Nick Herbert welcomes PCT's re-think on hospital A&E services

Arundel & South Downs MP Nick Herbert has welcomed a re-think by the West Sussex Primary Care Trust on its plans to downgrade Accident and Emergency services at local hospitals.


Under the PCT's ‘Fit for the Future' proposals, two out of the three A&E departments at St Richards Hospital, Worthing Hospital and the Princess Royal Hospital at Haywards Heath were set to be downgraded.

But following a public outcry over the proposals, the PCT has reconsidered its plans.  Accident and Emergency services are now likely to be retained at all three acute hospitals in West Sussex - although the majority of trauma cases and emergency surgery will be centralised onto one site.

The change would reflect the controversial ‘Best Care, Best Place' re-organisation, under which emergency surgery and trauma cases are now transferred to Brighton from the PRH, which nevertheless retains a consultant-led A&E department.

However, celebrations over the partial reprieve of A&E services will be tempered by news that the PCT still plans to centralise maternity services at one hospital.

The PCT will meet in Pulborough on Thursday to consider the results of its public consultation on ‘Fit for the Future' and to consider new options put forward during the process.

The PCT says that it received 328,000 responses to its consultation, including through petitions.  Two key messages arose: there was no support from the public or clinicians for the model that would see Princess Royal Hospital as a community hospital, and A&E departments should stay on all three hospital sites.

Papers prepared for Thursday's Board ask it "to take serious note of the issues raised and the concerns expressed.  As a result of public consultation, some of the proposals will be revised and additional initiatives put in place through the Implementation Programme to address many of the concerns expressed through the consultation process."

The Board of the Brighton and Sussex University Hospitals Trust has already announced in November that it wants to retain A&E services at the Princess Royal Hospital.

It now seems likely that A&E services will also be retained in some form at both St Richards and Worthing Hospitals.  The move follows consideration of new proposals put forward by local clinicians.

Sir Graeme Catto, President of the General Medical Council and independent chair of the PCT's Options Assessment Panel, has been shortlisting options put forward during the public consultation, which closed last November.

Under the PCT's original models of care, only one hospital in West Sussex would have had full consultant-led A&E services.  The other two hospitals would have had downgraded urgent treatment centres or minor injuries units.

The PCT's Board is now asked to take "particular account" of a new model which will allow all three hospitals to retain consultant-led A&E services.  However, one hospital, either St Richard's or Worthing, will become a Major General Hospital, and maternity services are likely to be centralised onto this site.

Medical Directors at all three hospitals have backed the new model.  In a statement ahead of Thursday's Board meeting, the Clinical Reference Advisory Group Steering Group

"... recommends that A&E services, intensive care, routine elective surgery and acute medicine should be maintained at all three hospital sites (Princess Royal, St Richard's and Worthing), alongside - for the south coast - a staged centralisation to one hospital site of consultant-led maternity services, inpatient children's services, the majority of trauma cases and emergency surgery.  This centralisation would be to either St Richard's Hospital or Worthing Hospital."

Eight criteria will be used in the decision over where the centralised services will be located.  These include the key issue of accessibility, which was omitted from the original consideration.

The PCT plans to decide on the model of services by 7 May this year, and on the location of centralised services - that is, which of St Richard's or Worthing will become the Major General Hospital - by early June.  It anticipates giving a clear decision by the beginning of July.

The PCT Board is also likely to agree that a review of services provided in the North East of the County should be undertaken.

The Board will also hear that improved financial performance this year means that the PCT is expected to break-even in 2007/08.  It also expects to receive more income in the years ahead than it originally planned.

Nick Herbert commented: "At last the PCT has listened to the views of local people.  The news that A&E services are likely to be retained at all three hospitals will be welcome, provided that they are essentially the same level of services as are provided now.

"A year ago we were told that deficits meant that a downgrading of services was inevitable.  Now the financial outlook has changed, and the folly of excluding the all-important issue of accessibility of services has been recognised.

"However, major questions remain.  Local people will take a lot of persuading that it's acceptable to have one consultant-led maternity unit for West Sussex, even if there are midwife-led units at the other hospitals.  The PCT will have to explain why there is a case for centralising maternity services but not A&E.

"Inevitably the communities of Worthing and Chichester will want their hospital to be the one which becomes the Major General Hospital, which will be very divisive.

"The PCT should take Sir Graeme Catto's advice and drop the unnecessary and confusing labelling of hospitals, which only encourages division.

"The PCT will also need to spell out very clearly exactly what level of A&E services will be retained at each hospital.

"Nevertheless, this does appear to be a significant step in the right direction."



Notes for Editors

1. The Board papers for the West Sussex PCT on Thursday 14 February can be seen at

Alexander Black