- The NHS England quango is running a public consultation in West Yorkshire from 28 August until 30th November, on its plan to stop providing specialised vascular services at Huddersfield Royal Infirmary.
- Following the consultation, the quango aims to make a decision by the end of 2019.
- The West Yorkshire and Harrogate Joint Health Scrutiny Committee wrote to the quango last April with a list of criticisms of the proposal. When the Scrutiny Committee met on 10.9.19, Councillors were not best pleased that NHS England’s response in August had failed to address key points. The Scrutiny committee has written back to the quango asking them to reply to these points.
- ck999 told the Calderdale & Kirklees Joint Health Scrutiny Committee meeting of 5.2.19 about the plan – but they didn’t seem to register the information and as far as we know they did nothing about scrutinising it. Maybe now is a good time to ask them why.
What are specialist vascular services?
Vascular services reconstruct, unblock or bypass arteries and are often one-off specialist procedures to reduce the risk of sudden death or amputation and prevent stroke.
At the moment in West Yorkshire, Leeds General Infirmary, Bradford Royal Infirmary and Huddersfield Royal Infirmary currently carry out specialised vascular operations.
The recommendation NHS England is consulting on is to stop providing specialised vascular services at Huddersfield Royal Infirmary.
In future only Leeds General Infirmary and Bradford Royal Infirmary would provide them – Leeds due to its status as a major trauma centre, and Bradford due to its co-location with renal (kidney) care.
NHS England’s plan would require all specialised vascular services patients in Calderdale and Kirklees who need an overnight hospital stay to go to Bradford Royal Infirmary instead. This would affect around 800 patients/year.
Even if NHS England was not planning to cut Hudderfield’s specialist vascular service, the local hospital cuts plan would still remove it from Huddersfield Royal Infirmary, because of the intention to turn Huddersfield Royal Infirmary into a small planned care clinic with outpatients, a walk in urgent care centre and a few medical beds for anyone admitted from the walk in.
In that case, specialist vascular services would be moved to Calderdale Royal Hospital which is planned to become the acute and emergency hospital for both towns.
Vascular diagnostics, day surgery and follow up care are not part of this consultation
As well as specialised vascular services, that are currently provided in West Yorkshire by Leeds, Bradford and Huddersfield hospitals, there are also vascular diagnostics, day surgery and follow up care provided by all the District General Hospitals.
Most patients would continue to access vascular day-case surgery, diagnostics, outpatient appointments and rehabilitation services in a District General Hospital – although possibly not their own.
Regular vascular patients might find themselves trekking across West Yorkshire for hospital treatment
This is thanks to a decision in 2018 by the West Yorkshire Association of Acute Trusts (all the District General Hospitals in the county).
In its wisdom (or desperation in the face of inadequate funding and staff shortages – take your pick), the Association has combined all the District General Hospitals’ general vascular services into one, under one management team. This serves the whole West Yorkshire population and has almost 40 vascular surgeons and interventional radiologists.
How is that going to work out? The West Yorkshire and Harrogate Integrated Care Service draft 5 year plan 2019-24 bigs it up as an example of how most hospital services from now on are going to operate in networks across the county (and Harrogate).
They claim that this will mean if one hospital has long waiting lists, and another doesn’t, patients whose District General Hospital has the long waiting list could go to the one with the shorter waiting list. They seem to think this is a good thing.
But it sounds like yet another set of transport problems for people on low incomes, who will now have to travel out of their town or area for hospital treatment. It will just make health inequalities worse and it exposes as an empty platitude the way the draft 5 year plan bangs on about reducing health inequalities.
The consultation is only about specialist vascular services
Info about the consultation is here.
Here is the downloadable consultation document .
Public consultation events in October
NHS England calls them listening events. Hmm. If previous public consultation events are anything to go by, they will be more like wrestling with fog events.
- Kirklees/Huddersfield: 3 October, 2pm until 4pm. Venue: The John Smith Stadium, Stadium Way, Huddersfield, HD1 6PG.
- Kirklees/Huddersfield: 15 October, 6pm until 8pm. Venue: The John Smith Stadium, Stadium Way, Huddersfield, HD1 6PG.
- Calderdale/Halifax: 8 October, 6pm until 8pm. Venue: The Arches, East Mill, 328 Dean Clough, Halifax, HX3 5AX.
- Calderdale/Halifax: 29 October, 6pm until 8pm. Venue: The Crossley Gallery, East Mill, 328 Dean Clough, Halifax, HX3 5AX.
- Bradford: 7 October, 2pm until 4pm. Venue: Midland Hotel, Forster Square, Cheapside, Bradford, BD1 4HU.
- Bradford: 14 October, 5pm until 7pm. Venue: Great Victoria Hotel, Bridge Street, Bradford, BD1 1JX.
NHS England consultation with new mandatory West and North Yorkshire Health and Overview Scrutiny Committee
NHS England is also consulting with a new mandatory West and North Yorkshire Health and Overview Scrutiny Committee, which is now being set up.
Up until now, the West Yorkshire and Harrogate Joint Health Scrutiny Committee, that deals with West Yorkshire and Harrogate Integrated Care System proposals, has been scrutinising NHS England’s plan for cutting and centralising specialist vascular services in West Yorkshire.
In a letter last April, the Scrutiny Committee objected to NHS England’s attempt to railroad them with last minute, sketchy information.
NHS England’s selective hearing ignores key staffing issues and damage to District General Hospitals’ ability to provide a range of safe services
At the 10th September meeting of the discretionary West Yorkshire and Harrogate Joint Health Scrutiny Committee, Calderdale Cllr Colin Hutchinson reminded everyone that after the last meeting this committee had written to NHS England in April asking for specific responses, but the quango hadn’t addressed all of them in their reply in August.
Cllr Hutchinson added that the Scrutiny Committee have now written again asking NHS England for their response to the issues they’d ignored.
For example, the stated reason for the specialist vascular services reconfiguration is the shortage of interventional radiologists. But even with cutting from 3 to 2 hospitals that provide specialist vascular services, there still won’t be enough Interventional Radiologists in Bradford to run the services as specified.
There are no West Yorkshire plans for training Interventional Radiologists as needed. And there’s nothing in NHS England’s response about this.
The Yorkshire and Humber Clinical Senate response said that some non-arterial sites (ie hospitals without specialist vascular services) may not be able to support Interventional Radiology services. This needs addressing because it could affect Huddersfield Royal Infirmary and could go wider.
For instance, all kinds of surgery are done at District General Hospitals, but if they don’t have vascular surgeons, staff and instruments, it shrinks the capacity of these hospitals to provide a range of safe services. This needs addressing by the mandatory joint scrutiny committee.
The Scrutiny Officer said they are seeking an extension from NHS England to their 30th November deadline for comments from the mandatory West and North Yorkshire Health and Overview Scrutiny Committee.
People need the same services wherever they are – NHS England’s proposal says this doesn’t matter
This point was made by Cllr Paul Godwin (Bradford), who said that NHS England’s response hadn’t addressed the effects of the loss of vascular services on a range of patients and A&E etc.
He added that they are returning to the old model, that services are delivered where staff are available – not where people need them.
People pay taxes everywhere and they need the same services wherever they are. NHS England’s document says it doesn’t matter.
Cllr Paul Godwin called this
“A retreat into the bunker.”
He said that the emphasis of NHS England’s document is completely wrong, it doesn’t begin to address issues.
He added that Leeds people need to visit the peripheries and find out how the proposed cut will affect people there. In order to show it’s got a sustainable population for specialist vascular services, Leeds boundaries have been opportunistically drawn to to take in Dewsbury Pontefract and Wakefield.
All in all, the plans for specialised (and regular) vascular services sound like a fair old mess.
Links from the NHS E consultation webpage
- Consultation and supporting business case documents
- Yorkshire and The Humber Clinical Senate report on West Yorkshire Vascular Services
- NHS England national service specification for specialised vascular services for adults
- Getting it Right First Time information and national report on vascular surgery
- Yorkshire and The Humber Clinical Networks