Stafford hospital's future

This letter is not for public oversight. Please don't post it to other local forums, discuss it with friends or email it to newspapers.

Dear Graham

Future of MSFT

Stafford & Surrounds and Cannock Chase Clinical Commissioning Groups have played a significant role in the development and delivery of the Clinical Implementation Plan for MSFT over the past fourteen months. The Consortia entered into the process fully committed to doing whatever was necessary to build a “clinically safe and financially viable model” at MSFT. However, despite everyone’s best efforts it is clear that a hospital, delivering a full range of services, cannot be sustained.

Our Boards now believe that if we cannot achieve a plan which delivers a safe, viable hospital that it is our duty to lead the development of a more radical plan for the delivery of care for our patients.

We have had further discussions at our respective Boards to understand the implications for both the Trust and the patients for whom we commission. The clinicians have understood the need for a more radical approach to designing what is delivered and have been frustrated by the lack of leadership from the Trust. While we totally advocate the principles and reasons for holding the recent LHE ‘Think Tank’ facilitated by ‘King’s Fund experts’, we were disappointed by the lack of ‘fresh thinking’ and radical options with which the event concluded. The health economy has been charged with “thinking the unthinkable” and we feel that as future Commissioners we have a duty to take this requirement seriously.

Before we share the model that we believe is right for Stafford and Cannock we feel that it is important to set out why we feel this radical approach is the correct one. Our future model has been arrived at based in part on the changes that will be made to the delivery of care and in part from concerns over the robustness of the financial planning around the Trust’s future.

Impact of CSIP on demand
First, the Long Term Care Strategy developed through CSIP and now adopted by our Boards will revolutionise care. Over the coming two to three years the demands of our patients will be transformed as a result of the care plans developed for our most dependant patients and the co-ordination of care by the case managers. The use of acute hospital services will be reduced in both frequency and length with patients only being admitted for focused interventions.

The delivery of urgent care will also be significantly redesigned with approximately 50% of the current activity being delivered through primary care led Urgent Care Centres. The Centres will respond to the patient’s urgent need and direct them into community services, where appropriate, which will further reduce the demands on hospital care.

Financial Position of the Trust
Commissioners question the true size of the financial gap estimated at £11.4m. The gap was quantified on the basis that all of the potential productivity gains would be fully achieved. While we don’t doubt that the Trust will make every effort to fully deliver the Productivity Gain, we think it unrealistic to believe they will deliver the plan in full. Therefore we believe that the gap will exceed £11.4m and for any plan to be credible we need to aim to deliver a reduction in costs nearer to £15m if we are not to risk future financial instability and the “slow death” of our hospital.

If we fail to ensure the future services in Stafford and Cannock are safe and financially viable we will continue to find ourselves either being asked to:

• Bail out the Trust by funding above tariff as we did last year and the year before using all of the SCR to ‘plug gaps’ rather than invest in development. This pressure will grow each year and represents a lost opportunity of investment for our patients in other areas of the local health economy.
• Accept lower quality as the Trust try to reduce support staff costs leaving more tasks to be picked up by the clinical staff, or
• Witness the slow demise of the Trust as they struggle to recruit staff into financially compromised specialities.

At a CCG development workshop, which was attended by every Practice in Stafford, potential models of care were explored. There was a strong convergence on a model which delivers four specialities described below:

1. Urgent Care Centre – Providing an urgent response to minor trauma and ailments which includes the management of limb fractures, wound care and pain in the otherwise well adult and child. This needs to be integrated with the OOH services to avoid duplication and waste.

2. Out-Patient Facilities – Delivered by one or more neighbouring Trusts on a ‘satellite basis’ i.e. locally to our patients who will then manage any in-patient activity arising from the appointment, with the possibility of rehabilitation care again delivered locally.

3. Diagnostics – Simple diagnostics such as X-rays in both Stafford and Cannock with others being rationalised to one site.

4. Maternity – Midwifery-led maternity unit.

For all other specialities the clinicians believed that care could be delivered either in the community or at other Providers such as UHNS, RWH, & Walsall.

Key to delivering the high standards of care and quality, which the people of Stafford and Cannock deserve, is the development of community based services for the elderly and those with a long-term condition. As part of the model of care we would envisage a shift of these specialities from secondary care into the community. This supports the fuller integration of consultant expertise with community nursing and social care thereby delivering high quality care, which is able to manage people with complex care needs in their own home or their local community.

We have shared this model with Cannock who, while wishing to explore this further, broadly supports the more radical approach. Commissioners recognise the political sensitivity of developing such plans and believe that these changes could be delivered through a two site solution.

We understand that the Trust were to present a model to Monitor by the end of January which should have Commissioner support. We are therefore surprised and extremely disappointed that we haven’t had any further discussion of the Plan despite our willingness to engage.

Finally, we are concerned that due diligence is given to the development of the plans for the Trust. Any decisions taken will have long lasting effects for both the local health economy and people of Stafford and Cannock. We therefore request that any decision making regarding the future of MSFT adheres to the principles of probity and are conducted in an open and transparent manner that would stand the test of scrutiny wherever challenged.

Our present position is that until we are involved in the discussions regarding the future of the Trust and receive assurance that anything more that the four specialities above can be delivered safely and viably, as responsible Commissioners, we could not support them.

We would welcome your urgent response and advice on how we can be fully engaged in the development of the model of care for our patients.


Kind regards



Steve Powell​​​Johnny McMahon
Chair, Stafford & Surrounds CCG​​Chair, Cannock Chase CCG
 
You're kidding?

I thought that posting an internal email announcing the death of MSFT on a site named "Stafford forum" would just stay here with no-one to read it...
 

wizzard

Well-Known Forumite
unlikely suspect, if you do a search on google for a broad range of subjects you will find stafford forum towards the top of the page, so if you want to keep something "local", then don't post it on here, non forum members will see it.
 

speak65

Well-Known Forumite
Interesting information.

I am sure we can keep this within these walls unless we accidently forget that we are supposed to be discrete
 

Withnail

Well-Known Forumite
wizzard said:
... if you want to keep something "local", then don't post it on here, non forum members will see it.
Unlikelysuspect said:
Please don't post it to other local forums, discuss it with friends or email it to newspapers.
I may be wrong - it would not be the first time - but i think people are rather missing the point.

I for one have just emailed it to the Guardian...
 

ExiledInStaffers

Well-Known Forumite
Predictable outcome really. Pretty certain on an older thread it was discussed that Stafford hospital would become a community hospital no longer performing emergency care or major operations. The irony of the well meaning cure the nhs campaign eh?
 

ExiledInStaffers

Well-Known Forumite
Withnail said:
wizzard said:
... if you want to keep something "local", then don't post it on here, non forum members will see it.
Unlikelysuspect said:
Please don't post it to other local forums, discuss it with friends or email it to newspapers.
I may be wrong - it would not be the first time - but i think people are rather missing the point.

I for one have just emailed it to the Guardian...
I am with you. I think he means do the opposite of what he says. Also hope his name isn't graham, else he hasn't really thought this through.
 

Biggus Dickus

Active Member
ExiledInStaffers said:
Predictable outcome really. Pretty certain on an older thread it was discussed that Stafford hospital would become a community hospital no longer performing emergency care or major operations. The irony of the well meaning cure the nhs campaign eh?
Absolutely predictable outcome But not sure any blame should rest with Cure the NHS
are we saying it doesnt matter how bad the service is we just put up with it or it gets removed?
 

joshua

Well-Known Forumite
ExiledInStaffers said:
Predictable outcome really. Pretty certain on an older thread it was discussed that Stafford hospital would become a community hospital no longer performing emergency care or major operations. The irony of the well meaning cure the nhs campaign eh?
If it means that there will be no more unnecessary deaths and that patients are treated with respect and compassion then i do not care about that accursed hospitals status.

We spend too much time chasing targets and loose sight of the real reason: to care for people.
 

ExiledInStaffers

Well-Known Forumite
joshua said:
ExiledInStaffers said:
Predictable outcome really. Pretty certain on an older thread it was discussed that Stafford hospital would become a community hospital no longer performing emergency care or major operations. The irony of the well meaning cure the nhs campaign eh?
If it means that there will be no more unnecessary deaths and that patients are treated with respect and compassion then i do not care about that accursed hospitals status.

We spend too much time chasing targets and loose sight of the real reason: to care for people.
You would care when being rushed to burton in the back of an ambulance as there will be no A+E. You will care when an elderly relative ends up in north staffs and their partner spends a fortune on taxis to visit. Losing a fully functioning hospital will be damaging to Stafford.
 

ExiledInStaffers

Well-Known Forumite
Biggus Dickus said:
ExiledInStaffers said:
Predictable outcome really. Pretty certain on an older thread it was discussed that Stafford hospital would become a community hospital no longer performing emergency care or major operations. The irony of the well meaning cure the nhs campaign eh?
Absolutely predictable outcome But not sure any blame should rest with Cure the NHS
are we saying it doesnt matter how bad the service is we just put up with it or it gets removed?
No blame. Just pointing out the irony.
 

blueboy21

Newbie
Unlikelysuspect said:
This letter is not for public oversight. Please don't post it to other local forums, discuss it with friends or email it to newspapers.
How did you get hold of this letter and what else are they planning?
 
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