The Governing Body of NHS Isle of Wight Clinical Commissioning Group (CCG) has formally accepted the recommendations of the Local Care Board in relation to the future of acute hospital-based services for the Isle of Wight.
The controversial proposals will see around 11% of complex, urgent care patients transferred for specialist care to the mainland where the outcome of their treatment would provide better results. At the same time, patients who currently travel to the mainland for routine care, should, in future, be able to have that care delivered on the island.
The view of the Trust and the CCG Governing Body is that residents of the Isle of Wight should receive the same standard of care as anywhere in the country and that services should be delivered on-island first wherever clinically appropriate, with residents only having to travel for services when it is essential to do so.
Isle of Wight NHS Trust is the only integrated acute, community, mental health and ambulance health care provider in England. It provides a range of services to an offshore population of around 140,000. It faces particular challenges given the ageing profile of the population, the increase in associated complex healthcare needs and long-term conditions. It also struggles to recruit specialist staff which leaves some services under-resourced and overstretched. Many acute hospitals serve a population more than twice the size of that on the Island which also means it is easier for clinical staff at other hospitals to retain and extend their skills because of the volume of procedures undertaken. The cost of providing these services on the Island, without the advantages of scale, also leads to financial challenges. The Isle of Wight NHS Trust’s deficit is forecast to grow to an unsustainable £23.6m by 2022/23 unless changes are introduced. The latest CQC inspection in July 2017 was Inadequate.
Stephen Parker, Interim Medical Director for Isle of Wight NHS Trust and Clinical Lead for the Acute Service Redesign programme, says: “Providing access to high quality and safe care for patients is our priority. Wherever possible, we should continue to give people the very best hospital based care on the Island. Where outcomes for certain complex procedures are significantly better on the mainland, more of our seriously ill patients should be able to benefit from these services. But overall this proposal will enable us to reduce the number of times people are asked to travel to the mainland, as more routine care and follow up appointments will take place on the Island.”
Dr Michele Legg, the chair of the CCG Governing Body, says: “This is about trying to get the balance right - we want to ensure that nobody has to make difficult journeys for hospital care unless they absolutely have to, but at the same time we must also ensure that Island residents can get access to the best, safest care when they need it.
“To try to strike that balance, we want to see more routine care provided to a high quality on the Island so that we limit unnecessary travel. But we also accept that, for a small number of patients with certain complex conditions, they will receive better care and results from their treatment from larger, more specialist teams than those we have based on the Island. These are teams that are performing multiple procedures every day rather than several times a year and who have access to specialist equipment and staff.”
CCG Governing Board members also recognised that travelling off the Island can, at times, be difficult, stressful, and costly for both patients and those who care for them. They say keeping this burden to a minimum will be a central concern in the next phase of work when more detailed discussions about services begin to take place. It also says further work will be undertaken with mainland hospitals to support the island to resolve its workforce challenges.
A full public consultation will be held later this year and the plans will also need to be considered by NHS England.
