Agenda item

- presentation by NHS Doncaster on the changes to the clinical arrangements at Mexborough Montague Hospital.

Jo Pollard, Programme Director, and Chris Staniforth, Chief Operating Officer, NHS Doncaster, gave the following powerpoint presentation on the proposals to change some services currently provided at Mexborough Montague and Tickhill Road Hospitals and provide more care closer to home:-

 

Why do we need to make these changes?

-        More care can now be provided outside hospital

-        NHS landscape and role of hospitals is changing

-        What patients tell us

-        New technology

-        Improve quality and experience

 

Our Principles – Services must be

-        Safe

-        Effective

-        Affordable

-        Value for money

-        Sustainable

-        Integrated

-        Local where possible

 

Government’s four tests – Any service change must have

-        Support of local GPs

-        Patient and public engagement

-        Clinical evidence

-        Consistent patient choice

 

What about the money?

-        No reduction in investment – just used differently

-        New Rehabilitation Centre with £4.9M costs at Montague Hospital

-        DBHFT build and equip the new Rehabilitation Centre including an application to the Fred and Anne Green Legacy

-        Maintain the current investment of £2.8M on acute care

-        £1.4M will be invested in additional home support services

-        £400,000 will be invested in intermediate care and step down services

-        £300,000 will be invested in community stroke services

-        £500,000 will be invested in other community services and palliative care

 

Our Proposals 1 – A redesign programme to

-        Reduce the time patients spend in hospital by providing high quality care for patients who do not need a hospital bed, at home or in a community setting

 

Our Proposals 2

-        Reduce the time patients spend on an acute hospital ward by developing a new 58 bed state-of-the-art rehabilitation centre at Montague Hospital which would improve outcomes for patients by enabling an intensive 24/7 model of care to be delivered

 

Our Proposals 3

-        Stop admitting to Montague Hospital those patients who were currently brought by ‘blue light’ ambulance for urgent care

-        Take urgent care patients directly to Doncaster Royal Infirmary or another district general hospital near to where they lived such as Barnsley and Rotherham

 

Why do we need to make changes?

-        People are living longer so we need to help them stay as fit as possible so they can enjoy a fulfilled life

-        Keeping elderly and frail patients in hospital beyond their urgent care period results in them losing many every day skills and this can quickly result in a loss of independence

-        Centralising rehabilitation services at Montague Hospital would maximise the benefit of having a large pool of skilled therapists who would be able to provide a 7 day a week service

-        More patients would be cared for at a single location instead of therapists spending valuable time travelling between hospital sites to see patients

-        Patients who needed urgent care should be treated at a facility that has a full range of support services

-        An enhanced new role for Montague would enable the hospital to continue to flourish and secure its future at the heart of the Doncaster community

 

The Service redesign would

-        Cut the time that patients stayed on a ward in a busy hospital by faster access to specialist inpatient and community based rehabilitation services that would help speed up their recovery

-        Improve health outcomes by helping patients get quickly back into everyday life

-        Provide more social care support and services that provided ‘intermediate’ care for people who did not need a hospital bed but were not quite ready to return home

-        Pilot a new assessment unit designed to speed up the discharge of people from hospital into the next stage of their care

-        Provide more home support services

-        Community based ‘outreach’ services to provide more care at home for people who have had a stroke to help prevent them from having another 1

-        Create a new centre of excellence for rehabilitation at Montague Hospital bringing together a wide range of skilled clinical staff on 1 site

-        Enable the closure of Ash, Elm and Rowan Wards at Tickhill Road Hospital and their service transfer to Montague

 

The change would also enable the local NHS to

-        Do more surgery at Montague Hospital, cutting the time that patients had to wait for an operation

-        Double the number and type of endoscopy procedures at Montague Hospital

 

Beds

-        160 (out of 872) beds affected by the proposals

-        Reduction in Doncaster beds of 73

15 to Rotherham/Barnsley

50 beds or equivalent in community

8 achieved by reduced length of stay

 

What happens next?

-        Public consultation finishes on 19^th December, 2011

-        All the responses would then be considered by senior NHS staff and summarised in a report

-        The report would make recommendations and explain how your views had been taken into account

-        Presented to the Board of NHS South Yorkshire and Bassetlaw in early 2012 for members to discuss and make a decision on whether the proposals should be implemented

-        The date of the Board meeting would be publicised.  The Board’s decision would be publicised in the local media and published on NHS websites

 

Discussion ensued on the presentation with the following issues raised/clarified:-

 

-        The Dental Access Service was a South Yorkshire resource for anyone to use.  Presently it was delivered from Mexborough Montague, however, it would move from the Hospital site and move to 1 of the Health Centres in Mexborough

 

-        The pilot phases would be based at the Tickhill Road site

 

-        The need to invest in community services and social care services

 

-        2 of the physicians were retiring and, under the Royal College Guidance, unless a stand alone unit provided back up services, they could not recruit;  Mexborough Montague did  not have a back up service

 

-        Rotherham Foundation Trust had been working with NHS Doncaster and in general supported the proposals and could absorb the anticipated impact

 

-        RDaSH had also been working closely with NHS Doncaster around the proposed changes and linkage between the specialist unit at the Hospital and community based rehabilitation was critical.  It was felt that the proposals helped to sustain the Hospital’s future and gave it a clear role removing areas of concern around clinical evidence and developed the rehabilitation hub for that area

 

Chris and Jo were thanked for their presentation.

 

Resolved:-  That a report on the proposals for the Dental Access Service be submitted to a future meeting.