1. Public Consultations Maternity Services Bridlington Hospital Scarborough and North East Yorkshire Healthcare Trust

2. Context (Why now?) current health policy thinking on reducing hospital beds and delivering care nearer to patients own homes, recent changes in care and treatment for a range of conditions that is available to patients, an increasing focus on the need to review services to ensure they are safe and sustainable, and fit for the future, current changes to the training of medical staff and reducing the number of hours junior doctors work, and the recent merger of Primary Care Trusts to form the East Riding of Yorkshire PCT, with a stronger commissioning focus

3. Context (Why now?) important that services provided at the Hospital work in collaboration with and complement the community services available locally as well as providing a range of acute hospital care, “Our Health, Our Care, Our Say” white paper details how health care should be delivered in community settings through the transfer of services from hospitals

4. Principle Health challenges.. provide a Minor Injuries service, integrated with local community services, to deliver 24 hour healthcare support care for increasing elderly people, integrated with intermediate health and social care service maintain and further develop alliances with larger acute hospitals to ensure a robust care pathway for patients who need other health services not provided locally manage the unscheduled care demand agenda deliver safe and secure maternity services

5. Shared local priorities Transport and travel difficulties in rural areas Access to local diagnostic/x-ray services and Consultant/out-patient services Retain safe and sustainable local services Meet the demands of each local population Improving use of beds/services in community hospitals Access to integrated minor injury services and out of hours care Access to local rehabilitation/stroke/intermediate care services

6. “Discussion Document” Aimed at key stakeholders Sets out direction for consultation Meetings with PAGER; Bridlington Health Forum; Bridlington Town Council; PCT Locality Group & key partners Maternity changes meetings with NCT; MSLC’s; Current and recent service users

7. What we have heard so far… Like local services Want to see hospital and community working together Realise change is necessary Accept new drugs and treatments Strongly support Bridlington hospital People prefer to be at home BUT… Sometimes afraid of falling ill Lack confidence in “joint working” Recognise need to travel but want least travel possible

8. What we have heard so far… Maternity: Support from local GPs Recognition of specialist nature of medical support Positive support for strengthening consultant input to ante and post natal Maternity: Public perception of “safer birth” in hospital Viewed as service cut Some concern on potential extra travel

9. Potential Benefits Quality To ensure provision of safe, high quality services To ensure services deliver the best possible health outcomes To improve patient experience Sustainability Improve the recruitment and retention of all staff (through enhancing roles and providing new opportunities) Define the intermediate level services provided at Bridlington hospital

10. Potential benefits Access Reduce inequalities, improving access Broader range of services provided to patients closer to home using technology Clinical staff in hospital and primary care to work together to deliver an increased range of local care Improve continuity of care, reducing number of different locations for treatment Support national performance targets

11. Potential benefits Affordability To work with the ER PCT to reduce duplication and optimise the effective use of resources across the health and social care community

12. Potential Constraints Must ensure patient and staff safety through clinically appropriate care Account for transport and rural access Services must ensure an adequate catchment population exists to ensure viability Services provided must have flexibility to meet the changing demands of the population

13. Potential Constraints Plans for acute services at Bridlington Hospital must be aligned with the ERY PCT and ensure that sufficient, viable primary and community care services exist Use of existing facilities and assets, notably Bridlington hospital site, must be optimised to be sustainable in the future Total cost of the health services provided at Bridlington Hospital must not exceed the total amount of money available to us to provide them Services provided must fit with the availability of clinical staff and available health service equipment and facilities Services provided must deliver reasonable value for money when compared with national comparator benchmarks

14. Maternity Services We will not treat childbirth as an illness and midwives will support well women to birth their babies with minimum intervention. If you need obstetric care it will be safe and reliable and of the highest quality because obstetricians will be able to spend more time directly supervising labour wards. Your baby’s life chances will not depend on where you live and we will reduce inequalities in the provision of healthcare which can contribute to babies being born with a low birth weight or stillbirths.

15. Maternity Services You will be cared for by the same midwife or small team of midwives throughout your pregnancy. You will have one-to-one care during labour helping to ensure that birth is a positive experience. You will be cared for by professionals working as an integrated team to secure the best possible outcomes for you and your baby.

16. Proposed Acute Services at Bridlington Hospital A “walk in” Minor Injuries service; plus joint with ERY PCT a 24 hour urgent care service Continue ante natal and post natal obstetrics and maternity care, including ultra sound “Home from Home” births at Bridlington Hospital probably discontinued in common with other community hospitals Patient safety and public misperception that delivery in these hospitals is safer than a home birth.

17. Proposed Acute Services at Bridlington Hospital Continue range of diagnostic services including X Ray services; could expand with ERY PCT to provide a “one stop” diagnostic and assessment service for some conditions Continue broad range of out patient services plus the potential to deliver a wider range of specialities where appropriate. Intensive general rehabilitation support requiring some specialist medical support plus nursing and therapy services as provided currently, with the potential to support all local stroke patients.

18. Proposed Acute Services at Bridlington Hospital Seek to expand existing services to provide specialist day treatments in renal dialysis and chemotherapy Increase the volume, and range of day case surgery provided at Bridlington Hospital Review range of acute medical services provided to ensure services are safe, sustainable and affordable Broad range of acute medical services at Bridlington hospital site Number of beds on site may reduce; as in most hospitals in England

19. Consultation Proposals Consultation period to last from 15 December 06 to 11 March 2007 Media briefing to launch consultation Full document available on request (also sent to key stakeholders) Summary widely available (e.g.libraries, GP surgeries) and possibly circulated to Bridlington Households Feedback forms in all documents & summary

20. Consultation Proposals Representative Groups can request Trust attendance at their meetings Public (and stakeholder) meetings will be held in Bridlington, chaired by the Patient and Public Involvement Forum Trust Board will review the results of the consultation at a Public Board on 27 March 2007 Outcome will be widely publicised