Please note this response should be read in conjunction with the consultation questionnaire

Transcription

1 POOLE HOSPITAL NHS FOUNDATION TRUST COUNCIL OF GOVERNORS RESPONSE TO THE DORSET CLINICAL SERVICES REVIEW CONSULTATION FEBRUARY 2017 Please note this response should be read in conjunction with the consultation questionnaire Section 1 Integrated community services (page 1) 1a To what extent do you agree or disagree that our proposal to provide services closer to people s homes using community teams based at local community hubs will deliver better care? Our response STRONGLY AGREE 1b The draft proposal for NORTH DORSET includes community hubs with beds at Blandford Hospital and at Sherborne Hospital, and a community hub without beds at Shaftesbury, possibly at a different site to the existing hospital. To what extent do you agree with the draft proposal for NORTH DORSET? Comments on NORTH DORSET 1

2 1c The draft proposal for MID DORSET includes a community hub at Dorset County Hospital with access to community beds in proposed hubs at Wimborne, Bridport, Sherborne and Weymouth Community Hospitals. To what extent do you agree or disagree with the draft proposal for MID DORSET? Comments on MID DORSET Specifically the governors support the development of Wimborne as a community hub with beds, but this should be complementary to the community hub developments in Poole Hospital /Bournemouth Hospitals. 1d The draft proposal for WEST DORSET includes a community hub with beds at Bridport Hospital. To what extent do you agree or disagree with the draft proposal for WEST DORSET? Comments on WEST DORSET Members welcome proposals for care to be delivered closer to their homes, but have expressed much anxiety about whether the actual delivery of this model of care will be able to meet all their community needs i.e. beds and other services, particularly as both the NHS and Local Government are chronically short of funding. Members are also concerned that the proposed GP practice closures may result in the opposite outcome. Therefore there is a risk that these GP practice closures will be detrimental to patient care and result in a service that is less well able 2

3 1e - The draft proposal for WEYMOUTH & PORTLAND includes a community hub with beds at Weymouth Hospital and a community hub without beds at Portland, possibly at a different site to the existing hospital. Westhaven Hospital would not be used as a community hospital hub, but the future of mental health beds at the Linden Unit will be considered as part of a separate review. To what extent do you agree or disagree with the draft proposal for WEYMOUTH & PORTLAND? Comments on WEYMOUTH AND PORTLAND 1f The draft proposal for PURBECK includes a community hub with beds at Swanage Hospital and a community hub without beds at Wareham, possibly at a different site to the existing hospital. To what extent do you agree or disagree with the draft proposal for PURBECK? Comments on PURBECK 1g The draft proposal for EAST DORSET is for a community hub with beds at Wimborne Hospital. St Leonards would close. To what extent do you agree or disagree with the draft proposal for EAST DORSET? Comments on EAST DORSET Members welcome proposals for care to be delivered closer to their homes, but have expressed much anxiety about whether the actual delivery of this model of care will be able to meet all their community needs i.e. beds and other services, particularly as both the NHS and Local Government are chronically short of funding. Members are also concerned that the proposed GP practice closures may result in the opposite outcome. Therefore there is a risk that these GP practice closures will be detrimental to patient care and result in a service that is less well able 3

4 1h The draft proposal for the POOLE LOCALITIES includes a community hub with beds at Poole (only if this is the major planned care hospital). Alderney Hospital would not be used as a community hub and proposals for its future would form part of a separate review of dementia services. To what extent do you agree or disagree with the draft proposal for the POOLE LOCALITIES? Our response (tick) STRONGLY AGREE Comments on POOLE LOCALITIES The response of strongly agree above is made on the choice offered in the consultation i.e. only if Poole were to become the major planned care hospital. Governors of Poole Hospital are very clear that their preferred option for Poole Hospital is as the major emergency hospital in East Dorset, therefore they would request that the CCG reviews its East Dorset community proposals under this scenario. However if Poole Hospital becomes the major planned hospital for East Dorset the proposal is for Alderney to close all of its community beds and that there would be a separate review of dementia services. The governors would like to highlight the importance of coordinating the future development of Mental Health services and physical health community services in East and Mid Dorset for which the future role of the Alderney hospital site is key. Finally members welcome proposals for care to be delivered closer to their homes, but have expressed much anxiety about whether the actual delivery of this model of care will be able to meet all their community needs i.e. beds and other services, particularly as both the NHS and Local Government are chronically short of funding. Members are also concerned that the proposed GP practice closures may result in the opposite outcome. Therefore there is a risk that these GP practice closures will be detrimental to patient care and result in a service that is less well able 1i - The draft proposal for the BOURNEMOUTH and CHRISTCHURCH LOCALITIES includes a community hub with short term care home beds at Bournemouth (only if this is the major planned care hospital) and a hub without beds at Christchurch. To what extent do you agree or disagree with the draft proposal for the BOURNEMOUTH and CHRISTCHURCH LOCALITIES? Comments on BOURNEMOUTH AND CHRISTCHURCH LOCALITIES 4

5 The proposed options for acute hospitals 2a To what extent do you agree or disagree with the vision for acute care in Dorset? 2b To what extent do you agree or disagree with the proposal to provide a major emergency hospital and a major planned hospital in the east of the county? 2c To what extent do you agree or disagree with the proposals for Dorset County Hospital to be a planned care and emergency hospital? 2d Which option do you prefer for the delivery of consultant-led maternity care and inpatient paediatric services for the sickest children? Our response (tick) Option A Comment In supporting option A (two units) the Governors have taken into account the very important issues of access and continuity of care, which are key priorities for our members. If Poole Hospital were chosen as the major emergency site, the access and continuity of care issues arising from one Unit would be minimised. However as Bournemouth is the CCG s recommended site we believe that mothers and their families in West of Dorset would be adversely affected if there were one Unit and if that one Unit was Bournemouth. Finally we also believe that if the two Units option is finally chosen sufficient resources must be invested to make both the Units in the East and West clinically and financially viable. 2e Which option do you prefer for the major emergency hospital and major planned hospital in the east of the county? Our response (tick) OPTION A 5

6 Section 3 Other comments and suggestions The Poole Hospital Governors have six comments, one general one about the whole CSR model and five specifically about the reasons why Poole Hospital should become the major emergency hospital in East Dorset. Comments on the overall CSR model, theory and practice In theory moving care closer to home and saving money by reducing nearly 300 acute hospital beds (based on CSR demand projections) may work. However we have major concerns that the significant investments in improved general practice, community and social care services (including beds in care homes) will ever be made. We would want these community and social care investments guaranteed and in place before any acute hospital beds are closed. Why Poole Hospital should be the major emergency hospital in East Dorset; (a) Access - our members have continued, in spite of data and assurances presented, to express considerable concerns about access. In particular Members have expressed concerns over the ability of the ambulance service to cope without more investment in ambulances and staff, to guarantee patients arrive at Royal Bournemouth hospital safely. Further they do not believe the CSR ambulance times realistically take into account the very busy summer and peak times traffic in Poole and Bournemouth. Finally Bournemouth Hospital is less well served than Poole Hospital for public transport and in Poole the Hospital is only a few minutes walk from railway and bus stations, with direct links to Purbeck and much of Dorset. (b) Disruption to services and staff It is a fact recognised by the CCG that significantly fewer clinical services would move under option A than option B. Yet the CCG still recommend option B (Royal Bournemouth Hospital). Our members believe that the CCG have massively underestimated the negative effect of such a high risk plan. Well established and respected clinical teams in both hospitals will be pulled apart and forced to find new ways of working in strange surroundings. This upheaval will only increase the early retirement of experienced staff and discourage existing and new staff to work in Dorset. It would be far better to build on the existing strengths of both hospitals i.e. option A, rather than throw everything up in the air. (c) Keeping cancer services together As a consequence of the current decision to put all intensive care beds on the major emergency hospital site and have no intensive care beds on the planned hospital site, the current recommendation will fragment cancer services. The reason being chemotherapy beds will move onto the Royal Bournemouth Hospital site as they need access to intensive care and Radiotherapy will remain in Poole. This fragmentation will have a significant negative effect on cancer patients and staff. The only option that keeps the Dorset Cancer Centre together is for Poole to become the major emergency site. Note the absence of any proposed intensive care beds on the Major Planned Hospital will also lead to problems if an emergency arises following planned elective surgery. (d) Finance Over the next 25 years Dorset CCG will spend nearly 30 billion. The ongoing costs of running option A and B are the same, yet the CCG have preferred 6

7 Royal Bournemouth Hospital site because of the additional one off capital costs of 42m. This one off capital cost may appear a lot but it is only 0.15% of what Dorset CCG will spend over the next 25 years. Therefore we believe both options should have scored equally on finance, as over 25 years the difference is not significant enough. We also believe in the long term 0.15% is not a price worth paying to compensate for the poor access, inevitable service disruption, increased clinical risk, loss of staff and fragmentation of cancer services arising from Option B. (e) This feels totally wrong There are 23 Poole Hospital governors, 6,500 members and the Dorset population we serve. Therefore whilst we have had many CSR conversations based on the numbers and facts, the most consistent and striking response we have had back from people has been this feels totally wrong. Indeed it cannot be right to move maternity, paediatrics, trauma and emergency services off the Poole Hospital site, it cannot be right to fragment cancer services and tear apart much loved and high performing clinical teams. We know that this may appear an emotional response, but we believe the CCG s CSR analysis ignores how people feel and has simply reduced this once in a lifetime decision down to numbers i.e. minutes and money, and ignores what people really value and care about. Section 4 Impact on equality 4 Are there any positive or negative impacts relating to equalities that you believe we should take into account? If so, are you able to provide any supporting evidence and suggest any ways we could reduce or remove any potential negative impact and increase any positive impact? If so there is a free text box for further comments Our response As a general comment our members have consistently pointed out that the greatest negative impact from proposals will fall on the independent frail, disabled, pregnant mothers and children, particularly for those whose circumstances make access to services already difficult. 7