Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

SWBTB (2/10) 045 (a)
Do Minimum Position: Retain all consultant led and maternity services at Sandwell Hospital and
improve standards. There would be no change to the current service model with the requirement to
improve the facilities to achieve the recommended standards, and also the need to improve clinical
leadership, operational management and workforce capacity.
Each option was considered against a range of issues including risks, non-financial benefits, public
consultation, financial impact. The outcome of this analysis is summarised in the table below.
Summary of Option Appraisal
Clinical Case for
Change
Non- Financial
Option Appraisal
Scores
Public
Consultation
Do Minimum Option 1 Option 2 Option 3
Does not meet Partly meets Partly meets
NCAT or RCOG NCAT and RCOG NCAT and RCOG
recommendations recommendations recommendations
Lowest score Second highest
score
Not included
26% of
respondents
preferred
Third
score
24% of
respondents
preferred
highest
Meets NCAT and
RCOG
recommendations
Highest score
43% of
respondents
preferred
Capital Costs £3.3m £1.8m £1.8m £1.8m
Affordability -£5,231k -£3,187k -£3,187k - £3,272k
(based on the
forecast
Obstetrics
trading position
in 2013/14 and
compared to a
baseline deficit
of £4.6m.)
Investment 3 1 1 2
Ranking
Cash Flow 3 1 1 2
Risks - Clinical Highest (numbers Joint lowest Joint lowest Second Highest
of red & amber) (numbers of (numbers of (numbers of
amber)
amber)
amber)
Risks – Financial Lowest Middle Middle Highest
& Activity
In summary the ‘Do Minimum’ position had the weakest position in the most areas of analysis.
Options 1 and 2 had the best position from a financial and risk analysis but neither of Options 1 and 2
were the preferred option from public consultation and neither fully meets 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,
2