Consultation on changes to hospital services in North Kirklees and

Wakefield District

Dewsbury public meeting – 21st May 2013

Process for tonight’s meeting• Short presentation summarising the changes proposed and

their impact on services for Dewsbury area residents

• ‘Question Time’ style session led by independent Chairman – Steve Richards

15 minutes on maternity services

15 minutes on inpatient paediatrics

15 minutes on emergency care

15 minutes on surgery

Remainder of time left on any other issues

Dr Simon EnrightConsultant in Intensive Care and Anaesthesia

Clinical Lead : Service StrategyThe Mid Yorkshire Hospitals NHS Trust

PROPOSED CHANGES TO HOSPITAL SERVICES

Maternity services – proposed changes

Dewsbury•Midwife-led birthing unit• ‘low risk’ births : home, midwife unit or

Pinderfields• ‘high risk’ births : deliver at Pinderfields

Pinderfields• Consultant-led unit for all ’high risk’ births• ‘low risk’ births : home midwife-led unit

Local antenatal/postnatal care

Children’s services

Dewsbury : • New assessment facility for children who

attend A&E • majority of current inpatients through new

facility • Those requiring longer inpatient care at

Pinderfields

Pinderfields : no change

Urgent assessment and outpatients at all 3 hospitals

Emergency care

Pinderfields• specialist trauma and emergency care centre for Mid Yorkshire• centre for emergencies needing inpatient care

Dewsbury• open access for emergency care (70% of current)• staffed by A&E trained doctors and nurses (24/7)• full resuscitation facilities • able to treat a wide range of conditions • some ambulance attendances• consultants remain during the day (0900 – 2000), on call 24/7• “ Emergency Day Care” on site to reduce need for admission

SurgeryDewsbury • Centre for routine inpatient surgery (more specialties)• Separation of emergency and planned surgery• Day surgery • Some minor unplanned surgery (day case)

Pinderfields • Emergency surgery, complex surgery (critical care)• Day surgery

Summary : Dewsbury Hospital• Midwifery-led birthing unit• Paediatric assessment facility• 24/7 A&E for majority current attendances• Inpatient medical beds (assessment and

rehabilitation)• Routine inpatient and day surgery • Outpatients• Diagnostics

How will North Kirklees residents benefit?• Maternity : access to 24/7 consultant-delivered care for high-

risk births• Childrens : majority of children managed through paediatric

assessment facility. Inpatients will have access to more specialist and on-site consultant care at Pinderfields

• Emergency : majority still seen at Dewsbury A&E. Sicker patients seen quicker by consultants and specialist teams at Pinderfields

• Surgery : routine operations (including inpatients) carried out locally. Emergencies, sicker patients seen by specialist teams at Pinderfields quicker with more backup

• Outpatients : more local appointments

Dr David KellyChair

NHS North Kirklees Clinical Commissioning Group (CCG)

HOW WE ARE RESPONDING TO WHAT WE HAVE HEARD SO FAR

–

• Children with complex needsEnhanced specialist medical and community nursing for children with most complex needs & more care at homeWork with families to ensure minimal impact.

• Paediatric Assessment Service Specialist assessment and treatmentOpening hours will be demand driven to cover majority of children. Initially open to patients until 10pmTransfers for overnight stay will be minimised (<1 day)

Listening to You – Children

Listening to You – Surgery• Surgical Assessment

Emergency Day Care will include surgical proceduresDedicated theatre lists Common procedures including kidney stones, ectopic pregnancy, abscesses, minor fracture

• Day Case Surgery All surgery will be local

• Planned SurgeryDeveloping post operative care to increase the number of people who can be treated locally

Listening to You – Emergency Care

• Emergency Day CareConsultant presence for longerUsing technology to enhance specialist support More conditions treated locally including; DVT, pulmonary embolism, chest pain, cellulitis, falls, collapse, headache, chest infections, GI bleed

• Elderly Assessment Specialist assessment for frail elderly patients

Listening to You• Maternity Services

We’ll keep an eye on numbers. If demand rises then we can review

• Outpatients appointmentswill be in DDH unless there is a good reason not to be

• TravelTravel Group reconvened to look at recommendations in their report. Will present costed options to commissioners. To consider at Deliberative Event.

More patients treated locally in Dewsbury

• Patient Group Now 2016/17

Outpatients Attendances 96,000 111,000

Elective Day Case Attendances 8,000 13,000

Elective Inpatient Admissions 1,500 2,500

Emergency Admissions 16,000 7,000 (Emergency Day Care)

Deliveries/births 2,500 500 +

Paediatrics 3,400 2,800 (Assessment)

Total: 123,400 136,800

INPATIENT CHILDREN’S SERVICES

MATERNITY SERVICES

EMERGENCY CARE

SURGERY

ANY OTHER ISSUES