1. Consultation on changes to hospital services in North Kirklees and Wakefield District Dewsbury public meeting – 21st May 2013

2. Process for tonight’s meeting Short presentation summarising the changes proposed and their impact on services for Dewsbury area residents ‘Question Time’ style session led by independent Chairman – Steve Richards  15 minutes on maternity services  15 minutes on inpatient paediatrics  15 minutes on emergency care  15 minutes on surgery  Remainder of time left on any other issues

3. Dr Simon Enright Consultant in Intensive Care and Anaesthesia Clinical Lead : Service Strategy The Mid Yorkshire Hospitals NHS Trust PROPOSED CHANGES TO HOSPITAL SERVICES

4. Maternity services – proposed changes Dewsbury Midwife-led birthing unit ‘low risk’ births : home, midwife unit or Pinderfields ‘high risk’ births : deliver at Pinderfields Pinderfields Consultant-led unit for all ’high risk’ births ‘low risk’ births : home midwife-led unit Local antenatal/postnatal care

5. Children’s services Dewsbury : New assessment facility for children who attend A&E majority of current inpatients through new facility Those requiring longer inpatient care at Pinderfields Pinderfields : no change Urgent assessment and outpatients at all 3 hospitals

6. Emergency care Pinderfields specialist trauma and emergency care centre for Mid Yorkshire centre for emergencies needing inpatient care Dewsbury open access for emergency care (70% of current) staffed by A&E trained doctors and nurses (24/7) full resuscitation facilities able to treat a wide range of conditions some ambulance attendances consultants remain during the day (0900 – 2000), on call 24/7 “ Emergency Day Care” on site to reduce need for admission

7. Surgery Dewsbury Centre for routine inpatient surgery (more specialties) Separation of emergency and planned surgery Day surgery Some minor unplanned surgery (day case) Pinderfields Emergency surgery, complex surgery (critical care) Day surgery

8. Summary : Dewsbury Hospital Midwifery-led birthing unit Paediatric assessment facility 24/7 A&E for majority current attendances Inpatient medical beds (assessment and rehabilitation) Routine inpatient and day surgery Outpatients Diagnostics

9. How will North Kirklees residents benefit? Maternity : access to 24/7 consultant-delivered care for high- risk births Childrens : majority of children managed through paediatric assessment facility. Inpatients will have access to more specialist and on-site consultant care at Pinderfields Emergency : majority still seen at Dewsbury A&E. Sicker patients seen quicker by consultants and specialist teams at Pinderfields Surgery : routine operations (including inpatients) carried out locally. Emergencies, sicker patients seen by specialist teams at Pinderfields quicker with more backup Outpatients : more local appointments

10. Dr David Kelly Chair NHS North Kirklees Clinical Commissioning Group (CCG) HOW WE ARE RESPONDING TO WHAT WE HAVE HEARD SO FAR

11. – Children with complex needs Enhanced specialist medical and community nursing for children with most complex needs & more care at home Work with families to ensure minimal impact. Paediatric Assessment Service Specialist assessment and treatment Opening hours will be demand driven to cover majority of children. Initially open to patients until 10pm Transfers for overnight stay will be minimised (<1 day) Listening to You – Children

12. Listening to You – Surgery Surgical Assessment Emergency Day Care will include surgical procedures Dedicated theatre lists Common procedures including kidney stones, ectopic pregnancy, abscesses, minor fracture Day Case Surgery All surgery will be local Planned Surgery Developing post operative care to increase the number of people who can be treated locally

13. Listening to You – Emergency Care Emergency Day Care Consultant presence for longer Using technology to enhance specialist support More conditions treated locally including; DVT, pulmonary embolism, chest pain, cellulitis, falls, collapse, headache, chest infections, GI bleed Elderly Assessment Specialist assessment for frail elderly patients

14. Listening to You Maternity Services We’ll keep an eye on numbers. If demand rises then we can review Outpatients appointments will be in DDH unless there is a good reason not to be Travel Travel Group reconvened to look at recommendations in their report. Will present costed options to commissioners. To consider at Deliberative Event.

15. More patients treated locally in Dewsbury Patient GroupNow2016/17 Outpatients Attendances96,000111,000 Elective Day Case Attendances8,00013,000 Elective Inpatient Admissions1,5002,500 Emergency Admissions16,000 7,000 (Emergency Day Care) Deliveries/births2,500500 + Paediatrics3,4002,800 (Assessment) Total:123,400136,800

16. INPATIENT CHILDREN’S SERVICES

17. MATERNITY SERVICES

18. EMERGENCY CARE

19. SURGERY

20. ANY OTHER ISSUES