Published: 15/07/2004, Volume II4, No. 5914 Page 10 11

Managers at Morecambe Bay Hospitals trust recently asked local people whether they supported a name change aimed at attracting health professionals to come to work in the area.

Chief executive Ian Cumming explains: 'Until the recent tragedy of the cocklers, nobody knew where Morecambe Bay was. I would go to meetings with other health service managers who would assume I was from a small district general hospital.

'That doesn't matter to me, but when we have placed adverts for staff in HSJ we have found out that people assume we are a tiny DGH tucked away somewhere in Morecambe.'

With several sites some distance from each other, including Westmorland General Hospital in Kendal in the Lake District and the Royal Lancaster Infirmary, the trust asked whether a name recognising its geographical status might prove fitting to mark its new university status, which begins in September.

But the public spoke out in what Mr Cumming says proved to be 'the most controversial issue' of a wider consultation on trust changes, including a foundation application.

Local people largely wanted to retain the trust's identity, and its new name will be University Hospitals of Morecambe Bay trust, although a strapline may be created to reflect its geographical spread.

Shortage of medical staff is listed as the biggest concern across the SHA by chief executive Pearse Butler. So it is clear that distinct challenges lie ahead for trust chief executives throughout Cumbria and Lancashire who hope to increase numbers of clinicians, not least because of the looming deadline of the European working-time directive.

Mr Cumming says this will only be met on 1 August if a sufficient number of junior doctors come to work in the area, and he explains that his area has always suffered from low numbers of junior doctor posts, particularly because of the significant distance to the nearest medical schools, in Liverpool and Manchester.

Mr Butler says: 'Too many junior doctors are taken from rotations based at Liverpool and Manchester, so they only spend part of their time on our patch.'

Trusts across the area have been awarded an increase in trainee doctor positions as a result of healthcare leaders in Cumbria and Lancashire lobbying the Department of Health, but they must now rely on postgraduate deaneries to recruit doctors to the positions.

Blackpool, Fylde and Wyre Hospitals trust chief executive Roy Male, beneficiary of 27 extra specialist registrar posts, says: 'There is a risk that in the first year some of these posts may be difficult to fill because there may not be the people out there.'

Mr Cumming, who hopes to gain from 31 new posts, adds: 'Some of them are already here and have already started, but in other areas the process needs to be jigged up a bit.'

His trust has been one of the pilots for the 'hospital at night' project in the drive to meet the directive. The project has reduced out-of-hours calls on doctors, but further help is needed.

The position is the same in Blackpool, but Mr Male says: 'My concern is with the longer-term supply of medical workforce. It takes four or five years to get through specialist registrar training but at the end of that the significant boost to consultant output will bring advantages.'

SHA-level discussions are exploring the possibility of establishing a medical school within its boundaries. But all parties urge caution, not least because the whole health workforce requires attention.

Mr Cumming says: 'If we do, it will be an evolutionary process rather than a big bang of, 'Here we go with a new medical school'.

We would also want to include other players in the area such as St Martin's College, in Lancaster, which offers nurse training.'

The trust will also offer more work in healthcare sciences, for example, by establishing a biomedical science degree in conjunction with Lancaster University.

Other workforce shortages in the area include dentists, and Morecambe Bay PCT has been attempting to tackle the problem.

Chief executive Leigh Griffin says: 'We are looking at opportunities to make NHS work more attractive to dentists, including salaried options, broadening workload to different settings and offering computer facilities and equipment.

'We are also working with Liverpool University on doing final-year dentistry placements.'

At a recent extraordinary board meeting of Morecambe Bay Hospitals trust, it was decided that the public was behind its wish to obtain foundation status, and the wave-1A application will go ahead.

While Mr Cumming hopes foundation status will attract healthcare professionals to the area, he says the oft-repeated concerns about creating a two-tier workforce by opponents of foundation trusts will not be relevant for his trust.

'Given a lot of the challenges we have in providing healthcare for such a rural population with such a large geography we have to work together.

'We are not Manchester, London or Liverpool; We are covering 1,000 square miles in terms of hospital services, so We are not really competing. Our main role is to provide acute services in conjunction with the PCT, ' he says.