Concerns have been raised about ongoing uncertainty over arrangements for emergency dermatology patients at a major teaching hospital, just a month before the service is set to be axed.
The future for trainee dermatology doctors at Nottingham University Hospitals Trust is also hanging in the balance as it emerged the hospital was in talks with trusts in Derby and Leicester to take on teaching.
HSJ revealed last month the trust was forced to axe its once renowned acute dermatology service following an “exodus” of medical consultants after the transfer of their contract to private provider Circle.
Circle won a contract, tendered by Rushcliffe Clinical Commissioning Group, in 2013 which made it the main provider of dermatology services delivered across the trust via the Nottingham Treatment Centre.
The trust told HSJ it was forced to scrap acute adult dermatology services, including emergency services, from February due to a lack of staff. From a total of 11 consultants in 2013, five left the trust rather than transfer to Circle, and of the three that did transfer, one remains in post.
Talks are underway between Circle, the CCG and the trust about arrangements for emergency treatment after February.
However, a source with knowledge of the situation told HSJ that while talks may be happening there were currently no contingency plans in place to treat local patients out of hours from February.
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The source said: “If there was an emergency in the middle of the night, a patient in [intensive care] or [who had] an acute drug reaction that was dermatological, it probably would have to be transferred to Sheffield or Norwich.
“If the ambulance arrives there in the evening there will be nobody [at Nottingham]. The Circle treatment centre will work only from 9am-5pm.”
David Eedy, president of the British Association of Dermatologists, said: “The service seems to be collapsing.”
He told HSJ that the association had asked Nottingham University Hospitals what it was going to do from February with acute dermatology patients coming in from other providers and with those already in the hospital, and what would happen to on-call cover for out of hours care of inpatients.
He added: “Patients need clarity on what happens next to their local services, and we also need to ensure lessons are learnt from this commissioning debacle.”
Asked by HSJ if there were contingency plans in place for the treatment of acute dermatology patients from February, a trust spokesman said: “We are currently in discussions with our local commissioners to agree a way forward in this matter.”
Vicky Bailey, chief operating officer of Rushcliffe CCG, said: “Commissioners are continuing to lead discussions with all parties based on all possible scenarios and we remain committed to maintaining quality acute emergency dermatology services for our local population.”
A Circle spokesman said: “We remain in talks with commissioners and Nottingham University Hospitals. The treatment centre continues to provide a comprehensive adult elective dermatology service, as per our contract, and we have recently hired full time staff in dermatology.”