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Clinical Commissioning Groups agree the future of acute hospital services in Worcestershire

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FOAHSW

Proposals to improve local health services in Worcestershire have been approved at a Board meeting held today (Wednesday 12th July).

The three Governing Bodies of NHS Redditch and Bromsgrove, NHS South Worcestershire and NHS Wyre Forest – who are responsible for buying healthcare services for Worcestershire residents – made the decision to support a clinical model which will bring stability and certainty to the local acute health service.

   The model, which has taken over five years’ to develop, will see the:
  • Centralisation of emergency surgery to Worcestershire Royal Hospital with skilled staff which will improve outcomes and patient experience
  • Creation of centres of excellence for planned surgery at the Alexandra Hospital
  • Retention of emergency and urgent care services at the Alexandra Hospital
  • Centralisation of inpatient care for children at Worcestershire Royal Hospital with the majority of children’s care remaining local
  • Centralisation of births at Worcestershire Royal Hospital with ante-natal and post-natal care remaining local.

The decision follows an extensive consultation process.

In a joint statement, Dr Richard Davies, Dr Anthony Kelly and Dr Clare Marley, said: “We recognise that not everyone will be happy with the CCGs’ decision today but, both national and local experts have agreed this is the right model for Worcestershire.

“We want patients to receive the highest standard of care and to know that they are safe when they are in hospital. We know that patients are concerned about a number of things such as travelling further for their care and the increased pressure on the Worcestershire Royal site. We have made a number of recommendations on future staffing levels, transport, maternity services and the quality of services provided to support the changes and to protect the quality of services for patients.”

Many of the changes proposed in the model have already been made under temporary emergency measures. This has given an opportunity to test the model and has seen a number of improvements to clinical outcomes for patients.

With this local approval, Worcestershire Acute Hospitals NHS Trust will now be able to take forward an application for a £29.6m capital investment to implement necessary improvements to deliver the clinical model. This will be subject to the usual NHS capital approval process.

***Ends***

Notes to editor


Recommendations

1.    Approval of Clinical Model - The three Worcestershire Clinical Commissioning Groups are asked to approve the Clinical Model proposed for acute hospital services in Worcestershire.

2.    Fit with Future of Acute Hospital Services in Worcestershire programme core principles - The Clinical Commissioning Groups are asked to affirm that this proposal meets the core principles of the Future of Acute Hospitals Services in Worcestershire programme based on the original vision and objectives and summarised as:

  • Patients will receive the highest standards of quality care
  • Services will be provided locally wherever possible and centralised where necessary 
  • Services will be integrated across organisational boundaries to provide a seamless experience of care.


3.    Strategic fit - The three Worcestershire Clinical Commissioning Groups are asked to affirm that this proposal:

  • Has been subjected to a full and thorough public consultation
  • Improves the clinical service and financial viability of the Trust 
  • Has met the NHS England Four Tests for service reconfiguration.


4.    Clinical Senate recommendations - Prior to the implementation of the Clinical Model the Trust must demonstrate their commitment to comply with the advisory recommendations made by the West Midlands Clinical Senate in June 2016, specifically including:

  • The staffing levels for the Emergency Department consultants at each site
  • Countywide rotation of Emergency Department Consultants
  • Middle grade and Emergency Department consultants at Alexandra Hospital need to
  • Rotate to maintain paediatric experience
  • Use of the emerging national model for Urgent Care service specification in reviewing
  • The current Urgent Care Centre specification
  • Review of the clinical procedures proposed relating to the Urgent Care Centre service
  • Further work to be undertaken between the Trust Management and acute medical
  • Consultants across both sites to develop the vision and implementation for sustainable countywide working.

5.    Quality and safety - In recognition of the continued concerns regarding the clinical safety and quality of services provided by Worcestershire Acute Hospitals NHS Trust and the ongoing poor performance against NHS Constitutional standards, it is recommended the Clinical Commissioning Group Governing Bodies continue to support enhanced surveillance of the quality and safety of commissioned services.

6.    Support for the Trust - As part of this it will be important to work with NHS Improvement to ensure that the Trust receives the necessary support and assistance to both implement the proposed Clinical Model and to deliver the required service improvements. In practice this should also include assistance from other NHS Trusts through partnering and support arrangements.

7.    Capacity and implementation plan - The Clinical Commissioning Group Governing Bodies recommend that NHS Improvement work with the Trust to review the Trust’s outline business case which details their capacity and implementation plan, ensuring capacity and demand will be appropriately managed and activity and capacity projections are consistent with Pre-Consultation Business Case and the Sustainability and Transformation Plan.

8.    Transport and access - Worcestershire Acute Hospitals NHS Trust must review the scheduling of its outpatient appointments and operations to take account of patient travel needs and individual circumstances. The Clinical Commissioning Groups and Worcestershire Acute Hospitals should work together with Community Transport Providers in Worcestershire to provide an enhanced transport service between the Alexandra and Worcestershire Royal Hospitals.

9.    Communication and education - Worcestershire Acute Hospitals NHS Trust and other local NHS partners must implement a comprehensive publicity campaign which clarifies where health services are available across the county and how people should access them. As a matter of urgency a communication campaign should be launched to clarify how children should access emergency services.

10.    Monitoring patient flows - The Clinical Commissioning Groups must monitor patient flows to providers outside the county on a monthly basis and work collaboratively with partners to mitigate any potential impact of increased patient flows should this occur.

11.    Maternity Services - Local access to maternity services should be a priority for the Clinical Commissioning Groups. In line with the implementation of ‘Better Births’, there must be local access to services for women and their babies, regardless of where they live. Women should have a choice of where to deliver with access to local maternity services for midwife-led ante-natal and post-natal care. The Clinical Commissioning Groups should also work with other providers to improve choice for mothers-to-be.

12.    Further review maternity capacity - The Clinical Commissioning Groups should undertake a further review before the end of 2020 of local maternity capacity and specifically the potential of introducing a midwife-led birth centre in the north of the county.

Media enquiries:

Please contact Sally Evans, Communications Manager, on 07423 524211 / 01905 681978 or email Sally.Evans17@nhs.net

More information is available on the website www.worcsfuturehospitals.co.uk