STRUCTURE: Controversial plans to reconfigure emergency services at two Yorkshire hospitals have been relaunched, amid concerns about their financial sustainability and staffing levels.

Last summer commissioners were set to begin a public consultation on proposals to close one of the emergency departments at Huddersfield Royal Infirmary and Calderdale Royal Hospital, both run by Calderdale and Huddersfield Foundation Trust.

The plans were met with fierce local criticism, and Greater Huddersfield and Calderdale clinical commissioning groups decided to pause the project until “enhanced and integrated community services” were in place.

However, an update in the latest risk register for the FT said Monitor is advising the trust on the review. A fresh business case will be sent to the regulator in September.

The update also said: “The CCGs are developing a pre-consultation business case (that will be consistent with the trust’s business case) and aim to commence public consultation in autumn 2015.”

When the plans were put forward last year, the FT said it would prefer to concentrate emergency services at the Huddersfield site, and planned care at Calderdale.

The trust is forecasting a deficit of £23m this year, and Monitor appointed a “turnaround director” in January to oversee its financial plans.

The risk register said: “Dual site working is one of the causes of the trust’s underlying deficit. Delays in being able to reconfigure services will impact on the trust’s financial recovery plan.”

It also noted the “extreme risk” of delays to the reconfiguration as a result of concerns about staffing levels in paediatrics and critical care, the trust’s ability to ensure seven day working, and the recruitment of medical staff.

Anna Basford, the FT’s director of commissioning and partnerships, said: “As part of our enforcement undertakings with Monitor we are required to develop a strategic sustainability and financial turnaround plan by September 2015. To do this we are currently reassessing all of the available options.”

HSJ asked both CCGs what increases there had been in community and step-down provision since last year.

Calderdale said it now commissions 36 nursing beds – six more than in 2014-15 – but the number of residential beds has dropped from 20 to 10. Additional beds were also commissioned in winter.

Greater Huddersfield said it commissions 40 beds – and has the potential to increase this over winter – which is the same as last year.