Health watchdogs from Cumbria County Council and Lancashire County Council have cautiously welcomed a 'public-first' approach to plans to revamp acute medical services in the Morecambe Bay area.
The councils' Joint Health Overview and Scrutiny Committee have issued a statement which considers the Primary Care Trust responses to several recommendations made by scrutiny in September 2006.
The statement welcomes a commitment from Cumbria PCT to develop a detailed and phased implementation plan on a joint basis with the University Hospitals of Morecambe Bay Trust on the changes to acute medicine in Morecambe Bay. This plan will include "break-points" where it will be necessary to demonstrate that essential enabling measures are in place before progressing with the subsequent action. The PCT has indicated that this detailed plan will be ready by May or June 2007.
The joint scrutiny committee welcomed several points in the PCT response. These include:
- The PCT concurs with the Committee's desire to see both medical and rehabilitation wards at Westmorland General Hospital;
- The PCT believes that there is scope for an outpatient medical emergency clinic at Westmorland General Hospital;
- The PCT accepts that community matrons, care management and step up care are essential components of the service system, and that investment is needed as an integral part of moving forward;
- The PCT is working with stakeholders (including carers) in shaping pathways of care and strengthening capacity and capability in communities, and recognises the scope for GP-led beds within Westmorland General Hospital;
- The PCT recognises the need for detailed criteria and risk assessment arrangements;
- The PCT accepts that the Royal Lancaster Infirmary and Furness General Hospital will need to demonstrate that they have the capacity, quality and facilities to meet the PCT's commissioning arrangements;
- The PCT believes that stroke rehabilitation services should be a continuing component of the service in South Lakeland, both in Westmorland General Hospital and in the community;
- The PCT agrees on the need to keep the public informed and engaged, and to involve the Patient and Public Involvement Forum and other representatives.
Councillor Jeff Garnett, Chair of the Joint Health Overview and Scrutiny Committee, said:
"Cumbria PCT is a relatively new body and is evolving all the time. It is reviewing and redesigning its services, but we welcome the fact that the PCT wants to maintain an ongoing dialogue with scrutiny and the wider community while it does this. We await more detail before deciding whether the PCT's plans and care pathways are in line with our own vision for how acute medical services should be delivered in the area."
The Joint Health Overview and Scrutiny Committee's statement called for further clarification in the following areas:
- options for patients currently admitted for acute medicine to Westmorland General Hospital;
- care pathways for patients currently admitted for coronary care at Westmorland General Hospital;
- plans and resources to reduce the shortcomings of additional travel from South Lakeland to the Royal Lancaster Infirmary and Furness General Hospital
- the impact on Adult Social Care, both in Cumbria and North Lancashire, and whether the impact is manageable;
- the effect of the proposals on patients in North Lancashire.
Once there is clarification on these points, the Joint Committee will then be able to finalise its view on the NHS response to its report and agree whether to take any further action. It is only at that point that the NHS consultation process with the Joint Committee will have been completed. The county councils have a statutory role to examine and make recommendations on whether the NHS Trust's proposals are in the interests of patients and health services across Morecambe Bay. If the Joint Health Overview and Scrutiny Committee is not satisfied with the Morecambe Bay NHS Trust's response to its recommendations, it has the power in the last resort to refer the matter to the Secretary of State for Health.
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