Bid to cut number of hospital patients ‘not safe’
Plan to axe A&E relies on a huge fall in admissions
CONTROVERSIAL PLANS to reconfigure health services in Yorkshire rely on preventing 250 patients a week from needing hospital beds, a report has revealed.
Proposals to centralise hospital care in Halifax and axe emergency services at Huddersfield Royal Infirmary (HRI) have attracted a storm of opposition and been referred to Health Secretary Jeremy Hunt.
A central target aims to reduce unplanned hospital admissions by 18 per cent through major investment in GP and community services to treat people closer to home. An independent review ordered by local officials, obtained by The
Yorkshire Post, reveals 250 fewer patients a week would need to be admitted to hospital beds under the plans. Based on a six-day week, this would mean reducing admissions by 42 patients a day – equivalent to four patients a week from each GP practice in the area.
Headline findings from a draft of the report were used by councillors as part of evidence against the sweeping changes in their referral of the plans to Mr Hunt.
But local NHS leaders say its conclusions support their case to improve care outside hospital and reduce demand for treatment. The final report from the NHS Transformation Unit warns the target 18 per cent cut over five years is “a challenging one”.
It said there were “few” parts of the UK where consistent reductions in admissions had been made on the scale required and sustained over five years.
The scale of improvement was “achievable” but requires the local NHS to become one of the best performing in the country, adding the “pace of change will have to increase significantly” to meet the targets. Former senior NHS manager Mike Ramsden, who chairs the campaign group Let’s Save HRI, warned patients faced travelling for care at neighbouring hospitals or further afield if the plans failed.
“We have asked for evidence of where this been done consistently and safely on this scale and we haven’t been given it. It’s a guessing game,” he said.
“The GPs we have spoken to say this is not doable and it’s not safe.
“Our stance has always been there is a need for change and for more care out of hospital but it has to be a sensible level with appropriate alternative provision.”
The report said efforts to reduce admissions would need to focus on patients with two or more long-term conditions and the frail elderly with multiple episodes of illness.
In their referral to Mr Hunt, Kirklees and Calderdale councillors said they were not convinced plans for a better community care would reduce demand on hospital services or that the reduction in admissions of 18 per cent was achievable to allow a cut of 105 beds to a total of 738.
A spokesman for NHS Greater Huddersfield and Calderdale clinical commissioning groups said the report confirmed an 18 per cent reduction in unplanned medical admissions over five years was achievable but required “best-in-class performance”, joined-up community programmes and contract changes.
The GPs we have spoken to say this is not doable and it’s not safe. Let’s Save HRI chairman Mike Ramsden on the target to reduce hospital admissions.
WHILE REDUCING the number of patients using hospitals beds through investing in community and GP services is undoubtedly a laudable aim, the targets being put forward to justify cutting emergency services at Huddersfield Royal Infirmary generate serious concern.
An independent review of the reconfiguration plans obtained by The Yorkshire Post reveal that their success relies on preventing 250 patients a week from needing hospital beds, equivalent to an 18 per cent reduction in admissions over five years.
In theory, if this could be achieved it would save the NHS money and deliver better services to patients, who in general prefer to avoid lengthy stays in hospital in favour of treatment closer to home.
But the worry is whether the target is realistic and what the repercussions will be should the aim not be achieved.
The NHS Transformation Unit has warned the target is a “challenging one” and that there have been few places in the UK where such reductions in hospital admissions have been achieved.
Local hospital bosses insist it can be achieved but equally accept themselves that meeting the aim requires them to become one of the best-performing NHS organisations in the country.
Campaigners say they are yet to be provided with evidence of anywhere else in the country where such a change has been successfully delivered and fear that if the plans fail, patients will be left with no choice but to travel considerable distances for care at other hospitals.
The proposals have already been referred to Health Secretary Jeremy Hunt by Kirklees and Calderdale councillors who are not convinced the plans are deliverable.
Given the potentially serious consequences of failure, the Government must seriously assess whether this target can actually be met.