Shake up of Greater Manchester services backed by city's CCGs

The options set out for the Healthier Together reconfiguration would see the centralisation of emergency and high risk general surgery, currently performed at ten Greater Manchester hospitals, on to four or five sites.

HSJ understands that the commissioning groups’ preconsultation business case for the reconfiguration has now been formally submitted to NHS England for assurance, with a decision expected by the end of this month.

The timing of the planned consultation is intensely politically sensitive, coming less than a year before the next general election.

HSJ understands that if Healthier Together gets the go ahead this month, the public consultation could begin immediately. This would allow the consultation to be completed ahead of the political party conference season in the autumn.

The proposals set out eight options for reconfiguration.

Under all of the options, there are three hospitals that would become “specialist centres” for emergency and high risk surgery.

These are the Manchester Royal Infirmary, run by Central Manchester University Hospitals Foundation Trust; the Royal Oldham Hospital, run by Pennine Acute Hospitals Trust; and the Salford Royal, run by Salford Royal Foundation Trust.

In four of the options, there would be only one other specialist centre in the conurbation.

This would be either University Hospital of South Manchester FT’s Wythenshawe Hospital, Stockport FT’s Stepping Hill Hospital, Bolton FT’s Royal Bolton Hospital, or Wrightington, Wigan and Leigh FT’s Royal Albert Edward Infirmary.

In the remaining four options, two of these sites would be specialist centres, in various combinations of Bolton or Wigan and UHSM or Stockport.

Three sites would not provide emergency surgery under any of the options: North Manchester General Hospital and Fairfield General Hospital, both run by Pennine Acute, and Tameside Hospital FT’s main site.

The Healthier Together team estimates that the sites that do not become specialist centres would still be able to treat 96 per cent of their current accident and emergency patients under the changes.

It argues that the changes are necessary to enable all hospital sites to meet rising quality standards within the constraints of the staffing and money likely to be available.

Under Healthier Together’s proposed model, two or three hospitals in each sector of Greater Manchester would pool their general surgery workforce to create a single service provided across all sites.

The team would be rotated across all hospitals in the network, but all emergency and high risk work would be performed at the specialist centre.

The other sites in the network, termed “general hospitals” in current Healthier Together jargon, would continue to perform day case and planned work.