Expand the range of services offered by the Alexandra Hospital.

It is clear from the review that Worcester Royal Hospital (WRH) is the least financially viable of the three sites yet the options are centred on development of this site rather than the other main site at Redditch, presumably because WRH is a PFI hospital. We consider that the option to expand Redditch should be considered.

Improve Productivity

There would certainly appear to be scope to improve on current productivity levels and a more realistic target might be to achieve national average LoS, supplemented by a more rigorous review of theatre utilisation, skill mix etc. It should be demonstrated that all of the opportunities to improve productivity by implementing the '10 High Impact Changes' have been pursued, e.g. day case usage, which we know to be variable across the Trust

Service reconfiguration, certainly at a 'simple' level, provides a relatively small proportion of savings. It is however likely to be by far and away the most controversial. Management time maybe better focused on the larger gains to be made from productivity (no matter how difficult), rather than split between this and the highly politically charged reconfiguration issues.

10 High Impact Changes

We strongly encourage the Trust to look first at the '10 High Impact Changes' as a method of improved productivity and to devote all management resource to the implementation of these changes. We believe that the reconfiguration options would detract from the work that needs to take priority and would benefit from more careful thought and work up.

[Many of the above issues were origionally documented by the Redditch and Bromsgrove Primary Care Trust]