Call for Creation of New Acute Trust to Save Services!
Save the Alex Campaign Group
Press Release 10th September 2015
Save the Alex campaigners have called for the Trust which runs Worcestershire’s hospitals to be replaced by a larger single Trust for the Birmingham sub-region, following news consultation on the proposed reconfiguration of the county’s hospital services has been delayed again.
Health bosses have announced consultation, which they previously insisted would take place later this year, has now been delayed until the New Year at the earliest. It is understood the latest delay has been caused by another failure to come up with a safe, sustainable model of delivering services which has widespread support amongst doctors.
Neal Stote, chairman of STA campaign, said: “This latest failure means if they do go out to consultation in February as they hope, which I very much doubt, this review will have been going on for more than four years.
“In that time the situation has deteriorated in terms of staffing, performance and financially. On top of that the evidence base is changing all the time and the reasoning behind the reconfiguration no longer stacks up.
“That doesn’t mean things don’t need to change. It means new potential solutions have now come along which could result in a greater, more sustainable service for patients that use the Alex and the wider Worcestershire area rather than the current proposal which is being cobbled together and will fail shortly after being implemented.”
One of those solutions was outlined by Health Secretary Jeremy Hunt in an interview with the Health Service Journal, where he said he believed there were too many Trusts acting as independent organisations and the answer lay in single, larger Trusts running a number of hospitals. He singled out UHB and its chief executive Dame Julie Moore as capable of taking control of a large number of hospitals over a wider area.
STA believes this is the only way to resolve the staffing and financial crisis gripping the area’s hospitals and a new Greater Birmingham or Mercia Trust should be created running hospitals across Birmingham as well as in Worcestershire.
These are the reasons STA believes the current reconfiguration no longer stacks up and a new single Trust for the Birmingham sub-region should be created.
Financially: The original financial argument for reconfiguration was the Trust needed to save £50million by 2015. £30million of that was to come from efficiency savings and the remainder from reconfiguration. However at the time the original financial modelling was done the Trust was breaking even. Now it is set to end this year £58million in debt.
If this happens it would push its total debt/deficit – including historic debts – to in the region of £140million. On top of this the Trust is borrowing millions of pounds to pay staff and suppliers as it is running out of cash.
This is unsustainable and the tax payer surely has the right to question why the
Department of Health is continuing to irresponsibly lend our cash to a failing organisation, which has never made money since its formation in 2000, rather than force other options to be looked at. Even if
the reconfiguration is successful, the savings won’t take the Trust out of deficit.
Creating a new Trust to run services across a wider area will clear the debt, allow hospitals to work together without worrying about the interests of their own organisations as they will all be one trust. It will also allow significant savings to be made from having a single HR and payroll team, single chief executive, single communications team, single management team etc.
This model is already working well in local government.
Workforce: A shortage of doctors was another main reason behind the reconfiguration. This has now increased over time which has resulted in the emergency closure of services, such as emergency gynaecology which has been centralised into Worcester, which are never going to come back. Paediatrics and maternity are next on the list.
The Trust itself is also now a toxic brand. Damaged by a report which found evidence of behaviour which could be considered bullying, uncertainty over the reconfiguration and sinking morale, the Trust is finding it difficult to recruit and retain staff. Even if the reconfiguration goes ahead rebuilding the Worcestershire Acute Hospitals NHS Trust’s reputation will be a long process.
A new trust would not have that stigma attached to it and would allow access to a larger workforce which could be rotated over a wider area. Giving staff the chance to work at a regional specialist centre like UHB, as well as to do more elective work in district generals like the Alex, would also create an attractive organisation for staff to work in, helping with recruitment and retention.
New evidence: Since the reconfiguration started new evidence has emerged. The Keogh report has suggested new ways of delivering A&E services and stressed the important part smaller district generals like the Alexandra Hospital have to play. Sir Bruce Keogh has also said not all hospitals need to provide 7 day working but could create a networked model whereby some of those services which need to be available 7 days a week are provided by hospitals over a wider area. This could mean people having to travel at weekends for certain services but it has a chance of being sustainable.
The Dalton report set out how a move to having a single Trust run multiple hospitals could be achieved while Simon Stevens, the head of NHS England, is also completing his maternity review and removing maternity services from the Alex before considering the findings of that report would be premature.
There are also calls for new ways of using staff or ‘task shifting’. This would see advanced nurse practitioners and midwifes taking on some of the tasks junior doctors currently perform. This could again lead to new models which would sustain more services locally.
Scrapping the reconfiguration and starting again would allow some of these models to be explored and would lead to a more sustainable solution.
Performance: It is clear WAHT cannot deliver. It is several months since it hit its A&E waiting time target and performance is so poor that it is likely we will once again this winter see departments overloaded and patients being treated in corridors. On top of that the Trust is missing its 62 day cancer target and has seen the number of people waiting more than 18 weeks for an operation rise to above 2,000. As a result the Trust has told doctors in Redditch and Bromsgrove to tell our patients to have their operation elsewhere while they catch up with the backlog. This would be laughable if it wasn’t so serious.
Having a larger, single Trust means this could be managed more effectively. Dame Julie Moore has already said UHB’s plan for the Alex would be to have more elective services on site and again it would allow staff and theatres to be used more efficiently.
Mr Stote added: “The evidence to ditch the current reconfiguration is overwhelming. It simply will not save the money the Trust needs to be sustainable and that’s if they can overcome the flaws with the clinical model.
“We agree with Mr Hunt’s solution to have fewer Trusts running more hospitals and believe WAHT should be scrapped in favour of allowing UHB to run all three county hospitals as part of a larger Birmingham sub-region Trust.
“Worcestershire doesn’t need a Trust of its own – what it needs is safe, sustainable services delivered as locally as possible. Unfortunately health bosses in Worcestershire won’t proceed with this idea as too many of them are concerned with saving WAHT at all costs and not with saving services.
“I call on Mr Hunt to intervene and to make this new proposal happen and we will be seeking to meet with MPs in the area to ask for their support in this.”