Agenda item

Mr. Andrew Guy, Leonie Beavers and Jackie Robinson attended to present a report which described a number of improvements that the NHS were planning to make to the way vascular services were provided in Cheshire and Merseyside.

It was explained that the planned changes were currently in the consultation stage of the process and that the review for Cheshire and Merseyside was part of a much wider national review of how vascular services were delivered. It was reported that the drivers for such a review lay in the idea that complex vascular procedures such as widening or narrowing arteries, blocked vessels and varicose veins had better outcomes for patients when performed in major centres with multidisciplinary teams working closely together.

It was highlighted that at the current time, treatment for vascular conditions took place at most district hospitals. As some of the procedures were complex and difficult, it was reported that not all hospitals in the region were able to offer the latest treatments or techniques. This was causing inequality of access and it was hoped that the proposed changes would go some way in making access fairer. Attention was drawn to the fact that the only services that would be relocated as part of the proposed changes were surgery on the arteries and some complex endovascular procedures. There would be no change in the location of outpatient clinics, initial investigations or follow ups, all of which would continue at local hospitals providing they met the requisite quality checks. It was also noted that as part of the changes, there were plans to start to screen older men for abdominal aortic aneurysms. It was explained that at present, local vascular services were not set to undertake such a screening programme in Cheshire. By moving a number of procedures to the proposed vascular centres, it was explained that this would facilitate particular local hospitals to become sites for screening.

In terms of the consultation process, it was emphasised that the aim of the consultation was not to decide whether to make the proposed changes or not as this had already been decided given the strength of scientific evidence and professional consensus. What was being consulted on was firstly how the vascular centres should be chosen and secondly how to achieve a balance between local access and high quality specialist care. It was reported that two events had be held, one with the public and one with NHS stakeholders. It was also noted that there had been 2000 respondents online. It was reported that the two main issues that had emerged from the process were regarding safety and local access.

It was reported that once the form of the changes had been finalised they would be implemented from November 2011 onwards.

After considering the report, Members raised a number of questions and queries. Firstly, with regards to the proposed aortic aneurysm screening centres, it was queried whether there would only be one centre for the whole of Cheshire. It was explained that it was not possible to provide a definitive answer at the current time as the number of screening centres would be subject to a local assessment.

Secondly, in line with the changes to the NHS commissioning structures, it was queried whether GP consortiums had been considered. It was confirmed that GPs had been invited to the consultation events.

A number of questions were asked regarding those residents who lived close to the border of other NHS footprints. The example of Alsager was given, as many of the residents used North Staffordshire hospital as their preferred centre. It was confirmed that connections had been made with hospitals in other footprints and that ‘cross-boundary flow’ would be facilitated and considered.

A concern was also raised over the impact that the proposed vascular centres would have on local hospitals in particular in terms of the availability of senior staff and the ability to cope with emergencies. It was confirmed that all Accident and Emergency staff were supervised by senior consultants and that this would continue to be the case. It was conceded that centralising services could possibly have an impact on emergencies. It was explained that it was the aim of the consultation process to make sure that when the changes took place the balance between local access and high-quality specialist care would be found.

As a final point, it was queried where the two vascular centres would be situated. It was explained that this had not been confirmed as proposals were still being invited from hospitals.

RESOLVED – That the report be received.