If you ask yourself – how would I approach this huge task of improving the NHS in Dorset?
You might go for something like this:
1. Introduce, stating the need for change
2. Consult widely, gather evidence and data
3. Formulate options using relevant experts
4. Consult relevant stakeholders for feedback
5. Check feasibility with implications and costings
6. Harden up the options
7. Publish both the options and preferences
8. Consult
9. Decide, make specific plans and implement.
Sounds simple, but it needs to be very well managed if the public are to be carried forward and to maintain their trust which requires a respect for openness and accessibility. It is simply not good enough to rely on‘due process’to do this, nor is it good practice to allow leaks and press releases to inform the public prior to publication and full consultation.
Below is a Q&A taken from the Dorset CCG’s ‘‘Dorset Vision web page.
Q: How many people who would currently attend Poole Hospital A&E would need to travel to Bournemouth Hospital under these proposals?
A: The majority of people who currently attend Poole hospital A&E would continue to have their health needs treated at the Urgent Care Centre. Under the current proposals, it is estimated that approximately 80% of all current emergency patients arriving at Poole hospital would continue to have their needs met at the Urgent Care Centre at Poole Hospital.
This assertion of 80% is not supported by the following recent data from Poole Hospital’s last annual report which gave the figure of approx 50% of all A&E attendances or some 33,000 admitted out of approx. 66,000 patients. As compared to Royal Bournemouth and Christchurch Hospital where approx 20,000 or just 23% of the 87,000 patients who attended, were admitted. The figure of 80% implies that approx 53,000 potential patients would be attending Poole UCC on current levels.
That is some 53,000 traumatised patients admitted to both hospitals who, either arrived independently or had a 999 call out attended by a highly skilled paramedic team/doctor. The medical team assessed and stabilised the patient on site before proceeding to the A&E which they considered the best destination for them. Some were admitted for further investigations, some for observation, some because they needed treatment and some because they had no safe place to go back to. More serious patients would have had initial treatments and then transferred to a specialist centre to continue treatment.
The CCG assertion of 80% of all current emergency patients arriving at Poole would continue to have their needs met does not stack up. I guess it is based on page 13 of https://www.dorsetsvision.nhs.uk/wp-content/uploads/2015/01/Hospital-types.pdf which headlines“Rochdale an advanced EUCC with step-up was developed, covering 80% of previous A&E volumes”
The figures below show that the figure could well be closer to just 43%. It would be interesting to find how they arrived at their number.
A&E attendance/admissions 2014 – 2015
All % are compared with the total number for the adjacent column
Attending |
% of total |
Admitted |
% of total |
Not admitted |
% of total |
|
Poole Hospital |
66120 |
43.26 |
33005 |
62.33 |
33115 |
33.15 |
Bournemouth Hospital |
86727 |
56.74 |
19943 |
37.67 |
66784 |
66.85 |
Totals |
152847 |
100% |
52948 |
100% |
99899 |
100% |
% Of Total Attending |
100% |
|
34.64% |
|
65.36% |
|
Source: Annual Reports and request.
The attendance and admissions figures and percentages are very different as Poole is the current Major Trauma A&E. The implication is that some 30 thousand or more cases each year that would have been admitted to Poole will go to Bournemouth under the proposal and this will come at a journey time/money cost.
The the raw figures do indicate that further investigation or explanation is required. Without more details on A&E attendance, location of call out, distance of travel and time of journey to each A&E, coupled with patient demographic projections, it is difficult to project future attendance for the current provision or indeed for the proposed changes. Maybe the CCG have done this and could release the data under a FOI request.
Whist there is much to commend the drive towards a better NHS moving it forward to meet the future needs of the people of Dorset there is a palpable lack of trust within the public of the national political process and fears that our CCG could be sucked into the political vortex of the‘new health market economy’and making plans only to have them compromised by false‘Austerity’. Poole’s MP Mr Robert Syms has already hinted at a‘likely’£60 million investment in Poole Hospital without making it clear whence this investment might come from.
©John Daniels 2016
Update as of 9th June:
Dear Mr Daniels
Thank you for contacting NHS Dorset Clinical Commissioning, and for sight of the article.
The response to your enquiry is currently being finalised and will be issued as soon as it is available.
Please accept our apologies for any delay in responding to you, but we are experiencing a considerable increase in public interest in the clinical services review at the present time.
Sincerely,
Dianne Poulton
Customer Care Team