Central Lancashire is likely to be served by a single Accident and Emergency unit under a plan to be put to the the public early next year.
A ring-fenced facility for pre-planned procedures and treatment is also expected to be set up to reduce the risk of operations being cancelled when there is an influx of emergency cases.
And two urgent care centres will continue to operate in the area to see patients with minor injuries and illnesses.
The proposals are the culmination of a two-year project to reorganise NHS services across Preston, Chorley and South Ribble, under the banner of “Our Health, Our Care” (OHOC).
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Information and engagement events have been held during the process, but a formal public consultation on the changes is now expected to begin in January 2019.
“We have consulted widely with a whole range of clinicians, staff and residents to develop a model of care,” said Dr. Geraldine Skailes, Medical Director at the trust which runs the Royal Preston and Chorley and South Ribble Hospitals.
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“We are very close to finalising [that model]. The main thing that will be consulted on...will be the configuration of services.”
And Dr. Skailes denied that there was little point in asking the public for its say if the overarching plan had already been decided.
“When we get to [the point of consultation], there will be a number of different options that we can present to the public for consideration,” Dr. Skailes said.
Proposed locations for individual services have yet to be put forward. But a draft document - based on work by six senior clinicians - reveals a focus on one emergency and major trauma centre, “delivering high quality emergency medical care 24/7”.
The Accident and Emergency department at Chorley and South Ribble Hospital has been operating for 12 hours a day for over eighteen months - and was closed completely, because of doctor shortages, for much of 2016.
Lancashire Teaching Hospitals NHS Foundation Trust currently has vacancy rates ranging from 10 to 23 percent across all grades of doctor employed at its two hospital sites. The overall vacancy rate amongst doctors stands at over 13 percent.
“We know that at the moment we are running two acute hospitals and are duplicating a number of our services across the two sites,” Dr. Skailes said.
“The new model will allow a degree of consolidation so we have one workforce that is able to concentrate on providing that high quality care in one place.”
Another plank of the proposal would see the creation of a planned care centre, whose wards would be “protected” from bed pressures elsewhere in the hospital system.
That could prevent the wholesale cancellation of operations which have been a feature of recent winter crises across the NHS.
Dr. Skailes - who took up her post in May - admits that finances are a factor in the proposed changes, but insists “high quality care for patients is our primary driver”.
“If we can work more efficiently, that happens to be more cost effective as well,” she added.
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OHOC is one of five partnerships across the health and social care sectors throughout Lancashire and South Cumbria.
Together, they make up an Integrated Care System (ICS), which identified a funding gap of £572m that would open up by 2021 - if no changes were made to the way health and social care is delivered in the region.
The ICS is also charged with better integrating health and social care, an aspiration which Dr. Skailes says is more than just a mantra.
“It’s absolutely crucial to the success of the model.
“One of the areas that we have struggled with is making sure that we do things once for patients, so we are working together to look at their social and care needs as well as their health needs.
“And if we are able to do that effectively, we are much more likely to be able to manage a patient’s needs as close to home as possible.
“I genuinely do see it will come to fruition,” Dr. Skailes said.
HAVE YOUR SAY
When the proposed changes to the NHS in central Lancashire are confirmed, they will be subject to formal public consultation. That is expected to happen in January 2019.
But residents can now have their say on what might be put on the table by completing an online questionnaire - surveymonkey.co.uk/r/ourhealthourcarefeedback
WHAT THE DRAFT PLAN PROPOSES
A single site for emergency and specialist care, including:
***A major trauma and emergency department.
***A centralised critical care unit.
***An acute care hub, including medical assessment unit and short-stay ward.
***Location for emergency surgery and high-risk pre-planned operations.
***An on-site urgent care centre for minor injuries and illnesses.
A planned care centre, including:
***High-volume unit for pre-planned operations with “protected” capacity to reduce the risk of cancellations.
***Enhanced theatre and treatment facilities.
***Frailty assessment unit.
***A second urgent care centre.
SUPER HOSPITAL NOT A PANACEA
A super hospital in central Lancashire will not solve the short-term challenges faced by the NHS in the region, according to a senior medic at the trust which runs the Royal Preston and Chorley and South Ribble Hospitals.
Dr. Geraldine Skailes, Lancashire Teaching Hospitals’ Medical Director, says a new facility could be on the horizon, but that the immediate pressures facing the system still need addressing.
“Our current proposals are looking at making our services safe and effective over the next few years. We are working closely with other localities [across Lancashire and South Cumbria] to consider whether the longer-term future should be a new hospital.
“Those plans are not yet well-formed, but we are actively working to see whether that would be an option for the future.”
The idea of a super hospital has been mooted for several years, but would require funding and approval from the Department of Health.