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NHS England’s drive to consolidate specialised services in the first half of the previous decade slowed significantly in the second, with an acceptance that some things can still be delivered locally.
But one specialty where things are still ploughing ahead – and giving rise to familiar cries of concern – is intestinal failure.
In a private letter, seen by HSJ, the British Society of Gastroenterology has flagged concerns about a process to substantially reduce the number of hospitals offering surgical care.
It warns the national body of an “impression that the scoring process [to select the hospitals] may not have been entirely fair” and has called for an independent review.
Currently, up to 40 hospitals offer some surgery for patients who have suffered intestinal failure, some of which perform very small numbers of procedures.
The plans involve reducing the number of surgical hospitals to 11, with around 22 hospitals (including the surgical centres) expected to host non-surgical intravenous feeding services.
There is an acceptance in the profession that consolidating surgery on fewer sites should improve outcomes, due to surgeons performing operations more regularly.
But Alastair McKinlay, president of the BSG, has told NHSE and the Department of Health and Social Care of concerns about how some of the surgical sites have been selected.
He wrote in late September: “Surgical IF centre status appears to have been awarded to some bids with lower scores, whilst others with higher scores were not successful. This has led to an impression that the scoring process may not have been entirely fair.”
Mr McKinlay said he would not comment further until he has heard back from NHSE.
The exit of NHS England’s chair Lord Prior early next year means his replacement will be appointed ahead of the organisation’s formal merger with NHS Improvement.
The sometimes controversial figure was heavily involved in the appointment of Amanda Pritchard as NHSE’s third chief executive, although the final decision was made by government.
At NHSE/I’s joint board meeting last month Lord Prior underlined the need for government to issue sustainable NHS capital and workforce settlements at its forthcoming spending review.
Lord Prior is a former Conservative health minister — though he gave up the party whip when he took the NHSE role — as well as a former chair of the Care Quality Commission and Norfolk and Norwich University Hospitals Foundation Trust.
An internal announcement to NHSE staff said: “Lord Prior joined our board in October 2018 and has championed the life sciences agenda at a time when Britain has led the world in developing covid therapies and vaccines.”