STRUCTURE: Reconfiguration of acute services in Worcestershire will go ahead after receiving the green light from the West Midlands Clinical Senate.
However, it did not sign off on the detail of a planned downgrade of accident and emergency services at one of Worcestershire Acute Hospitals Trust’s sites.
The trust has been developing plans to reconfigure its services since 2012 because of concerns current arrangements are not financially or clinically sustainable.
Plans developed by an independent clinical review panel would see inpatient paediatric and obstetrics services transferred from Alexandra Hospital in Redditch to Worcestershire Royal Hospital.
A&E services would be downgraded at Alexandra Hospital to a “networked emergency centre”, linked to a major centre at Worcestershire Royal.
While the senate supported the transfer of obstetrics and gynaecology and emergency services to Worcestershire Royal, it did not support the A&E shake-up because of concerns over patient safety.
The senate said it had concerns about “sustainable staffing” at Alexandra Hospital, with the potential for trainees to be removed from the site.
It also raised fears about “public and staff misunderstanding”, the nature of emergency care at the hospital and “increased clinical risk” arising from the removal of key services.
The senate said it supported “in principle” the proposal to consolidate inpatient paediatrics at Worcestershire Royal, but called for the development of clear plans to show how extra paediatric capacity could be created there.
It said further work was also needed to “develop a common understanding” between staff and the public about where sick children from Redditch and Bromsgrove should be taken to and when.
This should include “detailed consideration of how seriously unwell children presenting at the Alexandra Hospital site… will be safely transferred to the Worcestershire Royal site”.
The senate’s conclusions were welcomed by Worcestershire Acute and the county’s three clinical commissioning groups.
The programme board responsible for the reconfiguration said it would undertake more detailed work on emergency care pathways.
It will take its plans for the other services to public consultation later this year.
Jo Newton, chair of the programme board, said: “The board acknowledges that the interests of the people of Redditch and Bromsgrove, whilst central, represent one part of the wider population, and we support collaboration between partners across Worcestershire as the only way to ensure that the whole population has safe and sustainable services.”
CQC publishes report on troubled A&E services
The Care Quality Commission has published its findings on Worcestershire Acute Hospitals Trust’s troubled accident and emergency services.
Last month the CQC put a condition on the trust’s licence following an unannounced inspection in March, requiring it to have the right staff skill mix at Worcestershire Royal Hospital.
The inspection report, published this week, highlighted delays in handovers from ambulance crews, a shortage of nursing and senior medical staff, and concerns about children’s safeguarding procedures and medicines management.
The regulator issued the trust with warning notices ordering it to make immediate improvements to children’s safeguarding, staffing levels and the maintenance of equipment.
Sir Mike Richards, the CQC’s chief inspector of hospitals, said “significant work” was required for the trust to meet “the standards people have a right to expect”.
Worcestershire Acute’s acting chief executive, Chris Tidman, said the trust had made “significant improvements” since the watchdog’s visit.
The CQC will return for a full inspection of the trust next month, after which it will be given a rating.
Clinical senate report, CQC report