Patients face hospital upheaval

TENS of thousands of patients treated at a Yorkshire hospital face sweeping changes which will leave some travelling miles for care.

Victims of heart attacks could be among those facing journeys of 40 miles or more for emergency treatment under plans to provide fewer specialist services at Scarborough Hospital.

Hospital chiefs say the moves will safeguard core services, including round-the-clock accident and emergency (A&E) and maternity care, and also lead to the provision of more care closer to people's homes.

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But last night there was criticism of the plans in an area where care has already been downgraded.

The proposals come as a result of concerns about the safety and sustainability of a number of specialist services in Scarborough which treat too few patients, while extra costs of providing hospital care in the area saw subsidies of 8m for services during 2009-10.

Hospital services have faced growing outside scrutiny over standards in recent years which is likely to be reflected next week when the Care Quality Commission imposes conditions on the NHS trust's new operating licence.

The proposals, drawn up following an 18-month review, include pledges to maintain A&E, a maternity unit and "hospital-type" services in Scarborough and Bridlington.

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But under the changes, heart attack patients as well as serious accident victims could bypass Scarborough for specialist care in neighbouring hospitals.

Patients requiring more complex surgery, including some with cancer, will also go elsewhere under new "clinical alliances" with other centres.

More people with long-term conditions will be treated in the community by specially-trained nurses and GPs. Patients will be able to access expert help from specialists in Scarborough Hospital, which will become a one-stop shop for diagnostic testing.

Planned surgery will still be carried out in Scarborough and Bridlington hospitals but will be mainly day case and short-stay work.

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Cash will be saved from reductions in outpatients and shorter lengths of hospital stays, leading to cuts in bed numbers.

The Tory MP for Scarborough and Whitby, Robert Goodwill, said NHS services in the area had "lurched from one crisis to another" and this would further undermine confidence.

"If people who have had heart attacks are going to be blue-lighted 40 miles to York that really is not acceptable," he said.

The chairman of the Scarborough and district branch of the North Yorkshire Local Involvement Network for patients, Leo McGrory, said there were continuing fears about the future of a fully-operational A&E and about transferring critically-ill patients along often congested roads.

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He accepted there was no longer a need for so many hospital beds but questioned if social care was in place to help people recover at home.

"We've always had the fear that services are being reduced and reduced and we're not really being consulted," he said.

However, the chief executive of the Scarborough NHS trust, Richard Sunley, said the plan offered a different model of care.

"It's long overdue and it is a clear vision for the services we wish to provide – without being constantly held back on finance," he said.

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Some specialist services had already moved but the vast majority of work would continue to be carried out locally and it was hoped more could be attracted to Scarborough and Bridlington.

Among the first changes would be those to urgent treatment which would see better coordination of A&E, urgent care and out-of-hours services, Mr Sunley said.

How patients are affected

Scarborough Hospital is 40 miles from the next nearest large hospital. It serves a population of 200,000 in an area also covering Whitby, Bridlington and Ryedale.

In future patients suffering heart attacks and serious trauma face being treated at neighbouring hospitals.

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Short-stay planned surgery will be performed in Scarborough and Bridlington hospitals. More care will be provided in the community, particularly for those with long-term conditions such as diabetes or respiratory ailments.