East Lancs Clinical Services Review

Tags: Campaign | health care | NHS

Friday, 07 July 2006 00:00

I have sent the following as my response to the "Meeting Patients' Needs" review: Cllr. Maureen Martin Chair, Joint Overview and Scrutiny Committee C/o. Emma Wilkinson Office of the Chief Executive, Lancashire County Council PO Box 78, County Hall PRESTON PR1 8XJ 7 July 2006 Dear Cllr. Martin, I am writing to urge the Joint Committee to request the Secretary of State for Health to invite the Independent Review Panel to examine and report on the proposals to change the structure of the local NHS and the way health services are delivered in East Lancashire. I make this request on two grounds. First, I believe the consultation process had serious shortcomings. These have been set out persuasively in the report of 22 June from the East Lancashire Hospitals Patients & Public Involvement Forum. Clearly, these should be given weight. The two alternative models put before the public do not represent all the options; a point made by the Forum. Both models locate “blue light” Accident & Emergency at Blackburn. A third option, never put before the public, would have retained A&E at Burnley. Secondly, I believe the adoption of either model a or b would adversely affect my Pendle constituents. No clinician has told me that the separation of planned care and A&E is misconceived, so I do not quarrel with this thinking. But the physical separation on two hospital sites of planned and unplanned has implications which, in my view, have not been adequately addressed. I have no confidence that the Ambulance Service will be able to get people with life threatening conditions to Blackburn while they are still alive. The consultation document is very thin on how the Ambulance Service would respond to this new challenge. We have been given no details of future additional staffing requirements and have received only vague assurances about the number of additional ambulances (2) and extra paramedics. We are told that if and when Burnley General becomes an “urgent care centre” 87% of people currently treated at Burnley A&E will continue to be seen there. It follows that 13%, or over 8000 patients, will have to go on to Blackburn. For many people in Pendle, and certainly in its more rural areas, this extra travel time could make the difference between surviving or not. Many of my Pendle constituents in the West Craven area look to Airedale for their hospital care. And while I believe there are no proposals at the moment to downgrade the hospital’s A&E to an urgent care centre, I cannot rule this out. We were given assurances when Blackburn and Burnley Hospital Trusts came together to form the East Lancashire Hospitals NHS Trust that services would be maintained on both sides, whilst acknowledging there would be synergies. These assurances turned out to have a limited shelf life. There is also uncertainty about the consequences of the Ambulance Services reorganisation over the border in Yorkshire. Ambulances have traditionally crossed over from Yorkshire into the West Craven part of Pendle to take patients to Airedale. I have no idea whether this arrangement will continue in future. However, if people with life threatening conditions in West Craven are given no alternative but to go to Blackburn there could be unnecessary fatalities en route. I also have concerns about the deskilling of clinical staff at Burnley once it loses its intensive care beds. We are told the high dependency beds, which will be retained at Burnley, can be “flexed up” to intensive care for short periods of time. But I remain to be persuaded there will not be a loss of skills. And if “complex cases” are routinely sent to Blackburn, fears have been expressed to me by medical professionals this will inevitably cause deskilling of doctors and doctors in training in Burnley. The Clinical Services Review has been in and out of the headlines for months and over this period members of the public and NHS staff have been in touch with me to voice their concerns. I also wrote to all GPs in Pendle asking for their views, if necessary in confidence, as these would inform my own thinking. One doctor told me of his “sense of deep worry over the proposed changes and the removal of so many core A&E services to sites further away …I think it is inevitable that were that to happen sooner or later someone is going to die in transit”. Another Group Practice told me of their concerns about locating A&E at the “furthest end of the patch” , suggesting A&E at a more central location. Yet another practice expressed concern about the ability of the Ambulance Service to cope. “The transport of patients from Burnley to Blackburn will be complex and life threatening for some.” There were also concerns expressed that patients taken to Blackburn could end up being isolated because of difficulties for relatives and friends getting over there. One doctor strongly supported the need for change saying the separation of elective and emergency work would improve clinical care, reduce cancellations and potentially, reduce waiting time for patients, while raising concerns about ambulance response times and the future of Airedale A&E. Nevertheless, the doctor went on to say that the options were limited and lacking detail. “More specific detail about the new services should be a prerequisite to accepting the proposals.” Another told me the proposals “have little to recommend them”. We all understand the constraints facing the NHS locally. The NHS has to ensure the hospitals, health centres and other physical assets are used in such a way as to get value for money. That said, my own feeling is that the decision to locate all A&E at Blackburn was taken at a very early stage and that the case was made to fit this predetermined conclusion. The facilities at Queens Park and the substantial investment there are driving change in the pattern of health service delivery which, in my view, disadvantages my Pendle constituents. At the very outset I expressed concerns about the implications of moving A&E from Burnley to the western end of East Lancashire. If one A&E is the inescapable corollary of separating planned and unplanned care, then it should be located in Burnley which is nearer the geographical centre of the catchment area. For these reasons, I hope the Joint Committee will recommend the involvement of the Independent Review Panel. Yours sincerely, GORDON PRENTICE MP < Prev   Next >