Updated: Trusts accept defeat after Manchester acute reconfiguration decision

The region’s 12 clinical commissioning groups yesterday selected Stepping Hill Hospital in Stockport as the region’s fourth site for emergency and high risk general surgery.

The decision means Wythenshawe Hospital in south Manchester; Royal Albert Edward Infirmary in Wigan; and Royal Bolton Hospital will all now lose this service.

It follows a consultation under the Healthier Together programme, which proposed that just four of the region’s 10 hospitals should be classed as specialist sites, with the rest as local general hospitals.

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Manchester Royal Infirmary, Salford Royal Hospital and Royal Oldham Hospital were guaranteed specialist status under all the options.

These three hospitals and Stepping Hill will be lead providers in four “single services”, which will share teams of clinicians for accident and emergency, acute medicine and general surgery with at least one neighbouring trust.

University Hospitals of South Manchester Foundation Trust, whose emergency and high risk surgery will now be performed by Central Manchester FT, has previously criticised the process.

South Manchester chief executive Attila Vegh said the trust was disappointed Wythenshawe Hospital was not chosen as the fourth site to provide emergency abdominal surgery.

He added: “We recognise this decision is the outcome of a diligent and comprehensive three year process, involving a public consultation and extensive data review which considered a large amount of evidence.

“We acknowledge that the decision to select Stepping Hill Hospital reflects the evidence presented around geography and travel times to different hospitals across Greater Manchester for patients and their relatives”

The changes are expected to save 300 lives per year, by providing enhanced consultant cover at all the hospitals within the available funds.

Jackie Bene, chief executive of Bolton FT, said: “Given the geographical spread of the three single services previously identified; Salford, Oldham and Manchester Royal Infirmary, it’s no great surprise that the fourth should go to the south of Manchester.

“This means for Bolton that Salford will be the main centre for patients who need emergency specialist abdominal surgery. I should stress that this will affect only a very few Bolton patients – maybe three a day.”

Rob Forster, acting chief executive at Wrightington, Wigan and Leigh FT, said the trust “fully accepted” the decision. He added: “The majority of our patients will continue to receive their treatment in our existing hospitals. Patients will also benefit from an increase in the number of consultants and the hours they will be working in our accident and emergency department.”

South Manchester, Bolton, and Wrightington, Wigan and Leigh stressed that their other specialist services would be maintained, such as orthopaedics at Wigan, maternity at Bolton, and plastic surgery in south Manchester.

The lead providers within each single service will have consultants based in accident and emergency for at least 16 hours a day, compared with 12 hours a day in the remaining “local general hospital” sites.

Emergency and high risk general surgery will only be performed at the specialist sites, with planned operations continuing on all sites.

The single services are (specialist site for emergency and high risk general surgery in bold):

• Manchester Royal Infirmary; Trafford General Hospital (both Central Manchester) and Wythenshawe Hospital (South Manchester)
• Royal Oldham Hospital, North Manchester General Hospital, Fairfield General Hospital in Bury, and Rochdale Infirmary (all run by Pennine Acute Hospitals Trust)
• Salford Royal Hospital (Salford Royal FT), Royal Bolton Hospital (Bolton) and Royal Albert Edward Infirmary in Wigan (Wigan, Writhington and Leigh)
• Stepping Hill Hospital (Stockport FT) and Tameside General Hospital (Tameside Hospital FT)

The decision, taken after a public consultation process, was swung by the implications for about 17,000 patients in north Derbyshire, who would not have been able to reach a specialist general surgery centre within 45 minutes if Stepping Hill was not chosen.

Commissioners said there was “no material difference” between the options in terms of quality, or affordability”.

The plans are set to be implemented in stages over the next 2-3 years.

Chris Brookes, medical director for Healthier Together, said: “This decision represents an unprecedented opportunity to start raising standards and saving lives by having hospitals working in partnership as part of shared ‘single services’, sharing their resources and expertise.

“Every site included in the review will improve their standards and quality of care. Additional consultants will be recruited across A&E and general surgery to make sure patients are seen more quickly by a senior doctor when they are seriously ill.

“Our aim is for all of hospitals to meet the recommended quality and safety standards, at the moment none of our hospitals in Greater Manchester do. It is estimated that by working in this way, we can save up to 300 lives a year.”

This story has been updated as there are 12 CCGs in Greater Manchester, not 11 as previously stated.