to receive palliative care in the place of their choice”.

In correspondence with the trust, Action 4 Whipps organiser Mary Burnett said its comments risked badly impacting staff morale and public confidence.

The 121-year-old Whipps Cross Hospital is one of 40 hospitals set to be demolished and rebuilt as part of the New Hospitals programme, launched by former prime minister Boris Johnson in 2020.

Construction was initially set to start to next year, with a view to opening the new centre by 2030, but delays have meant that is now “highly unlikely”.

In the meantime, the Margaret Centre will remain in use.

The spokesperson added: “Prior to completion of the new hospital, ‘gold star framework care’ will continue to be provided in the Margaret Centre as well as on an increasing number of general medical wards elsewhere in the hospital.

“This will enable Whipps Cross to address the fact that most patients pass away on a general medical ward and therefore the hospital needs to ensure that high-quality inpatient care is fit for purpose across multiple wards and not just in the Margaret Centre.”

A report by Barts Health, put before councilllors in March, revealed the eleven beds in the Margaret Centre were primarily being used for acute care – short-term treatment for a condition – rather than their intended purpose.

Use of hospice beds in the borough is “low” and Whipps Cross was subsequently “moving away from solely having a dedicated ward for specialist end-of-life care,” it said.

However, representatives from both Redbridge and Waltham Forest said they had heard “no case for doing away with the Margaret Centre”.

Councillor Richard Sweden, then chairman of the joint health overview and scrutiny committee, said at the end of the meeting: “What we have heard is a very compelling case for end-of-life care in the community being severely lacking. There is a greater need for these facilities.”

Alastair Finney, representing the trust, said there was “no threat” to end-of-life care being provided at Whipps Cross, but Barts Health was looking into how it would be “best provided”.

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Sebastian Mann

Local democracy reporter