West Yorkshire Joint Health Scrutiny Committee is due to hold a working group/development session on the NHS Long Term Plan before the end of the 2018/19 Municipal Year. But they haven’t yet set the date.
It needs to be sooner rather than later. CK999 has warned Councillors on the Committee that the NHS Long Term Plan promise to save half a million lives is not based on any evidence.
Regardless, the NHS Long Term Plan aims to determine what Integrated Care Systems do over the next 10 years. And this means the whole of the NHS in England: the Long Term Plan says all 44 Sustainability and Transformation Plans must become Integrated Care Systems by April 2021.
We have asked the West Yorkshire Joint Health and Overview Scrutiny Committee to carefully scrutinise all proposals from West Yorkshire and Harrogate Integrated Care System, to see if they are based on or justify themselves by an appeal to NHS England’s phony promise of saving half a million lives.
Full fact has investigated this promise and found there is no evidence to underpin it. Many other informed commentators have pointed out the NHS Long Term Plan is not so much a plan, more a set of aspirations. We know aspirations are not an adequate basis for planning NHS services.
Vascular services centralisation
West Yorkshire Joint Health and Overview Scrutiny Committee needs to thoroughly unpick any claims for improvements to the quality of patient care, in the proposed West Yorkshire vascular services centralisation. This has been ordered by NHS England.
The proposal is to close all the vascular beds at Huddersfield Royal Infirmary, and move them to Bradford Royal Infirmary alongside the existing Bradford vascular beds.
So Calderdale and Huddersfield patients (about 800/year) will have to go to Bradford for inpatient stay and major operations to restore blood supply to arteries to prevent death and severe disability.
All other vascular activity currently provided in Huddersfield, including day case (minor) surgery, diagnostics and outpatient clinics, will stay at Huddersfield Royal Infirmary.
Staff shortages are the reason NHS England gives for closing Huddersfield Royal Infirmary’s “arterial centre”. Because there aren’t enough staff, at the moment Bradford and Huddersfield hospitals provide a joint alternating weekly on-call rota – meaning that at any one time, only one of the two hospitals can admit emergency vascular patients out of hours.
The other justification for this centralisation is that in order to keep their skills and competences in good shape, arterial surgeons and teams need a catchment population of at least 800K. This allows them to do at least 60 abdominal aortic aneurysm (AAA) procedures/year (10 per surgeon); and at least 50 carotid endarterectomy (CEA) procedures. (This is a procedure to reduce the risk of strokes by removing fatty deposits which narrow the carotid artery and restrict blood flow to the head and neck).
However this claim is undermined by the performance of arterial surgeons at Huddersfield Royal Infirmary. Outcomes are good and their performance is in line with or above national expected levels. This is despite that fact that the catchment population is 498,000 and Huddersfield Royal Infirmary arterial centre only does 30 abdominal aortic aneurysm (AAA) procedures/year and 45 carotid endarterectomy procedures/year.
Evidence is mounting that hospital services centralisation discriminates against people on low incomes – particularly those reliant on public transport.
We discussed this in a meeting we had with Owen Wiliams and other Calderdale and Huddersfield hospital trust bosses in February. We told him that some people on low incomes are simply stopping using key services.
Since that meeting, other patients have come forward with info that their GPs no longer refer them to their local District General Hospital, but are referring them to hospitals in other towns in W Yorks and even to hospitals in South Yorkshire, including Sheffield and Rotherham.
We would like West Yorkshire and Harrogate Joint Health and Overview Scrutiny Committee to investigate the effects on patients’ access to hospital services of the networking of hospitals by West Yorkshire and Harrogate Integrated Care System and West Yorkshire Association of Acute Trusts.