Acute services could switch provider in major overhaul

A consultation has been launched today into the future of hospital based stroke, maternity, inpatient gynaecology, and urgent and emergency paediatrics across the region.

The consultation document proposes moving many specialist services from South Tyneside District Hospital, run by South Tyneside Foundation Trust, to Sunderland Royal Hospital, run by City Hospitals Sunderland FT.

The overhaul aims to tackle the recruitment challenges, inability to hit clinical standards, difficulty meeting national guidelines and reduce the bill for locum doctors.

The reconfiguration options include:

• All hyper-acute and acute stroke care provided at Sunderland Royal Hospital.
• Retaining a consultant led maternity unit at the hospital alongside midwife led care for low risk births.
• Providing inpatient gynaecology surgery from Sunderland Royal while continuing to provide day case operations and outpatients consultations at both sites.
• A single special care baby unit in Sunderland.
• Providing a 24/7 paediatric emergency department at Sunderland Royal.

Acute stroke services have all been centralised at City Hospitals Sunderland since December. The other options could see maternity, gynaecology and paediatric services at South Tyneside Hospital closed or downgraded.

Only stroke services have a preferred option, which would mean patients from both areas have continuing rehabilitation at Sunderland with further rehabilitation provided in their local area.

The other two options would have South Tyneside patients moved to South Tyneside District Hospital three or seven days after being admitted.

Commissioning leaders refuted the suggestion the changes would see South Tyneside District Hospital reduced to little more than a “cottage hospital”.

South Tyneside Clinical Commissioning Group chief executive David Hambleton said further clinical reviews are planned over the coming months, which could see services centralised at South Tyneside.

He added: “That is one of the themes that has come back to us most consistently, is you are just trying to make South Tyneside into a cottage hospital.”

He said although there are no plans to make the Royal Sunderland a “hot site” and South Tyneside a “cold site”, it was a long term option.

Dr Hambleton said there will be a “clear rationale” about which services are located at which site.

He said: “Inevitably there will be a conversation about what’s the end game here. We just haven’t got there yet.”

The Next Steps document published by NHS England in March pledged to support sustainability and transformation partnerships that seek to split “hot” emergency and urgent care from “cold” planned surgery facilities to allow more efficient bed use.

While some of the options will make savings of more than £1m and others require up to £450,000 of investment, Dr Hambleton said the consultation was not about saving money. He added: “Money is not the primary driver.

“While there are certainly some differences in whether we need to invest or save money, it’s not massively significant either way.”

The consultation runs until 15 October and follows a clinical review of the four services, which began last year.

Further clinical reviews will start over the coming months, investigating a range of services including general surgery and acute medicine.

It builds on the integration between South Tyneside and City Hospitals Sunderland trusts. Ken Bremner was appointed leader of both trusts in September, with a joint board going live in November.

However, both organisations are clear they will not be merging with the boards of each trust holding the joint team to account.