Agenda item

(Chris Fearns, the JSR Project Director and Director of Strategy for Worcestershire Acute Health Trust will attend with Rose Johnson, Associate Medical Director and A&E Consultant.)

The Board received a presentation in respect of the Worcestershire NHS Joint Services Review, Worcestershire hospitals – fit for tomorrow, from representatives of Worcestershire Acute Health Trust (WAHT). Members were reminded that a number of pre-prepared questions had been forwarded to WAHT.  The presentation was an overview on the case for change of the Joint Services Review and provided information on the models of care which were currently being developed together with details of the project’s planned timetable and any associated governance issues in relation to it.  Members were informed that this was a joint review between the commissioners, NHS Worcestershire and the Acute Hospital, which commenced in March 2012 with the aim of a final business case being prepared by January/February 2013.  The review was for the whole of WAHT’s services which operated from 3 sites plus 4 community hospitals. 

It was a clinically led review and covered 4 work streams, Women and Children, Emergency Care, Elective Care (planned care) and Elderly Care.  Representatives from each of these work streams had been involved from primary care and secondary care, together with clinicians from a whole range across the community including ambulance services, nursing and general practitioners.  The Models of care, which had been identified and which were explained in detail to Members, would then be appraised in order to assess which should be put forward as final options.  It was emphasised that, in all the Models identified, outpatients, diagnostics and primary care facilities would be maintained and provided exactly as they were at the moment in all parts of the County.  The Models were focused on the acute in-patient or emergency admission type of work.

The evaluation framework was explained to Members in detail, together with the non financial and financial criteria and weightings that would be considered when creating the shortlist of options which would be included in the final consultation.  It was stressed that this was a clinically led and patient centred review and every opportunity was being taken to involve the public in the engagement process.  There would be continued external scrutiny through the Worcestershire County Council Health Overview and Scrutiny Committee, the National Clinical Assessment Board and Stakeholder Reference Board.  Details of the revised project timetable were provided together with details of the governance arrangements, accountability and decision making process which would be followed in order to reach the formal public consultation stage in Autumn 2012.

(A copy of the presentation is attached at Appendix 1 for information.)

The representatives in attendance were:

Christine Fearns – Joint Service Review Project Director

Dr. Angus Thompson – Consultant obstetrician and gynaecologist, Clinical Director for Obstetrics and Gynaecology.

Dr. Anthony Kelly – General Practitioner from Droitwich.

The Board discussed the following areas in detail and the representatives from WAHT responded to questions:

• The potential closure of the Accident and Emergency department at the Alexandra Hospital in Redditch.  (Specific statistics had been requested in respect of admissions and it was confirmed that these would be provided to the Board with an explanatory briefing paper.)
• The increase in life expectancy of the population and the affect this had on the way services were delivered and the changes that needed to be made in order to support those with long term chronic conditions and which it was felt could best be managed within the community.
• Travel (for example by public transport) and accessibility concerns, including traffic congestion (particularly in Bromsgrove) and what were viewed as excessive parking charges at hospitals for patients, visitors and staff and the inclusion of this as part of the modelling process.  The WAHT representatives confirmed that these issues had and would continue to be considered in any decisions that were made.  However evidence from across the country was being researched where the outcomes still appeared to be better despite such problems, particularly in respect of trauma where increased travel time did not have an adverse clinical effect on patients.
• Particular areas of specialist care already being centralised at specific hospitals within the County and the current provision of two trauma units within the County.
• Any impact that the Joint Services Review could have on the Princess of Wales Hospital in Bromsgrove.  It was explained that this was not part of the review as it was looking at acute hospital services and not community hospitals.
• Details of the external assessment and the experts involved.
• The levels of units in respect of midwifery and the role of a midwifery led unit and details of Model B, Members were informed that a similar model to this had recently been put in place at Cheltenham and Gloucester.
• Details of the finances which had led to this decision and of the budgetary position of WAHT together with any overspend and efficiencies of the hospitals concerned and necessary efficiency savings.  (Information on PFI was available on the WAHT website.)
• The role and experience of junior doctors nationally and how this was managed and the involvement of consultants on a more regular basis with junior doctors.

The Chairman thanked the representatives of WAHT for a detailed and informative presentation.

RESOLVED that the presentation be noted.