Dear Simon,

The Future of Acute Hospital Services in Worcestershire

The Future of Acute Hospital Services in Worcestershire will be decided at a Committee in Common of all three Worcestershire Clinical Commissioning Groups on Wednesday, 12 July 2017.

I would be grateful if you would record this contribution to this meeting, to be held in public, as I am unable to attend because the House of Commons is sitting.

The Alex was the number one issue during the recent election campaign, and as a parliamentary candidate, and now a newly elected MP I quickly understood why people are concerned and anxious by what has been happening for some time now.

After having full services including maternity and an Accident and Emergency department for under-16s at the site for many years local families come to rely upon them, and to see them permanently removed is very hard to understand.

People also don’t want to travel out of the local area, and not everyone has a car, and the parking can be an issue when you get to Worcester Royal. Even a simple accident on the M5 can cause long delays, and this kind of uncertainty is the last thing a mother in labour, or a parent with a sick child, needs to be thinking about as they make their way to Worcester.

Likewise, when you’re a parent and you have to leave your child in hospital overnight you want to be close to them.

People in Redditch also think that as the town is growing, they should have all these services ready for the future population. They point to new housing developments in our area and worry that this will make services stretched in future.

During the election campaign and after, I’ve talked to thousands of people, who raised this with me. I remember one young Mum, who broke down in tears, saying that she had moved to Redditch specifically because of the Alex, so that she could start a family. She has a condition meaning that if she goes into labour, she is at very high risk, and would need extremely fast access to a maternity unit. She is now unwilling to get pregnant again, even though she would like a second child, for fear that she would not be able to get to the Worcester Royal in time.

There is also a fear that somehow this situation means the Alex will be closed in future. There is a perception that additional downgrades will be made.

I understand that your proposals are clear that you do not recommend that the Alex should be closed, either now or in the future, or that you intend to make any more downgrades to services, but I would be grateful for your assurance on this point.

People in Redditch will welcome once and for all clarity that there are no plans to close the Alex, and that Redditch will have a hospital both now and in the future that is fit for the size of the town.

I think it is only right to bring to your attention formally that the perception exists among local people that, in their view, the consultation process has been unsatisfactory.

Now we are expecting to see the outcome of the consultation process, put to the board of the CCG in this meeting held in public. The proposals are no surprise, they have been publicly available for some time now and I have read them carefully.

I have been asked whether or not I support these proposals, and even though the events leading up to this happened long before I was the MP, a role I have had for only one month, I cannot give my full support to the proposals for the reasons above.

I cannot support any proposal that removes services from Redditch, in favour of having them delivered at the Worcester Royal, against the wishes of Redditch people.

And it is clear that people in Redditch did not support this either.

In your own business case, for instance, you show that 3,206 survey responses were received and that Redditch was very well represented in these responses. Indeed, it notes that compared to all Worcestershire residents the respondents were more likely to live in Redditch and have had experience of using the services at the Alex.

In the consultation, 81% of respondents opposed the centralisation of maternity services to Worcester Royal. Similarly, for children’s inpatient services, 80% of people disagreed they should be moved to Worcester, and only 20% agreed.

People are understandably left with the impression that their area, Redditch is being unfairly overlooked in favour of Worcester.

Local people, therefore, do not feel this consultation was a true consultation. It presented the decisions as a foregone conclusion with no option to have services returned to the Alex, nor did it explain what would happen if local people overwhelmingly opposed this decision, and this is in fact what has happened.

While I understand that there are good clinical and safety reasons for services to be consolidated, that you have gone into detail about in the business case,  I think it is unfair for local people to be asked to give their views, which would naturally lead them to think that they might have an influence over the outcome, to then find that their concerns were not adequately addressed.

I would, therefore, be grateful for your response to this, and what you intend to do in the future to meet the needs of the projected population growth, or any other changes that occur in the population.

I am seeking reassurances that the level of services provided is right for the size of the town and local population in the future.

I am also requesting to be kept fully informed of any future decisions on service changes, and will be asking the CCG to look again at their consultation process in future, so that it commands the confidence of the public.

I greatly appreciate the open communication we have had in the past and the constructive working relationship we have. I look forward to that continuing in the future, so that the people of Redditch receive the best possible health services.

And while being frustrated with the negative aspects of this process, it’s important to recognise the positives also. The proposals will lead to benefits for Redditch, including:

  • A new urgent care centre, sometimes known as a walk-in centre, that will be open to adults and children 24 hours a day, capable of treating minor and moderate illness for children.

  • A dedicated new women’s centre with gynaecology/day-case and outpatient facilities. Some gynae surgery will transfer to the Alex too.

  • Upgraded operating theatres so that the Alex can become a centre of excellence for planned surgery, which will include more breast surgery that will transfer from Worcester to the Alex.

  • Most planned orthopaedic surgery from Worcester Royal Hospital to the Alex

  • A new children’s outpatient department.

  • Improved endoscopy facilities.

  • More ambulatory care (Medical care provided on an outpatient basis including diagnosis, observation, consultation, treatment, intervention and rehabilitation) that will move from the Worcester Royal Hospital to the Alex

I further note that the consultation claims that irrespective of the changes 95% of people would continue to receive their care in the same hospital as now and 80% of children who currently receive their treatment at the Alex would continue to do so. Also that diagnostic tests and outpatient appointments would take place in the Alex, as now.

It’s unfortunately true that as I hear from my constituents, when they have to travel to Worcester for treatment, there are occasional cases where they receive poor care. We know that many factors have led to the Worcester hospital being placed into special measures, which we all hope to see improving as quickly as possible. I have met with the CEO Michelle Mackay to discuss the work she and her team are doing to improve this situation, I understand it will take some time due to the complexity of the issues they are facing.

I also understand that the way health services are being delivered up and down the country is changing. It’s no longer the case that every growing town the size of Redditch has a full-service hospital in the town, with maternity, full A and E, and every other speciality. There are places much larger than Redditch that don’t have these facilities and where people have to travel.

And it is important that health services across the whole Worcestershire health economy work together, and that facilities are considered at all Worcestershire hospitals in this consultation, I recognise the work that you have done in this regard to ensure a joined-up approach.

This is because increased specialisation, with access to equipment, staff, and technology, does mean patients ultimately get better care, and more lives are saved, an outcome we can all surely agree is in our best interests in the long term.

I note here that the West Midlands ambulance services, which would be called upon to transfer critically ill patients including children, is the recognised as the best in the country, it is important therefore to recognise the importance of ambulance services in saving lives and deciding where is the best place for critically ill patients to be treated, this might not always be in the nearest hospital.

Given that we where we are, I recognise that it would achieve nothing to re-open the consultation process at this point or call for it to be overturned.

I want to work closely with you so that we see the consultation outcomes delivered quickly and effectively, the promised capital investment delivered, to take into account the strength of feeling of local people, and to ensure that in future, we take a different approach.

And it is important that health services across the whole Worcestershire health economy work together, and that facilities are considered at all Worcestershire hospitals in this consultation, I recognise the work that you have done in this regard to ensure a joined-up approach.

The Alex is my number one priority as Redditch MP, which is why I have already asked questions in Parliament, why I’ve secured a debate next week in Parliament, and why I’ve held meetings with yourself, Secretary of State Jeremy Hunt, and WAHT Chief Executive Michelle Mackay.

I share your passion for making the Alex the best it can be, protecting the services that are there, and seeing the new promised facilities and services being delivered quickly. We are very lucky to have the Alex in Redditch, and lucky to have such fantastic care delivered by such dedicated NHS staff on our doorsteps.

I would like to take this opportunity to thank all staff in our Trust for working extremely hard to care for their patients and their families, and I fully recognise that they don’t always have an easy job and have to work under conditions of stress and pressure.

Please feel free to contact me at any time to discuss this or any other matter relating to local health services in Redditch.

Kind Regards

Rachel Maclean