To invite members of the public to speak on the subject of the proposed changes to Worcestershire Acute Hospitals NHS Trust’s services.
Please note that those residents who registered to speak in advance will be given priority. Each resident will have a maximum of five minutes to speak.
Minutes:
The Chair explained that prior to the meeting two people had registered to speak. They would be given priority in terms of speaking to the commission, though all those present would be invited to share their views once the registered speakers had finished.
The following speakers proceeded to talk to the commission during the meeting:
a) Mr Peter Pinfield
The Health Commission was advised that Mr Pinfield was the Chair of Worcestershire Healthwatch. Healthwatch operated independently to the NHS and provided an opportunity for residents to provide their views about health services. The Chair of Healthwatch had no decision making powers in respect of the future of health services but could help to communicate the views of the public to health bodies. When the CCGs’ consultation ended it was likely that NHS England would contact Worcestershire Healthwatch for feedback about the process that had been followed during the consultation and the outcomes.
The Health Commission provided a useful opportunity to consult with the public about proposed changes to health services. It was important for the Health Commission and the public to be aware of rules in respect of consultation about changes to health services, the rights of the public under the NHS constitution and how the public could influence the outcomes of any such consultation process.
Mr Pinfield urged people to read through the CCGs’ consultation document and to complete copies of their questionnaire. The greater the number of respondents, the more the CCGs would have to take into account the views of residents. When raising concerns and highlighting any suggested flaws in proposed changes there needed to be evidence to support those claims.
b) Mr Anthony Moran
Mr Moran explained that he was a resident of Studley, Warwickshire, who had supported the work of the Save the Alex campaign. Despite acknowledging the opportunity to respond to the CCGs’ questionnaire Mr Moran noted that residents were feeling fairly despondent as these proposals followed submission of a petition that had clearly demonstrated residents’ support for retaining services at the Alexandra Hospital. Furthermore the questionnaire issued by the CCGs did not appear to provide the public with an opportunity to change the outcomes of the consultation.
When the Trust was first established the level of demand for services in 2017 had not been anticipated. References were regularly made in the press to the pressure arising from treating elderly patients and inadequate social care provision. However, demand for health services was also growing to meet the needs of patients of all ages with increasingly complex health needs. Without sufficient financial investment in the NHS this problem with pressure on services would continue to escalate.
WAHT had received a lot of criticism for the way the review of services had been handled and the current proposals. However, Mr Moran noted that developments at the local level were influenced by decisions at the national level. Residents had been urged to convey their concerns to the local MP; Mr Moran suggested that residents needed to do more than this. Efforts still needed to be made to protect local health services but the approach that was adopted needed to change. Worcestershire was not the only area where major changes were being proposed to health services; residents across the country needed to work together to challenge the Government’s approach to managing health services.
c) Mr Philip Berry
Mr Berry explained that he and his wife had moved to Redditch in 2015 to live close to their children. During the time they had lived in Redditch they had used services at both the Alexandra Hospital and in Birmingham. They had first become aware of the pressures on local services in 2016 when the subject had received significant media coverage. The Save the Alex campaign, which had helped to raise the profile of proposed changes and attempts to retain services, was a credit to the local community.
When the Alexandra Hospital was introduced it had been intended as a new hospital for a growing community. The Borough was still growing, with plans to build over 3,000 houses across the Borough at various different sites. The projected new housing figures needed to be taken into account when considering community needs and likely future demand for health services. Mr Berry suggested that to reduce services at a local hospital was to undertake a social crime and an A&E Department that did not provide services to all could not be considered a proper A&E department.
Transportation issues still needed to be addressed. If an emergency bus was not available residents could not rely on existing bus services, particularly in the evenings. Taxi services could be used but these would be expensive costing approximately £40 for a return trip. Ambulances were available but could only provide finite levels of support. Recent coverage in the press had also revealed that ambulance services had been queueing at Worcester Royal Hospital in recent weeks which would impact on capacity. Some residents would have access to a car but it could take time to travel to Worcester Royal Hospital to access Maternity and Paediatrics services, particularly when there were traffic jams on the M5.
Mr Berry expressed concerns about the centralisation of Stroke services. Members were asked to note that national marketing campaigns in respect of Stroke services urged immediate action whenever it was suspected that a person had suffered a stroke. Mr Berry questioned whether this speedy response was possible for Redditch residents when services had been centralised at Worcester. In this context Mr Berry suggested that a full range of services needed to be available for residents to access at the Alexandra Hospital. This needed to include Maternity and Paediatrics services.
At the previous meeting of the Health Commission reference had been made to the Trust’s budget deficit. Mr Berry suggested that providing additional funding to the trust would not necessarily resolve their financial problems. Instead greater thought needed to be given to the Trust’s finances and how these were managed.
d) Ms Helen Grant
Ms Grant explained that she wanted to talk to the commission in her capacity as a mother, wife and resident.
The CCGs’ proposals outlined plans to centralise emergency surgery at Worcester Royal Hospital. This would result in more patients from Redditch travelling to Worcester, either having been referred by the Alexandra Hospital or having been taken directly to Worcester Royal Hospital. Ms Grant questioned whether Worcester Royal Hospital would have the capacity to accommodate these patients in light of recent reports in the media about significant numbers of patients at the hospital and two deaths. In cases where capacity was limited in Worcester there was a risk that emergency surgery might be performed at the Alexandra Hospital despite the lack of specialist staff being on site. A case of this nature had recently been brought to Ms Grant’s attention, and no attempt appeared to have been made in this instance to find out whether a transfer could have been made to the Queen Elizabeth Hospital Birmingham.
Similarly Ms Grant raised concerns that if Paediatric Services continued to be centralised at Worcester Royal Hospital staff with the skills to support children in an emergency would not be available at the Alexandra Hospital if and when needed. Many parents living in Redditch would be concerned about the waiting times at Worcester Royal Hospital and would prefer to take their children to hospital in Birmingham for treatment. Ms Grant suggested that centralising services at Worcester Royal Hospital would ultimately lead to a reduction in beds and staff.
The move of Maternity Services to Worcester Royal Hospital had caused concerns amongst many mothers Ms Grant knew living in Redditch. It had been suggested that mothers would have a choice about where to give birth, however, some of Ms Grant’s friends had not been provided with a choice and one had had to fight to be allowed to give birth in Birmingham.
The CCGs’ proposed changes were likely to have an impact on ambulance services. However, the impact on West Midlands Ambulance Services did not appear to have been addressed in the consultation document. Ms Grant suggested that the trust needed to address this.
e) Ms Sharon Harvey
The Health Commission was asked to note that 20 per cent of residents living in the Borough did not have access to a car and many families only had access to one car which would not always be available in an emergency. The CCGs’ consultation document referred to the transport options available to people in this position including community transport which was estimated to cost £27 for a return journey. A lot of residents would struggle to afford this. The minibus option referred to in the consultation document would cost £10 each way; again Ms Harvey suggested a lot of people would struggle to afford this. Public buses could transport residents to Worcester Royal Hospital from the Alexandra Hospital for £14 (return), though this did not take into account the cost to a resident of travelling to the Alexandra Hospital. This was a problem for residents living across the county, not just in Redditch.
Members were advised that many residents would not be aware of the Health Commission meetings or would struggle to attend these meetings for a variety of reasons. To enable a larger cohort of people to submit their views for the consideration of the Health Commission Members could not rely on public meetings to consult with the public but needed to be prepared to be proactive and to engage with local residents directly. Ms Harvey urged those residents watching the proceedings at the meeting on the Save the Alex Facebook page to submit their views for the consideration of both the Health Commission and the CCGs.
f) Ms Maureen Rowley
Ms Rowley explained that she lived in Redditch and could not drive so relied on public transport. Unfortunately bus services had regularly been cut in recent years whilst fares had been increasing. Whilst Ms Rowley often received a lift to access services at the Alexandra Hospital she did not feel it was appropriate to ask friends and family to drive her to Worcester Royal Hospital and to wait whilst she received treatment. Ms Rowley also noted that it was not appropriate to rely on ambulance services to access hospitals.
Recently Ms Rowley had travelled to the Queen Elizabeth Hospital Birmingham. The hospital had been easy and relatively affordable to access at £5 for a return journey. Redditch residents could also travel to the Queen Elizabeth Hospital Birmingham by train and the train journeys were regular and operated until after 11.00pm.
The Health Commission was asked to note that day services were also affected by the changes that had been made to services in Worcestershire. Ms Rowley had been due to receive a day procedure under general anaesthetic and had been invited to attend Worcester Royal Hospital. When she had requested that the appointment take place at the Alexandra Hospital she had been advised that the consultant could not get to Redditch and so a search was being undertaken to identify a new consultant who could carry out the procedure in Redditch.
g) Mr Ian Johnson
Mr Johnson explained that he was involved in the Save the Alex campaign.
Members were asked to note the case of a patient who had been taken to the Alexandra Hospital who had suffered a cardiac arrest. The decision had been taken to refer the patient to Worcester Royal Hospital but unfortunately this could not take place because there was a lack of capacity. Whilst the patient had survived this experience had caused a lot of distress to the patient and to staff.
It was important for residents to respond in the consultation process and Mr Johnson urged everybody watching the meeting on the Save the Alex facebook page to do so.
h) Mr Rob Underwood
Mr Underwood explained that his children had a rare medical condition which meant that they required immediate hospital access in an emergency. Mr Underwood lived a few minutes from the Alexandra Hospital but some distance from the Worcester Royal Hospital. As the Queen Elizabeth Hospital Birmingham was closer to Redditch this would be the preferred destination for his children but Mr Underwood was concerned he would not be believed if he raised the need to travel to Birmingham rather than Worcester during an emergency.
Mr Underwood noted that there were supposed to be two ambulances for Redditch patients. However in reality he suggested that there was only one as the other served Bromsgrove. Mr Underwood also had concerns about the performance of Trust services.
Unfortunately defibrillators would not save the lives of Mr Underwood’s children but good and accessible hospital services could. Mr Underwood questioned who he could hold to account for moving hospital services and for any complications that might arise in the event of an emergency.
Public speaking finished relatively early in the morning. In the absence of the public Members noted that they could achieve more by concluding the meeting and consulting with residents directly. It was therefore agreed that the meeting should close at 12 noon.