Vision for the Vale of Leven Hospital

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Your chance to comment on proposals to shape the long-term future of the Vale of Leven Hospital. VISION FOR THE VALE OF LEVEN HOSPITAL The Vale of Leven Hospital plays an important role in providing health services to communities in West Dunbartonshire, Helensburgh and the Lochside. For the past ten years there has been much debate and uncertainty about the hospital’s future. NHS Greater Glasgow and Clyde have now completed a thorough review of services and are able to describe a Vision for the Hospital which will end the uncertainty faced by our staff, by our patients and local communities. New arrangements to sustain 70% to 80% of the 24 hour unplanned medical care currently delivered at the Vale The range of planned outpatient, daycase and diagnostic services provided will continue and will be expanded More than 18,000 appointments, operations and treatments which patients currently have to For adult mental health inpatient services we travel to Paisley or Glasgow for will, in future, be describe two future options on which we would provided at the Vale also like your feedback. It is vital that we hear The Community Maternity Unit will be sustained your views about all of these proposals. and promoted On page 11 of this newsletter you will find The Minor Injuries unit which treats 9,000 patients details of how you can make your views known. each year will be sustained Rehabilitation inpatient services will continue to This newsletter provides only a brief be provided at the Vale, although the number of summary of our Vision: you can obtain beds will reduce the full consultation paper by calling Inpatient mental health services for older people 0800 027 7246 or downloading it from our will be sustained on the site website http://www.nhsggc.org.uk/valeofleven A new, purpose-built health and social care centre Our Approach Patients will be screened by ambulance crews as well as GPs NHS Greater Glasgow and frequent discussions Clyde took on responsibility during the past two years, for the Vale of Leven Hospital and by our staff who will in April 2006. strive to ensure that anything One of our key principles in we do is safe and provides developing the Vision for excellent care. the Vale has been to aim to We firmly believe that the provide high quality and safe Vision we have developed services as locally as possible. represents the best possible This is the challenge that has balance between providing been presented to us by local access to high quality the groups of independent services and a requirement experts that have considered to travel for more specialist the services offered at the or intensive care on the Vale, by community groups in occasions when it is required. A new model for unscheduled care

Since 2004, people who experience the Based on the detailed work most serious injuries through accidents or sudden we have undertaken since illness have been transported directly to the receiving the review team’s recommendations, we are Accident and Emergency (A&E) Service at the proposing that new service Royal Alexandra Hospital in Paisley. There are arrangements be introduced: also other types of patients, whose condition is The Medical Assessment not as serious, but still need swift assessment and Unit will become a Consultant Supported GP led Acute Unit treatment before possible admission to hospital. There are currently 5,000 and will provide unplanned patients from the Vale of These patients receive what is called ‘unscheduled’ medical care to between 4,400 Leven catchment area each medical care. This is currently provided by the Vale and 5,300 patients every year – between 70% and 80% of the year who attend the of Leven Hospital’s Medical Assessment Unit. current level A&E service at the Royal Unscheduled medical care need to change the way The Unit will be operational Alexandra Hospital. These 24 hours a day and be staffed patients will continue to is provided to 6,300 patients in which unscheduled The Unit will be operational 24 hours a day and be staffed by by General Practitioners (GPs) receive care there. each year at the Vale and medical care is provided trained to provide appropriate General Practitioners (GPs) with support from consultants. is supported by access to at the Hospital. hospital care; they will receive Our proposals for anaesthetic cover. This is level of paramedic services, including The challenge is to provide advice and support from hospital unscheduled medical care would mean in place because a small consultants if it is required vehicles to enable the rapid transfer of unscheduled care in a way that between 1,000 and 1,900 of the 6,300 proportion of the patients which is clinically safe and Patients will be screened by patients around the clock. receiving this type of care ambulance crews, local GPs and who currently attend the Vale Medical allows as many patients as in the Vale Hospital using clinical Assessment Unit will also need to attend at the Vale may be at higher possible to be treated at Our Vision for the Hospital is that risk of becoming more protocols and a clinical scoring the A & E in Paisley. This will include, for there will be no change to its the Vale of Leven Hospital. system. If it is safe, and clinically example, people who have suffered a seriously ill and requiring Independent experts who appropriate, patients will be Minor Injuries Unit. This treats stroke, epileptics suffering convulsions, urgent treatment. reviewed services in August cared for in the Vale. If patients 9,000 patients each year who have people with serious gastro-intestinal There have been four reviews 2008 thought that a model are more seriously ill and are at greater risk, potentially requiring suffered conditions like wounds, of anaesthetic services at the of care could be developed bleeding and people who have overdosed higher dependency care, they on drugs. fractures, dislocations, sprains, Vale of Leven Hospital, the which would allow between will be taken to the A & E at the burns and eye injuries. most recent in the summer 36% and a maximum of Royal Alexandra Hospital. The We are committed to working with the of 2008. All concluded that 83% of unscheduled medical scoring system will be a further Scottish Ambulance Service to provide the development of the one which anaesthetic services are not patient care to be retained extra funding needed to ensure an increased sustainable 24 hours every at the Vale of Leven. is already in wide use in the local area. day. This means that we Maternity EXPANDED services As a result of public consultation earlier in 2008, we have agreed to maintain the Vale’s Community Maternity Unit. Over ‘Planned’ care is by far the appointments or courses provided at the Vale of the next three years, we intend to put most commonly used type of treatment) at the Leven Hospital by 18,350 in place and deliver a plan aimed at of service at the Vale of Vale covering outpatient patient episodes – an generating greater awareness of the Leven or any other hospital appointments, day increase of 20%. excellent work undertaken by the Vale’s – this means that the treatments and operations, This would mean that 18,350 midwifes and encourage women, where treatment is organised in short-stays, diagnostic tests, fewer journeys will need to possible, to give birth in their local advance following referral routine maternity check-ups be made from the Vale hospital. The unit supports 14,000 from a GP or as a follow-up and day services for area to Glasgow or Paisley patient episodes each year and we hope to previous hospital care. older people. to allow patients to to see more in the coming years. Each year, there are 90,000 We propose to increase the receive treatment. patient episodes (individual amount of planned care Rehabilitation & services We propose bringing in the following new services to the Vale: for older people A new £3.6 million dental Development of a The provision of a In future, we propose that RheumatologyService complex offering community, comprehensive day-to-day care will be general and secondary dental (treatment of problems with care allowing people who joints, soft tissues and Rehabilitation service provided by the medical attend 4,700 appointments at connective tissues) bringing on the Vale of Leven site workforce covering the the Glasgow Dental Hospital to a further 1,500 appointments is a key element in our rest of the Hospital. to the Vale be treated closer to home Vision for the Hospital. There are currently 59 Expanded specialist rehabilitation beds at the Expanded surgical services, Older people who have including increased numbers services including kidney Vale of Leven Hospital been first admitted to of patients receiving Ear, Nose dialysis and cancer care allowing but a number of these are 3,750 appointments to be either medicine, medicine and Throat (ENT), orthopaedic, often occupied by general general surgery and endoscopy provided at the Vale rather for the elderly, surgery or medical patients. (internal investigation using a than in Glasgow orthopaedics may require small camera) appointments, In the future we propose a further period of time operations and procedures at We also plan to increase the 37 rehabilitation beds and number of appointments at the in hospital to allow them the Vale. New services in retain one in four beds ophthalmology (eyes) and Vale for people undergoing to be fit for discharge. CT, Ultrasound, x-ray, for older people needing urology will also be developed. This care is called Together these developments mammography and fluoroscopy continuing care. will mean 7,200 patient examinations at the Vale by ‘rehabilitation’ and it appointments at the Vale as 1,200 each year should be delivered as In addition to inpatient opposed to Paisley or close to people’s homes services, there will also Glasgow. We will support and families as possible. continue to be consultant this with investment of led outpatient clinics and approximately £700,000 in As is currently the case, new surgical equipment a day hospital for elderly patients requiring people provided on the inpatient rehabilitation Vale site. We are also care will continue to have exploring the a named rehabilitation development of a consultant responsible palliative (end of life) for their care. care service at the Vale of Leven. Examples of how the proposed changes affect different patients

Road Older person Suffering Unstable Drug Suspected Suffering Generally Badly Patient Mum to be Patient Patient to Patient Patient with Patient Patient with Patient Cancer patient Patient accident with chest diabetic overdose Stroke sickness and unwell Sprained referred requiring have hernia to have urological requiring arthritis undergoing undergoing requiring victim breathing pains diarrhoea wrist after for x-ray internal repaired cataract condition examination kidney dialysis chemotherapy wisdom internal difficulties fall examination removed for possible teeth injuries and with eye disease removed broken bones endoscope

Patient makes Patient Patient attended by ambulance crew or GP: condition assessed using clinical scoring system own way to Patient referred by GP or as follow-up to previous hospital care referred Vale’s Minor by dentist Injuries Unit or is referred Patient in Attend Vale Attend by NHS 24 Attend Vale Attend Vale stable for appointment Vale for day Attend Vale for Attend Vale for for regular for regular Attend Vale for Transported direct condition surgery Patient in Patient Transported direct appointment Attend Vale for appointment appointments appointments appointment to A & E in Paisley stable found to to A&E in Paisley Attend appointment condition have blocked Extra Vale for day arteries Taken to service surgery Vale Medical capacity No change Extra Extra Extra Receive No change Assessment Unit Attend New service service service New No change Taken to treatment Vale for day Service capacity capacity capacity Service Vale Medical Change to and Taken to service surgery Assessment sent home No change specialist West Unit of Scotland Condition stable Heart and Transported direct – admitted to Attend Vale’s Risk of possible Lung Service in No change to either to RAH ward or sent Community problems No change Condition Clydebank specialist stroke unit home after Maternity Unit with mother stable – or Western Infirmary treatment for ante-natal, or baby admitted to if needing clot birth and ward or sent Condition busting drugs post-natal care home after New worsens treatment Service Referred to No change consultant-led maternity unit Change to No change in Paisley service No change Vale staff Patient in arrange urgent stable transport to No change condition Royal Alexandra Hospital Paisley No change Patient in Patient in poor Patient in stable stable condition or likely Taken to condition condition to get worse Vale Medical Condition Assessment worsens Taken to Transported direct Unit Vale Medical to A&E in Paisley Assessment Vale staff Taken to Condition Unit arrange urgent Vale Medical worsens transport to Assessment Unit No change Royal Alexandra Condition stable Hospital Paisley – admitted to Condition stable Vale staff ward or sent admitted to ward arrange urgent home after or sent home transport to Royal Condition stable Condition worsens treatment No change after treatment Alexandra admitted to ward Vale staff arrange Hospital Paisley or sent home urgent transport to after treatment A&E in Paisley No change No change

No change

No change No change Bed numbers and Mental HEALTH patient episodes SERVICES Our proposals for mental health take into account feedback received during public consultation in 2008 on modernising mental health services across Clyde as a whole.

In addition to taking account of public feedback we have also been able to take advantage of the We think that, taken together, these Our Vision for the Hospital is to medical staffing arrangements proposals mean that we can retain significantly enhance the level of arising from the wider Vision for around 72% of the Vale of Leven’s non-inpatient activity. The table the Hospital. For these reasons surgical and medical inpatient beds below summarises the impact that our Vision is to retain the on the site – up to 88 out of the our vision will have: current 122 beds. elderly mental health received during based crisis team which has acute admission beds pre-consultation we been established is already Area Current Future Change on the Vale of Leven site believe that this proposal ensuring that fewer patients Patient Patient and transfer the continuing will be well received. require admission to hospital. Episodes Episodes care beds for elderly mental For inpatient mental We therefore project that the health patients from number of acute inpatient Outpatient Services 50,000 50,000 No change health services for adult Dumbarton Joint Hospital to patients between the ages beds for adults will reduce Daycase and Short Stay 7,000 7,000 No change the Vale of Leven Hospital. of 18 and 65, the community from 18 down to 12. Planned Procedures Based on the feedback Planned Diagnostic 11,500 11,500 No change Services There are two possible options for Community Midwifery Unit 14,000 14,000+ Information where the inpatient service can be services campaign provided in the future: Day Hospital for Elderly 7,500 7,500 No change Patients • Refurbished accommodation in the Vale Primary Care Emergency 10,000 10,000 No change of Leven Hospital. Services OR Minor Injuries Unit 9,000 9,000 No change • New, purpose-built accommodation at Medical Assessment Unit 6,300 4,410 – 5,292 20 – 30% less Gartnavel Royal Hospital in Glasgow (Unscheduled Care) We would welcome your feedback on New Planned Care Services – 18,350 20% more both options. Diagnostic, Outpatient, Treatments & Daycase Procedures

Total 115,300 131,760 14% more result of transferring these A new purpose built patients, or as a result of the closure of the Erskine Bridge or Health And Social Care Centre local roads. Similarly, an audit that was undertaken after We plan to further Community Mental develop the Vale of Health Services, A&E services transferred to the Leven Hospital site nutrition and dietetics, RAH revealed that there was by building the physiotherapy, podiatry no detrimental clinical impact replacement for the (feet), audiology on patients from the Vale of Alexandria Medical (hearing) children’s Leven area as a result of Centre there. This will services and this change. ensure that the Vale a Community offers a complete, Nursing team. We do appreciate that co-ordinated package of relatives, carers and friends £18.2 million of want to visit patients receiving services on one investment will be used care in Paisley. There is already site spanning primary to provide a modern, a subsidised bus service (the care, community fully equipped facility health, hospital adaptable to new 340) between the Vale of Leven and social services. working patterns and and Royal Alexandra Hospitals These will include GPs, changes in healthcare. in place to make the journey easier. We propose to promote this service and encourage Transport and Access more people to make use of it. each year. Significant numbers of these will travel by ambulance. We firmly believe that Tell us what the Vision we have developed represents you think... the best possible balance between This consultation was launched on 31st If you would like this providing local access October 2008 and a copy of the full information in a different to high quality services consultation paper can be obtained language or format (e.g. from our website: and a requirement large print or audio cassette) to travel for more http://www.nhsggc.org.uk/valeofleven or by calling 0800 027 7246 during please contact: specialist or intensive normal office hours. 0141 201 4915. care on the occasions when it is required. Comments on all aspects of our proposals are welcome We understand that local people have Email us... We think that our proposals to access care. In total we concerns about transporting [email protected] will mean that more patients anticipate that 18,350 fewer patients to the Royal will be using the Vale of journeys will need to be Alexandra. However, since Leven Hospital in future to made for planned care. Write to us... 2004 approximately 5,000 access outpatient, daycase John Hamilton The changes that we propose patients each year have Head of Board Administration and diagnostic services. This for unscheduled medical care travelled to there to receive NHS Greater Glasgow and Clyde means that fewer people in would mean that between Accident and Emergency FREEPOST SCO6902 Argyll, the Lochside and West Glasgow 1,000 and 1,900 patients care. The Scottish Ambulance Dunbartonshire will need to G1 4BR would have to travel to the Service has not identified any travel to Glasgow or Paisley There is no need to affix a stamp to the envelope. Royal Alexandra Hospital adverse clinical outcomes as a We are organising public events during the consultation period: Thursday, 27th November 2008 If you wish to attend any of these meetings, Commodore Hotel, Helensburgh please register by calling: 2.30 to 4.30pm and 6.30 to 8.30pm 0800 027 7246 Monday, 1st December 2008 Places will be allocated on a first come, first Dumbarton Burgh Hall served basis. Don’t forget to say if you want 2.30 to 4.30pm and 6.30 to 8.30pm to go to the afternoon or evening session. Wednesday, 14th January 2009 We appreciate that the timings and format Vale of Leven Academy, Bonhill, Alexandria of public meetings will not suit everyone, 6.30 to 8.30pm only especially those who to prefer to ask questions and make comments informally. Monday, 19th January 2009 For that reason, we are arranging a number Dumbarton Burgh Hall of drop-in sessions around the area during 2.30 to 4.30pm and 6.30 to 8.30pm the consultation period. There is no need to Wednesday, 21st January 2009 book a place in advance, simply go to the Commodore Hotel, Helensburgh venue at the time that suits you best. 2.30 to 4.30pm and 6.30 to 8.30pm We will advertise these sessions as soon as they are arranged in the local press, on In all but one of the meetings (Alexandria) screens at local health centres and the Vale we have been able to arrange separate of Leven Hospital and on our website. You afternoon and evening sessions to ensure can call 0800 027 7446 at any time to as many people as possible can attend. check forthcoming dates.

0141 201 4915