WORTHING HOSPITAL: How the recommendation was made

Q. Who is making decisions about the Fit for the Future consultation?

A. West Sussex PCT is a statutory body with the strategic responsibility for planning and delivering health services across West Sussex to ensure they are in the right place where they are needed and that they are sustainable into the future.

The PCT has led the Fit for the Future review of local health services in the county.

Part of this process was a major public consultation which ran from June to November 2007.

Q. Why is there a need to review health services?

A. West Sussex needs a health service that is flexible and responsive to the improvements and changes in medical practice along with the changing health care needs of local people.

That's why we constantly review how health services are provided.

The changes need to be clinically sustainable and financially viable. These two principles do not conflict.

Centralising services in West Sussex does not mean closing any of the hospitals in the county.

Our long term plans will see more services move out of hospital to be closer to where people live.

This is in line with national policy to shift health care away from hospital and towards the community and preventative services.

Q. Have any decisions yet been made?

A. The PCT has already made a decision on the 'service model' for the people of West Sussex (May 7 Board meeting).

A&E services will stay at Princess Royal, St Richard's and Worthing Hospitals, together with intensive care (treatment and monitoring for people who are in a critically ill, or unstable, condition), routine planned surgery (when a patient goes into hospital on a specific day, for a specific operation, such as a hernia repair) and acute medical emergencies, for example heart attacks, strokes and chest problems.

There will be the gradual move of consultant-led maternity services, inpatient children's services, emergency surgery, for example acute appendicitis and the majority of trauma cases, including hip fractures, to one hospital site.

The PCT is recommending that the location for these services is Worthing.

As well as the consultant-led maternity service, West Sussex PCT has promised to increase the range of birthing options for local women by providing two midwife-led units at other locations in West Sussex; a service which is currently not available, and access to home births.

Q. How will the PCT decide on the location of the three services to be centralised?

A. Eight criteria were used to choose the model of care:

1. Acceptability '“ reflecting the views of stakeholders and the public.

2. Accessibility '“ how easy it is to get to health services

3. Clinical sustainability '“ making sure that services are safe and of high quality now and in the future.

4. Deliverability '“ ensuring there is the capacity to meet the needs of the population and that services are managed well.

5. Financial sustainability '“ making sure health services are affordable now and in the future.

6. Health outcomes '“ meeting the needs of the population, improving health and well-being and addressing inequalities in health.

7. Wider strategic fit '“ planning to fit with other strategic issues such as emergency planning, economic and environmental issues.

8. Workforce implications '“ ensuring that high quality staff continue to be recruited and the best use made of their skills.

Four of these were relevant in making the choice of location:

Accessibility, Clinical sustainability, Deliverability, and Financial sustainability.

Q. Which hospital has the PCT recommended?

A. The recommendation which the PCT Board will be asked to approve is that

Worthing should be the location for the three services to be centralised on the south coast of West Sussex.

Q. Why have you recommended Worthing and not St Richards?

A. The Board took time, challenged facts and looked at evidence before using its judgement and knowledge to come to a recommendation.

There were relatively small differences between the two hospitals and it has been a difficult decision.

However, the Board felt that Worthing provides the best location for centralised services for the greatest number of people in those areas with poorest health outcomes and highest deprivation.

Q. This is a recommendation '“ when will the final decision be made?

A. The Board will be invited to approve the recommendation at its meeting on June 4 at Copthorne Hotel Effingham Gatwick in Copthorne, West Sussex.

Q. What does this mean for Worthing?

A. Consultant-led maternity services, inpatient children's services (acutely ill children needing to stay overnight), and emergency surgery (such as acute aneurysm and significant trauma cases for example injuries to the head and chest following a major road traffic accident), will be centralised at Worthing.

Q. What does this mean for the people of Chichester and St Richard's Hospital?

A. For most local people they will continue to go to St Richard's for outpatient clinics and services like day surgery, X-ray, physiotherapy and occupational therapy, just as they do now.

Only a minority of people needing emergency surgery (operations requiring a stay in hospital, not daycase operations), a very few medical patients (for example, patients with a major stomach bleed) and mothers wanting a consultant-led hospital birth will go to Worthing.

Q. What will this mean for Worthing and St Richard's Hospitals?

A. Both hospitals have excellent groups of staff, clinicians and managers.

The PCT welcomes discussions already taking place between clinicians and Trust Boards to develop the clinical and managerial networks working closely together.

This would ensure sharing of knowledge and expertise, which will bring even greater benefits to patients.

Q. Has the PCT taken into account views of staff and the public?

A. The PCT values the input from a wide and diverse range of people, including members of the public, MPs, partners, and staff in the local NHS.

During the public consultation the PCT received almost 39,000 responses from people in West Sussex and the surrounding areas '“ both individual responses and bulk responses including petitions, fliers, letters, postcards or forms that people signed '“ representing the views of the local population.

The responses revealed that travel times to hospitals, services' ability to cope with a growing population and the impact on staff morale were three of the key issues arising from the proposals that concerned the residents of West Sussex.

The PCT specifically asked people throughout the consultation period for feedback about the factors that the Board should use to help weigh up the pros and cons of the various proposals and the analysis of that feedback helped us to draw up the decision-making criteria.

Q. What are the next steps?

A. The PCT Board will be asked to approve the recommendation that Worthing is the site for the three services to be centralised.

It is unlikely that any significant change will take place in under 18 months and the overall target for reshaping health services is a period of up to 3-5 years.

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