"The End for the Douglas Bader Unit!"

The Douglas Bader Unit or DBU as it is more commonly known, the only dedicated amputee ward in the UK, was lost when the new Queen Mary’s Hospital in Roehampton was opened in early 2006. This is because DBU was merged with Connaught Ward, a stroke rehabilitation unit and St. John’s Ward, an elderly patient ward.

As an ex-DBU and Connaught patient myself, I feel that I am one of the few patients with the experience and insight to comment constructively on this issue.

As I couldn’t understand why or how this decision had been made I decided to try and establish the facts hopefully preserving something very unique in the process as I was in no doubt that DBU was the best at what it did; that is amputee rehabilitation!

I knew that when important decisions of this nature have to made, the Department of Health is very keen for public and patient involvement “PPI” to form an integral part of any decision making process. Using amputees as the example, ‘The Standards and Guidelines in Amputee and Prosthetic Rehabilitation’ states very clearly that it is ‘Good Practice’ that “Patients and Carers should be involved in the planning and review of Rehabilitation services in their area” and “Each PARC should have and proactively support a User Consultative Committee, made up of a representative sample of Users/Patients/Carers of the Centre in collaboration with appropriate staff”. I am not aware and cannot find any Consultative Committee that allows amputees to put forwards their views on any issue.

So I contacted various representatives of Wandsworth PCT including Stuart Reeves, Melba Wilson, Helen Walley and Colin Smith to establish the level of PPI and credible research that had been adopted by the PCT when making this decision.

The amount of PPI completed by the PCT appears to be:

1. Around 2000-2003 ‘some’ PPI was completed through the Wandsworth Health Council but as this now does no longer exist, no one appears to know what was done or said and cannot produce evidence or copies!

2. Two presentation and comment sessions were completed to the Roehampton Limb User Group in 2003 and as a result a number of areas were identified where the group could help input into the design process” these were:

a. The angle and design of the ramp to the Upper Ground floor level.

b. The design, number and location of disabled toilets.

c. The specification of furniture and the location.

d. The number of disabled parking bays.

It is worth noting that any view or opinion on the DBU merger with any other ward(s) were not included.

So as result of this lack of PPI, I decided to do my own. Having now spoken to a significant number of amputees and stroke patients I can say that on the whole, nobody appeared to be aware of any merger and there was a consensus from both set of patients that any merger would not benefit their particular patient group. Nobody I have spoken to has been involved in or was aware of how they could be involved in any PPI issue, specifically the merger of these facilities.

As a consequence I wanted to support the growing concerns about this merger with some credible clinical research. So I established the research I wanted to use and presented this to the directors named above along with the PPI committee. This research has not been disputed.

On review of the ‘new hospital information’ produced and published by Wandsworth PCT on 12th May 2004 it was clear that the clinicians had been working with the architects to ensure that the hospital would suit the needs of themselves, which itself raises a number of questions. It pointed out that it had held a “couple of sessions” where “invited patients” were given the opportunity to comment on the designs. We have to question what lengths the PCT had gone to ensure a representative representation of each patient group affected. They also implied that the DBU was moving over to the new hospital, with no changes, which clearly was not the case.

Further investigation highlighted that the PCT’s own research recommendes separation and segregation of particular patient groups, which was further supported by opposition to the merger by some senior clinical professionals within the hospital.

In summary it appears as if Wandsworth PCT did not adopt enough ‘Good Practice Principals’ in terms of its PPI and the adoption of any credible research for any of the patient groups concerned coupled with the lack of adoption of their own research and some senior clinical professionals opposition.