Lewisham's dedicated Sickle Cell Unit, a pilot project that has significantly improved patient care and achieved top performance in NHS England key performance indicators, is facing an uncertain future due to a funding crisis. The unit, which operates 24/7 and serves over 1,000 patients in Lewisham, has been instrumental in reducing A&E waiting times and hospital stays for individuals with sickle cell disorder. However, the pilot project, which has been running for two years, is due to end, and urgent investment is needed to prevent a return to previous levels of inadequate care.
Concerns have been raised about a potential return to the previous status quo of poor care
if the unit closes. This includes a history of multiple inquiries at a national level about the poor care that this particular set of patients experienced going through A&Es.
While specific key performance indicators of this inadequate care were not detailed, it was noted that the average life expectancy of these patients is far below the average in the UK, more so the worst care they receive.
The urgency for investment is stark, with the service having run out of money for this service and doors closed
as of October 17th. Michael Barns, Advanced Clinical Lead for Haematology at Lewisham and Greenwich NHS Trust, presented the NHS perspective, detailing the unit's success in achieving a less than 30-minute target for emergency care, with an average wait time of 8 to 12 minutes. He stressed that the unit's operational cost of £600,000 per year is generating significant savings, with a projected gross saving of £1.4 million.
These savings are considered conservative, as they were calculated based on 55% of operations, whereas the unit is now operating at 100%. The projected £1.4 million saving is based on a reduction in the length of hospital stays and a 75% reduction in our 30-day readmission.
It is anticipated that long-term savings will be even greater as the unit's full capacity is realised.
Isiorono Igho-Orienru, founder of the Sickle Cell Shine Initiative, highlighted the critical need for a Lewisham-specific needs assessment and the formal embedding of sickle cell within health inequality strategies. He also recommended establishing a community-NHS partnership forum and strengthening primary care awareness and training. Catherine Mbema, Director of Public Health, committed to taking forward the recommendation to include sickle cell within health and inequality strategies,
with further discussions planned to support residents with sickle cell disorder. While the commitment has been made, specific timelines and metrics for measuring success in embedding sickle cell within these strategies are yet to be defined.
Tullie Yeghen, Haemoglobinopathy Consultant Haematologist, added that while the pilot has been successful, new investment is crucial to address unmet needs and understaffing.
For more information on health inequalities in Lewisham, refer to the Health Inequalities Programme Future Areas of Focus document. Further details on the community and NHS perspectives can be found in the Sickle Cell Disorder Community and NHS perspectives in Lewisham report.
