STRUCTURE: University Hospitals of Morecambe Bay Foundation Trust could lose up to £2m a year through commissioner plans to transfer its complex vascular surgery work to another trust, its board was warned last week.
Commissioners plan to establish three specialist centres to carry out all “major vascular interventions” in Cumbria and Lancashire, a paper to the foundation trust’s July board meeting explained. The centres would also provide services for the populations of Wigan, Bolton, and Dumfries and Galloway.
Earlier this month primary care trust cluster NHS Lancashire informed Morecambe Bay – which is forecasting a deficit of around £30m for 2012-13 – that it had lost its bid to be selected as one of those centres.
The decision would mean some or all of the vascular work currently undertaken by the trust would be transferred elsewhere, it suggested.
While the paper said many details of the proposed reconfiguration remained “unclear”, it added that if the trust lost all of the work currently undertaken by its vascular unit the “potential loss of income” was “projected to be over £2m” a year. If the unit was able to retain outpatients work and day surgery the potential income loss for the trust would be around £1.3m a year.
Eric Morton, interim chief executive at Morecambe Bay up to the end of July, said consultant staff had developed the vascular unit over 40 years, and it had developed a “regional and national reputation, based on excellence of speciality training”.
He added: “We want to keep the services within our hospitals and we have lodged a formal appeal against the decision.”
The Morecambe Bay board paper said the decision could have other knock-on effects for the trust, including “difficulties” for other specialties that have come “to rely on in-house vascular services”, particularly orthopaedic and gynaecological surgery. “It is probable that the expectation to resolve haemorrhagic complications will fall upon general surgeons who may not be recently experienced or trained in appropriate techniques,” it stated.
It added that the designation of UHMB trauma units may be put at risk, it would lose the senior higher surgical trainees who currently train at the vascular unit, and loss of a surgical unit with “a reputation for excellence in clinical outcomes” was “potentially harmful” to the trust as a whole.
According to the report, the PCTs plan to commission the three “vascular intervention centres” from North Cumbria University Hospitals Trust, East Lancashire Hospitals Trust, and Lancashire Teaching Hospitals FT. It stated that UHMB’s bid scored “comparatively or better than” North Cumbria’s in most areas, but scored lowest on risk assessment “the parameters of which were financial, legal, potential failure of service transition” and “potential failure of full service delivery”.
FT regulator Monitor intervened in UHMB earlier this year to install a new chairman, after a series of care and governance failings were uncovered at the trust. It has since seen a number of other changes to its board, with a new permanent chief executive, Jackie Daniel, due to take over on 1 August.