More clues, more questions! Oh the Trauma!

And oh the irony! Saturday 10th August we spent a windy but great afternoon at the Huntingdon Carnival talking to local people about the uncertain status of Hinchingbrooke – we chose the theme “Your Guess is as Good as Ours” because we are asking questions of the “Cambridgeshire Leaders” but the answers are not forthcoming in any form that is useful.

Then just TWO days later the Health Service Journal caused a stir by announcing that “Cambridgeshire Leaders” have set out plans to remove all trauma work from Hinchingbrooke (“a struggling district general hospital”) as part of a major clinical reconfiguration.

Q1: WHO ARE THE “LEADERS”?

Well there is the Clinical Commissioning Group (CCG) – made up of clinicians and NHS execs – who are (in theory) the budget holders and in charge of commissioning NHS care for our county region which is also known as ‘FootPrint 21’ which is governed by something called the Sustainability & Transformation Partnership Board (STPB) – which has no LEGAL STATUS and is simply a collection of interested parties including charities, local authority figures and various NHS groups & bodies who have all agreed to collaborate – whooppee!

Q2: IF THE STP HAS NO LEGAL STATUS…?

Why is it making proposals and decisions about our NHS services? This can’t be right can it? Yet that is what is happening. (NHS England wants all STPs to become Integrated Care Systems by 2021/2 – that’s another post coming soon).

At the STP Board meeting in July Caroline Walker, CEO of North West Anglia Foundation Trust (yes that is what Hinchingbrooke is part of now) delivered a paper that contained the clues…

In December 2018, DHSC/NHSI (Dept of Health/NHS Improvement) supported significant Wave 4 capital investment in the local system, including an allocation of £25,536m for investment in the redevelopment of Hinchingbrooke Hospital, to include renewal of the 7 main theatres, additional capacity of 55 beds and a modest upgrade of urgent care facilities to meet compliance standards and improve the effectiveness of ambulatory care and acute assessment. Q: All sounds good so why are they axing Trauma?
For trauma and orthopaedics, it was agreed to progress with planning for the redistribution of DGH trauma away from Hinchingbrooke to Peterborough City Hospital and Addenbrooke’s Hospital… (continued)

This will constitute a significant service shift, and the team will work on the assumption that public consultation will be required.
There needs to be an early view of the high level business case to test whether this development will be affordable in terms of the overall clinical and financial sustainability of the system. It is possible that further changes may need to be made to elective orthopaedic pathways in the system in order to ensure that there is sufficient operating and post-operative capacity. Q: Elective meaning patients making decisions to have treatment and having to self-fund perhaps?
In the case of Huntingdonshire, there appears to be a higher than average rate of elective admissions for the system, which will be explored as part of the modelling. This may bring opportunities for Hinchingbrooke to become a hub for a wider catchment population to ease pressure on other services within the system. Q: Is NWAFT seeing Hinchingbrooke as a centre of making money from elective treatments?

Q3: What about the Public?

What about them? seems to be opinion. Despite the fact that throughout Caroline Walker’s paper it is repeated that: This will constitute a significant service shift, and the team will work on the assumption that public consultation will be required. (Sometime soon we assume)

Q4: If the capital funding has been applied for and agreed hasn’t the decision been made?

And what would be the point of a consultation?

Q5: What about the A&E status at Hinchingbrooke?

So what can we do?

Well… you could write to the STP Board and ask them exactly what is going on with the proposal to axe Trauma at Hinchingbrooke. The next meeting of the STP Board is the 19th September – details are HERE

Or attend the next Clinical Commissioning Group on the 3rd September in Ely – Details HERE

You could ask your local councillors what they know about the changes taking place as it will affect their work and their duty to protect local services.

Despite being labelled “scaremongerers” we have been predicting that major changes will take place at Hinchingbrooke since we fought the merger in 2016/17. These changes are inevitable (unless the public put their foot down) because of the national mandate laid down in NHS England’s Long Term Plan – which focuses on centralising acute services, pushing more care out into the community and encouraging more charity & 3rd Sector organisations to take up the flack (and funds). They want to keep people OUT of hospital – for all the wrong reasons – money.