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31 March 2017 | Newsletter #11
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Healthcare for the Future: Update

Healthcare for the Future Newsletter 

This month saw two important decision-making meetings following the Healthcare for the Future public consultation which took place between 26 September 2016 and 19 December 2016.

The outcome of the NHS Cumbria Clinical Commissioning Group’s Governing Body decision making meeting on 8th March 2017 and Cumbria County Council’s Health Scrutiny Meeting on 22nd March 2017 are detailed below.

There has been a lot of media coverage, but we wanted to ensure we had let you know the results of these meetings. The decisions are detailed below, but within them there is a significant commitment to work with the community to tackle some of the issues raised during the consultation.

This is particularly around maternity and paediatrics. This will be through working closely with patients, public, staff, community groups and elected representatives where we will pool our collective knowledge and expertise and collaborate on doing all we can to ensure consultant-led maternity services can be delivered safely at the West Cumberland Hospital.

An independently chaired co-production steering group (the Working Together Group) will examine the issues. The independently-chaired Independent Review Group will work collaboratively to develop criteria and milestones and will assess progress.

There is also a commitment to continue and develop the excellent work with communities in Alston, Maryport and Wigton around future services based at those community hospitals.

There is also a reassurance that no services will change immediately – unless for safety or operational reasons. Transition will only be agreed once the Implementation Reference Group is satisfied that patients, staff and the community have been involved and helped shape the new services and that transition can be carried out safely.

NHS Cumbria CCG’s chief executive Stephen Childs, said: “We hope we have found a way forward, but we will need the support of everyone – NHS staff, the community, the groups we have been engaging with throughout the process as well as other health professionals, to try to ensure safe and sustainable services into the future.

“We know it won’t be easy, but we also know there is a great energy and passion for the NHS and we want to harness every opportunity to create the best outcomes for west, north and east Cumbria.”

The outcomes of those meetings are detailed below.

NHS Cumbria Clinical Commissioning Group's Governing Body meeting

NHS Cumbria Clinical Commissioning Group’s (CCG) Governing Body met on 8 March 2017 to discuss the options that were the subject of the public consultation.

The meeting considered recommendations developed from the options consulted upon, in light of the public feedback, and following subsequent clinical workshops. It was held at the Oval Centre in Workington and observed by members of the public, including health and local authority partners, and representatives of community and campaign groups who have been involved over recent months.

In respect to each of the services areas consulted upon, the Governing Body decided:


Maternity

To implement and test the viability of Option 1. To maintain consultant-led care at the West Cumberland Hospital, with some high risk women giving birth in Carlisle. During a 12 month period there will be an Independent Steering Group established to involve the community working in partnership with health professionals (co-production) to enable the very best efforts to be made to tackle the challenges the service faces, particularly around recruitment and retention of key staff, especially in paediatrics and anaesthetics. An important element of this co-production work will be an independent review of anaesthetist recruitment in relation to maternity services undertaken by the Royal College of Anaesthetists as soon as is practically possible.

At the same time there will be the development of an alongside midwife-led unit at the West Cumberland Hospital. The unit will be assessed as though it were ‘free-standing’ to better understand the level of risk to expectant mothers and babies.

If Option 1 is not proven to be deliverable or sustainable then Option 2 should be implemented at the end of the 12 month period (Consultant Led Unit and alongside Midwifery Led Unit at Cumberland Infirmary Carlisle and a standalone Midwifery Led Unit at West Cumberland Hospital).

If following the audit of the midwife led unit, Option 2 is not deemed to be safe, then Option 3 should be implemented. (Option 3 is a Consultant Led Unit and alongside Midwifery Led Unit at Cumberland Infirmary Carlisle and no births at West Cumberland Hospital).
 

Paediatrics

To implement Option 1. This option involves the development of an inpatient paediatric unit serving west, north and east Cumbria based at the Cumberland Infirmary in Carlisle along with a Short Stay Paediatric Assessment Unit. At the West Cumberland Hospital in Whitehaven there would be a Short Stay Paediatric Assessment Unit for children requiring short term observation and treatment. There would be some overnight beds at Whitehaven for children with less acute, low risk illnesses but children who needed more acute inpatient admission would be transferred to Carlisle.

The Governing Body agreed that if Option 1 ultimately proves to be unsustainable, then Option 2 for Children’s Services may need to be implemented. This would mean no paediatric overnight beds in Whitehaven.


Community hospitals

To implement Option 1 which will see the consolidation of inpatient community hospital beds into six sites. In total there would be 104 inpatient beds at Whitehaven (Copeland Unit), Cockermouth, Workington, Penrith, Brampton and Keswick. However the Governing Body support this being implemented in a phased way through the proposals developed by the communities, in Alston, Maryport and Wigton, over the next few years.  

Emergency and acute care

To implement Option 1. This will see 24/7 A+E services maintained at both the Cumberland Infirmary in Carlisle and the West Cumberland Hospital in Whitehaven. An intensive care unit will be retained at Whitehaven, with the most seriously ill patients transferred to Carlisle. This option will also see the development of an innovative, ‘composite’ workforce model developing staff to cover a wider range of roles. 

Hyper acute stroke services

To implement Option 2. This will see a hyper acute stroke unit (HASU) developed at the Cumberland Infirmary in Carlisle, with all possible stroke patients taken directly to the unit, and any arriving at Whitehaven transferred to Carlisle for assessment and treatment by a specialist multi-disciplinary team. Rehabilitation services will be maintained at the West Cumberland Hospital. 

Emergency surgery, trauma and orthopaedic services

The Governing Body agreed to make permanent the earlier interim changes which saw the centralisation of emergency complex trauma and orthopaedic surgery at the Cumberland Infirmary.

This will also see more minor trauma surgery carried out at the West Cumberland Hospital along with some non-complex day case surgery. There will also be additional outpatients fracture clinics introduced at the West Cumberland Hospital.

Cumbria County Council’s Health Scrutiny Committee meeting

On 22 March 2017, Cumbria County Council’s Health Scrutiny Committee met to consider the decisions made by the NHS Cumbria CCG’s Governing Body.

The Committee agreed to proceed with the decisions made by the CCG in all service areas with the exception of the decision on maternity services.

It was decided to refer this to the Secretary of State, Jeremy Hunt, who will now make the final decision.

NHS Cumbria CCG’s chief executive, Stephen Childs, said: “We fully respect the decision of Cumbria County Council's Health Scrutiny Committee to refer the Governing Body's decision on maternity to the Secretary of State. We will play a full part as the process becomes clear.

“With respect to other service areas, we will now start planning and we will involve and update the community as that work progresses. No changes will take place until the services can be transitioned safely unless for safety or operational reasons.” 

More infomation
You can find more information about the Healthcare for the Future public consultation by visiting our website at www.wnecumbria.nhs.uk 

You can find an EasyRead version of the consultation document and a large text version of the document by clicking on the Current Consultation tab and then on the Consultation Document tab.

Under the Current Consultation tab you will also find a tab for the Publications Library.  On this page you can access a number of technical documents, briefing notes and other background material on the optional changes outlined in the Healthcare for the Future public consultation document.

Frequently Asked Questions
By visiting our FAQs page you can find responses to questions that were raised during the consultation. These questions are broken down into themes which include maternity services, community hospitals, Integrated Care Communities, acute stroke services and more.

To visit this page please click the following link: http://www.wnecumbria.nhs.uk/frequently-asked-questions/

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