STRUCTURE: There is ‘not convincing evidence’ that proposals to reconfigure services hospitals services in Calderdale and Greater Huddersfield would ‘produce better health outcomes for our population or represent good value for money’, a council commissioned report has found.
Calderdale Council set up the People’s Commission, chaired by Oxford Brookes University professor Andrew Kerslake, in wake of local opposition to proposals drafted by providers, which included downgrading an accident and emergency unit.
Calderdale and Huddersfield Foundation Trust, South West Yorkshire Partnership Foundation Trust and social enterprise Locala published a strategic outline case in February last year, which they later developed into an outline business case, setting out five alternative models of service provision.
Their preferred option was for Huddersfield Royal Infirmary to become a specialist site for acute and emergency care, while Calderdale Royal Hospital would focus on planned hospital care. This would result in downgrading A&E services at the hospital.
The report called for the Calderdale Clinical Commissioning Group not to propose any changes to hospital services “that would be far reaching and expensive… until and unless there is good evidence that changes to community health services can provide a better approach to healthcare provision”.
Plans by the CCG to redevelop community services “do not evidence that they will take demand away from acute services in general and A&E in particular”, the report said.
The commission also found “the local health and social care system has not worked well together in developing changes”, and recommended that Calderdale Health and Wellbeing Board should “step up to the mark and take a lead in driving improvement across [the system]”.
The CCG said “further work and discussion” would be required before it would be ready to formally consult on any proposed changes.
A CCG spokeswoman said: “We welcome the recommendations from the commission’s latest report, which we will consider in more detail as part of our own robust approach to ensuring local people have their say on the future of health services.
The CCG would “continue to work in partnership” with other local organisations “to ensure that any future plans are joined up and developed with the views of local people at the heart of our decision making”, she added.
The health and wellbeing board chair Janet Battye said there “will be changes in hospitals” but “they should not take place” until there is “strong evidence that [enhanced community services] will deliver more effective services than those currently provided by hospitals”.
Cllr Battye said that to make this happen it was necessary for providers and commissioners to work more closely, looking at the whole health system “even if that means giving up some resource and control.”
The People’s Commission report
- CALDERDALE AND HUDDERSFIELD NHS FOUNDATION TRUST
- Health and wellbeing boards
- Local government
- NHS Calderdale CCG
- NHS Greater Huddersfield CCG
- Service design
- Social enterprise/shared ownership
- SOUTH WEST YORKSHIRE PARTNERSHIP NHS FOUNDATION TRUST
- Specialist care
- West Midlands
- Yorkshire and the Humber