Yorkshire hospitals to axe some children's operations due to lack of staff

Proposals to stop evening and weekend children's operations at three regional hospitals because of a lack of staff are still due to go ahead - despite bosses at the affected sites failing to support the plans.

Monday, 19th June 2017, 6:00 am
Updated Tuesday, 20th June 2017, 3:51 pm
Barnsley Hospital is one of the sites affected by the proposals
Barnsley Hospital is one of the sites affected by the proposals

A consultation response from Barnsley Hospital has warned “there is no evidence current arrangements are unsafe”, while bosses at the other hospitals in Chesterfield and Rotherham have separately raised concerns about costs and whether the changes will reduce clinical confidence in their sites.

Regional NHS bosses are to decide on whether to back proposals to axe some unplanned out-of-hours children’s surgery and anaesthesia services at Barnsley, Chesterfield and Rotherham hospitals at a meeting on June 28.

While the final business case is yet to be made public, a spokesman for the Commissioners Working Together group behind the proposals said: “If approved, the proposals would also see some unplanned, out-of-hours children’s surgery and anaesthesia services being delivered in a more planned and consistent way across the region, with a small number of operations no longer being provided at Barnsley, Chesterfield and Rotherham Hospitals.”

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Officials say sending affected child patients to Sheffield, Wakefield or Doncaster instead is being suggested because of a lack of qualified doctors and nurses to serve all of the sites.

But none of three affected hospitals has fully backed the proposals after concerns were raised by doctors and patients. Almost 800 people have signed a petition to retain Barnsley’s current service.

Diane Wake, chief executive of the Barnsley Hospital NHS Foundation Trust at the time of the consultation, said: “Clinical staff from anaesthetics, paediatrics and surgical specialities have expressed concerns about the proposed changes. A strong view has been expressed that there is no evidence that current arrangements are unsafe or resulting in inferior outcomes.”

While the consultation documents state the changes may reduce surgical activity in Barnsley by 10 per cent, Ms Wake, who has now left her role as chief executive at Barnsley Hospital, said some initial data had suggested it could result in a 40 per cent cut and the latest position is that up to 20 per cent of operations may be affected.

She said: “If the total is a 20 to 40 per cent reduction then the trust would not be able to support the proposals as there would be a detrimental impact on our anaesthetic team’s competence to manage children if their opportunities to do so under the controlled conditions of planned surgery are reduced by that much.

“It is essential that anaesthetists maintain these competencies so that they are able to provide emergency care to critically-ill children presenting to our Emergency Department.”

But Barnsley Hospital has issued a further statement today to say its concerns have been taken into consideration following the consultation.

Richard Jenkins, Barnsley Hospital chief executive, said: "The proposals are a result of partnership working between all hospitals and commissioners across our region and we are pleased they take into account our concerns.

"The new proposals are intended to improve how the services are run and we will continue to work with all our partners to make sure any change results in the best outcomes and gets the safest and best care for our patients."

In response to the consultation, Dr Gail Collins, medical director at Chesterfield Royal Hospital NHS Foundation Trust, also failed to fully support the plan and suggested a ‘distributed service model’ sharing resources across all the affected hospitals is pursued instead.

She said: “We agree that an option for ‘no change’ is not realistic or tenable, but we do not fully support the preferred way-forward.”

Dr Collins added: “In occasional emergency situations our current experience of transferring local children is that there is limited capacity. Increasing numbers of transfers could complicate the pathway for children – and taking them by ambulance even further afield will also create additional demand on both ambulance and hospital staff and services.

“Along with ambulance transportation, a children’s nurse would need to accompany any child being transferred, increasing workforce requirements at a time when there is limited capacity within children’s nursing.”

Chris Holt, chief operating officer at Rotherham NHS Foundation Trust, said while its board supports the proposals in principle, it requires further assurance and clarification on a number of matters.

The consultation response said: “We are concerned that the level of investment required to implement the proposed changes, along with the additional costs that will need to be incurred within the proposed configuration and the inability to remove the full costs from those hospitals that do not retain the services will lead to a considerable financial pressure increase across the South Yorkshire and Bassetlaw footprint.”

A business case for the plans has been developed by Commissioners Working Together – a partnership between the eight clinical commissioning groups for South and Mid Yorkshire, Bassetlaw and North Derbyshire - over the last three years.

Des Breen, medical director for the partnership, said: “We’ve been constantly talking with our hospitals throughout the review process, and more recently on their specific questions raised as part of the consultation. We’ve taken all questions into account and the final business case, which is due to be published at 10am on Wednesday June 28, addresses these. The business case also responds to what patients and the public have told us, with all information and proposals due to be discussed and a decision made by the joint committee of CCGs.”