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Maternity and Paediatrics Update - 20 December 2017​

I am delighted to be able to confirm today that Dorset Clinical Commissioning Group (CCG) has signalled its intention to work to maintain a consultant-led maternity and overnight children's service in Dorchester as part of a single maternity and paediatrics service for Dorset.

This is great news for our patients and our staff. I would like to thank our local residents and staff for their patience during the last 18 months. We will now work with colleagues at Poole Hospital and Royal Bournemouth Hospital to develop a sustainable model for families in our local communities.

The announcement was made by Tim Goodson, CCG Chief Officer, at today's meeting of the Dorset Health and Overview Scrutiny Committee (DHOSC).

The decision to create a maternity and paediatrics service for Dorset with shared pathways was made by the CCG's Governing Body in September 2017 after the conclusion of the Clinical Services Review public consultation.

The Governing Body also agreed to 'seek to commission the delivery of consultant-led maternity services integrated across Dorset County Hospital and Yeovil District Hospital for the Dorset population'.

However, Somerset Clinical Commission Group has now decided to carry out a review of clinical services across its own county, which will include maternity and paediatrics.

Mr Goodson told the HOSC: 'We have been in discussions with Somerset CCG around the future possible configuration of maternity and paediatrics services across Dorchester and Yeovil.  It is now Somerset CCG's intention to carry out a full clinical service review similar to that which Dorset has already undertaken and they would wish to include the options for maternity and paediatrics services, including those at Yeovil, as part of that review.

'We know from our experience that such reviews are complex and take a considerable time to undertake and reach a decision point.

'We believe that having gone through the review in Dorset and raised a number of concerns around the future sustainability of these services, that we need to give a clear steer on the future of the services.  We are taking this step now to give local parents, children and staff a degree of certainty about their future.

'Dorset CCG's Governing Body will need to agree a way forward in the new year. Whilst I would not wish to pre-empt any decision, it is our intention to create a single service across Dorset and work to maintain a consultant-led maternity service and overnight paediatrics service in Dorchester, as well as at the major emergency hospital.

'If a sustainable model can be found then we will consult with the public on these proposals before making any decision. We will remain open to Yeovil Hospital joining part or all of their service with Dorset in the future should that be the outcome of Somerset's review.'

Patricia Miller
Chief Executive​


Dorset County Hospital Welcomes CSR Decisions - 20 September 2017

Dorset Clinical Commissioning Group’s Governing Body today (20 Sept) approved the Clinical Services Review recommendations.

Dorset County Hospital NHS Foundation Trust has issued the following statement in response:

“We are delighted that the Clinical Commissioning Group’s comprehensive review has recognised the importance of DCH continuing to provide planned and emergency services to people in the west of Dorset.

“We are looking forward to building on the collaboration work with our partners in health and social care to ensure we can provide high quality emergency and district general hospital services for our patients now and into the future.

“The CSR outcome reflects and supports our drive to deliver outstanding care for people in ways which matter to them. It provides the foundation for a bright future for DCH, with some exciting developments on the horizon, including the new radiotherapy centre and integrated community services hub.

“We are committed to building high quality services across Dorset, and ensuring that the needs of people in the west are fully taken into account, with investment throughout the county to support improvements.

“We welcome the CCG’s preferred option for paediatric and maternity services in the west, with DCH working with Yeovil District Hospital (YDH) to provide a sustainable and safe service for women and children. Our consultant paediatricians and obstetricians will continue to work with their colleagues in Yeovil on the best possible solution for the local population.

“Any proposed changes to services in either hospital would be subject to further local public consultation by both Dorset and Somerset CCGs as appropriate.”​​

You can find out more about the recommendations that have been approved on the CCG's website: www.dorsetccg.nhs.uk​



Dorset County Hospital Trust Board Statement -19 January 2017

Dorset County Hospital NHS Foundation Trust supports the Clinical Services Review (CSR) case for change and we encourage the public, patients and our staff to respond to the consultation.

The NHS is facing rising and unsustainable costs to meet increasing demand, while trying to improve the quality and consistency of care and health outcomes. The CSR offers an opportunity to ensure the people of Dorset continue to receive safe and high quality health services. We support this approach to change which has been driven by evidence, clinical leadership and practicality.

We welcome the proposed designation for Dorset County Hospital as the ‘planned care and emergency hospital with 24/7 A&E’ as we believe this is best for our local population. This means we will continue to provide the district general hospital services we currently deliver to our patients under the CSR proposals.

However, this proposed designation would not mean ‘no change’ at DCH. Our own strategy is clear that rising demand on our services coupled with stretched resources mean we cannot carry on doing things the way we have always done.

Regarding the options for paediatrics and maternity, our preferred solution for providing a sustainable and safe service for women and children is to work with Yeovil District Hospital. The CSR is an opportunity to ensure these services are organised in the most sustainable way for the future which best meets the needs of the local population. A collaboration between DCH and YDH has long been viewed as a desirable outcome by clinicians at DCH. Our consultant paediatricians and obstetricians will continue to work with their colleagues in Yeovil on the best possible solution for the local population.

In terms of the options for the siting of the major emergency centre in the east of the county we believe both options are possible. We accept the CCG’s preferred option regarding the location of the Major Emergency Hospital due to the analysis and evaluation showing Option B as a more accessible and affordable option.

We fully welcome the proposed move to more joined up services. We are already working closely with our community care and primary care partners and look forward to taking the opportunity to further strengthen those links.

Following the outcome of the consultation we look forward to working with the CCG to ensure any future service changes proposed are both safe and sustainable and that the focus of CCG investment in the east and in community services does not adversely impact services provided to patients in the west of the county.

We are also encouraging our staff to respond to the consultation as local residents – they and their families are NHS patients too. We are also seeking professional views of our staff to feed into our formal Trust response.

It is vital that local people respond to the consultation through the channels set up by the Clinical Commissioning Group – online or by filling out the printed consultation document questionnaire. Copies are available around Dorset County Hospital, including our main reception area.

For our full questionnaire response, please click here​.

You can read the Trust's response to the CCG's mental health acute pathway questionnaire here​.


Dorset County Hospital Council of Governors Response to Clinical Services Review

The Council of Governors broadly welcomes the proposals of the Clinical Services Review.

The Council of Governors agrees with the proposal that Dorset County Hospital remains as a 'planned care and emergency hospital with 24/7 A&E' and maintains its status as a Major Trauma Unit.

Whilst the Council of Governors acknowledges the reasons for some specialist emergency services being located for some or all of the time at the Major Emergency Hospital, it is concerned about travelling times for and the adequate provision of ambulances for the rapid transfer of the small number patients who require urgent treatment at the Major Emergency Hospital.  The ambulance service must have the provision and prioritise the inter-hospital transfer of these patients who require very urgent treatment. Governors would request that data on travelling times is collected for these patients to ensure that transfer times are reasonable and are not delaying emergency treatments to the detriment of patients' health. Consideration should also be given to the effects on patients and their relatives with respect to difficulty in visiting as visits from friends and relatives are important to the recovering patient.

The Council of Governors sees the merger of paediatric and obstetric services with Yeovil District Hospital to be essential for both the communities of Yeovil and South Somerset and North, South and West Dorset. The Council of Governors would be totally opposed to transfer of these services to the Major Emergency Hospital due to the travelling times involved and the effect on deprived and vulnerable communities.

The Council of Governors accepts the Clinical Commissioning Group's proposal to site the Major Emergency Centre in the East of the County in Bournemouth.  This will result in a natural increase in emergency work at Dorset County as we will become the nearest 24hr A&E for geographical areas to the east of Dorchester previously in Poole Hospital's catchment area. Governors insist provision is made by the Clinical Commissioning Group for Dorset County Hospital's A&E and emergency medical and surgical services to have sufficient capacity to deal with the significant increase in emergency workload as a result of the location of the Major Emergency Hospital in the east of the county.

The Council of Governors would like to see the Clinical Commissioning Group regularly review and report back on the success or otherwise of the proposed changes. When the relocation of services from Dorset County Hospital has not resulted in benefits to patients the CCG should undertake to repatriate those services to Dorset County Hospital.

Governors would like to emphasise that they do not see the proposals as an ideal solution for the people of Dorset, but accept it as a compromise in order to deliver services within a financially constrained National Health Service.

The Council of Governors would encourage all members of the trust and members of the public to respond to the consultation set up by the Clinical Commissioning Group by completing a questionnaire available from https://www.csr.dorsetsvision.nhs.uk/   

Duncan Farquhar-Thomson
Lead Governor DCHFT
30 January 2017


CSR Background

The Clinical Services Review (CSR) is a programme of work led by Dorset Clinical Commissioning Group to analyse the future health needs of the people of Dorset and plan how best to meet them. 

Led by local GPs, Dorset Clinical Commissioning Group is the organisation responsible for securing the NHS health services needed in Dorset. 

A three month public consultation on changes proposed in Dorset’s Clinical Services Review (CSR) ran from 1 December 2016 to 28 February 2017.

Local residents were encouraged to take part in the 12 week public consultation to give their views about proposals that could see major changes to acute hospital and community care services across Dorset.

If agreed, the changes will help Dorset to deliver its forward-looking five year plan for improving health and care services, which are published in the local Sustainability and Transformation Plan.

The Clinical Services Review was launched in response to major challenges which health and care face both in Dorset and across the rest of the country. These include:

  • a growing population with more people living longer
  • an increasing demand on services
  • workforce shortages that will be difficult to fill
  • variations in the quality of care
  • a potential funding gap of at least £158m per year by 2020


Mak
ing the changes proposed in the CSR would mean high quality services would continue in Dorset for the future and more lives could be saved.

During the consultation, people were asked for their views on proposals which have been developed by local doctors and health professionals, and representative groups of patients and the public.

These include changes to the larger hospitals in the county and bringing more care closer to home through the development of community services including new hubs.

Updates on the CSR will be given out via social media channels twitter.com/DorsetCCG and Facebook.com/NHSDorsetCCG.

An independent report looking at responses to the Improving Dorset’s Healthcare Clinical Services Review consultation has been published.  The 400 page-report, written by specialist consultation analysts, Opinion Research Services, gives details of the public response to proposals for the future of acute and community services across Dorset.

The report looks at responses from more than 18, 500 people who shared their views on the options for consultation either online, or by post. It also analyses feedback from thousands of other people that took part in focus groups, a telephone survey or made their views known through written submissions or petitions.

The full report and further information is available online.