Reconfiguration of Spinal Services in and

Improving spinal services for Cheshire and Merseyside with a single service model for spinal surgery in Cheshire and Merseyside

Context Spinal services provide treatment for a diverse and complex range of conditions, ranging from disabling spinal pain, the correction of congenital spinal deformations and complex surgery

The vision • To improve spinal services across Cheshire and Merseyside by delivering a spinal service that: Excels in quality, safety, consistency in excellent patient experience, research, innovation and teaching

• To be recognised internationally as a leading spinal provider

• Integrate all spinal provision across Cheshire and Merseyside with a lead provider

• Patient Choice is unaffected by this development and other providers offering services will be available

Background

Spinal Surgery Services are required to be CCG commissioned (non-complex) or NHS specialised commissioned (complex).

Cheshire and Merseyside has had four commissioned providers of adult spinal surgery: • Aintree University Teaching Hospitals • The Royal and Broadgreen Hospitals Trust • The Walton Centre NHS Foundation Trust • Warrington and Halton Hospitals NHS Foundation Trust (2017 service suspended)

The service at Warrington and Halton Hospitals was subject to a review in 2017 by the Royal College of Surgeons and the service has remained suspended since 2017.

Recommendations for High Quality and Safe Spinal Surgical Provision

An Independent review of Spinal Surgery Services in Cheshire and Merseyside by Getting it Right First Time (GIRFT) made a number of recommendations including: • Complex spinal surgery should take place on a single site and should be co- located with Major Trauma services • Elective surgery should be performed at scale • Development of a single on-call rota for out of hours/emergency consultant cover

GIRFT is the recognised national improvement programme for hospital delivered services

Model of care for Cheshire & Merseyside To ensure the recommendations are implemented safely The Walton Centre has been identified as the lead provider is The Walton Centre NHS Foundation Trust

The Walton Centre is co-located with the Aintree Hospital site which is the regional major trauma site and Liverpool’s orthopaedic site.

The Walton Centre is the only site which can: • Provide at scale outpatients, non-complex spinal surgery, complex spinal surgery and emergency spinal surgery • Enable the implementation of a single pathway for emergency spinal surgery, with access to 24/7 diagnostics • Provide a concentration of both specialist neurosurgeons and orthopaedic surgeons

There is potential for outpatient services and non-complex surgery to be performed at the Captain Sir Tom Moore Building (formerly known as the Cheshire and Merseyside Treatment Centre) as a satellite unit from the Walton Centre.