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Big interview: Elizabeth Gill, Chairman of High Weald Lewes and Havens CCG
5:00am Sunday 15th December 2013 in News
THE ARGUS (TA): Can you explain the reasons why the review was held?
Why can’t things continue as they were at the start of the year?
ELIZABETH GILL (EG): We conducted this review to address long-standing problems in maintaining safe and high quality services over two consultant-led sites in Eastbourne and Hastings.
There are national and local problems recruiting and retaining trained staff in these specialisms which has made it difficult to consistently provide safe services locally.
The CCGs decided to review maternity and paediatrics a long time before the temporary changes in May this year, but this did increase the urgency on us to do something about it and find a long-term solution. As practicing local GPs we cannot tolerate a system which has seen too many women and babies placed at risk of serious harm in childbirth.
TA: Can you summarise the six options being considered?
(EG): We are committed to providing two midwife-led birthing units, a consultant-led maternity service, an overnight paediatric ward and two short stay paediatric assessment units.
There are six ways this can be arranged over our hospital sites in Eastbourne, Hastings and Crowborough.
The most significant difference is that we are not proposing to return to a twosite model for consultant-led maternity, in-patient paediatrics and emergency gynaecology, because we do not feel services can be safely sustained in this way.
TA: Why can’t having consultant-led maternity services (obstetric) at both Eastbourne District General Hospital and the Conquest Hospital in St Leonards be an option?
(EG): The units on their own are too small and there are not enough specialist staff to maintain consultantled maternity services safely over two sites. This is a national issue and you will find many other smaller consultant-led services across the country being reviewed in the same way.
Locally there were some very worrying safety trends which thankfully have been brought under control by the temporary changes in May. As GPs we cannot continue to expose local women and babies to these risks. We are aiming to find a permanent solution that provides safe and high quality services for local families into the future.
TA: Similar changes to maternity services were proposed in 2006/7 by the former primary care trusts and they were subsequently overturned by the then Health Secretary in 2008 on the grounds that it would leave women with less choice and longer distances to travel. What has changed since then to lead the CCGs down a similar path?
(EG): There has been significant investment and effort since 2008 to maintain the two-site model. Despite best efforts, East Sussex Healthcare NHS Trust has not been able to fully implement the recommendations made at the time, mainly because it has continued to experience problems recruiting and retaining staff. As a result the problems in maintaining this configuration of services have continued and the concerns around safety have increased. There are a whole range of safety and quality measures which we have not been meeting locally and that is not good enough.
TA: Why do paediatric inpatient services need to be based at only one of the two hospitals? Won’t that put children at risk?
(EG): We did review these services independently but have concluded that they should be situated at the same location to reflect the critical links including the special care baby unit and neonatology services.
The vast majority of children attending hospital do not require an overnight stay. We would continue to have a short stay paediatric assessment unit for emergency and planned care for children at both Eastbourne and Hastings. There is no evidence to suggest this model would present any additional clinical risks to children.
TA: Will the CCGs be considering the transport issues that may spring up as a result of the changes? Not everyone has access to a car and may need to rely on public transport?
(EG): The ability for the public to access services is one of the criteria against which we will assess these options and we are keen to discuss this more widely with the public, transport providers and the local authority as part of the consultation we are anticipating in January.
TA: Will the changes save money?
(EG): This is about improving the safety and quality of services for local women, babies and children. This is not about saving money. The financial implication of the models will have to be considered but money is not and never has been a driver in this review.
TA: What feedback have you had from doctors, nurses and other workers who will be affected by the changes?
(EG): We engaged widely with the public, clinicians and staff affected in developing these options. Staff are keenly aware of the challenges we have faced in providing these services and are generally positive about the options because they recognise the need to improve safety and quality.
We will continue to engage with staff during the consultation period to explore the challenges and opportunities presented by the various options.
TA: How will members of the public benefit from any changes that are made?
(EG): Our aim is to develop a model where women have a choice of safe birthing services which meet national and local standards for safety and quality. This has not always been the case in East Sussex. As local GPs, we feel passionately that local women and children deserve the best and safest possible NHS services, and we are determined to provide them.
TA: How will people be able to make their views known about any proposals put forward and how will their opinions be taken into account?
(EG): The options will be considered by East Sussex County Council’s health overview and scrutiny committee (HOSC) on January 10. HOSC will consider whether the options represent a substantial change to local services and should therefore be subject to formal public consultation.
We are planning to launch a 12-week programme of formal public consultation, providing many opportunities for the public to find out more and have their say. I would urge people to keep an eye on our websites, follow us on Facebook and Twitter and look out for our consultation materials when they are published.
TA: What are the next steps and when are any changes likely to take place?
(EG): We are aiming to make a final decision of the best option and locations for these services in the summer, after considering the feedback from public consultation. We will aim to implement whichever option we decide upon as soon as possible.
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