Dr Matt Walsh, Chief Officer of Calderdale Clinical Commissioning Group (CCC), will update the CCG governing Body this afternoon about the latest plans for the “transformation” of Calderdale NHS and social care. The meeting is public and takes place at 2pm, in a Function Room at Shay Stadium, Halifax.
The Calderdale NHS and social care shake up has been carried out somewhat under the radar since last August, when the Calderdale and Greater Huddersfield Clinical Commissioning Groups backed off from their scheduled autumn 2014 public consultation, in the face of a loud and determined public “No” to their proposals.
These proposals included the closure of Calderdale A&E and other acute hospital services at Calderdale Royal Hospital, such as acute children’s services and complex maternity services, and the transfer of many hospital-based services into the “community,” with the aim of cutting acute and emergency hospital admissions.
Plain Speaker has done its best to track developments since last August, not least by bringing a public petition to Calderdale Council Adults Health and Social Care Scrutiny Panel that asked them to call in the NHS organisations to explain their plans.
This afternoon Dr Matt Walsh, the Calderdale CCG Chief Officer, will update the CCCG Governing Body on:
- What plans are afoot for Calderdale Royal Hospital and Huddersfield Royal Infirmary, including plans for “pre-consultation engagement” that will allow the CCG to “talk to the right people about the right things”!
- What is happening to the new Care in the Community scheme aka Care Closer to Home, which takes services out of the hospital with the aim of cutting acute and emergency hospital admissions
- What is happening with the new “Vanguard” scheme, which has been set up to fast track the Care Closer to Home scheme in the Upper Calder Valley – see separate article, link available soon
The Chief Officer’s Report to the 11 June CCCG Governing Body meeting outlines key facts.
Plans for Calderdale Royal Hospital and Huddersfield Royal Infirmary – Right Care Right Place Right Time
On April 16th, Calderdale and Huddersfield Clinical Commissioning Groups (CCGs) presented their joint position on options for future hospital services to the hospitals Trust, based on the CCGs’ “potential model” for Urgent and Emergency Care. The Chief Officer’s report doesn’t say what this “joint position” is, so I’ve asked this question of the Governing Body, which I hope they will answer:
- What is the Commissioners’ joint position on options for future hospital services?
The April 16th meeting also explored in detail the hospital Trust’s Planned Care model as presented in their Outline Business Case.
(Plain Speaker reported on the hospital Trust’s Outline Business Case (OBC) when it was published in autumn 2014.
In summary, the OBC comes down on the side of making Calderdale Royal Hospital the small planned care hospital, carrying out planned treatments like hip or knee operations, with only 85 of its current 350 beds in use and no A&E, just a Minor Injuries Unit that would see around 22,500 patients a year.
24/7 acute and emergency care would be at Huddersfield Royal Infirmary. This would include trauma, major surgery, crticial care, acute & specialist medicine, inpatient paediatric services and complex maternity services.
In addition to minor injuries units, the OBC says both hospitals would provide outpatient care for children and adults, midwifery-led maternity units and specialist psychiatric liaison services.
The OBC sees a possible future for the “redundant” space in the rest of CRH as a care home and hospice, and says:
“There is potential to link up with other Care Home or Hospice providers” (p141)
And this “spare capacity” at CRH could generate an extra £15m income from “additional commercial activities” (p175) )
On 7th May at a “roundtable” meeting with the hospital Trust, NHS England and Monitor,
Calderdale and Greater Huddersfield CCGs’ Chief Officers outlined plans for taking forward changes to both community (Care Closer to Home/Vanguard) and hospital services.
The Chief Officer’s Report doesn’t say what these plans are, so I have sent in this question to be answered at the Governing Body meeting:
- What is the content of the plans for community and hospital work that the 7th May roundtable meeting discussed?
Calderdale CCG has also produced the first draft of its Quality and Safety Case for Change and is working with the hospitals Trust to develop this.
Again, the CO’s Report is coy about what this Case for Change might be, so I have asked this question that I hope the Governing Body meeting will answer:
- What are the contents of the quality and safety case for change?
On 20th May the Hospital Services Programme Board agreed to set up two clinical working groups to develop more detailed plans for Planned Care and Urgent Care.
Other papers for the Governing Body meeting show ongoing problems with Calderdale A&E, and with CRH failing to provide the amount of “elective” care that it is contracted to provide. This is things like planned operations for hips, knees etc.
They also show ongoing issues with the hospital Trust’s deficit.
Serious risk rating for Right Care Right Place Right Time scheme
The risk log presented to the Governing Body has a serious red risk rating (level16) that the Right Care Right Place Right Time scheme won’t deliver – resulting in poor services, lack of financial benefits from the new system and inability to change hospital and community services in ways needed to deal with quality, finance and workforce issues in the CCG’s case for change – this includes the need to help fill a £154.5m funding gap over the next 5 years
It also has a serious (level 12) risk rating that the hospital cuts and closures consultation will be delayed because of the closure of Yorkshire and Humberside Commissioning Support Unit, which provides the comms team.
Care in the Community update
The Care Closer to Home scheme is moving services out of the hospital into the community (without any public consultation).
Plain Speaker has reported on this scheme here and here.
The Care Closer to Home Phase 2 Specification went to the Calderdale CCG Quality Committee in March. Phase 2 covers:
- Ambulatory Care S (ASC) conditions – angina, asthma, dementia, (current hospital admissions will be reviewed)
- Children’s emergency admissions
- Overview Business Case (where is this Overview Business Case?)
These Phase 2 specifications will be tested against 7 clinical priorities, including:
- levels of local engagement
- “what evidence we have in each of these areas that moving the service from the hospital in to the community” [sic]
- capability available to manage the move