Report calls for 'new kind of casualty' at Wycombe Hospital

The report, compiled by healthcare consultancy Durrow, was commissioned by Wycombe MP Steve Baker earlier this year.

Mr Baker said: "This report sets out how a new kind of casualty unit could deliver 24/7 gold-standard emergency care in Wycombe for a clear majority of patients. It is an innovative yet realistic proposal which the NHS could deliver within current resources."

He added, however, that the report was merely a suggestion he hoped would be looked at and considered by the key health organisations in the area.

Wycombe Hospital's A&E centre closed in 2005, before Emergency Care was closed in 2012 and was replaced by a 24/7 Minor Injuries and Illness Unit following a Free Press campaign.

Mr Baker told the BFP: "I think they (Durrow) have produced an excellent basis for discussion, and that’s the feedback I’ve had from other local parties.

"Its advice from people who are experts in the field, and any input it may have on the future of services at Wycombe would be decided by the responsible organisation - the CCG."

Mr Baker added that since the report was commissioned, more had emerged nationally to support its proposals - in particular reports concerning the difficulty patients may have in accessing GPs, leading them to visit A&E instead; fears raised by the Royal College of GPs over an upcoming shortage of GPs; and an increasing need to combine social care with health care.

Mr Baker said: "I’m asking the NHS to look carefully at whether this is the right way to take small hospitals like ours into the future."

He added that, as MP, he had a leadership role in raising the issue of our health services’ future, but he respected the role of the CCG as being responsible for its actual provision.

Mr Baker came under fire from Wycombe’s Labour group earlier this year, which highlighted that two of Durrow’s senior leaders are Ruth Harrison and Derek Smith. Ms Harrison oversaw the controversial changes at Wycombe Hospital which led to A&E and maternity services moving to Stoke Mandeville Hospital.

She also received £140,000 when she quit the NHS Trust before a report was released which criticised the way senior management handled the outbreak of a super bug at Stoke Mandeville in 2006.

The national newspapers also reported in 2011 how her husband, Mr Smith, earned £248,041 for working just 97 days over a ten month stint in charge of Dorset Count Hospital where he proposed 200 job losses and a pay freeze. He also claimed £20,000 for travel and food expenses.

Mr Baker defended his move, saying he was determined to find a "constructive" way forward on dealing with the "irresistible trend towards centralization" of hospital services.

He said he had looked for options at the Conservative Public Services Policy Commission and said: "Only one serious proposal for a new generation of local acute hospitals emerged. It was the proposal from Durrow.

"That is why I asked them to set out how their ideas could be implemented by the NHS in Wycombe."

Speaking to the BFP yesterday, Mr Baker said he was keen for discussions over Wycombe's health services to be constructive, and that the more he explored the situation, "the more I realise that our NHS must not be politicised and kicked about".

He added that the professionals running our services had to deal with increasingly complex problems and healthcare needs, such as an aging population and more people suffering from multiple conditions.

He said the problems facing Wycombe, and the controversial transfer of some of its services, such as A&E and Maternity, had been a national issue, with many hospitals across the country facing similar challenges.

He said: "My hope is that we can have a mature conversation and that all our local politicians accept that we are not going to get an old style A&E back.

"This is not the fault of any individual, this is the product of long term development of health services over decades."

Key points of the Durrow report - A Better Future for Wycombe Hospital (2015-2040)

With Wycombe Hospital a host site for several organisations operating from it - including Buckinghamshire Healthcare NHS Trust, South Central Ambulance NHS Foundation Trust and the Chiltern CCG - the report notes there is no one composite plan for the future of the hospital.

Instead, Wycombe forms one piece of a jigsaw for the different organisations using it, and who also use other sites. Durrow says it has tried to "stand back and make some common sense suggestions".

The reports states: "We do not want a thinned down semi-acute hospital in constant financial difficulty. We want gold-standard medicine in a successful modern acute hospital open around the clock."

It details four key proposals: 1) That a 24/7 service caters for all with urgent need or who may be uncertain where they should go, combining the MIIU and GP out-of-hours service with the hospital service itself. Transfers to other hospitals that have specialist skills and equipment would still be part of this set-up, but the overall service would aim to be more cohesive and hopefully overseen by one agency.

2) The report proposes that there always be a crewed ambulance on site for urgent medical transfers, that a redeveloped hospital site would host an ambulance station that would become part of the hospital, with ambulance crews and hospital staff becoming more closely integrated.

3) The hospital site is in urgent need of a makeover, the report says, with the old tower in poor condition and nearing the end of its life. Modernisation and upgrades to the site, including improving pedestrian access. The hospital trust, Buckinghamshire New University and Wycombe District Council all share a common interest in such a renewal of this area and the report suggest these bodies could join to propose a redevelopment plan.

4) The care it provides should become more ‘integrated’ and simple to understand. The hospital could become a registered provider of primary care - therefore offering GP appointments too - and hopefully reduce patients' confusion over where they should go for different aspects of health care. The report suggests the separation of hospital doctor and GP would become blurred, with a clinical faculty on the new site that would include both specialist and family doctors.

To read the full report go to MP Steve Baker's blog by clicking here.