Trust Board Decide to Engage Consultants

Ken Taylor's ballot of the Consultants at City regarding the interim reconfiguration plans really seems to have got the wind up the Trust board. The following letter went out to all consultants on the 13th June 2007 (click here for original copy).

Sandwell & West Birmingham Hospitals NHS
NHS Trust

Chief Executive
': 0121 507 4847
Fax: 0121 507 5636
Email: john.adler@swbh.nhs.uk


To: All SWBH Consultants
cc: Executive Team, DGMs


13 June 2007


Dear Colleague

Shaping Hospital Services for the Future

Those of you based at City Hospital may have received a letter from Ken Taylor proposing a ballot of City consultants on the Trust’s plans for service configuration change in advance of the “Towards 2010” plans for a new hospital. In the light of this I am writing to remind all consultants whether based at City or Sandwell where we are in the process with these important plans.

Our plans for change in pathology, paediatrics, neo-natal care and surgery have been developed over the last 18 months following extensive discussion with clinicians from the services involved. As this work has proceeded there have also been many opportunities for the wider clinical body to contribute to the discussion which many of you have taken. Finally, as you will be aware, we carried out a four month formal public consultation on the plans that concluded in mid-March 2007.

As a result of ongoing work with clinicians and in the light of the outcome of the consultation the final proposals recommended to the Trust Board incorporated a number of important changes:

· the Paediatric Assessment Unit at City Hospital will be open for 24 hours a day;

· there will be a 24 hour Surgical Assessment Unit at City to increase support for A&E and reduce the numbers of patients needing transfer to Sandwell;

· elective colorectal surgery will be retained on both sites to ensure there is support for gynae-oncology at City Hospital.

The Trust Board approved the plans for change at its meeting in May. The Birmingham local authority scrutiny committee referred the proposals for emergency surgery only to the Secretary of State and we are waiting for confirmation of the next steps in this process. The rest of our proposals were not referred and can therefore proceed. The ballot that Dr Taylor is seeking to organise does not have any formal status as part of the Trust’s decision making on these plans.

For those of you who have received Dr Taylor’s letter, there are two particular points that I would like to stress.

Firstly, the Trust has strong support for the plans for a new hospital and is moving rapidly in developing these further. In addition to longstanding support from our PCTs, and public support shown through the consultation, we have also recently had renewed confirmation of SHA and DoH support for the programme at their latest review of the plans. I am also pleased to be able to tell you that the Trust Board approved the business case for the purchase of the land on which the new hospital is to be built at its meeting last week. This business case will now go to the SHA for their approval. Work on the detail of the plans for the new hospital is also well underway as part of the process of preparing the hospital outline business case for submission in March 2008.

Secondly, the steering groups and the executive team carefully considered the range of possible options for change in both paediatrics and neo-natal care and in surgery before deciding to proceed with these plans. We are clear that we have identified the best options available to us. The plans for a single paediatric inpatient unit at Sandwell have been developed alongside the plans for developing the neo-natal unit at City and taken together include significant capital and revenue investment in these services. The plans for emergency surgery were developed alongside plans for bringing elective surgical services together and are designed to make the best use of the theatre capacity available to us at each of our sites. We believe that the proposals approved by the Board provide the best way forward for our services and now want to focus on planning for implementation so that we can get on with developing our services for the future.

The proposition on the ballot is essentially for the status quo. It is of course entirely up to each consultant whether you wish to participate in the ballot at all and if you do, which way to vote. I trust, however, that this letter has helped ensure that you remain up to date with our progress on these plans and are presented with a full and accurate statement of the position. As always throughout this process, if you have any questions or wish to discuss further please do not hesitate to contact me,

With best wishes.

Yours sincerely,

John Adler
Chief Executive


Isn't it amazing what it takes for a Trust Board to engage its consultants?
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I am going to respond to some points in John Adler's letter:

In his second paragraph the Chief Exec. talks about extensive discussion with clinicians from the services involved. He is presumably referring to the Sandwell-based Medical Director and Sandwell-based Clinical Directors in Paediatrics and Sandwell-based surgeons? I have been getting a very different message from the City-based clinicians. At no time has the Trust balloted the senior medical staff at City on their proposals.

The consultation was fundamentally flawed. It did not address the multi-ethnic population served by City Hospital. It did not tell the community that if they had an ill child or a surgically ill adult although they would be assessed at City Hospital, if they needed to stay in hospital longer than 24 hours they would need to be moved by ambulance to Sandwell Hospital. This would be the only population in Birmingham subject to this inferior form of care, and it would not be suffered by people going to Sandwell Hospital with the same problems. Are these plans really tenable expressed in this way?

However in spite of consulting the wrong population and not providing them with the full facts, the proposals were still resoundingly rejected.

The Chief Exec. omits to mention that the Commission for Racial Equality are now involved in the reconfiguration plans.

How the Executive Team have concluded that they have the best options for Paediatrics and Emergency Surgery is a complete mystery. The best options for whom? Not for the poor people of West Birmingham. Not for City Hospital.
I think it means the Trust has a very different agenda. and the sooner we understand what that agenda is the better.

There has to be a very real concern after what has happened in Coventry with the Walsgrave PFI. The local health economy is going to have to find many millions of pounds and there will be severe cutbacks at the hospital. One has to ask the question well what about the new University Trust PFI here in Birmingham? It is a bigger project than Walsgrave. How will that black hole be financed? Could it be at the expense of City Hospital and the population it serves? What chance of another big PFI happening in the near future in the Birmingham area? Can anybody answer these questions please? Would it not be sensible to maintain the status quo at City Hospital until that new PFI happens as the Executive Team try to assure us it will?

Ken Taylor. Posted 00.15hrs 19th June.