Reaching the options
The options for public consultation have been developed by four groups of healthcare staff from medicine, surgery, women and children’s services and diagnostics and clinical support. They were supported by NHS Foundation Trust governors, senior managers and representatives from partner organisations.
Testing the options
All options needed to meet the following criteria:
- they would provide a safe service for patients which would be sustainable in terms of staffing and resources over the next five years, meeting all relevant national standards and guidelines of professional bodies such as the medical Royal Colleges and the Department of Health
- they would be affordable within the agreed national cost structure for providing health services
- it would be feasible for the options to be successfully implemented during the five years to 2013.
Examining benefits to patients and staff
If potential options passed all these ‘hurdles’, their likely benefits to patients and staff were then explored for the level to which they improved:
- the patient’s experience of care and the way different healthcare professionals work together to deliver care for each patient
- access to services - on the basis of ‘centralised where necessary and localised where possible’
- recruitment and retention of staff - making the most of existing skills, more opportunities for developing skills, less difficulty with staff cover across Trust sites
- sustainability of services and innovation – new, flexible ideas that can help the Trust care for more patients.
The options explored by the four groups fell into five main categories or clusters:
- Cluster 1: no change/status quo
- Cluster 2: two sites leading on acute hospital care (closing one general hospital)
- Cluster 3: two sites leading on acute hospital care, plus proposals for the third site to be redeveloped as a planned centre and providing local health services and urgent care
- Cluster 4: one acute site, one elective (planned care) site and one community hospital
- Cluster 5: one acute site, two community facilities with midwife-led unit(s).
Although all services could no longer be duplicated across three sites, a key objective for our clinicians, and for the Trust’s management, was to ensure that all sites are used to their maximum potential.
Cluster 3 was the only one that successfully met the agreed three initial hurdle criteria, and would maximise the use of all sites.
This was then developed by the Trust’s clinicians into the two final options on which the public are being consulted – Options A and B.