All is not-well for Bridlington Hospital

The two public consultations that started last December one looking at the future of Bridlington Hospital, the other at Trust-wide maternity services - are now almost complete, and the Trust Board will consider the recommendations at its meeting next Tuesday.

With regard to Maternity , the recommendation to the Board is that facilities be created at Scarborough Hospital that will provide wider choice to a greater number of women across our entire area.

Chief Executive Iain McInnes said, This consultation set out to identify how we could provide safe, sustainable and equitable maternity services across the Trust. By providing a modern, fully-equipped home-from-home unit next to our maternity department, we ll fulfil all these requirements. We are recommending this approach, based on expert independent clinical advice, to ensure mums to be have more choice and better care.

It is our view that women will then feel confident in choosing a low-intervention, midwife-led natural birth, secure in the knowledge that, if anything unforeseen were to happen, they are literally just seconds away from epidural relief, specialist medical care, or a dedicated obstetric theatre. Far more women will have real choice, and we believe that it will be a safer, more popular service for the great majority of our residents. Crucial to the recommendations are clinical comments made by Professor Arulkamar - a close colleague of Sheila Shribman, national Tsar for maternity services - who visited the Trust last month and met with midwives from all Units. Following the consultation with patients, the public, staff and national clinical experts, a decision was reached that the greatest benefit to the most women would be provided by a fully-equipped central unit, adjacent to the main maternity department. The range of facilities in the new unit, including birthing pool, en-suite facilities, and accommodation for partners, and its proximity to the consultant-led unit, will make it a safer and more appealing option for mums-to-be who may be reluctant to give birth twenty miles from access to medical intervention should it become necessary.

Presently, women in Bridlington, Whitby and Malton can, providing they meet safety criteria, access the existing, small midwifery units, which provide no medical cover or access to epidural pain relief. Scarborough women currently have only the option of either a home birth or delivery in the acute environment of the main, consultant-led unit.

By developing a dedicated midwife-led unit on the Scarborough site, available to mums from across the area, not only will everyone eligible have the possibility of a birth without medical intervention, but proximity to the main maternity department will make this an attractive option for far more than the 150 or so women (of a total of around 1750 births per year) who currently choose a midwife-assisted birth.

On the future of services at Bridlington Hospital:

Following extensive public consultation and a visit by Professor Sir George Alberti, the UK s Emergency Care Tsar, the Board will consider plans for a new service to be introduced that will give Bridlington residents rapid access to the best quality emergency care.

Based on independent expert clinical advice, the board report recognises that, whilst the current configuration of services is not sustainable on the grounds of safety and quality, it is nevertheless appropriate to develop a plan for Bridlington which will identify the range of acute medical services that can safely be provided locally.

The emergency clinic will be modelled on the very successful Acute Physicians Unit now running in Scarborough. This ensures that patients who come to the hospital as emergency admissions are quickly assessed by highly experienced consultants. Experience at the Scarborough Unit has shown that this approach leads to a more appropriate range of tests, obtained more quickly, and a more confident and accurate diagnosis. As a result, fewer patients are admitted unnecessarily, and can instead be allocated appropriate alternative care, resulting in a better quality of care for the patient and better use of hospital beds. Said Iain McInnes, This approach is proven to ensure that patients are only admitted when it is in their best interests. It avoids local people having to be admitted and then waiting for test results, only to be sent home without needing treatment. By using consultants from Scarborough to support our Bridlington-based doctors we can improve care for local people.

An assessment unit for older people is also proposed. This would provide services for patients referred by their GP who may not necessarily require an overnight stay, but for whom GPs want a specialist opinion. The independent experts concluded that these developments are crucial to ensuring the Hospital s continued accreditation for training junior doctors, which we are unlikely to retain unless changes are implemented, but which is vitally important in order to provide good quality patient care and medical cover. Professor Alberti will continue to participate actively in planning the future of emergency care at Bridlington Hospital, whilst Roger Boyle, Cardiology Tsar, is to visit so that he can contribute to discussion around the provision of cardiology services across the Trust.

The Board will decide at its meeting next Tuesday 26 June 2007 if it should accept the recommendations of the report.