Agenda item

To consider a report of the Head of Scrutiny and Member Development on proposed changes to the patient pathways for Major Trauma across Yorkshire and the Humber

(report attached)

The Board considered a report of the Head of Scrutiny and Member Development providing background information around proposals to change existing local patient pathways for accessing Major Trauma services across Yorkshire and the Humber. 

The Board also considered written submissions from NHS Yorkshire and the Humber and Leeds Teaching Hospitals NHS Trust.

It was proposed to establish 3 sub-regional Major Trauma networks across the region, including designated Major Trauma Centres (MTC), with Leeds Teaching Hospitals NHS Trust (LTHT) due to become a designated MTC for West Yorkshire from April 2012.

The Board welcomed the following representatives who attended for this item:

·  Tim Barton (Strategy Lead) – NHS Yorkshire and the Humber

·  Matt Neligan (Executive Director Commissioning Development) – NHS Airedale, Bradford & Leeds

·  Helen Barker (Divisional General Manager, General Surgery) – Leeds Teaching Hospitals NHS Trust 

·  Karl Milner (Director of Communications and External Affairs) – Leeds Teaching Hospitals NHS Trust

·  Dr Jeff Perring (Director for Paediatric Intensive Care Unit (PICU) and Medical Lead for Embrace) – Sheffield Children’s Hospital

·  Alison Hollett (General Manger, Critical Care Directorate (which includes Embrace)) –  Sheffield Children’s Hospital

·  Dr David Macklin (Associate Medical Director) – Yorkshire Ambulance Service (YAS)

It was reported that major trauma was not a common occurrence and the total number of major trauma patients across the region was relatively small.  Nonetheless, the proposed changes were aimed at improving outcomes and the quality of life for patients.  It was also highlighted that the proposed network approach and designation of MTC reflected the available evidence in terms of outcomes for patients.

Representatives from Leeds Teaching Hospitals NHS Trust (LTHT) reported that there were some funding issues still to be resolved, which were a result of the patient number modelling/ assumptions used to date.  It was outlined that this was not an isolated issue for the Trust and reflected the national position.  However, it was stated that a phased implementation was proposed, which would allow more detailed analysis of patient numbers and subsequent implications for the Trust. 

Representatives from Yorkshire Ambulance Service (YAS) outlined it would be implementing a triage programme, to help in the assessment and appropriate assignment of major trauma patients across the network.  It was stated that there was some nervousness around the potential volume of patients, but it was believed that the proposed phased implementation would result in a smoother transition to the new arrangements.

It was reported that the full impact on provider organisations, including LTHT, YAS and Embrace was difficult to predict at this stage.  Nonetheless, the proposed phased implementation would provide an opportunity to capture actual numbers and therefore help to better describe the proposals. 

LTHT outlined that current plans were based on a maximum of 521 additional patients.  However, it was reported that this would result in little change for trauma patients within the Leeds boundary.

The Board discussed the proposals in more detail, with the following issues highlighted:

·  LTHT leading the sub-regional network, with monthly network meetings.  Consideration was also being given to rotating medical staff, to help maintain skills within units and across the network.

·  The role of YAS in a major incident and helping to direct patients to an appropriate site within the capacity limits of individual units;

·  LTHT was set to operate a 26-bedded trauma ward with an improved rehabilitation service for patients;

·  Work was progressing to resolve the potential funding gaps likely to arise as a result of the national tariff and shift in activity across individual units;

·  Commissioners and providers were working together to ensure the stability of services.

In summarising the discussion, the Chair thanked all those in attendance and proposed that, following the first phase of implementing the proposals, a further report be presented to the Board in the new municipal year that would provide a more detailed analysis of the arrangements, patient numbers and associated implications.

RESOLVED –

(a)  That the information presented be noted and the representatives in attendance be thanked for their contribution to the discussion;

(b)  That a further report, providing more detailed analysis of the arrangements, patient numbers and associated implications, be presented to the Board in the new municipal year (Autumn 2012).

Cllr. W Hyde rejoined the meeting during discussion of this item at 11:45am (approx.)