Anger is growing over proposals which could see either Huddersfield or Halifax lose its A&E unit.
But as the dust settles on revelations about another NHS shake-up plan, officials and clinicians behind the proposal say the plan to have a casualty department in just one town is not the only option.
And they say they are “open minded to new ideas” before they launch a formal consultation with the public this summer.
They have so far come up with four options.
Keep things as they are.
Having Huddersfield Royal Infirmary (HRI) specialise in acute, specialist and emergency care with Calderdale Royal Hospital (CRH) specialising in planned care - effectively closing A&E in Halifax.
The opposite of option 2 - basing acute, specialist and emergency care at CRH and planned care at HRI
Downgrading both hospitals and relying on a major emergency centre in a larger town, as recommended by NHS chief Sir Bruce Keogh.
Hospital chiefs favour option two but the rest of the team behind the plan say they currently have no preference but stress option one is “unlikely”.
And they say they will continue to work on more options while receiving feedback from the public and health experts.
The plan comes less than a year after a major NHS reshuffle of primary care, in which clinical commissioning groups (CCGs), who control 80% of the £95billion NHS budget, were formed.
It also comes amid a proposal to re-design services at neighbouring hospitals in Dewsbury, Wakefield and Pontefract.
A decision on whether Dewsbury A&E will be downgraded is expected by the end of March.
Less than 24 hours after the plan for Huddersfield and Calderdale hospitals and health centres was published, The Examiner spoke to the team behind the latest service revamp to ask some key questions.
Who is behind this latest NHS shake-up?
There are seven organisations involved in the plan to reshuffle health care across the region: Kirklees and Calderdale councils, Greater Huddersfield and Calderdale CCGs, Calderdale and Huddersfield Foundation Trust who manage the two hospitals, South West Yorkshire Foundation Trust, who manage mental health services in Kirklees, and not-for-profit health company Locala, who operate much of Kirklees’ community care and district nursing.
Why and how have these options been designed?
A spokesman for the strategic review, said: “We’ve been doing work on this for almost two years for many reasons.
“They are; there are a lot more older people to take care of, we’ve got more long term conditions such as obesity to deal with, and we’ve also got reduced resources.
“We’re not going to pretend there’s not a financial element but the main thing is we need to provide a better service.
“We’ve already talked to about 5,000 people about the care they need. They say they don’t want to be in hospital and want more services brought to where they live.”
Will jobs be lost in the reshuffle?
Thousands of people are employed across the primary care and hospital sectors in Kirklees and Calderdale, of which more than 2,500 are members of trade union Unison.
A spokesman said staff briefings had already been held at a number of sites.
“What we can do is to make a commitment to staff that they will be fully informed of what is happening as it progresses.”
What happens now - why wait until the summer to consult the public?
The team behind the plan have brought their best ideas to the table and are now waiting for the reaction before they decide exactly what to formally consult on.
A spokesman said: “People are assuming what was discussed is the only option. These are the topics, we now need to have a discussion about with patients, the public, MPs and staff.
“There are significant risks in doing nothing which undermine the safety and quality of our care.
“But we are saying, what else might emerge that we could go to consultation with.
“We currently have four options but more ideas may come forward that are just as valid.
“It would be arrogant for the NHS to say this is our only option.”
Is the option of downgrading both A&E units and relying on a bigger centre at Leeds serious?
A major review of A&E last year by NHS England’s Sir Bruce Keogh recommended reducing the number of hospitals with full casualty departments and creating larger specialised A&E units, dubbed Major Emergency Centres.
Sir Bruce’s blueprint would see more patients with serious or life threatening conditions receiving treatment in specialised centres instead of at A&E.
The spokesman said: “We may need to move to a position where we have 40 to 70 super centres, as recommended by the Keogh Review.
“That could mean having a major centre that is not in this area. We could have a different kind of A&E that doesn’t have the top end stuff.
“It’s a totally different idea designed to remove the pressure where a lot of the people going into hospitals now, won’t be in the future.
“So how quickly can a paramedic get to you and which hospital should you go to – it wouldn’t necessarily be the closest but the one where the best services are.
“We don’t know where our major centre would be yet.”
Have the extra travel times from Calderdale to HRI and vice versa been considered?
“Travel is a major consideration and everyone involved is well aware of that,” said the spokesman.
“There will be a lot of work looking at travel implications.”
If the option to move A&E to Huddersfield is taken, will maternity services be kept at Calderdale or will they move?
The spokesman commented: “You would expect the consultant led services to be on the same site as A&E so if that’s how it played out then they would be at Huddersfield.
“It hasn’t been decided but what we have suggested is having midwife led maternity services at both hospitals.
“The majority of deliveries are not high risk so most births could be handled at either hospital.
“We’re also hoping to offer more home births but these are all things we need to have a conversation about.”
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