Trust answers questions over proposed downgrading of DGH

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The Herald put a series of questions to the East Sussex Healthcare NHS Trust this week following the plans to temporarily downgrade maternity services at the DGH.

The move also means that children will no longer be able to stay overnight in the Friston Ward. Since the decision was made by NHS bosses to agree to a preferred option which is to maintain a consultant-led obstetric service, neo-natal service (including the Special Care Baby Unit), have in-patient paediatric service and emergency gynaecology service at the Conquest Hospital only and establish a stand alone midwifery-led maternity unit at the DGH, residents have been in touch with the Herald to voice their concerns.

The trust says it has been advised by doctors, midwives and nurses, together with the National Clinical Advisory Team (NCAT), that the current maternity and paediatric services in East Sussex cannot continue as they are at present.

Below is the trust’s response to the Herald’s questions.

The changes are expected to come into effect on May 7. What exactly will happen on this date, will there be a gradual change implemented in the days running up to it?

Yes, the changes will be implemented during the morning of 7th May. However, we will be reviewing every woman who goes into labour or any child who needs to stay in hospital overnight in the days immediately before this on a case-by-case basis, to ensure that they are cared for at the most appropriate site.

How many letters, calls etc of concern/agreement has the trust received from residents since these changes were agreed?

Correspondence has been received from 13 individuals since the temporary changes to services were agreed. In addition, our Patient Advice and Liaison Service (PALS) has dealt with two enquiries about the changes, both relating to paediatric services.

What changes did the trust make following the decision in 2008 to retain services at the DGH? We understand it was told to keep both Hastings and Eastbourne sites adequately staffed.

The recommendations of the Independent Reconfiguration Panel (IRP) were made to East Sussex Downs and Weald and Hastings and Rother Primary Care Trusts and not East Sussex Healthcare Trust (or East Sussex Hospitals Trust as it was at the time). In response the PCTs published a Maternity Service Strategy in 2009. The strategy included a number of actions and service improvements which have been made by the Trust. These include offering direct access to midwifery services, establishing services for early pregnancy, developing a telephone triage service for ante-natal patients and recruiting to consultant vacancies.

The PCTs strategy also included an intention to maintain a two site consultant led obstetric service. The Trust worked with the PCTs to implement this element of the strategy. However, despite a great deal of effort, the Trust has been unable to recruit a full establishment of middle grade doctors for some considerable time. This is partly because of changes in employment law and immigration but more significantly the size of our units has meant that we are not an attractive option for middle grade doctors as they don’t get the range of experience that they would get on larger units and this impacts on their ability to maintain and develop their skills. Increasingly doctors who do come and work at the Trust require further training and development before they have the range of competencies required to deliver their full role. We are able to support these doctors to develop but this can take time.

The difficulties in recruitment and the impact this had on the service were made clear to the PCTs and mitigations were agreed. However, in March the Trust Board decided that these mitigations had become too complex and fragile and therefore the decision was made to temporarily change the configuration of the services to ensure they were sustainably safe.

What measures have been put in place for employees who will now be working in Hastings? Will their transport costs be covered?

In line with Trust policy, staff moved to a different base will have all excess travel costs reimbursed. Information has been made available to staff about the alternative travel options such as car sharing and public transport. In addition we have made arrangements for a shuttle bus to operate between the Eastbourne DGH and Conquest Hospital for staff who cannot make other arrangements. This arrangement will be reviewed on a regular basis and adapted if required.

The trust has said if a woman giving birth runs into complications at the DGH then when they are transferred a midwife would go with them. Are there enough midwives on hand for this to happen if several women need to be transferred during the space of a few hours?

Yes, if several transfers were needed within a few hours, we would use the on-call community midwives, supervisor and manager on-call to provide cover.

Is it true that consultant medical staff in the obstetric department have no idea if they will be transferred to Hastings or their contracts terminated?

No, this is not true. The consultants at Eastbourne DGH have had one to one meetings with senior managers and HR to discuss how the changes will impact on them and the consultant rota is now being finalised. No contracts are being terminated as a result of these temporary changes.

Is it true that one of the proposed locations for alternative accommodation for the new Pevensey ward is Litlington ward, which is currently Maternity and SCBU?

No, this is not true. The changes to maternity services are temporary and there are no plans to change the use of Litlington ward.

Has the hospital told staff, either verbally or in writing, not to speak to the press about the changes?

No, the Trust has not given any such instruction to staff.