Please send this letter to your councillor Re Poole Hospital

Dear Councillor

I am emailing as a Swanage Town Councillor, and as co-ordinator of Defend Dorset NHS residents group, to ask if you, your Party, and/or your Council would write to Dorset CCG to support an “A&E Local’ model for Poole Hospital – this would mean the retention of daytime A&E care at Poole.

Although the Secretary of State decided on 13th January not to veto the Dorset NHS reconfiguration plans, an “A&E Local” model was suggested by the Independent Panel as a “possible viable option” for Poole.

A&E Local would be an alternative to the proposed Urgent Care Centre, and would support BCP Council to meet their responsibilities under the 2012 Health and Social Care Act to maintain timely access to care for residents. Unless the A&E Local option is adopted, the plans mean a reduction in the number of Dorset A&E + Maternity units serving the conurbation from 2 to 1, and long emergency journeys, putting lives at risk, from many Dorset areas.

 What is A&E Local?

When the Independent Review Panel (IRP) were asked to look at the Dorset reconfiguration plans in June 2019, the then Health Minister Stephen Hammond suggested an “A&E Local” model might address the concerns in Dorset, please see his letter to the IRP (attached), bottom of page 1.

Although the ‘A&E Local’ model has not been finalised, we understand that it is expected to be a fully functioning A&E that is open for 16 hours per day, but closed overnight:

 This model would address the issue of chronic daytime congestion across the Poole/Bournemouth conurbation inhibiting emergency access to Bournemouth Hospital from most of Dorset.

This model would also mean less pressure on Bournemouth Hospital A&E, which would otherwise be the sole A&E and Maternity for the conurbation catchment population, and West Hampshire, who will have Dorset trauma, specialist maternity and children’s care on their doorstep for the first time. 

While it is not yet clear what the A&E Local model would allow in terms of maternity and paediatric care, a co-located A&E is a pre-requisite for maternity care.

In the IRP’s advice to the Secretary of State, the last two paragraphs deal with the future development of services and discuss the issue of an ‘A&E Local’ – a model between the Urgent Care Centre that is currently proposed for Poole, and a conventional A&E. Please see page 10 of the attached advice.

 What’s the difference between A&E Local and an Urgent Care Centre?

A&E Local would treat medical emergencies. Dorset Healthcare University Foundation Trust lists the injuries that an Urgent Care Centre can treat. They are the same as the injuries that can be treated in Swanage Minor Injuries Unit:

 Support for retention of A&E, Maternity & Paediatric care at Poole

36,910 Dorset residents signed petitions to retain A&E and Maternity at Poole, and two Dorset MP’s – Richard Drax and Oliver Letwin – wrote to support referral of the plans back to the Secretary of Sate.

There was widespread support for the referral across 9 Dorset Parish, Town, District, Borough and County Councils.

There remain grave concerns about the capacity of one A&E and Maternity at RBH to cope with not the conurbation catchment population and West Hampshire – some 750,000 people. A similar ‘giant’ A&E in Portsmouth, serving a population of 625,000, has been in special measures, with the staff reporting that they feel overwhelmed and deskilled “it’s like a war zone” and patient waits of 10 hours to be seen not uncommon.

There also remain grave concerns about the travel time to Bournemouth Hospital in a medical, trauma or maternity emergency from most of Dorset.

At the Court of Appeal Judicial Review hearing, the Judges accepted that longer journey time in an emergency would lead to more deaths. Based on the CCG’s own calculations for the Court, in the worst scenario this could mean 400 additional deaths of ambulance patients each year. This figure does not include the risk to non-ambulance patients. The vast majority of maternity and child emergencies do not attend A&E by ambulance.

I hope that BCP Councillors will work with us, with Dorset Councillors, and with Dorset CCG, to protect good quality emergency care in Dorset by supporting the retention of 16 hour A&E care at Poole. Please seek support among fellow Councillors for the A&E Local model, and consider how best to support Dorset CCG to implement this model.

Best wishes

Debby (Monkhouse)

Swanage Town Councillor

Co-ordinator, Defend Dorset NHS Residents Group


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