This report on the 2nd June Mytholmroyd drop in session on the proposed Calderdale and Huddersfield NHS shake-up comes from Dr Chris Day of Calderdale 38 Degrees NHS and Green Party member Gary Scott, who is organising the Save Our A&Es float at Halifax Gala on 14th June. A report by Rosemary Hedges, Secretary of Calderdale 38 Degrees NHS, will be posted shortly.

Some readers may not know about the proposed changes to our NHS and social care in the area. Basically, the Hospitals Trust, the community health care company Locala and the Mental Health Trust are proposing to:

• close one or both A&E departments in Calderdale and Huddersfield
• reduce acute and emergency hospital care in Calderdale and Huddersfield
• replace this by health and social care in the community and four minor injuries units (in Todmorden, Holme Hospital, Halifax and Huddersfield)
• treat all patients needing acute and unplanned care in Huddersfield Royal Infirmary
• turn Calderdale Royal Hospital into a planned care clinic using about 1/4 of the current beds

These proposals are described in more detail in the Strategic Outline Case – Transforming Services in Greater Huddersfield and Calderdale. The NHS organisations are now calling these proposals “Right Care Right Time Right Place”, or “Right Care” for short.

If you’re attending any of the remaining drop ins and would like to report on what you find, please contact us.

The drop ins are sessions where the NHS organisations are supposed to explain the proposals to the public, and find out what the public thinks of them.

The NHS organisations have a legal duty to do this, because the public has a right to be involved in making decisions about NHS reconfigurations (changes).

Dr Chris Day said,

“The Mytholmroyd engagement went as expected with very few members of the public attending. The NHS staff were very friendly and offered us coffee and a place inside out of the rain for the stall. It seems about 15 people had attended before we set up the stall from 5 till 7 and only 3 more people attended during that time (all 38 Degrees members).”

Gary Scott reported that he attended the drop in from around 3.30pm, when there were around 10 members of the public there. He spoke to someone from the West and South Yorkshire and Bassetlaw Commissioning Support Unit, who, he said, couldn’t really give him precise reasons why the event was happening, or why it was felt that this was the best method of finding out what the general public thinks of the “Right Care” proposals.

Gary then spent around half an hour talking with an Assistant Director at the Calderdale and Huddersfield NHS Foundation Trust. Their conversation yielded the information that:

• Most Hospitals Trust staff haven’t been consulted yet, but the process is ongoing.
• It was unclear whether Yorkshire Ambulance Service had been consulted about the “Right Care” proposals, but if they hadn’t been they would be.
• It was not known how many job losses would result from carrying out the “Right Care” proposals, but the Assistant Director confirmed what the Trust has already said – that most of the anticipated savings on the wages bill would come from a huge reduction in payments to locums/agencies (and their inflated costs over permanent employees).
• The Assistant Director was unable to clarify the costs of the Right Care proposals and whether they would save money for the Hospitals Trust or not.
• Asked why many services had already moved to Leeds and Huddersfield, and why the public hadn’t been kept informed of these changes, the Assistant Director told Gary that this had been a straightforward clinical decision.

Dodgy evidence that centralising acute and emergency services will solve Trust’s staff retention problem
Gary also asked about the Hospitals’ staff retention problem. The National Clinical Advisory Team Report last June gave this as a reason for recommending the closure of Calderdale A&E department and moving all acute services to Huddersfield Royal Infirmary. The Assistant Director told Gary this was a national problem, but she couldn’t explain how having a similar number of consultants based on one site would alleviate it.

Dr Day said that other members of the public attending the drop in had also been told that centralising consultants was a justification for closing Calderdale A&E.

Dr Day pointed out that this justification has a history going back to March 2007, when the NHS Support Federation reported that the government’s case for hospital closures was based on dodgy evidence.

At that time, proposed hospital cuts and reductions in at least 60 areas were expected to include the downgrading of A&E, paediatric and maternity departments.

A pro-privatisation think tank produced evidence to support these proposals. But close analysis of this evidence showed that it failed to demonstrate conclusively that there is any overall clinical benefit from centralising services in fewer hospitals.

Asked if the Right Care Right Time Right Place model had been trialled and tested elsewhere to prove its viability (before closing A&E and reducing other acute and emergency hospital services), the Assistant Director told Gary she didn’t know.

She was also unaware of problems that have arisen as a result of the closure of A&E departments in Burnley and Newark.

Gary asked about Calderdale Clinical Commissioning Group’s involvement in preparing the Strategic Outline Case (SOC). Despite having their name on the slide show presentation of the SOC, the Clinical Commissioning Group are still maintaining they had nothing, or little to do with it. However the Assistant Director was very clear that they had been fully involved, at all stages.

Gary said that when he asked what would happen to Calderdale Royal when its beds were 3/4 empty as a result of turning the hospital into a planned care clinic,

“The Assistant Director really waffled at this one, and it was one of the questions that seemed to make her most uncomfortable. I suggested it would make a perfect opportunity for a private Health Care company to come in, but she didn’t wish to comment on that, understandably.”

Gary’s overall impression was,

“I certainly felt she was trying to be as open and honest as possible, whilst maintaining the party line, but I could have written most of her answers in advance.”