SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Prior to consultation clinicians recommended adopting the major hospital service model and
to reduce the number of major hospital sites in NW London. This recommendation was
approved by the Clinical Board and the Programme Board pre-consultation.
9.7.4 Feedback received about identifying the correct setting of care during
consultation
During consultation we received feedback about the hurdle criteria. Part of this feedback is
detailed in Chapter 5, Section 5.3.1. We described the feedback received during consultation
about the process used to identify consultation options. We asked people to consider the
way we decided which hospitals to recommend as major hospitals, as set out in sections 15
and 16 of our consultation document. 4,541 people answered this question. Of these 60%
agreed, 28% disagreed and the remaining 12% of people either had „no views either way‟ or
responded „not sure/ don‟t know. This feedback is also applicable to the hurdle criteria and
the remainder of this chapter, because sections 15 and 16 of the consultation document also
contain details of the hurdle criteria and the evaluation criteria used in Stage 6 (described in
Section 9.8).
In addition to this feedback we received feedback from organisations addressing the first
hurdle criterion:
Hammersmith & Fulham Council and its Health, Housing & Adult Social Care Scrutiny
Committee (joint response)
“The methodology used to identify and choose between the various reconfiguration options
is open to challenge as it contains a number of fundamental flaws.”
Independent report conducted by Tim Rideout Limited on behalf of the London
Borough of Ealing Council
“Clinicians concluded that “their desired clinical standards could not be met if all nine current
NW London acute sites … were to become major hospital sites”. This is attributed to
manpower and skills/experience constraints, and staffing costs. The business case does not
provide the evidence for this conclusion. Given its importance in underpinning the proposal
to reduce services provided at four of the nine sites, this is a significant omission.”
North West London Joint Health Overview and Scrutiny Committee
We agree with the underlying principles and building blocks which “Shaping a Healthier
Future” promotes as the basis for future emergency care provision;…We note the technical
process followed to appraise the options and are broadly supportive of the conclusions
reached in arriving at the eight options. We feel the criteria used can be seen as fair and
have been applied objectively.
9.7.5 The implications of this feedback on our analysis to identify the correct setting
of care
The feedback we received about the first hurdle criteria did not include suggestions for
alternatives. We considered the feedback received as follows:
Response to feedback about available workforce as referenced in the Rideout
report: To achieve the standards for emergency surgery described in Chapter 7
requires 10 consultants per hospital. There are currently only 45 emergency
9b. Decision making analysis stage 5 290