Saving more lives Information and Consultation Meeting Improving services for Emergency Medical Patients Information and Consultation Meeting

Issues for today The changes we are making Why we are making them The changes we could make The consultation process and the next steps

What are we talking about? What is emergency (acute) medicine:- types of illness and doctors, how it has evolved, the future? How do we do it now

Current emergency medical services Heatherwood Wexham c.12 medical emergency patients per day, mainly GP referrals. Limited capacity c.27 medical emergency patients per day, mainly 999s Selected patients only; unable to admit the most acutely ill medical emergency patients. Able to admit all medical emergency patients; already admits many ‘Heatherwood residents’ Limited range of investigations, facilities and specialists; transfers to Wexham Specialist facilities such as Intensive Care Unit, A&E, Coronary Care Unit No emergency surgery 24 hour surgical support

Why do we have to change? Best practice – Admission to a specialist centre for the most acutely ill patients, with: Highly trained staff who deal with a high volume of patients The right kind of equipment and facilities Training accreditation – Withdrawn for medicine at Heatherwood from August 2009 onwards (April 2009 visit) European Working Time Directive

Right Care Right Place Consultation 2008 Hospitals will change but no plans to close any local hospitals More outpatients in the community – e.g. Bracknell Healthspace Urgent Care Centres: Bracknell, Wexham and Minor Injuries pilot at St Marks (Heatherwood Minor Injuries unchanged) Improving care for stroke & heart attack patients: thrombolysis for stroke & angioplasty for heart attacks in line with national clinical guidance (Not possible to provide this at Heatherwood)

High Quality Care for all Principles: Lives will be saved if trauma care, heart attacks and strokes are treated in more specialised centres Changes should be locally led, patient centred & clinically driven Planned care and outpatients should be more local Technology allows more & more day and short stay surgery

For information Changes from August All emergency medical patients to Wexham Park (or Frimley Park or Royal Berkshire Hospital) instead of Heatherwood Overall no reduction in beds across sites Retention of all current outpatient clinics and range of tests at Heatherwood

Wexham Park Hospital Other benefits and service improvements More medical staff at Wexham Park will enable us to offer : Direct admission to the Coronary Care Unit Direct admission to the Acute Medical Unit, bypassing A&E Enhanced senior doctor cover over the weekends Compliance with the European Working Time Directive for Junior Doctors Hours Continued top quality accredited training for all junior medical staff Enhanced stroke unit

For consultation Additional services proposed for Heatherwood Consultant led Rapid Assessment Clinic for patients who may not need admission. Rehabilitation ward for patients recovering from a medical emergency Medical Investigations Day Unit for patients who need planned day treatment for investigations/procedures More planned cardiology procedures for local residents Centralisation of the Trust’s pain management service at Heatherwood Land made available for a permanent GP Practice on the site, subject to PCT support

Heatherwood and Wexham Park Foundation Trust 2009 onwards A single unified Trust Two hospital sites Community services in local towns Ever evolving and continuously improving clinical services

Heatherwood Hospital Future focus on planned care £2m for new Orthopaedic theatre & theatre refurbishment by November More Orthopaedic surgery especially foot & ankle surgery New Urology diagnostic centre in Ward 5 including biopsies At least 70% of Oral Surgery and 80% of Plastic day surgery at Heatherwood Options to transfer some Cardiology procedures and Medical Investigations Day Unit from Wexham (for Ascot/Bracknell residents)

Wexham Park Hospital Focus on emergency & acute care Emergency medicine and surgery Acute stroke & heart attack treatment Consultant obstetrics & maternity including special care Day, Short Stay Surgery & higher risk surgery Intensive Care & high dependency respiratory care Coronary Care & Cardiac Catheter Laboratory Diagnostics, outpatients & rehabilitation Accident & Emergency Care Additional ward space for transferred Heatherwood Medicine service

Information & Consultation Legal advice taken following Deanery changes, two separate processes recommended Information giving exercise where Trust has no choice (emergency medical patients from Heatherwood to Wexham & other hospitals) Consultation exercise for areas where Trust can offer genuine options (additional services for the Heatherwood site)

Process Engagement Jan 08 – April 09 Process plan Launch formal ‘Information & Consultation’ document on 5th May 2009 Questionnaire in consultation document with freepost envelope and available online External market research company to run feedback analysis to ensure independence (Synovate)

Process Engagement plan incl Close 13 July 2009 10,000 documents plus posters and flyers 10,000 letters to Trust members Advertising in papers and radio Libraries, GP’s, hospitals 10 public meetings MP’s briefing LA CEO briefing Councillor briefing Close 13 July 2009

Public meetings: full details in the document 26th May, 10.00 Bracknell 27th May, 19.00 Windsor 28th May, 14.00 Ascot 3rd June, 14.00 Slough 9th June, 19.00 Ascot 11th June, 19.00 Maidenhead 16th June, 19.00 Denham 18th June, 14.00 Windsor 23rd June, 14.30 Maidenhead 25th June, 19.00 Bracknell 17

Next Steps Public, stakeholder and OSC responses Final response date:13th July 2009 Independent analysts report Final report including decisions approved Changes implemented Public meeting within 3 months

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