After our general questions about hospitals (see previous blog post), we asked about the main proposals listed on the Hospital Service Review page of the South Yorkshire and Bassetlaw Integrated Care System (SYBICS) website: https://www.healthandcaretogethersyb.co.uk/ .
These main proposals are summarised here:
Some respondents were cautiously optimistic about some of the proposals, but more were suspicious because of the lack of information and their fears of opportunities for privatisation.
What do you think about A&E Services?
In response to this question there was unanimous support for the Minor Injuries Unit in Sheffield.
There was also this comment:
“There is no slack in the provision, which means that in the case of an emergency that affects significant numbers the services would be under extreme pressure. This is not satisfactory for patients or workers. There are also known times when numbers increase dramatically and it should be possible to manage these more effectively. Walk in clinics and minor injury units play a crucial part but they are (or have) disappearing. the problem often is that some people have difficulty accessing health centres or GPs so everything becomes an Emergency.”
What do you think about maternity services and proposals?
- “‘Home choice’ is not a choice. Deliver a baby in a safe environment. i.e. hospital is better and the reason why we have a low death rate. In case of sudden emergency, home is a bad idea.”
- “No the resources are not there this is just a way to let in private providers”
- “Although women may be classed as low risk things can change during labour. It’s bad enough with current arrangements where senior and expert help may be delayed. It will be much worse if midwife levels remain low, if midwives are subjected to tick box procedures and if units are closed. MLUs should only be instituted when there are adequate levels of trained and experienced midwives and medical advice and assistance are quickly available if necessary.”
- “I have been very disappointed that some of the specialist services that supported young and possibly single mothers, have closed. These were crucial in their ability to support individuals and also to refer or signpost them on to other services where young parents can find longer term personal support”
- “Encouraging less use of hospitals / maternity units and more home births is NOT ‘increasing choice for women’. It is a deeply irresponsible path to take, and surely just a cover for reducing maternity beds across the region, when capacity is already overstretched (Barnsley closed its doors only last week, and has frequently reported women giving birth in inappropriate circumstances).”
What do you think about Services for Acutely Ill Children?
Here are some ‘translations’ of the proposals:
- “‘More care for children at home/in community’. This means more parents looking after sick children.”
- “‘Explore focusing 24/7 paediatric units on few sites.’ This means further away from families.”
- “It sounds like a cop out and less care overall. In the community’ can mean almost anything.”
Other comments included:
- “Nobody wants their children to be in hospital but I feel this proposal is driven by staffing issues and cost issues, not by need. There is a real risk of overcrowding specialist facilities if IP units close.”
- “Sheffield Children’s Hospital has a fine reputation locally ~ people tend to trust them. Whilst the case for more community services is a good, we mustn’t assume it’s a cheap one. So once again how these are funded and whether they are then classed as ‘social care’ responsibilities is critical to their success. We cannot see the problems associated with the elderly replicated within children’s health needs”
- “Children’s ward @ Bassetlaw! Now moving ill children to Doncaster as no overnight facilities! JUST WRONG!”
- “They should be treated in their own local hospital whenever possible”
- “I support increases of services in the community, short stay units and long stay units; we need to excel in all areas”
- “I don’t think we can lose any hospital provision and retain patient safety.”
- “Short stay units is a good idea as are community but would not like to see a reduction in the number of inpatient beds. This would not alleviate the issues as more children are being treated as inpatient because of their complex needs”
What do you think about Stroke Services?
- “There should be a drive to staff these services in every dgh [District General Hospital]”
- “Much of this depends on good and fast diagnosis; and provision of good rehab services locally. Have they looked at the whole pathway? And do we have enough vascular nurses to help with the rehab locally?”
- “I am worried that the acute stroke unit in Rotherham looks like closing. Stroke victims need to be seen as soon as possible, not transported miles to Sheffield or Doncaster. Irreversible brain damage is more likely with delays.”
- “What exactly is the ‘standardised approach’? Discharge should be timely and patient-appropriate, not ‘early’ (too early?).”
- “Centralising Hyperacute stroke unit services makes sense but acute stroke units must not be blighted. Consultant presence and support is important at these sites as well. If acute stroke units fail, then the hyperacute service will get blocked up and people will spend longer further away from home with all the difficulties that causes.”
- “I’m always suspicious of anything labelled ‘standardised’, it has to be responsive to local conditions. Having said that there have been significant advances in understanding and responses to Strokes, and certainly these need to be ‘standard’ in every area. If paramedics can receive the appropriate training so treatment can be given with as little delay as possible, this has to be a good thing”
- “Hyper Acute should not be centralised, they should remain local. I disagree with early discharge. It is a cost cutting exercise & I dont know what you mean by ‘support services on… Acute Stroke Unit’. Do you mean there will be no doctors? If so, I disagree.”
- “Personal experience was of a lacklustre service under pressure”
- “Stroke patients and their families should be absolutely ready for discharge, never pushed or hurried into it. DO NOT CLOSE the HASUs at Barnsley or Rotherham: lives and post-stroke quality of life will be risked. all units should give the best, specialist treatment possible to enable quicker recovery times”
What do you think about Gastroenterology Services?
Responses reflected the lack of information given in the proposals:
- “Which sites? Is this a review or half a review?”
- “How will the public know which hospital to go to? Will this result in relying on the 999 service to know? Will patients always be discharged by ambulance? What arrangements have been made for inter-hospital transport (for visitors)? Has the proposed inter-hospital bus service been implemented?”
- “I am unsure of the reasons for or practicality of this”
- “We should extend the availability of emergency services to all A&E departments”
- “All hospitals with A&E departments should be treating emergency GI cases. Reducing provision in any location risks patient safety. It is a faulty mentality to be referring to “out of hours” in relation to any kind of emergency; provision should be consistently available at all 7 hospitals.”
- “Not sure how this differs from current but think at least 1 in each area”
What do you think about creating a Health and Care Institute?
[for South Yorkshire and Bassetlaw]
- “What is this? It could be a good idea but I don’t know enough about it”
- “What is it? Is it public and within the NHS? What would it do? Who would fund it?”
- “Money should only be spent on this if it offers a genuine step forward and is welcome by those already providing workforce training”
- “Sounds like a good plan. However, my recent experience in setting up an institute in a professional workforce is that although everyone says great, employers say excellent idea, the only people who will pay for it will workers themselves. It could be the neoliberal answer to Unions, and it is hard to see an institute being able or willing to mount the challenge to government that has been seen over the last few years”
- “NO MORE REORGANISING!”
- “I have no idea what this is but no doubt it will involve private companies so I am against it”
- “Only if it does not divert money from NHS services or Social Care provision. Underfunding is now so severe, and money is wasted in costly private contracts – we simply can’t afford to lose another penny. There are already very strong links with the universities in Sheffield; can this be extended to encompass the SY&B region more effectively?”
What do you think about creating an Innovation Hub?
[for South Yorkshire and Bassetlaw]
- “Should not duplicate stuff elsewhere and not from clinical resources”
- “Good idea, but every hospital should also practice innovation as part of their job too.”
- “Another one? What is wrong with the existing one? What influence/pressure would it have on persuading consultants, GPs and CCGs to accept any new innovations?”
- “I’d rather see money spent on getting our existing services right than on developments which may only have small effects despite costing quite a lot to develop.”
- “NOT NEEDED”
- “What the Dickens is that?”
- “Is this not already in place via HEE [Health Education England]?”
South Yorkshire & Bassetlaw NHS Action Group would like to hear your comments on what you’ve read in this blog.
It’s too late to forward your comments to the Reviewers – but your views are welcome.
Also it would be good to know if you knew that:
- the Review port was happening (July 2017 – April 2018)
- the Report was published (9th May 2018)
- that your comments on the Report were invited? (12th June – 13th July 2018)