NORTH LANARKSHIRE COUNCIL

REPORT AGENDA ITEM No.

To: SOCIAL WORK (PLANNING AND Subject: NHS GREATER - ADMINISTRATION) SUB COMMITTEE PUBLIC CONSULTATION ON ACUTE CLINICAL SPECIALTIES

From: DIRECTOR OF SOCIAL WORK

Date: 6m AUGUST 2002 I Ref: SM I

1. PURPOSE OF REPORT

1.1. The purpose of this report is to seek approval for the Council’s response to a set of documents issued for public consultation by NHS on the future of four clinical specialties in acute .

2. BACKGROUND

2.1. For over 2 years NHS Greater Glasgow has tried to establish a new strategy for the delivery of acute hospital services. North Lanarkshire Council has commented on a number of consultation documents during this period, particularly in respect of proposed changes to the functions carried out at Hospital. These could reasonably be summarised as moving from providing a range of inpatient care to becoming what is described as an and diagnostic centre and minor injuries unit. This course of action was eventually decided by Greater Glasgow NHS Board on 29 January 2002. Inpatient care would be carried at and Gartnavel General Hospital.

2.2. Issues concerning the loss of general surgery/ general medicine and accident and emergency services from Stobhill, and access to alternative inpatient care for people from North Lanarkshire, were raised by the Council at the time. On this occasion NHS Greater Glasgow is consulting on the future of four clinical specialties in acute hospitals. The specialties are:

Dermatology Services across Greater Glasgow Inpatient Ear, Nose and Throat (ENT) Services for adults and children in North and East Glasgow Inpatient Services in North and East Glasgow Services in North and East Glasgow

2.3 The consultation will run until 2 August 2002 and the responses will be discussed on the meeting of the Board on 20 August 2002. The Council has secured an extension until 9 August 2002 in order for Committee to consider the matter.

3. CONTENT AND NORTH LANARKSHIRE COUNCIL RESPONSE

3.1 The consultation proposes changes to the delivery of four clinical specialties. In respect of , at present these services are provided on 6 different sites. It is proposed to have a core dermatology centre; 3 or 4 ambulatory dermatology centres providing local consultation, minor procedures and treatment; and a paediatric dermatology service.

\\swrnothO1 fnpbnohqdataWLANNING\Committee Reports\2002 Reportshhsgg cr.doc 3.2 Ear, nose and throat services are provided on 3 outpatient and 2 inpatient sites, including 14 beds on the Stobhill site. It is proposed to centralise the inpatient care at Gartnavel General Hospital.

3.3 Inpatient opthamology services are provided at Stobhill and Gartnavel. It is proposed to transfer all inpatient surgery to Gartnavel, so that all people would be admitted to a dedicated opthamology ward with enhanced specialist care. 95% of opthamology activity, which is of the outpatient variety, would remain at Stobhill.

3.4 North Glasgow presently has 3 inpatient gynaecology services at Stobhill, Glasgow Royal Infirmary and the Western Infirmary. The occupancy level is said to be 560% in the current year. The proposal is for inpatient surgery and gynaecological oncology to be transferred from Stobhill to an integrated purpose built 33 bedded ward at Glasgow Royal Infirmary. Gynaecology would remain a significant user of the ambulatory care hospital at Stobhill. This would affect almost 1200 people (per year - check), a proportion of whom would come from North Lanarkshire.

3.5 North Lanarkshire Council welcomes the opportunity to be consulted and seeks assurances that the delivery of services would not be adversely affected. It is recognised that there are issues involved in delivering specialised medical services on different sites that make this is a different issue from the previous removal of general services from Stobhill Hospital. The content of the proposed response is attached at Appendix 1.

4. RECOMMENDATIONS

4.1, Committee is asked to:

(i) approve submission of the response to NHS Greater Glasgow set out in Appendix 1; and

(ii) otherwise note the contents of this report.

Jim Dickie Director of Social Work 18 July 2002

For further information on this report please contact Duncan Mackay, Planning and Development Manager (Community Care Partnerships) TEL: (01 698 332067)

\\swmothO 1fnpbnohqdataWLANNING\Committee Reports\2002 Reportshhsgg cr.doc Department of Social Work Scott House Merry Street Motherwell

Contact: Duncan Mackay Telephone: 01698 332072 Our Ref: VF/SMacV E-mail: @northlan.gov.uk Your Ref: Fax: 01698332097 Director of Social Work Date: 23 July 2002 Web Site: www,northlan,gov.uk Jim Dickie

Mr John C Hamilton Head of Board Administration Greater Glasgow NHS Board Dalian House PO Box 15329 350 St Vincent Street Glasgow G3 8YZ

Dear Mr Hamilton

Re Public Consultation: Acute Hospital Clinical Specialities

Thank you for the opportunity to express our views on the above matter and for the extension granted to our response.

North Lanarkshire Council has a significant interest in these proposals, as they will affect a substantial number of people who live within its boundaries and particularly the future of Stobhill Hospital, which serves the local community.

You will see that the attached response concludes with a number of specific issues. We would seek an early response from NHS Greater Glasgow in respect of these.

I look forward to hearing from you.

Yours sincerely

Jim Dickie Director of Social Work

C:\TEMP\appendixqublicconsultation_acutehospclinicalspecialities.doc APPENDIX 1 NHS Greater Glasgow Public Consultation: Acute Hospital Clinical Specialities

Introduction This response has been prepared by officers in North Lanarkshire Council with regard to the consultation in respect of a number of acute hospital specialities, namely gynaecology, in- ophthalmology and in-patient ear, nose and throat (ENT) services in North and East Glasgow as well as Dermatology Services in Greater Glasgow.

North Lanarkshire welcomes the opportunity to provide an input to this consultation since the proposals affect a significant number of residents living in the Millerston - Moodiesburn corridor, many of whom currently access acute hospital services from Stobhill Hospital.

Specific comments in relation to each of the acute hospital specialities currently under consideration are provided below.

Gvnaecologv Services in North & East Glasgow

The creation of a purpose built facility within a single site within Glasgow Royal Infirmary is likely to have a number of benefits for . However, great care needs to be taken to ensure that the needs of patients who attend for maternity services or who attend for terminations are considered carefully in the planning and design of the new facility. Also, staff need to have adequate support and resources to enable them to deal effectively with the increased level of maternity and termination services.

Under the proposals there would be no in-patient beds at Stobhill Hospital which means that North Lanarkshire residents who may be going through a traumatic time in their attendance at either general or oncology services would not be near their homes and families. This is likely to create problems in terms of people travelling to visit them. It is not clear what consideration has been given to public transport and parking facilities at Glasgow Royal Infirmary.

Furthermore, this Council seeks assurance that the lack of local in-patient beds at Stobhill Hospital will not have an adverse effect on the quality of care that people receive and also that the Ambulatory Care Hospital at Stobhill will be able to cope with the increased demand for day cases due to the proposed overall reduction in in-patient beds.

Inpatient Ophthalmologv Services in North and East Glawow

The proposal to transfer in-patient surgery from Stobhill to Gartnavel appears to be built on positive grounds. However although it is only likely to affect 5% of current patients, careful consideration should be given to issues around transport. Older people are more likely to need ophthalmology services and accessing services and/or visiting family and friends in Gartnavel is likely to be difficult and have financial implications, most particularly for those using public transport.

Furthermore, when there is a need for emergency ophthalmology services, the travelling time to Gartnavel General will be crucial but will obviously take much longer under the new proposals for North Lanarkshire residents than it would to Stobhill Hospital. This Council is concerned that this may be detrimental to individuals and seeks further information on how emergency situations will be dealt with.

C:\TEMP\appendixqublicconsultation_acutehospclinicalspecialities.doc Impatient Ear, Nose and Throat (ENT) Services in North and East Glaspow

The proposal to move the in-patient surgery from Stobhill and Gartnavel appears to be well founded for those patients who require head and neck surgery and specialist care.

However, the reduction of out-patient clinics in GRI and Stobhill does not appear to be a constructive proposal in view of the number of day-cases and out-patients at both sites. This is likely to have a significant impact on the local communities in terms of accessing services locally. Furthermore, travelling to Gartnavel from this area can be time consuming and expensive. Although we appreciate the reasons for centralising in-patient ENT services, it will also have an impact on the provision of emergency services. Again this Council is concerned that this may adversely affect North Lanarkshire residents and seeks further information on how emergency ENT services will be provided.

Dermatology Services in Greater Glasgow

The restructuring of the provision of dermatology services appears to be founded on solid reasons. However a lot will be expected from Ambulatory Dermatology Centres and again this Council would seek assurance that they will be able to cope with the demands that will be made on these services. Furthermore in emergencies the travelling time to Southern General can be crucial. As already stated in this response, travelling is also likely to be a major issue for people visiting family and friends.

Paediatric Speciality Services

North Lanarkshire Council recognises that the proposal to transfer of all paediatric speciality services to Royal Hospital for Sick Hospital, Yorkhill, is likely to have a very positive impact for children and young people. However, the travelling for families could be problematic and needs to be given serious consideration.

Conclusion

While this Council recognises the need to rationalise the provision of the above acute hospital specialities, there are a number of issues in respect of which North Lanarkshire seeks clarification:-

1) The above proposals appear to place a heavy reliance on Ambulatory Care Services at Stobhill Hospital being in a position to deal effectively and efficiently with what is likely to be an increased demand on services, due to an increased number of day cases resulting from the overall reduction in acute hospital clinical speciality beds - we require information in respect of how these will be resourced to undertake this increased level of service. 2) Specific detail with regard to the emergency services, out of hours services andor responses that will be provided in respect of the above acute hospital clinical specialities to North Lanarkshire residents living within the NHS Greater Glasgow area. 3) Transport strategy for all of the acute hospital sites since there are real issues for North Lanarkshire residents in accessing any of these, in particular:- 0 Glasgow Royal Infirmary - parking 0 Gartnavel General - accessibility and cost of public transport 0 Southern General - accessibility and cost of public transport Royal Hospital for Sick Children, Yorkhill - parking, accessibility and cost of public transport.

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