GPs warn emergency care consultation must not be prejudged

But the Greater Preston and Chorley and South Ribble Clinical Commissioning Groups (CCGs) declined to link the so-called “case for change” with concerns about the sustainability of urgent and emergency care. The document outlined a series of reasons for a rethink about health provision, including staff shortages, poor patient flow through the hospital system and an ageing population. The argument has been made throughout the course of the year, while Central Lancashire’s NHS has been carrying out informal consultations under the umbrella of “Our Health Our Care”. Back in August, draft proposals to address the problems highlighted in the case for change suggested a single Accident and Emergency unit in the region, the continued operation of two urgent care centres for minor complaints and the creation of a new ring-fenced centre for pre-planned operations. The locations of each of the proposed facilities are to be the subject of a formal public consultation which has now been delayed until next May. But Chorley and South Ribble CCG member Dr. John Cairns claimed the trust which runs the Royal Preston and Chorley and South Ribble Hospitals had preconceived ideas about what the new model should look like. “There are some at Lancashire Teaching Hospitals (LTH) and other organisations who have prejudices about what is best for the system. “My worry is that this [process] could distract us from holding LTH’s feet to the fire over their own performance. Their voice should come from a respectful position and, as they are not doing their own job particularly well, we shouldn't have them tell us our job,” Dr. Cairns added. Chair of both CCGs, Denis Gizzi, said that “all options are on the table”. “That is a guarantee we give to the public and regulators and that is what we have got to do,” he added. Meanwhile, Clayton Brook GP Dr Satyendra Singh wanted reassurance that the consultation was more than “a paper exercise”. “The case for change gives people expectations, but as far as I know, there is no new money for it. It will make people think that particular problems are going to be solved,” he warned. But report author Jason Pawluk told him that money was “a secondary point” and that the only decision for CCG members was whether there was “a consistently-described case which avoided predetermined thinking”. The joint committees unanimously agreed to support the case for change - but only after “decoupling” it from issues about the sustainability of the acute sector. Lancashire Teaching Hospitals referred a request for comment to Our Health Our Care, which said: “The committee approved the case for change, subject to the scope being broadened to reflect the inter-dependencies between out of hospital and community care. This gives the programme team the mandate to further develop a clinical vision and a model of care, taking into account feedback received through engagement with clinicians and members of the public. “Once the model of care has been approved, options for how this might be delivered will be developed. We will continue to undertake comprehensive engagement activities to ensure people have an opportunity to have their say, and we will ensure comments are given due consideration. “Any proposals for significant changes to services will be subject to a formal statutory public consultation process once they have been through the relevant and robust sign off and assurance processes.”