Let your voice be heard on future Weston General Hospital services
Weston General Hospital at the Heart of the Community
Let your voice be heard on future Weston General Hospital services
Weston LibDems are responding to the engagement process North Somerset Clinical Commissioning Group (NSCCG) have initiated within this local area. We are seeking all member's views with the intention of reaching a collective agreement to have our voice heard.
Our response will be collated with many others by an independent auditor to present findings to the NHS and all the agencies involved in these proposals. Weston LibDems would like to congratulate NSCCG for the opportunity this affords for well-informed conversation and public feedback opportunities.
March 22nd Pub'n'Politics Event at The Imperial Notes. Please follow our video link on Facebook. https://www.facebook.com/WsMLibDems/
Speaker Colin Bradbury (Programme Director NSCCG):
Four ideas developed by local doctors and nurses
- A&E: Not enough staff to run AE on 24/7 basis. It's a problem now. Most patients come during the day. Most serious cases go elsewhere overnight. Major trauma goes elsewhere to a specialised major trauma centre. Staff/expertise main driver of outcomes, not journey times.
Proposal: No specialist trauma doctors, but minor injury unit staffed by nurses over night. Already in action in Cheltenham.
- Surgery : WsM has excellent reputation surgeons and excess operating theatre capacity. Can we attract more routine operations? Ie Orthopaedics.
- Emergency surgery. Could more complex cases be done elsewhere? Do a theatre team need to be kept on ready basis overnight?
- Critical care. WsM critical care unit too small to be effective. Blend of beds (high dependency, critical care…) could be increased - more effective use of budget.
Two enabling proposals: Closer working with other hospitals. DRs as resource for population, not tied to hospital and consequently would move within an area as appropriate. Working more closely with community and primary care. How do we get medically fit people out of beds and back home?
Questions directed from the room:
Q Does change look at just Weston or whole NHS system in this area?
Focus on hospital but looking at the wider or domino impacteffect that Weston changes will have locally.
Q In relation to national NHS reforms?
Part of national SDP. This is first program in NS, others will follow elsewhere in area.
Q IF you had all the funding you want, would changes still go ahead?
Yes, there are issues beyond funding. Weston struggles to attract staff. Not enough A&E docs nationally - WsM can't attract them from Bristol, Plymouth etc. filling this shortfall costs ££ ie. Locum cover is costly.
Clinical outcomes. It makes sense for hospitals to specialise on rarer conditions.
Q Will some of these proposals make it harder to recruit to WsM Hospital, as interesting work is outsourced. Would teaching opportunities be lost? Is there a threat to our ability to grow? WsM is a fast growing town with young people who want good services (and older people who need cardiac care etc)
Unsustainability of WsM makes the hospital unattractive. Taking away uncertainty makes it easier to recruit. Partnership with other hospitals could open up opportunities for rotation/exchange of doctors.
Q Pensioners are worried about A&E. Worried about going to a hospital a distance away and not having family to help/transport options. Older people worried about change in general. Elderly need a fair deal.
Transport is a big consideration. Not only for patients but for visitors. Detailed set of proposals will be put forward and discussions with council will occur about transport links.
Q - are special cases only going to Bristol overnight, or are people being sent elsewhere in daytime, so why would we need critical care beds?
AE proposals only related to overnight. Full AE service during the day and planned operations which is why we want to increase critical care beds. We want to increase planned ops too.
Q - Weston does have very good critical care service at the moment.
Q - Council is under financial pressure, cutting bus services, would NHS subsidies bus services?
NHS does provide some transport service for patients being transferred between hospitals.
Q - Emergency care changes feel like they are driven by cost savings, not efficiency.
Savings on locum and agency rates. But it is not just about cost - can't recruit sufficient A&E DRs. Walk in cases will still be seen by emergency nurses. Money saved can be reinvested elsewhere.
Q - How do you make WsM hospital more attractive, by reducing services? Vicious circle?
Break down walls between hospitals - give people opportunities to move between hospitals/gain experiences.
Q - is there a shortage of nurses?
WsM finds it easier to recruit nurses than DRs but challenge to get emergency nurse practitioners.
Looking for a managed transition - keeping DR coverage as nurses trained up.
Q - Nurse training costly, and students have to pay the cost of training. = shortage of nurses in future (national problem)
Q What's been done to attract more Drs?
This is not a problem unique to WsM - all hospitals fishing in same pond for talent. Consequently, as the smallest acute hospital, WsM is struggling to attract the right talent. There is a lot of time when DRs wait for beds to be freed up from A&E overnight cases from nursing homes. This is a problem as we know we could recruit more DRs if we could assure them they would be given an opportunity to practice.
Cheltenham already made a transition to Nurse led overnight A&E.
Q last inspection was poor. Are some of these proposals a reaction to criticisms?
This work will help improvements that need to be made. Address label of "unsustainability" and to reduce instability amongst staff. Partnership with Bristol university hospitals, which have an Outstanding ranking, will allow WsM to return to community acclaim. Private practice already book the hospital at the weekends because of the quality of care.
Q what is alternative in respect of A&E changes? Sounds like there are no other options.
At the moment we are setting out the case for change and problems that need to be solved. We are focusing our resource on time of greatest need which is in the daytime. We are not selling these proposals as THE solution but asking for feedback on the thinking so far. We will listen to ALL the responses and consider carefully how we shape the next steps. This will then form part of another official consultation to be published later.
Q is this the start of Hospital specialisation - or are we simply handing off work we can't cover. What will WsM specialise in?
Looking to make WsM Centre of Excellence in planned and elective surgery with a specialsim in eldery care. No hospital does everything - ie. Bristol doesn't do orthopaedics.
Q - evidence from Cheltenham?
Evidence so far is that the model is robust and safe way to deliver care. Took a little while to bed in but we can learn from them.
Q - How will relationship with council develop on social care work?
Council and hospital already work closely together. Not necessarily about spending more money, it's about finding ways to work better together ie. Use same IT system.
Q - Difficulty with enabling strategies is that we've been saying this for years, but nothing happens. Silo mentality gets in the way. People protective of budgets. Nature of NHS hasn't encouraged integrated working - how do we break this down?
There is now a realisation that we need to work together - that we can't carry on as we are on our own. Need to work together. NSCCG has seen a step change in willingness of hospitals to work together. If WsM falls, other hospitals will have to pick up burden. Ie. WsM/Bristol partnership is a good example.
If we carry on as we are, £300,000,000 gap in funding will occur.
Q - What's causing crisis in social care? What's being done to address this?
Q - Pensioners pay in more to system - get less out.
WsM should specialise in older person care - that's the population to be served.
Q - big gap is transition between hospital and community care. If hospital is excellent, doesn't fix problem of insufficient community care.
Q - CCG is facing issues outside of control. Ie. Social care, NHS funding, recruitment.
Q - Is this solving the short term problem - how do we solve the long term issues?
This plan is not going to create a perfect hospital. But will take away the unsustainability label.
Q - Patient choice.
Need to get better at promoting patient choice and getting people to choose WsM for operations. Don't want this to be destabilised by emergency cases taking up beds and disrupting planned operations.
Q - What's being done to improve WsM reputation.
Q - People would be far better served at Weston, but people choose to go elsewhere because of bad WsM rep.
Q - What do ambulance service say?
They are fully involved. Not being asked to do anything more.
Q - very pleased that engagement is taking place. Good to see NSCCG reaching out to the community.
"buildings don't deliver healthcare, people do"
Next steps:
- 3 events - 28, 29, 39 March
- NSCCG website feedback form
- More detailed plan to be developed on basis of feedback
- NHS England/SW England Medical senate to vet plans on medical safety
- Local council review
- 3 month public consultation = autumn/winter
Please respond with opinion as soon as possible for collation into response. The official response will be returned by the deadline of 6th April 2017.
