STRUCTURE: Commissioners are preparing to consult on proposals to downgrade two accident and emergency units run by Mid Yorkshire Hospitals Trust, which is forecasting a £26m deficit for 2012-13.

The Mid Yorkshire Clinical Services Strategy, developed over the past 18 months, was presented to the board of the West Yorkshire primary care trust cluster earlier this month. It has the backing of Wakefield and North Kirklees clinical commissiong groups and of the acute trust itself.

The trust runs three hospitals sites - Pinderfields, in Wakefield; Dewsbury; and Pontefract. Currently all three have accident and emergency units, although Pontefract has been forced to close at night for a long period due to lack of medical staff.

Plans in the agreed strategy include:

  • Pinderfields retaining full acute medicine and A&E, known as an emergency care centre; while Pontefract and Dewsbury are downgraded to become “emergency care units in an integrated emergency care network”.
  • Pontefract and Dewsbury become centres for elective surgery, outpatients and diagnostics and sub acute services.
  • Dewsbury’s maternity unit becomes midwife led. The hospital also hosts a clinical decision unit and centre for neuro-rehabilitation.
  • All non-elective activity is consolidated at Pinderfields together with intensive care unit and high dependency care facilities.

A cluster board says the proposals will deliver “separating emergency and elective care to improve quality and outcomes”. The changes are largely as predicted by an HSJ Local Briefing about Mid Yorkshire in April.

The National Clinical Advisory Team and Department of Health gateway process were due to review the plans this month. A public consultation is due to begin in March.

Shadow home secretary Yvette Cooper, MP for Pontefract and Castleford, has spoken out against the proposals.

As well as a large deficit, the trust faces questions about its future as an organisation. It is not on track to become a foundation trust by the government’s April 2014 target, and could be subject to the provider failure regime, so far only applied to South London Healthcare Trust.

The HSJ Local briefing suggested that a possibility was for the trust’s three hospitals to be split and taken over by other providers in the area.