What is Right Care Right Time Right Place?
Right Care Right Time Right Place (RCRTRP) is a five-year plan which, broadly, aims to make hospital services more efficient.
It is part of the wider Care Closer to Home scheme, which aims to move a greater proportion of healthcare services out of hospitals and into the ‘community’, for example into doctors’ surgeries and at home.
What will happen if it goes ahead?
Huddersfield Royal Infirmary (HRI) will be demolished and replaced with a smaller, 120-bed hospital next to the Acre Mills outpatient unit.
While it will focus on planned operations and clinics, the hospital will have an urgent care centre for non life-threatening injuries and illnesses.
Crucially, it will not have full emergency care services.
Calderdale Royal Hospital (CRH), Halifax, will be expanded to focus on unplanned and emergency care, making it the nearest emergency care centre for a substantial proportion of Huddersfield residents. It will have up to 700 beds.
Meanwhile, services which do not have to take place in a hospital – for example, appointments following surgery – will be transferred to community facilities.
Why was CRH chosen for emergency care and not HRI?
CRH was the cheaper option, saving £31m over five years.
The decrepit state of large parts of the 50-plus-year-old HRI and the trust’s PFI obligations meant that CRH – opened in 2001 – seemed the better option.
Why do we ‘need’ it?
The demand on local NHS services is higher than ever, particularly on A&E departments.
While the Government says it has spent more than previous governments on the NHS, funding is not keeping up with demand.
Britain’s population is growing and people are living longer, resulting in a larger population of people over 60 who generally have greater health needs.
The trust, which runs HRI and CRH, is in serious financial trouble. It recorded its first deficit last year, it is expected to end the financial year £21m in the red and its deficit could spiral out of control if its services remain unchanged.
A private finance initiative (PFI), used to build CRH, is strangling the trust. For a campus that cost £64m to build, the trust will have to pay £774m by 2058.
Running both hospitals as they are could burden NHS services in Huddersfield and Calderdale with £281m of debt by 2022.
Local NHS chiefs say the current set-up, consisting of two hospitals, often duplicating their services, is inefficient and unsustainable.
Furthermore, the trust has been unable to recruit sufficient doctors and nurses to staff their wards.
How much will it cost?
The scheme requires £478.8m, which will come from the Department of Health and the Treasury. There is, however, no guarantee it will get the full amount.
The new HRI will be built under a partnership, most probably with private investors.
How much money will it save?
The scheme will slash the hospital trust’s deficit from £27.5m per year to £9.5m a year.
NHS watchdog Monitor has, however, said that a recurring £9.5m deficit is ‘unsustainable in the long run’.
Who is behind the plan?
RCRTRP has been devised by Greater Huddersfield and Calderdale clinical commissioning groups (CCGs), the local NHS organisations which manage healthcare in Huddersfield and Calderdale.
Huddersfield CCG chair Dr Steve Ollerton talks to our reporter Dave Himelfield
The plan has been created in conjunction with hospitals trust Calderdale and Huddersfield Foundation Trust, NHS services provider Locala, Kirklees Council, Calderdale Council and other organisations.
It has been overseen by NHS England and NHS advisory body, The Yorkshire and Humber Clinical Senate.