Why are changes to the hospital being proposed?
In 2011 Worcestershire Acute Hospitals NHS Trust (WAHT) approached its commissioners NHS Worcestershire(the people who buy health services) because it had concerns about the financial and clinical sustainability of services in the county as a result of its own financial issues and a freeze in government funding, as well as a national shortage of middle grade (junior) doctors. Clinical evidence is also showing people suffering from heart attacks, strokes and serious trauma are more likely to survive if they are treated in a specialised centre (for these three services people are already treated at Worcester or Birmingham). This led to the setting up of the Joint Services Review (JSR) in January 2012 and proposals to downgrade the Alex in June last year, and further mooted in February of 2013.
NHS managers say there is a shortage of doctors. Why can’t they get them from abroad?
In theory they can but Worcester Trust can’t afford it. The Trust needs to save £50 million by 2015, it has an historic debt of about £18 million which is hitting its ability to pay its bills on time and has resulted in it having to take out a £12 million government loan in December 2012 and they continue to struggle financially in 2013. Other Trusts, such as University Hospital in Birmingham, which has about £70 million in the bank, are recruiting from abroad to help fill the gap but it is still not enough. Ultimately not enough doctors are being trained and it is unlikely to get better anytime soon.
The review has been running for well over 20 months – why is it taking so long?
Ultimately because of you, the public, supporting the Save the Alex Campaign and doctors in Redditch and Bromsgrove who opposed plans which would have seen our hospital reduced to just a ‘cuts and bruises clinic and a diagnostics centre’. These views forced the JSR team to think again. In October, as a result of public pressure and a lack of choice, the GP commissioners started a process to see if other providers could take over the Alex and provide services there. At this point Worcestershire Acute Hospitals NHS Trust decided to revise their option and try to provide as many services as possible at the Alex.
On the 19th September 2013 NHS Redditch and Bromsgrove Clinical Commissioning Group published their prospectus which seeks to commission all present services at the Alex.
What has been decided so far?
On February 26th the JSR team met to discuss the recommendations made by the Worcestershire Clinical Senate (made up of the most senior doctors and nurses in Worcestershire). For clinical reasons they agreed that services such as A&E, maternity and paediatrics should be centralised into Worcester under option 1 but also backed allowing option 2 (a link-up with Birmingham providers) to be developed further and put to the public option 2 and three Birmingham providers are involved – the QE, Birmingham Women’s Hospital and Birmingham Children’s Hospital. Currently option 1 & 2 are being independently assessed.
This independent assessment work will not result in a final decision being made and indeed may result in further options that have yet to be even considered.
What can Birmingham Trusts offer and why don’t we know more about this option?
The JSR process was set-up to find a Worcestershire solution to WAHTs problems. As a result there was no remit to allow other providers into the process. This changed on April 1st when GP Clinical Commissioning Groups in Redditch and Bromsgrove, Wyre Forest and South Worcestershire took charge of buying hospital and other NHS services in Worcestershire.
It is believed the Birmingham Trusts can offer at least what Worcestershire is offering, if not better. There are significant advantages to people in this area of linking up with a successful Foundation Trust hospital; the QE is one of the most technologically advanced hospitals in the country with some of the best facilities and consultants in Europe, and it is a teaching hospital (most of the world’s leading hospitals are teaching hospitals at the cutting edge of medical science and surgical innovation). The Birmingham Trust doesn’t have problems with debt and has funds to invest in the Alex and its staff. There are also better transport links so people can get there.
If the Birmingham Trusts take over the Alex won’t this mean that Redditch will end up dealing with an overflow of patients from Birmingham?
It is possible that some extra patients will come to use some services at the Alex but at the moment patients from this area are often referred to the QE, Women’s or Children’s hospitals in Birmingham for treatment. This will depend on the range of services provided at the Alex and there may be new, improved clinics and treatments. What is important is that services flow seamlessly with all patients getting access to high quality treatments and the care they need and deserve.
Why is Redditch losing out and not Worcester?
Simple. The Worcester site is a PFI hospital, meaning it was built using private money which the Trust must pay back at a rate of about £30 million a year – equivalent to about 9 per cent of its annual income – over a 30 year period. The Worcestershire Royal is also one of the largest non- teaching hospitals in the country. It would not make practical or financial sense to downgrade it.
When will a decision be made?
A final decision, which will be taken by the GP Clinical Commissioning Groups after formal public consultation, is now not expected till 2014.
The CCGs want to make sure they achieve the best possible mix of services for patients who use local NHS hospitals. They are determined that services in all the NHS hospitals in Worcestershire have a safe and sustainable future.
What about emergency calls – will the ambulance service know where to take seriously ill patients?
Patients that need complex, specialist acute or medical care will be taken to the nearest specialist centre that is best equipped to deal with their problem.
How will I get to Worcester for an appointment if I don’t drive and how will my family be able to get there if they don’t have a car?
Good question and Save the Alex don’t know either.