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NHS Primary Care Trust
meeting
On
15 October 2007 the West Sussex County Council held one of
its series of 18 meetings to discuss its response to
the public consultation by the newly established NHS
Primary Care Trust serving West Sussex
(1) on
setting up of a major general hospital and
reorganising the three district general hospitals
in the area at Worthing, Chichester and Brighton.
The consultation, which closes on 30 October, invites
views on three Options which have been worked up with
doctors, nurses and other health professionals, local
authorities, voluntary groups and selected members of
the public.
Option A
proposes upgrading the district hospital at Worthing
to a major general hospital at Worthing
supported by a local general hospital at
Chichester (St Richards) and a community hospital
at Haywards Heath (The Princess Royal).
Option B also
proposes upgrading the district hospital at Worthing
to a major general hospital but supported by
two local general hospitals, one at Chichester
and the other at Haywards Heath
Option C
proposes upgrading the district hospital at Chichester
to a major general hospital supported by a
local general hospital at Worthing and a
community hospital at Haywards Heath.
The hospitals
Major general hospitals
provide acute medicine, accident and emergency
srevices, inpatient children’s services, emergency
surgery and consultant-led hospital births to serve a
population of 300,000 or more.
Note: the PCT seems to have some doubt about the true
figure; it could be as high as 450,000.
Local general hospitals
provide an urgent care centre, surgical beds and
surgical day cases, a range of diagnostics, outpatient
clinics and rehabilitation and beds for those with
some special medical conditions to serve a population
of 150,000 to 200,000
District general hospitals
provide a range of clinical services, but not
specialised services, to serve a population of about
150,000.
Community hospitals
provide a minor injures unit, some diagnostics,
community and rehaibilitation beds and teams odf staff
from from health and social sevices working tgether to
support people to live independantly to serve a
population of less than 100,000.
Below these come the local hospitals, such as Horsham
and Crawley, and the raft of community health and
social services.
Issues summarised by the PCT speakers.
First, the need to provide ‘top of the skill’
specialist consultant training and to support some
specialist equipment requires the catchment area of a
major general hospital.
Second, the long-term intention is to provide as many
services services as possible at local community
level.
Third, while the PCT has to eliminate its present
deficit of £100m over the next two years, the purpose
of the proposed reorganisation of the hospitals is not
to reduce spending but to ensure that it is
distributed to the best advantage and community
services have a crucial part to play.
Issue raised by questioners
The population of West Sussex is concentrated in two
main areas - the coastal strip and the Horsham/Crawley
conurbation. This has implications for siting only the
one major general hospital proposed although,
as the population of the County is some 750,000 and
growing, it was suggested that, asssuming a catchment
area of say 350,000, there is a case for a second
presumably sited to serve the needs of the north of
the County, Gatwick Airport and the M23 and M24
motorways. There is also a strong demand for access,
closer than the coastal strip, to the less specialised
but more frequently used services, such as maternity
and accident and emergency units.
A
site for a second general hopital at Pease Pottage has
been proposed and the Crawley Local Development Plan
also provides an alternative site west of Crawley.
According to the PCT neither has been judged to be
clinically sustainable, financially sustainable and
deliverable but at least part of the reason seems to
be that, while each PCT is responsible for the
provisions in its area, it is always possible for
patients to express a preference for a facility
outside it and this could tend to draw patients from
the Surrey hospitals which, as they have spare
capacity, would be further destabilised. This seems
unlikely as the Surrey hospitals are not popular with
West Sussex patients or their families. Be that as it
may, the PCT has indicated that it will revisit the
issue when the responses to the hospital consultation
are known.
The PCT has plans in hand for a second consultation on
the community services such as Doctors’ Surgeries,
Practice Nurses, Pharmacies and health promotion for
which it is responsible, also for other services such
as care in the home and other social
services. The PCT also has
its eye on a share of section 106 Agreement monies.
This raises the issue of ‘cost-shunting’and the PCT
was criticised for not combining its hospital
and community consultations.
To conclude - we were exhorted to sign
the WSCC’s petition calling for the PCT’s options to
be reviewed.
Oliver Palmer
(1)
Creating an NHS Fit for the Future’ West Sussex
Primary Care Trust 2007 |
