Better Healthcare in Bucks: tell us what you think

The consultation is now closed. For complete details, please visit www.buckinghamshire.nhs.uk/bhib/

16 January 2012

A public consultation was launched today (16 January) on proposals to develop health services in Buckinghamshire.  The proposals have been developed through the Better Healthcare in Bucks programme by hospital doctors, GPs, nurses and other clinical colleagues. They are aimed at ensuring that local people can continue to have access to high quality, safe and accessible services which offer a good patient experience, make the most of developments in healthcare and meet future challenges. Between now and April 16, patients and the public will have an opportunity to contribute views and ideas on the proposals and this feedback will be considered in detail before any changes go ahead.

The proposals recommend making changes to:

• emergency care
• general medical inpatient care, including gastroenterology, diabetes, respiratory and medicine for older people services
• elderly care
• breast care
• specialist ‘networked’ vascular services.

Better Healthcare in Bucks set out to ensure that:

• comprehensive and expanded community services are available to support more patients closer to, or within, their own homes where possible
• a full range of general acute services (such as outpatient clinics, diagnostic testing and day case procedures) continue to be provided from Wycombe and Stoke Mandeville hospitals
• all specialist acute services are provided from dedicated centres within either Stoke Mandeville or Wycombe Hospital, to enable patients to access expert staff and facilities when they really need it.

The proposals set out to:

• refocus the emergency medical services at Wycombe Hospital, run by GPs and emergency nurse practitioners providing diagnosis, advice and treatment to people with minor injuries or illnesses, supported by the A&E departments at Stoke Mandeville and Wexham Park hospitals
• centralise specialist inpatient care for emergency medicine, respiratory, gastroenterology, medicine for older people and diabetes at Stoke Mandeville Hospital, complemented by the specialist stroke and cardiac services based at Wycombe Hospital 
• centralise and create a specialist breast care centre at Wycombe Hospital, to provide initial assessment and outpatients for people with breast problems.

The following new services are also proposed:

• day assessment unit for older people at Wycombe Hospital to allow them to be cared for without overnight admission to hospital
• step-down ward for elderly and medical patients at Wycombe Hospital – who still require 24 hour hospital care but with less specialist input 
• telephone and email advice service for GPs and ambulance crews to help them better support patients out of hospital
• urgent next-day outpatient appointments to help patients avoid hospital admission
• full specialist diagnostic support for GPs to help them better manage patients in the community or at home.

If the proposed changes take place, the vast majority of people would continue to go to the same hospital as now. And for those who may need to go elsewhere for their care, they will have an improved patient experience, with better outcomes.  

The launch of the consultation follows a programme of involvement and engagement events in September and October 2011.  During these events, people told us that they have confidence in health services which are provided in the community  or at home and are prepared to travel to get specialist hospital care with better results. At the same time, people also commented that they had concerns about travel and transport and wanted to see more information about NHS services and better co-ordination between different parts of the NHS.  People also commented that patients should not go to A&E for minor injuries and illnesses and that more use should be made of community based services such as pharmacies and GP surgeries.  The comments and feedback given during the engagement phase helped doctors and other clinicians to shape the proposals announced today.

Dr Graz Luzzi, Medical Director for Buckinghamshire Healthcare NHS Trust, said: “These proposals are all aimed at providing as much care as possible locally for the majority of people, while developing specialist care with high quality outcomes for the small number of patients who need these services. Our engagement and involvement process demonstrated that people understand and support these principles – they want care closer to home, when this is appropriate, and understand why they might need to travel further for specialist care.  We hope that people will look at our proposals and have confidence in what we are suggesting.  They have been developed by doctors and their clinical colleagues on the basis that they will give patients the best experience and the best results, now and in the future.”
 
Dr Geoff Payne, Medical Director for NHS Buckinghamshire and Oxfordshire Cluster said: “During our consultation phase, we will work hard to reach as many individuals and organisations as possible, to discuss our proposals and hear what people think.  There are some very committed individuals in our local communities who will want reassurance that what we are suggesting is best for local patients. We need to listen and take account of their views. We hope that they will continue to stay involved so that we can have open and honest conversations about what we want to change and why. At the end of the day, we all have a common purpose – to ensure high quality, patient-centred, accessible, safe and sustainable services for people in Buckinghamshire.”ENDS

 

For more information on Better Healthcare in Bucks: www.buckinghamshire.nhs.uk/bhib/

The following table sets out the calendar of consultation events. These will be supplemented by a road show visiting libraries and shopping centres, question time sessions with senior doctors and a range of other events.  Representatives of the Better Healthcare in Bucks programme will also be giving presentations to and holding discussions with a wide range of organisations including local government bodies, community and patient groups.

Please note that places at the events need to pre-booked, by phoning 01494 552256 or emailing betterhealthcareinbucks@buckinghamshire.nhs.uk

Consultation Meetings	Date	Time
Marlow Court Gardens	Thurs. 2 February	18.30-21.30
Buckingham Community Centre	Wed. 8 February	18.30-21.30
Evreham Centre - Iver	Mon. 13 February	14.00-17.00
The Oculus - Aylesbury	Tues. 21 February	14.00-17.00
Chesham  Community  Hall	Mon.27 February	10.00-13.00
King’s Centre - Wycombe	Tues. 28 February	10.00-13.00

 

The following tables summarise the proposed changes to both acute hospitals:

Wycombe Hospital
Outpatient services (adult and children)	No change proposed
Day case procedures (adult and children)	No change proposed
Elective treatment centre (planned surgery)	No change proposed
Midwifery-led birth centre	No change proposed
Antenatal care	No change proposed
Diagnostic services (for example x-ray, endoscopy)	No change proposed
Specialist stroke services (including hyperacute stroke and  acute stroke)	No change proposed
Specialist cardiology services	No change proposed
Critical care support	No change proposed
Vascular service	Day surgery, diagnostics, outpatients and surgery to prevent strokes caused by carotid artery disease would remain unchanged. Complex inpatient surgery (including abdominal aortic aneurysms) proposed for John Radcliffe Hospital in Oxfordshire to do.
Urgent care service	For those who currently attend the EMC at Wycombe without having seen their GP or another clinician first, they will still be able to attend the new urgent care service. If your GP or ambulance service determines that you require urgent hospital attention you will be directed to the most appropriate A&E department (eg Stoke Mandeville or Wexham Park hospitals).
Breast care services	Proposal to centralise initial assessments and first outpatient appointments at Wycombe Hospital through the creation of one-stop clinics in a new specialist breast care unit. Chemotherapy for breast cancer will continue in both Stoke Mandeville and Wycombe Hospitals
Inpatient services	Proposal for emergency respiratory, gastroenterology, diabetes and medicine for older people admissions to be admitted to Stoke Mandeville Hospital. Creation of a step-down / community hospital ward for older people at Wycombe Hospital.
Multidisciplinary assessment service for frail or elderly patients	New service development for Wycombe Hospital. GPs will be able to refer into this service and obtain advice and support for patients to remain out of hospital
System of fast access for diagnostics, assessment and specialist opinion for GPs to help keep patients out of hospital	New service development for Buckinghamshire

 

Stoke Mandeville Hospital
Outpatient services (adult and children)	No change proposed
Day case procedures (adult and children)	No change proposed
Accident and Emergency Department (adult and children, including trauma and GP-led centre)	No change proposed
Emergency surgery (adult and children)	No change proposed
Maternity services (including antenatal, inpatient and neonatal care)	No change proposed
Paediatric services (including inpatient care)	No change proposed
Diagnostic services (for example x-ray, endoscopy)	No change proposed
Specialist plastics and burns services	No change proposed
National Spinal Injuries Centre	No change proposed
Specialist ophthalmology service	No change proposed
Critical care support	No change proposed
Cancer care and haematology	No change proposed for the majority of services. Proposal to centralise initial assessments and first outpatient appointments  for patients with breast-related symptoms at Wycombe Hospital through the creation of one-stop clinics in a new specialist breast care unit. Chemotherapy for breast cancer will continue in both Stoke Mandeville and Wycombe Hospitals
Inpatient services	Proposal for emergency respiratory, gastroenterology, diabetes and medicine for older people admissions to be admitted to Stoke Mandeville Hospital.
System of fast access for diagnostics, assessment and specialist opinion for GPs to help keep patients out of hospital	New service development for Buckinghamshire