Gwent Clinical Futures Public Consultation Document Blaenau Gwent Local Health Board Caerphilly Local Health Board Monmouthshire Local Health Board Newport Local Health Board Torfaen Local Health Board Gwent Healthcare NHS Trust On behalf of Gwent Community Health Now it is your chance to have your Message Council, I am pleased to welcome say on these radical and exciting you to the “Clinical Futures” public proposals. As your local health consultation document. It is becoming “watchdog” we at Gwent Community from Gwent increasingly clear that the existing Health Council will oversee the formal pattern of health facilities and ways consultation process (starting on of working cannot deliver the kind of 18th September 2006 and lasting Community services you have a right to expect. for 12 weeks). We will receive and Health services must change; standing consider all comments made during still is not an option. The Welsh the consultation period on the Health Council Assembly Government document proposals outlined in this document. Designed for Life addresses these We will then advise the local NHS issues and sets out its plans to create organisations whether there is a world class health service for Wales sufficient public support for these over the next 10 years proposals. The NHS in Gwent is taking the lead Please read this consultation document in Wales in producing far reaching carefully and take a few minutes to fill ideas for your healthcare in the 21st in the consultation questionnaire at the Century. This document sets out back of this document. Your response options for improving health services is important – the future of local health in the Gwent area by developing a new services in the Gwent area depends way of delivering the health services on it. that local people need. These options are the result of more than 18 months of work and discussion with patients, healthcare professionals and their local communities. Vernon Caldwell The proposals contained within this Chairman document, have been developed by Gwent Community Health Council local NHS organisations, including Gwent Healthcare NHS Trust, Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen Local Health Boards. According to these plans, in future more care will be provided direct to you in your home, your GP surgery and some provided in community centres or clinics. Most hospital care will be provided in your Local General Hospital network. Only the most complex care will be delivered in a Specialist and Critical Care Centre that supports the network of Local General Hospitals. 2 Clinical Futures Public Consultation Document Contents Executive Summary Chapter 1 Why we need to change Chapter 2 Improving the health service for the Gwent area Chapter 3 Developing a Local General Hospital in Newport Chapter 4 Developing a Local General Hospital in North Monmouthshire Chapter 5 Developing a Local General Hospital in Torfaen Chapter 6 Developing a Specialist and Critical Care Centre Chapter 7 Tell us what you think Glossary Consultation form Clinical Futures Public Consultation Document 3 Executive Summary In this public consultation document we explain why change is being proposed to the way in which health services are delivered in Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen. We also describe the options for the future shape of hospital services. We have for some years now been ◆ Safe, high quality treatments discussing the possibility of developing within a reasonable timescale in a new “model of care” for the NHS in modern facilities that meet your Gwent. In 2005, Local Health Boards specific needs. issued a discussion leaflet called “Your Healthcare- the Future” and invited ◆ Improved local access to clinics, local people to give their views. The treatments and tests and more response was overwhelming and support to help you to stay resulted in the development of the independent. proposals that are outlined in this public consultation document. ◆ Services that are integrated and ensure that different organisations The proposals form the ‘Clinical and health professionals work Futures’ plan for the Gwent area and together across settings to provide will change the way we provide local continuity of care. health services by delivering more care closer to where people live, with the To achieve this, Clinical Futures aim of providing proposes: 4 Clinical Futures Public Consultation Document ◆ More and better primary care Nevill Hall Hospital site or the services delivered from GP surgeries, Maindiff Court Hospital site resource centres and directly into people’s homes (Level 1) ◆ Torfaen at one of these locations : the existing County Hospital site, or ◆ A network of 6 new “Local General an alterative site. Hospitals” delivering many of the services that are currently We also propose to build a single delivered from community Specialist and Critical Care Centre hospitals and District General which will serve the whole of Gwent Hospitals (Level 2) and will therefore need to be located on a site accessible to the entire Gwent ◆ A single Specialist and Critical patient population. Our proposal is Care Centre serving all of the that to benefit the entire Gwent patient Gwent area (Level 3) population, the most appropriate site would be located either at Llanfrechfa In this consultation document we Grange, Cwmbran or at an alternative ask for your views on the options we site within a three mile radius of the have considered for three of the new Croes-y-ceiliog roundabout and we Local General Hospitals, one each for would like your views on this. Newport, North Monmouthshire and Torfaen. We also want your views on the options for the Specialist and Critical Care Centre. Through a separate consultation process we have already received support for the new hospitals planned for Blaenau Gwent and Caerphilly boroughs. These plans are excluded from this consultation process but residents of these areas will still be interested in proposals for the services they will access from the We would like to know which option other hospitals in the network. you think would be best for each hospital and why. We propose to develop Local General Hospitals in There are many ways to become involved in this public consultation ◆ Newport at one of these locations and they are outlined in Chapter 7 : a new city centre site or an out- of this document. Please read this of –city centre site consultation document carefully and take a few moments to complete the ◆ North Monmouthshire at one questionnaire. of these locations: the existing Clinical Futures Public Consultation Document 5 Current Services services have grown rapidly over CHAPTER 1: recent years, there is not yet an The total area covered by Blaenau appropriate level of services across Gwent, Caerphilly, Monmouthshire, all parts of the Gwent area. Why we need Newport and Torfaen Local Health Boards is shown in the map above. ◆ 12 community hospitals which are The population for the whole area focused largely around the Valleys to change is 550,000. Some residents of communities. Many of these South Powys, Gloucestshire and have served local people well for Herefordhsire also access services from decades, but are now outdated the Gwent area. and no longer appropriate for modern hospital services. Recently there have been good examples of developing new types of service such as the Integrated Health and Social Care Unit at Monnow Vale. ◆ Mental health services which are provided in various locations, often separate from other health services, with facilities that include old institutions such as Maindiff Court and St Cadocs which have long been planned for closure. Learning Disability services are currently provided in community settings and at Llanfrechfa Grange Hospital Health services are currently delivered although these are currently subject in the following way: to a reprovision programme which will be completed in 2007. ◆ Primary care services which are delivered by more than 100 GP ◆ Acute hospital services which practices across the Gwent area are provided mainly at the main and a range of optometrists, District General Hospitals sites pharmacists and dentists. Services – the Royal Gwent Hospital and in some areas are very well Nevill Hall Hospital - with some developed, whilst in others they are services also provided at Caerphilly more limited through problems of District Miners Hospital. Demand recruitment and poor primary care for services at each of the District premises. General Hospital sites has grown significantly over recent years. ◆ Community teams which are available in each borough and ◆ Tertiary (highly specialised) services support both GP and hospital are provided on regional or national services by delivering care to people basis and although some tertiary in their own homes. Although these services are provided by Gwent 6 Clinical Futures Public Consultation Document Healthcare NHS Trust e.g. Neonatal We must make services more services for very sick babies, many accessible to our population tertiary services are provided from the University of Wales Hospital Currently, local access to hospital Cardiff and some from England. services is generally limited, with patients having to travel to busy District General Hospitals for many services that could be provided as Reasons to change effectively nearer to home. Waiting times for services are often a problem There are many pressing reasons why due to this over reliance on district we need to change the way we deliver hospital services.