Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

SWBTB (2/10) 045 (a)
Sandwell PCT will also require agreement to the consultation from Heart of Birmingham teaching PCT
Board. Due to the timing of the HoBt PCT Board meeting chairman’s action has been agreed and will be
endorsed at the HoBtPCT Board meeting in March 2010.
In approving a preferred option the Boards will need to consider the outcome of the public consultation.
16.2 Implementation
Once a preferred option has been approved a detailed implementation plan will be developed and will
include user and staff engagement. This will be developed over the next two months and will be subject
to a further Gateway Review. The aim will be to present the implementation plan and seek approval to
implementation from the Board meetings of Sandwell PCT, Sandwell and West Birmingham Hospitals
NHS Trust Board and Heart of Birmingham teaching PCT Board in May 2010.
17. CONCLUSION
This report has presented a business case for the preferred option recommended by the Project
Steering Group for the medium term review of maternity services. The Business Case has presented a
non financial, financial and risk analysis of the three short listed options that formed the basis of public
consultation and compared this to the ‘Do Minimum’ position. In addition it has taken into consideration
the clinical case for change presented to the Board in September 2009 and the outcome of public
consultation.
The ‘Do Minimum’ position was not part of public consultation but included in the Business Case as a
baseline and had the weakest position in the other areas of analysis.
Options 1 and 2 had the best position from a financial and risk analysis although not significantly better
than Option 3. Neither of Options 1 and 2 were the preferred options from public consultation and do not
fully meet the recommendations from external clinical reviews.
Option 3 has the strongest non financial appraisal score and is clearly the preferred option from public
consultation. In addition Option 3 meets the recommendations of the external clinical reviews. However,
it is weaker from a financial (although not significantly weaker) and risk analysis. In terms of the risk
analysis Option 3 carries similar financial and activity risks to those of options 1 and 2 and whilst it has
no red clinical risks post mitigation it does have the additional risks associated with attracting sufficient
births to the stand alone Birth Centre to make this clinically and financially viable.
On this basis Option 3, is the recommended option from the Project Steering Group i.e.
, All consultant led care and, all in-patient services and, temporarily all births would transfer to
City Hospital. A Stand Alone Midwifery Led Birth Centre would be developed within Sandwell
and, once operational, some midwifery led low risk births would relocate to the new centre in
Sandwell. Low risk midwifery led antenatal care and routine screening will be available in
Sandwell and at City Hospital. Consultant led antenatal care would be relocated to City Hospital.
All Neonatal care would be provided at City Hospital
The capital investment required by the Trust under Option 3 to create the additional capacity required at
City Hospital and relocate remaining offices and outpatient based clinical services from the existing
women’s building at Sandwell Hospital is £1.85 million. The investment appraisal over a 4 year period for
Option 3 shows a Net Present Value (NPV) of £8.29 million, an Income and Expenditure impact of
£1.27million and an overall improvement in the trading position of maternity services by 2013/14 of
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