Sweeping centralisation proposed for Manchester services

A review of the city’s three main hospital sites, led by former trust chief executive Sir Jonathan Michael, has estimated that recurrent savings of up to £29m can be made by reorganising eight service areas.

It has suggested that obstetrics, critical care and paediatric care should be consolidated on fewer sites. The review was published by Manchester’s health and wellbeing board ahead of a meeting next week.

Groups of clinicians from Central Manchester University Hospitals Foundation Trust, University Hospital of South Manchester FT and North Manchester General Hospital – part of Pennine Acute Hospitals Trust – were asked to draft proposed service models in each specialty, with support from consultancy firm McKinsey.

Eight care models have been put forward for further discussion, though the locations of each service were not considered.

HSJ has seen an internal document suggesting the chief executives of the three providers are set to publicly welcome the review’s findings.

The review had created a potential difficulty for Pennine Acute, which was progressing its own transformation plans involving North Manchester General Hospital. There appeared to be friction between trust chief executive Gillian Fairfield and council leaders over the plans last year.

However, it was announced suddenly in February that Dr Fairfield was going on secondment to Brighton and Sussex University Hospitals Trust. Sir David Dalton, chief executive of Salford Royal FT, has taken over on an interim basis.

Sir Jonathan was appointed after commissioners threatened to tender services if the trusts could not agree plans to remove duplication of services in the city.

He said in his introduction to the review: “However, much I respect the organisations and individuals providing care for patients from these hospitals, I do not believe that existing arrangement for hospital services in the city of Manchester serves the best interests of the population.

“The different hospitals have different mixes of specialist and general services, different priorities and different ways of working. This has led to duplication, indeed triplication in some services, variations in clinical outcomes, variation in patient experience and access to services. There is inefficiency and waste due to duplication and all hospitals are experiencing recruitment difficulties in shortage clinical staff groups.”

He has recommended that discussions continue on the eight specialties while plans are drawn up for other service lines, including surgical oncology. The review will move into a second stage looking at potential governance and organisational changes at the three trusts.

The providers are already implementing “single services” for emergency care, following a major consultation process that concluded last year.