Professor's Reply To Removal of CMU & Acute Medical Services From Bridlington District Hospital From Public

Dear Mrs Featherstone

First of all my apologies for not responding sooner to your very detailed and heartfelt email of of 5 April. 

I am of course a great supporter of local hospitals.  However as a clinician I am very keen that whatever is done is good quality and safe and good for patients.

I would say immediately that I see a secure and bright future for Bridlington Hospital.  However, I think it is inevitable and important that what happens in the hospital is somewhat different to the activities of today.

My main concern - and I think those of the local population - are for the people who are acutely ill and require emergency care.  I would stress that this amounts to 7 or 8 patients per day.  What someone with an acute medical emergency requires is a team of consultants available 24 hours a day with the appropriate expertise to deal with their problems.  For a heart attack, for example, we now know that people do best with so-called primary angioplasty provided that they can get to an appropriate hospital within 90 minutes.  If this is not possible, then thrombolysis, i.e. clot-busting, delivered by paramedics and delivery to a coronary care unit which has the support of an intensive care unit, cardiologists preferably around the clock, and anaesthetists is necessary.  This cannot be provided at Bridlington.  Unfortunately there is only one cardiologist and the number of cases of genuine heart attacks who are seen at Bridlington is insufficient to warrant supporting a large team of specialists and supporting staff.  It makes much more sense for patients to combine forces on the Scarborough site and indeed for quite a lot of people in the future to send them to the primary angioplasty centre in Hull for people living at the South end of the patch or even to South Tees. 

As far as other acutely ill patients are concerned, again one needs round-the-clock expert care.  Many of these are older people who require expert assessment rather than admission and I have suggested strongly that there be a consultant-delivered assessment service available for older people telephoned in by General Practitioners.  This will avoid several people a day going to Scarborough at all.  In the end therefore we are arguing about a very small number of people who will have safer, better quality care by going to Scarborough or elsewhere.

I am determined however that more people from the Bridlington area are looked after locally than at present.  I have suggested that we increase outpatient services so that people don't have to go so far to see a consultant for an appointment.  There will be increased amounts of day surgery and for those people who do go elsewhere for acute admissions, it is suggested that they be returned to Bridlington Hospital as soon as the acute episode is over, making it both pleasanter for them and more convenient for families.  We have also suggested running an assessment service, i.e. an ambulatory care service, for children on the Bridlington site.

I think there is a bright future for Bridlington but I think we also owe it to people like yourselves and the residents of Bridlington that you get the right treatment on the right occasion and that for very serious illnesses you may indeed be moving a bit further.  There is no evidence at all of people dying in the back of ambulances.  Paramedics are now much more skilled and treatment starts from the time they arrive at the patient's home.

Maternity care has been looked at separately and again it is a question of numbers of people. 

A final point concerns Accident & Emergency.  I have suggested strongly that the Urgent Care Centre be open around the clock, or at the very least from early in the morning until midnight so that only ambulance cases would go to Scarborough.

I hope these points provide some reassurance and certainly reasons for the decisions.  These are based on clinical principles, but do of course depend on capacity being made available to take the extra patients in Scarborough and really good community services.

I would be happy to discuss this further with you at any time.

Yours sincerely

George Alberti

Professor Sir George Alberti
Clinical Director for Service Reconfiguration

Emeritus Professor of Medicine
University of Newcastle Medical School
Newcastle upon Tyne
Tel. +44 191 222 6602
Fax +44 191 222 0723