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Worcestershire Acute Hospitals NHS Trust

Clinical Model for the future of Worcestershire’s acute hospital services agreed by Programme Board

21 January 2016

The Future of Acute Hospital Services in Worcestershire
’s Programme Board has accepted the clinical model for the county’s future services and recommended it to the three Clinical Commissioning Groups for approval.

Under the proposed model 95% of patients will see no change to the way they currently access services in the county and all three of the county’s acute hospitals – the Alexandra, Kidderminster Hospital and Treatment Centre and the Worcestershire Royal – will remain open. Worcestershire will also retain its two Accident and Emergency Departments and the Minor Injuries Unit at Kidderminster.

The main proposed changes to services are:

  • Separation of emergency and planned care to improve outcomes and patient experience
  • Creation of centres of excellence for planned surgery
  • Urgent care centre for adults and children at the Alexandra Hospital
  • A&E remaining a the Alexandra Hospital (adult only) with robust arrangements for managing a seriously sick child if they arrive unexpectedly or their condition deteriorates and they need an inpatient stay in hospital
  • Centralisation of inpatient care for children at Worcester with the majority of children’s care remaining local
  • Centralisation of consultant-led births at Worcester with ante-natal and post-natal care remaining local
  • Centralisation of emergency surgery

The Governing Bodies of the three Clinical Commissioning Groups will be asked to approve the model for onward submission to the West Midlands Clinical Senate for review at their next Governing Body meetings. 

The Governing Body meetings are:

  • NHS Redditch and Bromsgrove CCG – 9am, Thursday, January 28th at Redditch Town Hall
  • NHS South Worcestershire CCG – 2.30pm Thursday, January 28th at Pershore Civic Centre
  • NHS Wyre Forest CCG - 9am Tuesday, February 2nd at Wyre Forest District Council

The meetings will be held in public and members of the public are welcome to attend.

Once the model has been reviewed by the Clinical Senate it will be passed to NHS England for assurance before being put to public consultation. No permanent changes to services will be made before the end of public consultation.

Jo Newton, independent chair of the Future of Acute Hospital Services in Worcestershire Programme Board said: “We have a model which the entire Programme Board has signed up to. It provides us with a blueprint for safe and sustainable, high quality services for the county. We have answered all the concerns of the West Midlands Clinical Senate and have widespread support for the model from clinicians across the county.”

You can download and read the full Proposed Clinical Model of Care here

FAQs – proposed clinical model

How much money does this save?

We expect the clinical model to directly save £4.8million through more efficient medical rotas and to enable a further £20million to be saved every year through recruiting to vacant posts, now that we have greater certainty around the future. 

Isn’t this just a done deal?

No.  Clinicians from across the county have developed and tested a model which they believe will provide the safest patient care on a 24/7 basis.  This will now go forward to be considered by the West Midlands Clinical Senate.  Following this the aim is to go to public consultation in the summer this year.

What are you going to do about transportation between the Alexandra Hospital and Worcestershire Royal?  Will you put a shuttle bus in between sites for staff?

We will be looking to put in place a shuttle bus service for staff working between sites.

For patients or visitors attending the Worcestershire Royal they can park for free at the Sixways park and ride and use the bus service where standard bus fares will apply.  Usual bus concessions apply for holders of the requisite bus passes together with the associated rules ie free travel for the over 60s and disabled etc after 9.30am only and £1 at all times for the under 19s.

We are working with Worcestershire County Council on transport and in particular how bus routes could be altered.  We are also looking at how we can make better use of community transport.

How will the Worcestershire Royal Hospital cope with the extra patients?

In the clinical model there will be more emergency work at Worcestershire Royal Hospital and more planned care, including orthopaedics, benign upper GI and breast surgery, will be transferred from Worcestershire Royal Hospital to the Alexandra Hospital.  This will free up space and capacity at Worcestershire Royal Hospital.   We have already opened up a Midwife led Birthing unit which has allowed us to accommodate the additional births and work is currently underway to expand the Emergency Department. A business case is currently being produced to ensure extra car parking can be provided.

The Worcestershire Royal Hospital is already missing its A&E and waiting time targets, how will having more patients improve things?

At the moment we cancel too many operations because there are patients with emergency conditions in the planned care beds.  By more separation of emergency and planned care, we will be able to reduce the numbers of cancelled operations and bring down waiting times as well as improve patient care and outcomes.

Where will you put the extra beds and wards?

We have identified that we will need at least 50 extra beds at Worcestershire Royal Hospital and we are currently working on plans to accommodate this.  We also plan to move more operations to the Alexandra Hospital to make the best use of our beds, our operating theatres and staff on both sites.  Confidence over the future will help to unlock investment in the Alexandra Hospital site.

Why can’t the Alex keep its maternity unit and children’s wards?

We cannot continue to staff two obstetric units and children’s inpatient units with the level of experienced staff required to meet the highest of standards.  This is something which is recognised nationally. Dr David Richmond, the president of the Royal College of Obstetricians and Gynaecologists (RCOG)recently proposed there should be a big expansion in the number of midwife-led units and a reduction in consultant led maternity units. The shortage of middle grade doctors and the specialist back-up services needed mean that the safest way to deliver 24/7 care is to locate inpatient services on one site.  However, the vast majority of care will still be available locally such as outpatient and same day assessment– it is only life changing events such as the birth or emergency inpatient admission of a child that will change.

Will Kidderminster Hospital be affected by these plans?

No - We are planning to increase the number of operations at Kidderminster. 

Why are services always moving from the Alex to WRH?

This is a clinically and financially sustainable model.  The Alexandra Hospital will see new services including breast reconstruction and chemotherapy.  It is vital that all of our hospitals continue to thrive.  It is important to remember that 95% of services remain unchanged.

If you have an urgent care centre the A&E at the Alex will not see enough patients to be viable and will have to close?

We are retaining an adult-only emergency department (A&E) at Alexandra Hospital.  It will be networked with Worcestershire Royal Hospital and be led by consultants.  It will be supported by a 24-hour urgent care centre for adults and children.  We are confident the West Midlands Clinical Senate will agree with us that the Emergency Department (A&E) will be sustainable and this is a recognised model delivered by other similar sized trusts.

Page last updated: 27 January 2016