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

2. 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

3. 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

4. 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

5. 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Training accreditation – Withdrawn for medicine at Heatherwood from August 2009 onwards (April 2009 visit)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

6. 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)

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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)

13. 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

14. 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)

15. 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)

16. 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

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

18. 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

19. Thank you