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Update on Path to Excellence – CCG court case judgment handed down

02/01/2019

Following the judgment handed down at the High Court of Justice, Leeds, by His Honour Judge Raeside QC on Friday 21 December, which has determined that the two Clinical Commissioning Groups (Sunderland and South Tyneside CCGs) involved in The Path to Excellence hospital transformation programme can implement changes based on decisions made around the future of hospital-based stroke, maternity and urgent paediatric care, the two CCGs have issued the following statement:

“We are pleased that the judge has supported our decision for phase one of the Path to Excellence programme and found our robust public consultation in 2017 to be a fair and lawful process.

“While we understand people's concerns, these changes have always been about doing what is right for our patients and protecting hospital services which are extremely vulnerable.

“These are much valued services and both CCGs took their decision making very seriously, based on clear clinical evidence and in the best interests of people in South Tyneside and Sunderland. We are already seeing real improvements as a result of the interim changes we have made, particularly for stroke patients in South Tyneside.

“Staff at our hospitals in South Tyneside and Sunderland can now look to the future with certainty as we move forward with these vital improvements in patient care. We remain fully committed to engaging openly with colleagues, patients and partners as we implement these changes and as we continue to develop plans to deliver clinical excellence through phase two of the programme."

Background to Path to Excellence
The Path to Excellence programme is a partnership of local NHS organisations working together to plan for the future and identify new and innovative ways of delivering high quality, joined-up, sustainable hospital services that will further improve the quality of care and patient outcomes for local people. The partners include:
• NHS South Tyneside Clinical Commissioning Group
• NHS Sunderland Clinical Commissioning Group
• City Hospitals Sunderland NHS Foundation Trust
• South Tyneside NHS Foundation Trust

The CCGs’ decisions
Stroke, obstetrics (maternity) and gynaecology and paediatrics (children’s) emergency services are amongst those South Tyneside and Sunderland hospital based services that are facing the most severe workforce sustainability challenges, driven predominantly by a shortage of medical staff resulting in service continuity, quality and financial pressures.
The proposed changes on how these services will be arranged in the future, means they can improve and, ensure better care for patients as well as provide the new opportunity to develop a modern holistic birthing centre for the first time in South Tyneside and Sunderland. The CCG decisions mean that clinical leaders at South Tyneside NHS Foundation Trust and City Hospitals Sunderland NHS Foundation Trust can start to work with local staff teams to make changes over the next several months.

The two clinical commissioning groups decided:
Stroke consultation option 1 will be formally implemented which is all acute strokes are directed to Sunderland Royal Hospital (SRH), with the consolidation of all inpatient stroke care at Sunderland. This model has been running temporarily since December 2016 due to service vulnerability and is showing improvements in patients accessing key diagnostics and treatment earlier. For example the rate of the use of clot busting drugs (thrombolysis) has doubled for South Tyneside residents, and with the percentage of eligible patients thrombolysed within an hour has gone from 0 to 60 per cent, meaning fewer people will die or have serious disability and more people have the chance to fully recover from their stroke.
This is based upon a very clear and compelling clinical evidence base, universally supported by clinicians. The change will aim to be fully complete by April 2019.
Maternity (obstetrics) and women’s healthcare (inpatient gynaecology) services option 1 will be implemented which is the development of a free-standing midwifery-led unit (FMLU), known as a birthing centre, at South Tyneside District Hospital and medically-led obstetric unit at Sunderland Royal Hospital. Gynaecology care requiring an overnight hospital stay will be carried out at Sunderland Royal Hospital, and care for minor gynaecology conditions, including day case surgery and outpatients clinics, will continue at South Tyneside District Hospital.
This provides an exciting new opportunity for both South Tyneside and Sunderland women as they said they wanted the choice of a home away from home birthing experience, a birthing centre for pre and post-natal care, with more holistic therapies.

This new centre will be developed with staff, women and other interested partners, and the ambition would be to create a vibrant new birthing centre at South Tyneside District Hospital which offers more choice for women across both South Tyneside and Sunderland.

Children and young peoples (urgent and emergency paediatrics) services option 2 the development of a nurse-led paediatric minor injury and illness facility at South Tyneside District Hospital – open 8am to 10pm – and 24/7 paediatric emergency department at Sunderland Royal as the most sustainable long-term model.
However, the clinical commissioning groups recognise that it will take a period of time for the development work for this be deliverable therefore approve option 1 for implementation in the short-term which is the development of a daytime paediatric emergency department at South Tyneside District Hospital and 24/7 paediatric emergency department at Sunderland Royal.

How to stay involved
For more information and to stay up-to-date with the Path to Excellence programme visit: www.pathtoexcellence.org.uk and sign up to MY NHS to receive regular updates.

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