Independent report calls on hospitals to work together even more closely
Wednesday 9th May 2018
An Independent Review set up to ensure people across South Yorkshire, Bassetlaw and Chesterfield continue to receive excellent hospital services now and into the future has made a series of recommendations in a report published today (Wednesday 9 May 2018).
The Hospital Services Review (HSR) Report strongly recommends that to continue to provide high quality services across the region, hospitals must work together even more closely and in ways that connect teams across all sites.
The central theme is for local people to continue to get as much hospital care as possible in their local District General Hospital (DGH). This includes a recommendation to keep all seven emergency departments (EDs) in Barnsley, Bassetlaw, Chesterfield, Doncaster, Rotherham, the Major Trauma Centre and ED at the Northern General Hospital in Sheffield and the ED at the Sheffield Children’s Hospital.
In new networks of care, it is proposed that different hospitals could take the lead for each of the five clinical services reviewed. The responsibilities of local hospitals could include strengthening the workforce and making sure that all patients get care to the same high standards. The networks would be designed with patients, the public and clinicians with the emphasis on delivering the networked service to a specification agreed across all hospital sites. The aim of care networks would be to ensure the hospitals work together to provide safe, sustainable, high quality care in an even more coordinated way.
Also among the proposals are two new regional centres of excellence to support the networks. A Health and Care Institute would link the region’s universities, colleges and schools with the NHS and local authorities to focus on region wide workforce solutions. As well as recruiting and nurturing the workforce of the future, it would include a single joint approach to developing and putting shared ways of working in place.
The creation of an Innovation Hub, which would be in partnership with the Yorkshire and Humber Academic Health Science Network, would spot and quickly roll out innovation schemes across the region, such as new technologies.
The review has identified real challenges in sustaining some services in every DGH, in particular children’s and maternity services, and the Report recommends that networks and wider collaboration are the best opportunity to sustain local services at their current levels.
In maternity services, the Report aligns its thinking with the findings from the public consultation that informed the national report, Better Births, which recommend maternity services support personalisation, safety and choice, with access to specialist care whenever needed. The HSR Report calls for more choice for women and recommends further work is carried out to consider the creation of more care in communities and midwife-led units, and further development of home birth services.
In children’s services the Report recommends expanding services for children in the community and in short stay units. This would lead to shorter stays for children and would likely mean there would be less need for longer stay inpatient wards. For those children still needing longer stays in hospital for more complex problems, it may be possible to provide this in fewer units and the Report recommends that further work be carried out to consider a small reduction in the number of inpatient paediatric units.
The Report also recommends that overnight and weekend services for emergency gastrointestinal bleeds are consolidated onto three or four sites. This is intended to increase the safety of services for patients, to make sure that in an emergency, all patients have reliable and rapid access to the care they need.
Work is already happening with local communities and organisations to ensure the right configuration of services are provided locally to support the needs of patients, while addressing the wider challenges, and the Report identifies where more opportunities could be explored.
Should the Report recommendations be accepted, additional work would be undertaken over the next year to further scope the options and the team would continue to hear from patients, public and staff.
Professor Chris Welsh, Independent Director for the review of hospital services in South Yorkshire, Bassetlaw and Chesterfield, said:
“We are fortunate to have some excellent services and staff from all professional backgrounds who are dedicated and skilled, and strive to deliver good care in the face of tremendous pressure.
“But the NHS is facing enormous challenges. Within the region, demand is increasing faster than ever predicted. Part of this comes from resource shortages, but part of it is the consequence of a system designed to provide treatment in every hospital for every condition that now needs to adapt to much more specialised and advanced treatment which can deliver better outcomes for patients. The system must change to meet these new needs.
“If the hospitals in South Yorkshire, Bassetlaw and Chesterfield want to continue to provide excellent services and attract and develop the best staff to run them, then it is my strong recommendation that they work together even more closely and in ways that connect teams across all sites.
“We have unfortunately seen some services withdrawn at short notice due to skill shortages because of the impact this can have on patient safety. Whilst the new networks of care may not be able to avoid reduction in local services in every case it will give by far the best opportunity to stop this happening in the future.”
“By working together better, outcomes for patients would continue to be improved and staff who work in the services would have fantastic opportunities to develop and learn. Staff are needed now more than ever and they could be certain that the hospitals in the region would be among the most attractive places to work and providing some of the very best care in the world.”
The Report also recommends:
- Looking at the sustainability of planned care (eg planned operations and tests) in more depth
- Exploring how to ensure better collaborative decision making between hospitals
- Setting up a Transport Reference Group (TRG) to develop a system-wide transport strategy with representatives from hospitals, commissioners, Yorkshire Ambulance Service and East Midlands Ambulance Service, local transport authorities, patients and the public.
The Report will now be received by the South Yorkshire and Bassetlaw Health and Care Working Together Collaborative Partnership Board in June and then the collective committees and individual boards and governing bodies and committees within the partnership throughout June and July. If the partners agree that a further phase of work should take place, to scope out options and to develop business cases for change, this would take another year with continued patient, public and staff involvement and, where appropriate, the relevant Health Scrutiny Committees.
If any major service changes required consultation, this would likely take place in 2019, with another one to two years before changes took effect.
Professor Des Breen, Medical Director for Health and Care Working Together in South Yorkshire and Bassetlaw, said:
“As a partnership, we asked for this review to be carried out to help us understand how we can make sure our services are of the safest and highest quality, now and in the future and I welcome this detailed and considered Report. The review team has spent ten months looking closely at hospital data, patient outcomes and experience, had in-depth conversations with the staff who run the services, the patients who use them and also the wider public.
“This is a very thorough piece of work which the partners in Health and Care Working Together will now consider in detail.”
While the Report focuses on hospital-based services, it also recognises that the services cannot exist and operate in isolation and the team also worked with staff in primary care, community care, mental health, social services and wider still to ensure that its recommendations build on related work that is currently under way and recognise system-wide interdependencies.
The review is just one part of the overall approach being taken by the partners in Health and Care Working Together. At the same time, work is underway to develop more and more ways of treating and caring for people in their homes and local clinics, so that they don’t need to go to hospital.