STRUCTURE: Smaller hospitals must ask ‘searching questions’ about the services they can realistically provide in order to guarantee their sustainability, a district general hospital chief executive has said.

Gavin Boyle, chief executive of Chesterfield Royal Hospital Foundation Trust, told HSJ that DGHs would need to be “really sure” that the services they provide are appropriate for their size and location.

Mr Boyle’s comments came as he outlined the trust’s five year clinical services strategy - an ambitious plan that includes a new £8.7m cancer facility, service reconfigurations and recruitment.

Gaving Boyle

Smaller hospitals must be ‘really sure’ that the services they provide are appropriate for their size, says Gavin Boyle

Mr Boyle said: “[Smaller hospitals] must be clear about those services which are appropriate for them to do.

“We have had to ask ourselves some searching questions about some of the services which we felt, as a DGH, we were pleased to have but actually, were they appropriate for this kind of hospital?”

Mr Boyle added: “We have accepted that aspects of one or two services we provide shouldn’t be delivered locally.”

He cited the centralisation of head and neck cancer operations at Sheffield Teaching Hospitals FT, which took over work previously undertaken at Chesterfield Royal.

Explaining the trust’s decision for drawing up the strategy, Mr Boyle said: “Creating sustainable clinical services is one of our key objectives, and the strategy is the underpinning detail that sits behind it.”

The trust’s clinical strategy involves the building of an £8.7m cancer treatment centre in partnership with Macmillan Cancer Support, which will provide approximately £2.5m of capital funds.

Planned capital works will require a total investment of £50m through to 2018-19, according to a forecast by the trust. The majority of this is set to come from the trust’s reserves.

Mr Boyle said that to secure cancer services at the trust it had invest in new facilities. “To be frank, the physical facilities that we provide services from, particularly chemotherapy, have served their time,” he said.

“Staff do a brilliant job given the facilities they have. If you identify a core service you have to invest in it.”

The hospital’s operating theatres will also be refurbished at a cost of £7.6m over the next two years.

An urgent care “village” will be built for £4.1m to provide emergency care, as part of an East Midlands trauma network.

Mr Boyle said: “The viability of a DGH depends on the quality of its networks.

“For us it’s a case of strengthening the partnerships we’ve developed in our own health economy, such as with Derby Hospitals [FT], where we are developing an integrated set of services, including in digital imaging.”

Chesterfield Royal, which provides a broad range of acute surgical care to adults and children, was one of 13 trusts picked to pilot seven day working last year.

The five year strategy includes a plan to increase compliance with 10 national standards for effective seven day provision, including quality improvement and the time to first consultant review.

Mr Boyle added: “Staff are anxious about what seven day working really means for them in terms of their work/life balance.

“But our local experience has been that, certainly the clinicians I speak to just ‘get’ it. They understand that this is the right thing to do.”