CCG Headquarters
Nightingale Close
Off Newbold Road
CHESTERFIELD
Derbyshire
S41 7PF
Tel: 01246 231255
Fax: 01246 514164
BM/RMC/LTR.024
21 October 2014
Address
Dear Sirs
North Derbyshire Clinical Commissioning Group (ND CCG) has fully engaged with the Healthier
Together process. We understand and are concerned about the potentially significant impact
the outcome could have on our rural population in the High Peak.
The population of High Peak is around 60,000 and predominantly their access to secondary
care hospital services is in Stockport or to a lesser extent in Macclesfield. The population is
older than the England average with a significant over representation of people aged 45 and
over.
We note throughout the process and the consultation document the focus on the clinical case
for change and would fully support anything that improves outcomes for patients. We would
also endorse a move towards achieving best practice standards with quality and safety
paramount through a networked arrangement of hospitals to ensure future services are
sustainable.
However we feel that ensuring access to those services is equally paramount and it is for
this reason that we only support an option that results in Stockport NHS Foundation
Trust as a specialist hospital.
The options outlined under Healthier Together are to have either four or five specialist hospital
sites. We understand that two fixed points were agreed as Salford Royal NHS Foundation
Trust and Central Manchester University Hospitals NHS Foundation Trust. We also note that
the Royal Oldham Hospital as part of Pennine Acute NHS Foundation Trust was added as a
third fixed site during the process without consultation because of the absence of a local
alternative. We understand that the rationale for this was that the three transport standards
were applied as hurdle criteria and were failed. We do not understand why the same process
was not applied to our population who currently cannot even access Stockport within the travel
standards set out by Healthier Together and the outcome of the consultation could potentially
make this worse.
Clinical Leader/Chair: Dr Ben Milton
Chief Officer : Jackie Pendleton
We regularly attend the Committee in Common and have continued to express our concern to
the project team about our non-voting status as our population in High Peak are significant
users of services in Greater Manchester and will be equally as affected as other communities.
It feels somewhat odd that Derbyshire County Council has been given a vote on the combined
scrutiny committee when we as a CCG have not on the Committee in Common.
Initially only one public meeting was organised in New Mills for our residents and we expressed
our concern about the lack of engagement and the project team agreed to organise a further
meeting in Buxton in September. It was also only after pressure was brought by ND CCG that
the project team agreed to hold a transport event in the High Peak.
People who attended these events overwhelmingly expressed their concerns about the
difficulties in travel to the current sites and how much more their journeys would be if services
were to move away from Stockport NHS Foundation Trust. Unfortunately no definition of
“complex surgery” was given or examples of specific conditions that this would affect so the
population are not aware of the numbers of people that might be impacted. Our understanding
is that this could be 4-5% of all non-elective admissions.
No analysis of travel times within our patch was included as part of the consultation work and
we were told that we had to complete our own travel analysis. It is highly unlikely that access
standard 3 (75 minute public transport access to a specialist site) would be met for our
population by any of the eight options. Our travel analysis is attached and reflects a worsening
of public transport access times if the specialist site was not at Stockport.
With regard to the 45 minute ambulance transfer standard; this is currently the approximate
time that it takes for a conveyance from Buxton to Stockport thus any travel further into
Manchester would fail that standard for a population of at least 8,000 people. We have serious
concerns and have raised them repeatedly with regard to the impact on ambulance services
and the times that a crew may be absent from Derbyshire County if having to travel further into
Manchester. This could have impacts on patient safety and performance which are a major
concern in such a rural area. We know that East Midlands Ambulance Services will be
responding in their own right and expect they will raise similar concerns
Finally we have concerns that the financial impacts of reconfiguration have not been considered
for our CCG. We would anticipate potential significant additional costs for ambulance services
to be required and we know that these have been fully assessed.
To confirm that our formal response is to support Stockport NHS Foundation Trust as a
specialist site.
Yours sincerely
Clinical Leader/Chair: Dr Ben Milton
Chief Officer : Jackie Pendleton
Dr Ben Milton
GP Clinical Lead/Chair
North Derbyshire Clinical Commissioning Group
Tel
01246 514985
Email [email protected]
Copy to:
Cllr Ann Western, Derbyshire County Council Leader
Cllr Dave Allen, Derbyshire County Council H&WB Chair
Cllr Caitlin Bisknell, Derbyshire County Council and High Peak Borough Council
Cllr Sean Bambrick, Derbyshire County Council Health Scrutiny Committee Chair
Simon Baker, High Peak Borough Council
Sue Noyes, east Midlands Ambulance service
Andrew Bingham MP
Clinical Leader/Chair: Dr Ben Milton
Chief Officer : Jackie Pendleton