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ISSUED BY WEST SUSSEX PRIMARY CARE TRUST – 20 FEBRUARY 2008 1
eBulletin
Issue 28 – 20 February 2008
This issue of the Fit for the Future eBulletin from West Sussex Primary Care Trust (PCT) provides an
update following the PCT’s Board Meeting on 14 February.
West Sussex PCT agreed a shortlist of six options
The West Sussex Primary Care Trust’s Board meeting in Pulborough on Thursday 14 February
marked one of the most significant stages in the next steps of the Fit for the Future programme.
Following an extensive public consultation, expert recommendations by Sir Graeme Catto (President
of the General Medical Council) and a new service model proposed by the Clinical Reference Advisory
Group (CRAG) for West Sussex and Brighton and Hove, the West Sussex PCT Board agreed to take
forward a shortlist of six options for consideration.
The Board has been considering three service models and two possible locations for centralised
services which means that a total of six options will now be taken forward. In his report to the PCT
board, Sir Graeme Catto categorised the six options under three headings entitled service models:
1. Service model one
One major general hospital (MGH), one local general hospital (LGH)
and one community hospital (CH)
Option 1: Worthing is MGH, St Richard’s is LGH and Princess Royal is CH
Option 2: St Richard’s is MGH, Worthing is LGH and Princess Royal is CH
2. Service model two
One major general hospital (MGH) and two local general hospitals (LGH)
The LGH will not have A&E and related services
Option 3: St Richard’s is MGH and Worthing and Princess Royal are both LGH
Option 4: Worthing is MGH and St Richard’s and Princess Royal are both LGH
3. Service model three (proposed by CRAG)
One major general hospital and two local general hospitals (LGH)
The LGH will have A&E and related services
Option 5: St Richard’s is MGH and Worthing and Princess Royal are both LGH
Option 6: Worthing is MGH and St Richard’s and Princess Royal are both LGH
ISSUED BY WEST SUSSEX PRIMARY CARE TRUST – 20 FEBRUARY 2008 2
PCT listened and learned from public consultation
The views of local people have helped influence the decision making process for changes to health
services as part of Fit for the Future.
An independent analysis of the 38,925 responses submitted to the PCT revealed that travel times to
hospitals, services’ ability to cope with a growing population and the impact on staff morale were just
three of the key issues arising from the proposals that worried the residents of West Sussex.
Public comments influenced the PCT Board when agreeing the decision making criteria. Issues such
as accessibility – recognising public concerns about this, deliverability – ensuring there is the capacity
to meet the needs of the population and that it’s managed well, and workforce implications – ensuring
that high quality staff are still recruited and the best use is made of their skills were taken into
consideration.
John Wilderspin, Chief Executive, West Sussex PCT said ‘Throughout the consultation we made it
clear that we would listen to what local people were telling us and that this would play a part in
shaping the decision making process. We specifically asked people for feedback about the factors
that the Board should use to help weigh up the pros and cons of the various proposals and the
analysis of that feedback has helped us to draw up the decision making criteria. We will make the
criteria widely available so that people can see that we have taken their views into account.’
Acknowledging the huge public response to the consultation Mr Wilderspin commented ‘I want to
thank the many thousands of people who made the effort to respond and contribute to the
consultation. We were very encouraged by the level of involvement and engagement that the
consultation generated. But we know from the feedback we have received that there are some areas
we can improve on – for example the way we present information, so that it is clear and concise – and
to be better at letting people know how their views are being heard and acted upon. We have learned
many lessons from the public consultation exercise and we will take into account the feedback from
the public to develop and improve our engagement and communication with them in the next phases
of the Fit for the Future programme and beyond.’
The public can access the independent report on the PCT website www.westsussexpct.nhs.uk under
the Board Meeting section.
Independent analysis of the consultation responses available
All the responses we were sent, not just petitions but individual replies, formal responses from
campaigns, MPs and district councils, were sent to an independent analyst - Dr Debbie Singh from the
University of Birmingham - to compile an analysis of the key themes and issues raised by the public.
Further information/copies of the public consultation report is available from the FFF programme
administrator. Please email: fitforthefuture@westsussexpct.nhs.uk or telephone 0800 7076975.
ISSUED BY WEST SUSSEX PRIMARY CARE TRUST – 20 FEBRUARY 2008 3
PCT Board agreed the process for decision making
West Sussex PCT has used three hurdle criteria - clinical sustainability, financial sustainability and
deliverability - to shortlist options, both for consultation and now for decision making.
We have always intended to use a broader set of criteria to make final decisions, and have consulted
widely on what those criteria should be.
The Board agreed on 14 February to eight decision making criteria which will be used to select the
‘model’ (configuration) of services for the future, and also the location for any services which we might
agree to centralise (the MGH).
The criteria were drawn up taking a number of factors into account including the feedback from the
public. We specifically asked people for feedback about the factors that the Board should use to help
weigh up the pros and cons of the various proposals and the analysis of that feedback has helped us
to draw up the decision making criteria.
The eight criteria are:
• Accessibility
• Clinical sustainability
• Financial sustainability
• Deliverability
• Workforce implications
• Health outcomes
• Wider strategic fit
• Acceptability
The link between what the public told us during the consultation and the agreed decision making
criteria is clear - for example accessibility takes account of public concerns around travel times, health
outcomes will address concerns around population growth and so on.
Key decisions will be taken in May and June
The decision to take forward a shortlist of six options follows many months of analysis - both during
and after the consultation period - and supports the expert recommendations put forward by Sir
Graeme Catto and the Clinical Reference Advisory Group (CRAG).
The PCT Board have agreed the timescale for decision making, subject to final agreement with the
Joint Health Overview and Scrutiny Committee (JHOSC).
This will be done in two stages - deciding on the service model early
May and then deciding on the
location of the centralised services (or the Major General Hospital) early June.
Work will now continue with our colleagues in the NHS Trusts, GPs, the Strategic Health Authority
(SHA) and with the JHOSC to allow the Board to come to a clear decision.
ISSUED BY WEST SUSSEX PRIMARY CARE TRUST – 20 FEBRUARY 2008 4
CRAG Steering Group recommended revised model of care
Through the course of the Fit for the Future consultation West Sussex PCT and Brighton and Hove
PCT have continued to engage with local senior clinicians through the Clinical Reference Advisory
Group (CRAG) Steering Group - made up of public health consultants from the PCT, clinical staff from
St Richard’s Hospital in Chichester, Worthing and Southlands Hospitals, Brighton and Sussex
University Hospitals (BSUH), GPs and senior staff from South East Coast Ambulance service.
In the past few months the CRAG has led a series of meetings with senior clinicians from across the
county to develop a revised proposal for hospital services for the PCTs to consider. As a result of
those meetings and their consideration of public views and current evidence, the CRAG
recommended that A&E services, intensive care, routine planned surgery and acute medicine should
be maintained at all three hospital sites (Princess Royal, St Richard’s and Worthing).
This would be alongside - for the south coast - a staged centralisation to one hospital site of
consultant-led maternity services, inpatient children’s services, the majority of trauma cases and
emergency surgery. This centralisation would be to either St Richard’s Hospital or Worthing Hospital.
BSUH, which runs the Princess Royal and Royal Sussex County Hospital, has already centralised
some services at the Royal Sussex County Hospital. These changes will be supported by the
development of more services in primary and community care and the ambulance service.
Review of health services in the North East will start in April
Sir Graeme Catto has been appointed to undertake a review of health services in North East Sussex.
The decision to review services in the north of the county follows the recommendation made by Sir
Graeme Catto on 14 February 2008 on options for acute hospital services in West Sussex. In his
report, Sir Graeme Catto does not recommend the option for a new acute hospital in the North East of
West Sussex but he recognised there was a need for a review to be carried out of health care
services, and access to them by the population in the North East of the county.
The PCT acknowledges that the Fit for the Future programme has been primarily focused on services
in the South of West Sussex and the Central Sussex areas. However, it is important that the benefits
of care closer to home, investment in primary and community care, and focus on wellness rather than
illness, are equally available to the population in the North East of the county.
A small panel will be established, chaired by Sir Graeme Catto, to review evidence and produce
recommendations to the PCT Board. The panel will specifically establish the current and future health
status of the population, review current access to health services, identify gaps in service provision -
or significant challenges in access to services - and seek both expert advice and the views of local
people on how these gaps should be addressed. The panel will then recommend to the PCT Board
how these gaps should be tackled in the light of both clinical and financial sustainability.
Work will start in April 2008 and a report will be presented to the PCT Board by the end of the year.
ISSUED BY WEST SUSSEX PRIMARY CARE TRUST – 20 FEBRUARY 2008 5
Brighton and Hove City Teaching PCT pledges to heed consultation findings
Travel time, transport arrangements and traffic congestion emerged as key worries for Brighton and
Hove residents who responded to public consultation about the local impact of possible hospital
changes across West Sussex.
An independent analysis of all 640 written and online consultation responses submitted to Brighton
and Hove City Teaching PCT also revealed concerns about the possible impact on the Royal Sussex
County Hospital if more services move there from hospitals elsewhere. These ranged from whether
the Royal Sussex could cope physically with an influx of additional patients to worries about whether
local people would be affected adversely by more people from outside the city using its services.
Brighton and Hove City Teaching PCT has pledged to make sure that local residents' views are
respected whichever options finally move forward. Director of quality and engagement for the PCT,
Amanda Fadero, thanked people who had made the effort to respond to the local consultation.
‘Although there was no clear favourite among the three main options put forward by West Sussex,
people in Brighton and Hove clearly value the Princess Royal Hospital very highly and supported
services being kept there’ she said. ‘They also recognised that the ability of hospitals to recruit, train
and keep high quality staff is crucial to their long term success. We have forwarded these and all the
other comments to West Sussex PCT so that it has as much information as possible when it makes its
decisions.’
Ms Fadero added that the analysis of Brighton and Hove responses yielded very clear messages
about protecting the interests of local people. ‘People understandably want it to be easy to get to
hospital, easy to park there if they have to come by car, and easy to get prompt, high quality care’ she
said. ‘They also want the NHS to improve its public consultation processes. We need to get better at
presenting information and options in a clear and concise way, and better at giving people
opportunities to comment and contribute. Our task now is to work on these issues with patient groups
and community representatives so that local views have a real impact and influence on decisions
about services. ‘We are about to start wide-ranging talks with local people about our plans for the next
three years. The views expressed through Fit for the Future consultation will help us ensure these
talks address the issues that matter most to local people.’
The next public Board meeting of Brighton and Hove City Teaching PCT on 11 March will receive a
report on the local consultation findings plus a report on the outcome of the West Sussex PCT
meeting on 14 February.
The analysis of Brighton and Hove City consultation responses, conducted by Dr Debbie Singh, an
independent expert from the University of Birmingham, is available on the PCT website at
www.brightonhovecitypct.nhs.uk.
This eBulletin is produced by West Sussex PCT and distributed to partner organisations, stakeholders
and staff. The eBulletin is also placed on the Fit for the Future website at:
www.southeastcoastfff.nhs.uk/Home/West-Sussex/The-Story-so-far/e-Bulletins.aspx
Our main partners in the local health economy include the health and social care organisations, West Sussex
County Council, the seven district and borough councils in West Sussex, the independent and voluntary
organisations, and the parish and town councils. This bulletin is widely distributed throughout West Sussex,
including partner organisations, local authorities, parish councils, MPs, the media and PCT staff. The eBulletin
is also available to individuals and partner organisations in Brighton and Hove who are interested in
developments during public consultation.
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