Following engagement with recent patients, staff and partner organisations, we are testing changes to the existing configuration of trauma and orthopaedic services across our hospitals in Basingstoke and Winchester, to understand the potential impact of centralising some of our trauma and orthopaedic services.
The changes will see us treat all trauma patients who require an emergency inpatient stay or surgery on broken bones at Basingstoke and North Hampshire Hospital (BNHH), with Royal Hampshire County Hospital (RHCH), in Winchester, becoming a centre of excellence for hip and knee replacement surgery.
We will be monitoring a wide range of quality and experience measures to ensure we see positive results and are able to quickly address any negative impact.
Click here to read the paper presented to Hampshire County Council's Health and Adult Social Care Select Committee in September 2019.
More information about the proposed changes can be found below.
We needed to make changes so we can:
The key elements of our new service model are listed below.
This new way of working is expected to deliver a wide range of benefits including:
Our extensive engagement around the concept of a critical treatment hospital showed that there is public and stakeholder support for the principle of centralisation of acute services.
The principle of centralising some services is already in place for patients in need of cardiology (centralised in Basingstoke) and stroke care (centralised in Winchester).
Centralisation of trauma and orthopaedic services has already been successful in many other Trusts, including Cheltenham and Gloucester, East Kent and the United Lincolnshire Hospitals.
While there is a case for a complete hot / cold split (with all trauma done in one hospital and all elective (planned) operations done in a separate hospital), additional work and engagement has already shown that this will not be possible without the significant investment of a new hospital building, which is not financially viable. We have therefore refined the service model to enable as much specialist centralisation as is practical (in line with recommendations from NHS England’s Director of Clinical Improvement, Professor Tim Briggs, the NHS long term plan and our clinical strategy) whilst still retaining local services where possible.
As with any service change of this scale, it will be important to test it thoroughly.
Before changing the service model, we consulted with our staff and updated our practical operational procedures so we are very clear about how we will see and treat the patients whose pathway into our trauma and orthopaedic services has changed. We also talked to patients to get their views and understand the potential impact on them and their families.
Through the testing phase, we will be monitoring a wide range of quality and experience measures to ensure we see positive results and are able to quickly address any negative impact. This will include seeking feedback from our patients and staff.
There are a number of things we just won’t know until we start working in this new way. By ‘testing’ the proposed service model first, we can:
We are monitoring the quality of the service through a range of quantitative and qualitative measures to ensure that any unforeseen consequences are recognised and addressed at the earliest opportunity. The national ‘Getting it right first time’ team has also recommended some performance indicators that will demonstrate a range of benefits to patients that we will be able to compare against our past and current performance.
We are planning to review the impact of the new way of working by Spring 2020 and hope to finalise the new service model during Spring 2020.
We are very clear that if the changes do not bring about the anticipated benefits, we will stop and revert back to our current service model until we can find a way that works. We will do this by working with the national ‘Getting it right first time’ team and other Trusts where centralisation of trauma and orthopaedic services has already been successful, including Cheltenham and Gloucester, East Kent and the United Lincolnshire Hospitals.
Once the emergency department team at Royal Hampshire County Hospital (RHCH) have agreed that it is necessary and safe for a patient to be transferred, they will arrange for an ambulance to take them to a bed that will have already been reserved for them.
If it is medically safe to do so, patients may be able to arrange for a friend or relative to drive them to Basingstoke and North Hampshire Hospital instead of going in an ambulance. However, patients will not be able to drive themselves. The nurses will let you patients know if this is an option for them.
We believe the proposed changes will be better for patients, with services local where possible and centralised where necessary (for example where it is clinically appropriate or a specialist requirement).
Both Winchester and Basingstoke hospitals, and Andover War Memorial Hospital, are run by the same NHS organisation. These new arrangements will ensure our patients receive assessmkent and treatment by senior trauma and orthopaedic doctors - 24 hours a day, seven days a week.
We understand, however, that people may have concerns about the practicalities of visiting a different hospital. We therefore want to engage with patients, their families/carers, the public and community and voluntary groups to understand those concerns and how we can overcome them – by changing elements of the proposed new service model, with support from partner organisations or through additional or new information, signage and support.
Where possible, we are asking patients to provide feedback about their experience of the new way of working and its impact on them and their families.
If you would like to give your feedback, please use the links below:
I have had direct experience of the arthroplasty
I have had direct experience of the orthopaedic trauma service
If you have general feedback about the new way of working, please complete online survey on the right hand side of this page.
We have already engaged with a wide range of stakeholders (staff, patients, carers and partner organisations) and held formal consultations with directly affected staff and directly affected medical staff as each group.
We did this to:
Now that we are testing the new way of working, we are asking patients to provide feedback about their experience and its impact on them and their families.
If you would like to give your feedback, please use the links below:
If you have general feedback about the new way of working, please complete the online survey on the right hand side of this page.
An overview of our engagement plans were included in the paper that went to the Health and Social Care Select Committee on 16 September 2019.
We plan to consider all the feedback together so that we are not considering any points in isolation, especially as they could collectively provide better ideas and options.
We will, however, regularly monitor the responses we receive in case there are any questions that we can helpfully answer straightaway, either individually or through FAQs.
We will use the insight we get from the feedback from the wide range of people and groups we engage with to shape the details of the final proposals. We will also use the information we receive to carry out an equality impact assessment.
Patient engagement information
Staff engagement information
Table of changes
Have your say
As part of the test, we are monitoring a wide range of quality and experience measures to ensure we see positive results and are able to quickly address any negative impact.
We would like to hear views about how we can make this work as smoothly and effectively as possible and how we can minimise the impact on staff and patients.
If you have been directly affected by the changes, please could you complete a specific patient survey so we can find out more about your experience:
If you have not been directly affected by the changes, click here to complete a general survey.