A proposal to improve the safety and quality of hospital-based services for patients on the Isle of Wight has been published today (Friday), revealing that the most acute stroke, critical care and neonatal patients will be transferred to mainland hospitals.
Under the new plans around 89% of current hospital activity will be retained on the Island, meaning broadly 8,000 patients will be treated on the other side of the Solent. All Level 3 NICU babies and all critical care patients with a length of stay over 24 hours will be transferred to Southampton or Portsmouth, as will all high risk and high complexity procedure patients undergoing emergency surgery.
The proposed changes are to ensure that Isle of Wight residents have health outcomes as good as any other NHS patient living in other parts of the country.
The Isle of Wight Clinical Commissioning Group are to now consider the proposal and, subject to approval from its Governing Body, there will then be a period of further testing and consultation with staff, public and partners over the course of 2018-19.
Seriously ill patients who fall into the following categories could also be treated on the mainland, if deemed appropriate:
• Paediatric patients with lengths of stay over 24 hours (except for safeguarding/mental health/cystic fibrosis/oncology cases)
• Babies born under 32 weeks gestation
• Women with significant congenital heart disease
• Patients needing surgery within 12 hours
• Patients requiring hyperacute cardiac care
• Stroke patients
• High acuity pneumonia patients
• Patients with complex revisions and complex ankle/foot injuries
• Patients with multiple fractures and pelvis fractures
It is said that fewer patients will travel to the mainland overall, as more routine planned care would be provided on the Island and follow-up appointments undertaken face-face or with the aid of technology. At a conservative estimate, this would reduce the overall number of patient journeys to the mainland by approximately 500 each year.
Mr Stephen Parker, Interim Medical Director for Isle of Wight NHS Trust and Clinical Lead for the Acute Service Redesign programme, said:
“Providing access to high quality and safe care for patients is our priority. Wherever possible, we should continue to give people the very best hospital based care on the Island. Where outcomes for certain complex procedures are significantly better on the mainland, more of our seriously ill patients should be able to benefit from these services. But overall this proposal will enable us to reduce the number of times people are asked to travel to the mainland, as more routine care and follow up appointments will take place on the Island.
“We have considered a range of alternative options during this process and I would like to thank all the clinicians, staff, patient and community representatives who have got involved and helped us reach this important milestone.
“Given the significant challenges we face, we do not believe that simply staying as we are and doing nothing is safe or sustainable. But neither do we want to see the wholesale transfer of multiple services off the Island, given the huge impact that would have on the quality of life for patients and their families or carers, and the significant transport costs involved. We believe our recommendation is therefore in the best interests of patients as it stands but we fully expect this outline model to continue to evolve as we undertake further discussions during this year.”
Councillor Dave Stewart, Leader of the Isle of Wight Council said:
“We need to give Islanders the same opportunities and access to safe, quality health and care as anywhere else in the country and this vision and framework gives us the opportunity to do that. We need to embrace technology within our health and care services to help us overcome some of the challenges we face as an Island, not just in terms of the surrounding water but the rural spread of our population in relation to services.
“Through our Local Care Plan we will also ensure that our community services are working most effectively and efficiently to deliver more care and support closer to home so that people only have to use hospital services when they really need to. We are also working to ensure people can return home safely and with the right support where they have needed to stay in hospital and we have already made great progress in ensuring we have fewer people waiting in hospital to return home. It’s about putting in place a whole system approach to integrating care so that we can offer the best care to our residents. It’s not a quick fix to deal with the existing pressures, it’s a longer-term plan to enable us to tackle these and other challenges that we may face in the future.”
Bob Seely MP has said:
“I welcome this report. We need to be able to offer Islanders the very best quality healthcare, and we need to support NHS staff in delivering that healthcare. Overall, I want as much health treatment, delivered safely and to the highest standards on the Island, as possible. I give Islanders my word that I will defend services and fight for the best deal for the Islanders.
“I accept the need to transfer a small number of specialist activities to the mainland, but welcome the ambition to have fewer patient trips overall across the Solent. Nearly 90 percent of current activity will be retained under the favoured option, Option Four.
“I am concerned that Option Four has previously included an approximate figure for bed losses at St Mary’s. I will be seeking reassurance on this, and I will be talking with the Trust further about some of the other implications of Option Four.
“My priorities are for patients to have fewer journeys to the mainland overall, and to get more treatment on the Island, even if for slightly more surgical treatments and cases of specialist care we have to go to the mainland. I want patients to have the best possible experience and the best possible care.
“We need to take the opportunity to return some services from the mainland to the Island, and we need wherever possible to use new technology and practises such as telemedicine to improve patient experience and care. I also want to see the Island as a centre of excellence in niche services, such as dementia care.
“I will continue to work with the Island’s NHS team to make sure that the Department of Health understands the unique challenges of providing world-class healthcare on the Island. I will be discussing this report with the Secretary of State for Health.”
There will not be any immediate changes and no decisions have been made. The Governing Body of the Isle of Wight Clinical Commissioning Group, which includes clinicians and lay members, will consider the recommendation at its meeting on 1st February 2018. If the recommendation is agreed, the IWCCG and NHS will carry out further testing and work with partners, staff, community and patient groups over the course of 2018. The proposal will also be reviewed and considered by NHS England as part of an intensive process lasting several months.
Further work will also be carried out to define how staff would work together in the most effective way, especially in key specialties where change is most required, and to ensure robust, seamless arrangements for transferring and discharging patients between hospitals are in place to support any proposed changes before they are implemented.
The public will also be asked for their views during a formal public consultation later in 2018 before implementation plans are developed and finalised.
