Epsom Hospital Update
TRUST CHANGES PRESERVE SERVICES AT EPSOM
The Epsom and St Helier Trust has put forward a revised set of proposals for Epsom Hospital which tackle the operational problems it has faced without changing the structure of services at Epsom. The plan involves changes to the way the hospital provides cover for night time staff, but retains the full 24 hour emergency service at Epsom. In addition, the Trust is to relocate the out-of-hours GP service to Epsom Hospital to provide extra support for patients who come to the A&E Department with less serious problems.
Chris Grayling has held a number of discussions with the Trust over the past month, and said he was delighted by the news.
"I am very relieved that pressure from the local community has helped secure the A&E service, and that the Trust has found a way of solving its problems without making major changes. This is not the end of the story - since the Trust will soon be making decisions about its long term strategy, and we still have to win the argument that Epsom should be the site for the proposed new hospital. But this is very good news about the short term future of services at the hospital."
This is the text of the Trust's statement:
Message from Lorraine Clifton,
Chief Executive
Briefing on Outcome of Short Term Review of Hospital
Services
As you know, the Trust's senior clinicians have had some concerns around maintaining patient safety at the Trust. In more detail these were:
- A&E - the number of doctors working at night
- A&E - Consultant cover at night
- Anaesthetics - number of doctors working at night
- The number of night-time operations
- The number of radiographers
Clinicians and managers from both Epsom and St Helier hospitals have been working together to generate solutions to these issues. This has been a very open process with a great deal of internal debate, and I am most grateful to staff for the many ideas that were suggested.
An expert panel of clinicians met on Friday to discuss these ideas and assess their impact on patient safety, and how they provide the best service for local people. This panel was made up of doctors from Epsom and St Helier Hospitals, representatives from the local Primary Care Trusts and representatives the Community Health Councils, (see list below for full membership).
The panel decided that no major changes to hospital services need to be made in the short term. Senior doctors, nurses and other clinical staff have generated solutions where they will work in new and different ways to keep services safe for patients. In detail these solutions are:
In A&E at night
- A support mechanism will be put in place which clarifies under what circumstances a doctor in A&E should seek advice from a more senior colleague. This happens informally at the moment but new agreed care guidelines will formalise this process. Senior doctors believe that this will make care safer for patients.
- It is proposed to relocate the GP out-of-hours service to Epsom A&E. This will mean that there will be extra doctors in A&E at night.
- We will continue to advertise for senior posts.
Number of Anaesthetists at night and the number of night-time
operations
- The panel believed it would be possible to carry out more emergency operations during the day but acknowledged that this would require major reorganisation of operating lists. The panel felt that these changes should be explored across both sites. This would reduce the workload of anaesthetists at night.
- We will continue to advertise for senior and middle grade posts
Shortage of radiographers
- We will work closely with Primary Care Trusts and the Modernisation Agency
- We will continue to advertise for posts.
These solutions are short term and we are currently working through plans for how the Trust will deal with the new European Working Time Directive which comes into force from August 2004. This will mean our clinicians will work less hours, so we will need more of them if we continue to work in the same way. I will be discussing with staff new and innovative approaches to way in which we work.
In the longer term we need to focus on the Clinical Services Strategy. This proposed plan will mean more patients are treated closer to home with the creation of several local community hospitals and one critical care centre. This process, and any other significant change to services, will involve full consultation with staff, patients and the public.
Lorraine Clifton
Chief Executive
