UPDATE 1 – CCG & CHFT reponds to your questions

Over the past few weeks we have collected your concerns and questions regarding the proposed changes at Huddersfield Royal Infirmary and Calderdale Royal Hospital.

We sent these questions to the CCG’s and hospital trust management for them to answer.

See their responses below

Q1: People were concerned around the distance to travel to Calderdale, even in a blue light ambulance. This theme also included the amount of traffic during peak times, roadworks, potential flooding and road traffic accidents therefore additional time to Calderdale hospital could be a life or death situation. How much time could these factors this add to the journey?

A: Detailed Reviews of journey times have been undertaken by an independent specialist organisation and their report is included on the CCG website here. It shows that the changes in car journey times for the areas served by both hospitals are all likely to be between 15 and 20 minutes extra. The changes are similar whether patients have to travel to HRI instead of CRH or vice versa.

For blue light ambulances, the independent analysis we commissioned shows that the average journey time now for patients being taken by ambulance to their local A&E departments is 15.94 minutes, for a single Emergency Care Centre at CRH the average journey time would be 22.42 minutes compared to 21.58 minutes if the Emergency Care Centre was at HRI. This is well within the advised maximum journey time of 45 mins. Although the ambulance journey is a little longer, all of the specialist services needed would be available at the Emergency Care Centre at CRH. We have direct experience to demonstrate there is benefit for patients in consolidation of clinical services and a slightly longer journey. For example since 2007 all acute trauma and surgery patients in Calderdale and Greater Huddersfield have been transferred direct to HRI, this has reduced mortality for this group of patients by 30%. This is despite the congestion that the public are concerned about. Also this is already the preferred pathway for patients who have a serious acute cardiac event (such as some heart attacks), serious head injury or major trauma, or a severe burn. These patients are now taken direct to Leeds or Wakefield in order to receive the best possible, most effective care.

Despite the work we have commissioned to understand and explain the changes to travel times, and the assurance we continue to provide that the nearest hospital is not always the best hospital to provide your emergency care in a life or limb threatening situation, we recognise people continue to have concerns about travelling between the two hospital sites.

Calderdale Council have plans for a road scheme to ease congestion on the A629 between Jubilee Road and the junction with Free School Lane in Halifax worth up to £4.5 million. This road improvement is planned to begin in autumn 2016 so would be complete long before the hospital reconfiguration takes place, should that be the outcome of the consultation. More information on the Council’s plans can be found on their website here.

Q2: Patients commented that ambulance services will be too stretched for the proposal to be achievable. People were concerned if they didn’t drive then they would have to call an ambulance as they couldn’t afford the expense of a taxi. Would this type of situation impact on response times throughout the whole of Kirklees? How could this situation be improved for those who did not have the means to travel long distances?  Public transport was raised as not a solution to transport issues due to decreased running times overnight and also that vulnerable people (who use A&E more than most) may not have easy access to Calderdale A&E. What other methods could be considered for vulnerable people or those with no transport?

A: The Urgent Care Centres would be able to treat:

• Sprains and strains
• Broken limb bones
• Wound infections
• Minor burns and scalds
• Minor head injuries
• Insect and animal bites
• Minor eye injuries
• A condition that would normally be treated at the GP practice but the practice is closed or the patient can’t get an appointment as early as liked

For this arrangement to work as well as possible we would need to:

• help people understand when it is appropriate to call for an ambulance, so that those who need emergency care can be taken directly to the Emergency Care Centre
• do more to work with NHS 111 and the public so
• that people could be signposted to the best place to get the right help
• Ensure that if people do make their own way to the Urgent Care Centre with problems that need specialist care, the staff in the Urgent Care Centre have the necessary skills to make sure they are stabilised and then transferred.

The Emergency Care Centre will provide care for the smaller number of patients from across Calderdale and Greater Huddersfield who come into hospital as emergencies with very serious, life-threatening injuries or illnesses, such as:

• Loss of consciousness
• Persistent, severe chest pain
• Suspected stroke
• Sudden shortness of breath
• Severe bleeding
• Serious injuries
• Severe stomach pain
• Severe allergic reactions
• Severe burns or scalds

The majority of these patients already come to the hospital by ambulance.

In essence, if the condition people require treatment for allows you to travel on public transport now, your local urgent care centre will almost certainly be able to treat you in the future, so travel arrangements will remain as they are now for this group of patients.

As part of the consultation we will be particularly looking at transport issues to enable us to understand what these are and come up with plans to address them if the changes go ahead. There are examples of some innovative transport solutions in other parts of the country where similar changes have been made e.g. Northumberland

 Q3: People raised concerns around the increasing population of Kirklees (especially Huddersfield) by creating new build homes and student accommodation.  This adds additional pressures upon roads, other public services.  Alongside this the UK is an aging population (and will need additional treatment/ support from A&E).Please provide calculations as to how the growing population and student numbers in Huddersfield will impact the A&E in Calderdale.

A: Population increase has been included in the planning work undertaken for the hospital reconfiguration.

Q4:Some comments were specifically focused upon travel distance and times from the valleys and towns outside Huddersfield (HD8, HD9 areas in particular). Please provide details of distance and travel times (both out and in peak traffic hours for a car journey not a blue light ambulance).

A: The travel times have been covered above. The travel report is available on the CCG website here.

Q5: Patients were also asking about pressures of waiting times and bed availability (if required) and staff at A&E in Calderdale and other hospitals within West Yorkshire when dealing with increased numbers of patients. How is Calderdale A&E set to deal with the increase of patients needing care in A&E? What are minimum waiting times expected?

A: Calderdale will have an urgent care centre and an emergency care centre. It will not look like the A&E that is there currently. The plans include building work to create both of these departments. The departments will be designed to accommodate the workload expected in the future. The waiting times are nationally set and will not change unless there is a change in the national waiting time.