Two district hospitals would stop providing hyper-acute stroke care and reduce access to paediatric surgery under a proposed shake up of services in Yorkshire.
A public consultation recommends Barnsley and Rotherham hospitals no longer provide care in the first 72 hours after a stroke, with centralisation of services in Sheffield, Doncaster and Wakefield.
A second consultation document says surgeons at Barnsley, Rotherham and Chesterfield hospitals would no longer carry out operations on children under general anaesthetic at night, weekends or for children needing an overnight stay.
The consultations, led by the Commissioners Working Together in south Yorkshire, north Derbyshire, Bassetlaw and Wakefield, are against a background of broad agreement that services are no longer sustainable due to specialist staff shortages and concerns over variable access and outcomes.
If the changes to stroke care go ahead, at least 1,200 patients a year are expected to be treated in Doncaster and Sheffield in line with recommended clinical thresholds, before being transferred to local hospitals.
Services will be maintained at Chesterfield Royal Hospital, which like Barnsley and Rotherham is a small centre dealing with fewer than 600 patients annually, pending any future review of services in the East Midlands.
Former neurologist Professor Graham Venables, clinical advisor to Commissioners Working Together, said: “At the moment, some of our stroke teams don’t treat as many patients as teams in other hospitals, meaning they have fewer opportunities to develop their skills and introduce new treatments, which could mean that in the future, some of our patients may not get the best care they deserve should they have a stroke.
“This, combined with a national shortage of specialist staff, means we need to act now and use our staff and facilities in a different way to make sure that everyone in our region has access to the best services and fast treatments after having a stroke.”
The changes to paediatric surgery would affect one in 10 children requiring operations. If the preferred option is selected, it would lead to the transfer of up to 1,900 procedures each year, mainly to Sheffield Children’s Hospital but also to centres in Doncaster and Wakefield.
Tim Moorhead, clinical chair of Commissioners Working Together, said there were national shortages of surgeons qualified to operate on children and changes would allow better deployment of clinicians given the low volumes of procedures involved.
Final decisions will be made in February.
Information provided to HSJ