LATEST NEWS

29/06/08

An interesting news report regarding the state of maternity within the NHS.

Maternity units 'under threat' Forty-one maternity units have been closed under Labour or are under threat, new figures unveiled by the Conservatives show. The data for units across England was obtained under the Freedom of Information Act. A total of 93% of NHS trusts responded to the request, put forward in March this year. They provided details of services that had closed over the last decade under Labour. A total of 10 units have closed, while a further five units have changed from being led by consultants to being led by midwives. The Tories said this change equated to "loss of full obstetric cover". Fifteen units were found to be under threat of closure or were planned for closure in the future. Some trusts said this was to make way for expanded maternity services at other hospitals nearby. The Tories also listed another 11 units under threat of losing services. The Tories said smaller units seemed to be particularly under threat, with proposals for reconfiguration and reviews of maternity services in different areas of the country. Shadow health secretary, Andrew Lansley, said: "These figures clearly demonstrate the foolishness of Labour's plans to super-size our NHS. As has happened far too often with this Government, ideology is seen as more important than a proper analysis of the facts. "Labour's drive for large numbers of births in ever more distant larger obstetric units will torpedo choice in childbirth and undermine quality care for normal births." Health Minister, Ben Bradshaw, said: "Time and time again the Tories say they want the NHS to be free locally to make decisions about the kind of services they should provide. Yet time and time again, when that freedom is exercised, the Tories oppose it." Source: MSN News

27/05/08

HOTC To Meet the IRP

We are happy to confirm that a delegation from the Hands Off The Conquest campaign group will be meeting members of the Independent Review Panel in the middle of June.

More information to follow.

25/05/08

It May Seem Quiet, But The IRP Need To Hear YOUR Voice!

The lack of recent updates may make it look like not much is happening, but a lot is going on behind the scenes. And now, more then ever, is the time for the people to whom this decision matters the most - the members of the public - to make their voices heard as loudly as possible.

After HOSC (Health Overview Scrutiny Committee) referred the matter back to the Secretary of State for Health, Alan Johnson, he decided that an Independent Review Panel should make the final decision. Members of the panel have already visited both Hospitals and the Primary Care Trusts and will be meeting with the Campaign Groups during June.

A final decision is expected around September.

And all of us need to make sure the IRP hears what we have to say!

Update: click here to find out how to make the IRP hear YOUR voice

25/03/08

Horton Hears a Yes - Panel Finds in Favour of Hospital

A similar battle to our own has been going on at Horton Hospital in Oxford. And we are delighted that the Independent Review Panel (IRP) found in favour of the hospital.

On the left is the IRP report to the Secretary of State for Health. The report not only recommend the Secretary of State to reject the proposals but also recommends a lot of further work. Click on the icon on the left to download the report (.PDF, 378kb)

22/03/08

High Court Judicial Review

The decision to cut maternity facilities in the area will be undergoing Judicial Review. The papers have been served at the High Court against the PCT and we now need to fundraise. Any money that is not used for the Judicial Review will be spent at the Conquest by the Friends, and it is therefore “a win, win” situation. If you are able to contribute, please contact us at donations@handsofftheconquest.org.uk

20/03/08

Margaret Williams (HoTC) on Nick Yeo’s departure

In response to Nick Yeo’s (Chief Exec, PCT) move away from this area, Margaret Williams had the following comments to make:

Firstly let me say that I am not in the least surprised that Nick Yeo is leaving, and fully expect others to follow. The decision to single site maternity is wrong as the Health Overview Scrutiny Committee have acknowledged by referring that decision to the Secretary of State for Health and on to an Independent Review Panel. The campaigners have always said that those making such a dangerous decision should leave.

Nick Yeo has shown that he is not committed to the area. He was brought in by the Strategic Health Authority to do the job of single siting maternity, and since he has not managed to carry that through he is now moving on to pastures new. I only hope that he does not intend to carry out another hatchet job in Hampshire.

My one hope now is that the new Chief Executive comes from the area in order that loyalty to the residents can once again become the most important factor of the job. In the past we have always had long standing, caring, local people and I trust that after this disastrous interlude once again common sense will prevail.

Margaret Williams
Chair Hands off the Conquest Campaign
Secretary Friends of the Conquest

15/03/08

Agenda for HOSC on Thursday 20th March 2008 - County Hall, Lewes

Item 5 on the agenda for this HOSC meeting is entitled Fit for the Future – update. The full 12-page document to accompany this can be found by clicking here (it requires Adobe Acrobat reader); the introduction is reproduced below:

Agenda Item 5   Report to: East Sussex Health Overview and Scrutiny Committee (HOSC) Date: 20th March 2008 By: Director of Law and Personnel Title of report: Fit for the Future – progress update Purpose of report: To summarise developments in relation to the Fit for the Future process in East Sussex following HOSC’s decision to refer the Primary Care Trusts’ proposals to the Secretary of State for Health.   -------------------- RECOMMENDATIONS HOSC is recommended to: 1. Note the developments in relation to Fit for the Future. -------------------- 1. Background HOSC has a duty to respond to East Sussex Primary Care Trusts’ (PCTs’) consultation on Fit for the Future proposals for obstetrics, gynaecology and special baby care, making recommendations based on the evidence available. On 10th October 2007 HOSC agreed a series of recommendations to the PCT Boards on issues which the Committee believed should be taken into account when the Boards are considering the various potential configurations of services. HOSC did not endorse any particular configuration of services, but recommended that the PCT Boards undertake a full assessment of the additional potential options which had emerged during the consultation process. On 20th December 2007 a joint committee of the two PCT Boards took a decision on the future model of services. The decision was for a consultant-led obstetric unit, special care baby unit and inpatient gynaecology service at the Conquest Hospital, Hastings with a midwifery-led maternity unit at the Eastbourne District General Hospital, and enhanced ante and post-natal care in the community. On 28th January 2008 HOSC held a special meeting to consider the PCTs’ decision. The Committee heard from the PCTs about the reasons for their decision and the decision making process. HOSC also took evidence from proposers of alternative options about the way in which their proposals had been assessed. HOSC decided, based on the totality of evidence collected throughout the Fit for the Future process, that the PCTs’ decision is not in the best interests of health services for East Sussex residents. The Committee agreed to exercise its power to refer the PCTs’ plans (with the exception of the enhanced ante and post natal care) to the Secretary of State for Health for independent review. This referral was conditional on the PCTs being given an opportunity to respond and the PCTs confirming their intention to proceed with their decision. 2. Further developments Following HOSC’s meeting on 28th January 2008, the HOSC Chairman wrote to the Chief Executive of the PCTs to confirm the Committee’s position, including the reasons for the decision to refer the proposals to the Secretary of State. A copy of this letter is attached at appendix 1. On 20th February 2008 the Chairman received a response from the PCTs’ Chief Executive. This response is attached at appendix 2. In summary, the letter outlines the PCTs’ perspective on HOSC’s concerns about the proposals and reiterates the PCTs’ view that the proposed model of care is the best way forward. It confirms that the PCTs’ plan to proceed with implementing the decision made by their Boards on 20th December 2007 and expresses their concern that a referral to the Secretary of State would delay implementation of what they believe to be the best service model. The HOSC Chairman responded to the PCTs’ letter on 3rd March 2008. This letter is attached at appendix 3. As the PCTs have confirmed they plan to proceed with their original decision, the letter indicates that HOSC’s decision to refer the plans to the Secretary of State stands and that the Committee will proceed with the referral. 3. HOSC referral to Secretary of State The HOSC Chairman’s letter of 3rd March 2008 (appendix 3) indicates that HOSC shares the PCTs’ desire for a swift resolution to the future configuration of services, in order to provide certainty for the public and staff. As there is a clear difference of view between the PCTs and HOSC on this matter an independent review initiated as soon as possible will give the best opportunity to achieve this. HOSC officers are currently compiling the detailed evidence to support HOSC’s decision to refer the proposals to the Secretary of State from the information obtained during HOSC’s evidence gathering programme. It is anticipated that this process will be completed, and the information sent to the Secretary of State, by the end of March 2008. The Secretary of State has said that, whilst Lord Darzi’s national review of the NHS is still underway, he will pass all referrals he receives from HOSCs to the Independent Reconfiguration Panel to seek their advice. The Independent Reconfiguration Panel is a national panel comprising clinical representatives, NHS management representatives and lay representatives. More information about the panel can be found here. 3.4 The Independent Reconfiguration Panel has set up a process for dealing with referrals whereby a sub-group of the panel undertakes an initial assessment of the issues to determine whether a full review by the panel is required. An initial assessment generally takes about one month and a full review a further three months. The Secretary of State will then require some time to consider the panel’s recommendations. If a full review is undertaken, the entire process from HOSC submitting its referral to a Secretary of State decision will take approximately six to eight months. ANDREW OGDEN Director of Law and Personnel

13/03/08

Nick Yeo leaves East Sussex Downs and Weald and Hastings and Rother PCTs

Press Release 10th March 2008 Nick Yeo appointed as Chief Executive of Hampshire Partnership NHS Trust Nick Yeo, the Chief Executive of East Sussex Downs and Weald and Hastings and Rother Primary Care Trusts (PCTs), has been appointed as Chief Executive of Hampshire Partnership NHS Trust which provides services for people with mental health needs and people with learning disabilities. Nick will be taking up his new post in the summer. Since joining the East Sussex PCTs in October 2006, Nick has overseen their development under a single senior management team. Nick will be leaving both trusts well on the way to delivering ambitious plans for improving health and healthcare for their respective populations and in stronger financial positions, with both balancing the books in 2007/8. In announcing his departure, Nick commented “It has been my privilege to be involved in the development of the local NHS within East Sussex. During my time here I have received great support and cooperation from across the local area, for which I am grateful.” “I believe that both trusts, working with staff, partners and the local community, are well placed to develop services and improve the health and wellbeing of the local population in the years to come. I will be leaving to take up an appointment working with some of the most disadvantaged groups in our society and whilst I will be very sorry to leave colleagues within East Sussex, I am looking forward to the important challenges ahead.’ Nick was heavily involved in the public consultation on the future of maternity, in-patient gynaecology and special care baby services in East Sussex which culminated in a decision by the primary care trust boards in December 2007. The East Sussex Health Overview and Scrutiny Committee (HOSC) has now referred that decision to the Secretary of State for Health for independent review. John Barnes, Chairman of East Sussex, Downs and Weald PCT, said “I am grateful to Nick for the considerable work that he has undertaken in moving NHS services forward in the local area. This includes his leadership in setting up the new primary care trusts and building a strong senior team to work across both organisations. We shall be very sorry to lose him but wish him well in the demanding task he is undertaking.” “As a result of the work done in the last eighteen months we have re-established financial control within East Sussex Downs and Weald PCT. This gives us a platform to make real progress in the months and years ahead.” Chairman of Hastings and Rother PCT, Charles Everett, added “Nick leaves the new Hastings and Rother PCT in a strong position.  He will be missed and I am sorry to see him go, but we wish him well for the important work he will now be undertaking within Hampshire. He leaves us with well established and ambitious plans for improving health services in Hastings and Rother.” Nick Yeo has given a commitment to support his successor in particular to ensure that the Independent Review Panel for the recent consultation on maternity services has all the evidence necessary for its work following the decision of the HOSC to refer the issue to the Secretary of State for Health. The primary care trusts are currently finalising the arrangements for appointing Nick’s successor.

04/02/08

HOTC have issued a press release to the media regarding the HOSC decision (see below) - please click here to read it in full.

As the new press release is on the home page, the HOTC response to the PCT decision to proceed with Option 4 has been moved to the Editorials section - please click here to read it.

31/01/08

Fit for the Future: HOSC decision and referral to Secretary of State

HOSC met on 28th January 2008 to consider the PCTs’ decision on the Fit for the Future. I am pleased to confirm the outcome of the meeting. HOSC agreed the following:

1. To support the PCTs’ decision to improve ante and post-natal care and associated outreach services as there is strong evidence that this is in the best interests of health services for East Sussex residents.
2. That the PCTs’ decision to establish a single obstetric unit in Hastings and a midwife-led unit in Eastbourne is not in the best interests of health services for East Sussex residents.
3. That HOSC will refer the PCTs’ decision to the Secretary of State subject to 3 conditions:
• The improvements to ante and post natal care being excepted from the referral.
• The PCTs’ being given the opportunity to respond to HOSC’s agreed position
• The PCTs’ response confirming their intention to proceed with implementing their decision or no response being received from the PCTs within 28 days.

The main reasons for HOSC’s decision to refer the PCTs’ decision to the Secretary of State were agreed as follows:

1. Evidence relating to the impact of longer travel times to the obstetric unit on the safety of women and babies.
2. Evidence of safety concerns relating to the distance of the midwife-led unit from the consultant-led unit and questions over whether this is the best configuration for midwife-led care.
3. A lack of convincing evidence that patient outcomes will be improved with a single site configuration for consultant-led care.
4. Evidence that there may be a reduction in choice due to the geography and the proposed configuration of services, which may be compounded in areas where there is significant deprivation
5. Evidence that possible alternatives which could maintain services on two sites may not have been fully explored and considered.
6. The divergence of clinical opinion on what configuration of maternity and obstetric services will be best for the residents of East Sussex.

HOSC has invited the PCTs to respond to the Committee’s decision and to confirm whether or not the PCTs intend to proceed with the decision made by the joint boards on 20th December 2007. As mentioned above, HOSC requested a response within 28 days and if no response is received, the Committee will proceed to make the referral to the Secretary of State for Health

Stephen Springthorpe, Independent Councillor for Silverhill, has made available his comments to this decision - please click here to read them.

22/01/08

East Sussex Health Overview and Scrutiny Committee , Monday 28^th January 2008

An East Sussex HOSC (Health Overview and Scrutiny Committee) has been called on the 28th January to discuss the PCT’s proposals. Both Margaret (HoTC) and Liz (Save The DGH) have been invited to contribute documents and attend the meetings.

Reproduced here is the letter from Councillor Sylvia Tidy inviting their contributions:

10th January 2008

HOSC is meeting on the 28^th January to consider the East Sussex PCTs’ decision on the Fit for the Future proposals (for single consultant-led maternity, special baby care and inpatient gynaecology units in Hastings and a midwife-led maternity unit in Eastbourne) and the response to HOSC’s recommendations published in October 2007.

The process to be followed at the meeting will be set out in the agenda to be published on 18 January but one of the key tasks for HOSC at the meeting will be to decide whether the PCTs have adequately assessed the alternative options, in line with HOSC’s recommendation that a full assessment of all proposals should be carried out prior to PCT decision making.

As one of the proposers of an alternative option, HOSC would like to give you the opportunity to provide a summary of your views on the PCTs’ assessment of your proposed option, specifically addressing the following points:

• Whether you agree that the PCTs have undertaken an adequate assessment (in comparison to their own options) of your proposal(s) and your specific reasons/evidence for this opinion.
• If you do not believe the assessment was adequate, the specific aspects of your proposals where you believe the assessment is inaccurate or incomplete.
• Whether you had opportunities to provide input to the assessment process (for example, clarifying the nature of your proposal) and the opportunity to comment on the final assessment of it.

Due to the volume of evidence HOSC has to consider, please limit your response to a maximum of 2 sides of A4 addressing the specific points above which HOSC will be considering on the 28^th.

I would also like to invite you to attend HOSC on the 28^th to give HOSC members the opportunity to ask questions to clarify the points you make in your paper. If you would like to take up this opportunity, please contact [name removed]

Please could you let us have your 2 sides summary by 12 noon on Thursday 17^th January 2008 so that the paper can be included in the agenda pack sent out to HOSC members and witnesses within the statutory deadline. It would also be helpful to know if you do not intend to submit a response.

Regards

Councillor Sylvia Tidy
Chairman
Health Overview and Scrutiny Committee

~

Margaret (HoTC) has put forward the following to the HOSC meeting

EAST SUSSEX HEALTH OVERVIEW AND SCRUTINY COMMITTEE
MONDAY, 28^TH JANUARY 2008 AT 3.30PM

SUMMARY OF VIEWS FROM HANDS OFF THE CONQUEST CAMPAIGN
WITH REGARD TO OPTION 5

Firstly may I thank HOSC for giving us this opportunity for comments to address the following points:-

Whether you agree that the PCTs have undertaken an adequate assessment (in comparison to their own options) of your proposal(s) and your specific reasons/evidence for this opinion.

Our answer to that is an unequivocal NO.

• We have asked since the beginning of the consultation for risk assessments on Options 1-4.  These have never been forthcoming.  We even asked in December 2007 with no reply. Therefore, we do not believe any adequate risk assessments have been carried out for Options 1-4 and that being the case no adequate risk assessment can have been carried out for Option 5.
• The New Assessment Panel only came into being after other Options (other than Option 5) started to appear.  Up until that point Option 5 was going to be assessed by the PCT within 3 weeks of the start of the consultation. This was never done.
• Although the public heard about Option 5 (one campaigner was allowed on the PCT panel at public meetings)  there was never anywhere for the public to comment on Option 5, only Options 1-4. The PCT then decided in their results not to include any Petitions or Voting Forms.  We believe that since people put names and addresses this should have been regarded as a comment.
• We do not believe that adequate financial risk assessments have been carried out.  The costings for Options 1-4 were extremely late, and we have never received detailed costings of Option 5.
• There were 5 Criteria used by the PCT

a) Clinical Effectiveness  b) Health gain and demographics
c) Sustaining two viable hospitals  d) Access and Choice  and
e)   Financial viability

a) We do not believe single siting to be clinically safe.  This is the main concern of GP’s in both Towns.

b) We do not believe there is any health gain in single siting.

c) We do not believe two viable hospitals are able to be sustained when removal of an emergency core service will result in the domino effect. Paediatrics must follow consultant led obstetrics and SCBU.

d) We do not believe there is more accessibility or choice in fact with believe that the reverse is true.

e) All Options cost more, and with the right staffing levels a two site option is financially viable.

If you do not believe the assessment was adequate, the specific aspects of your proposals where you believe the assessment is inaccurate or incomplete.

1. When, towards the end of the consultation the New Assessment Panel was created with Professor Field as the “independent chair”, we were not allowed direct access to him.  We could only contact him via the PCT.
2. In order for a full assessment to be made it was essential that our medical experts had direct and constant contact with Professor Field in order that any queries could be discussed. This did not happen.
3. The PCT, not the campaigners, decided to split Option 5 into Option 5a and 5b. We were not aware of this until the next meeting with Professor Field.  We were never given the opportunity of revoking this or even deciding whether this was a way forward, and this then resulted in complete confusion among all interested parties.
4. Although I have an email from the Chief Executive Nick Yeo stating that the East Sussex Hospital Trust would be able to consider Option 5 at their recommendation meeting in July this was not done.  I attended that Board meeting only to be told that on instructions from the PCT only Options 1-4 could be considered.

Whether you had opportunities to provide input to the assessment process (for example, clarifying the nature of your proposal) and the opportunity to comment on the final assessment of it.

1. We had very little opportunity to provide input into the assessment process since the meetings with Professor Field always took place at a time which was most inappropriate to our medical advisors. They are full time working people looking after the public and are not able to simply leave their surgeries in order to comply with meetings arranged by managers.
2. Although the Assessment Panel was supposed to be made up of two campaigners, or medical advisors and two PCT representatives,  every time Michael Wilson was there to “take notes”.  However, although the campaigners were not allowed to participate, Michael Wilson frequently did, therefore the Terms of Reference were broken.
3. No minutes of the meetings were received by campaigners.
4. We have never had any opportunity to comment on the final assessment and have no knowledge of what the final PCT assessment was or how the conclusions were reached.  The last we knew was receipt of Professor Field’s Final Report in July.  We have not been approached by the PCT for any input into the assessment since then.

We have been asked to keep this statement brief, however should you require any evidence to support any of the above statements they can, of course, be made available to you. We would ask all members of HOSC that if you have the slightest doubt that the decision reached is the right one, then you should refer the matter to the Secretary of State for Health or the Independent Review Panel.

Margaret Williams  (Chair, Hand Off the Conquest Campaign)

Archived News can be read by clicking on this link