Setting out the facts of the acute and maternity consultation

We’re currently consulting on £450 million proposals to transform acute hospital and maternity services in Leicester, Leicestershire and Rutland.

The consultation is being run by the three NHS clinical commissioning groups (CCGs) in Leicester, Leicestershire and Rutland – Leicester City CCG, West Leicestershire CCG, and East Leicestershire and Rutland CCG.

A huge part of the consultation is capturing feedback and opinion in our on-line survey and at the series of on-line events we have held. While it is important to debate the proposals, filling in the consultation questionnaire is the best way for your views to be considered.

We know that with a service reconfiguration of this size there is bound to be some misinformation circulating. We feel it’s important to dispel any myths and set out the facts. Below is a summary:

Isn’t consulting during a world-wide pandemic just a way of getting this over the line? Shouldn’t you have waited?

We recognise that the world has changed, for everyone, not just the NHS. One of the only certainties is that we will be living with increased uncertainty for a long time.

It would be tempting for organisations to shelve plans and put off decisions in the hope that the future becomes more certain.

We think that is the wrong approach especially now when we consider all that we have learnt in planning for, and dealing with, the impact of the first and second waves.

We have a legal obligation to consult, and we are consulting in different ways to reach as many people as possible, including seldom heard and often overlooked groups. We have also taken legal advice and revised our communications and engagement plan as a result of the pandemic.

You haven’t taken the implications of the pandemic into consideration, have you?

That simply isn’t true. 

At the very heart of the reconfiguration is our clinical strategy. Its key aim is to focus emergency and specialist care at the Royal and the Glenfield hospitals and separate non-emergency from emergency care. That means that when we are very busy, at time likes this, those patients waiting for routine operations are not delayed or cancelled because we have had to prioritise an influx of emergency patients.

It’s right to say that our frontline staff are working under increasing pressure because of the pandemic but once reconfigured we believe that that pressure would be eased. We will no longer have to run triplicate rotas for staff on three hospital sites. 

Had the timing been different our hospitals would have been better able to cope with COVID 19 in their reconfigured state and far fewer operations would have needed to be cancelled.

Isn’t the consultation a tick box exercise? Haven’t you already made your decision?

Absolutely not – this is about listening to the public and ensuring they have a say on how our future healthcare system is set up. These plans are about reconfiguring services that are fit for the future, but we can’t do that without hearing from the people and patients who directly use our NHS services. What we don’t want is a health service that is solely designed by those people who work in it. It has to be designed by those people who experience the services. 

Their feedback is absolutely vital, and our final decisions must be based on what is in the interests of the highest number of people across Leicester, Leicestershire and Rutland.

Isn’t this just about saving money and not about transforming healthcare?

The main driver for us is about providing high quality, sustainable care, however the financial side is obviously an integral part of the decision-making process.

What we’re trying to do with these changes is to get the best value we can from the resources we invest. It’s about spending the money that we do have on the right things in the right way.

Our services are currently organised in a way that is down to history rather than design, often in buildings and facilities that are outdated and not fit for the delivery of modern healthcare. 

This often means that clinical services which should be operating side by side aren’t, which is creating confusion and multiple journeys for patients. Other times, by providing the same services from multiple sites, our staff and resources are spread too thinly - stretching them to breaking point.

It’s on this basis that we believe these changes are absolutely essential in order for us to improve clinical quality, make the most of a workforce that is already depleted due to national shortages, as well as improving the experiences and outcomes of our patients.

I don’t understand what the treatment centre at Glenfield will do.

This Treatment Centre would become a one-stop-shop for planned care, allowing the full range of diagnostics, work and procedures to be carried out all under one roof. It will have its own dedicated operating theatres and intensive care beds.

Crucially this will help us to achieve our clinical vision for separating elective and emergency activity. This will help to prevent the cancelling of routine work when the emergency side of the hospital is under pressure, something which we know is often distressing for patients and their families and leads to poor experiences of care.

Doesn’t moving services from the General mean they will be crammed onto the Leicester Royal Infirmary and Glenfield sites?

No not at all. Access would actually be easier and 100,000-day case procedures and 600,000 follow up appointments would be done differently e.g., done closer to home in the community which is what patients say they want. More appointments will also be done remotely, over the phone and via the internet. Others will move to the new Treatment Centre at Glenfield Hospital

We are also creating extra parking spaces on site at both Glenfield and the Royal Infirmary so access and parking would be easier.

Won’t these proposals just move travel congestion from Leicester Royal Infirmary to Glenfield?

Within these plans there is a real shift in terms of where the activity will take place. Historically many outpatient appointments have taken place face to face. We know that that isn’t always what patients want so going forward there will be a reduction in those kinds of appointments with new ways brought in, which will lead to less traffic on the roads around the sites. Face to face appointments will continue to be made for those patients who need to be seen in person or who are not digitally enabled. 

We are also working with travel experts to look at our green travel plan and help reduce the number of patients and staff coming to appointments or to work in their cars.

An extra 139 acute beds isn’t enough is it?

Even as we continue to fight COVID-19, we do believe that there is enough, and these additional beds will stand us in good stead beyond 2024. We are also creating the equivalent of 161 additional beds by continuing ongoing work to  ensure that every minute of a patient’s hospital stay counts and they only stay with us for as long as is necessary and appropriate.

We will, as always, keep our bed planning under constant review. If absolutely necessary, we maintain the flexibility to increase bed numbers if we need to. We are also retaining 33 acres of land at the Glenfield hospital should we need it in the future.

However, having too many patients in beds is actually a sign that we are not doing enough to prevent patients from becoming unwell and not caring for them in the community. That means using bed numbers isn’t the best way of assessing how good the proposals are.

Aren’t you closing Leicester General Hospital?

That is not the case. Yes, it would no longer be an acute hospital but would instead become a new community health campus – which will be a vital part of our local health service.

Proposals include continuing to operate the existing diabetes centre of excellence as well as stroke rehabilitation facilities and inpatient beds, and imaging facilities including scans and x-rays to help diagnose patients’ conditions more quickly.

The consultation is also asking for views on a range of other potential services which could be included on the site. These include a GP-led urgent treatment centre, observation facilities for patients who do not need to be admitted but need to be monitored for up to eight hours, community outpatient services and much needed extra primary care capacity for this part of the city.

Won’t maternity care be less safe if it is based in one place at the Leicester Royal Infirmary?

The new maternity hospital will create a safe and a more sustainable environment to give birth in addressing concerns raised by a number of maternity reviews.

Our priority is to provide maximum choice of place of birth for women and families across Leicester, Leicestershire and Rutland, including home births, midwife-led deliveries and more medicalised births where necessary. 

Isn’t the closure of the midwifery-led unit at St Mary’s Hospital, Melton Mowbray to the Leicester General Hospital going to leave new Mums without vital post-natal support?

We are proposing to relocate the existing midwife-led unit from St Mary’s hospital in Melton Mowbray to the Leicester General Hospital. The existing facility is significantly underused, with fewer than three births taking place there a week which isn’t clinically or financially sustainable. We believe that moving it to Leicester would make it accessible to many more women.

Our priority is to provide maximum choice of place of birth for women and families across our whole area - including home births, midwife-led deliveries and more medicalised births where necessary. 

We would also ensure that there is support for antenatal and postnatal care in the local community, close to people’s homes, which people have told us is important to them.  We would look to local centres or hubs to provide drop-in breastfeeding support sessions and we hope to expand the number of maternity support workers to provide breastfeeding and baby care support.  Many of these services will continue to be delivered from within Melton Mowbray.

Are you selling land off at Glenfield just to make money?

Maintaining, keeping and servicing buildings that are not used on the site is costly and means that we are not using NHS money effectively.

Some land would be sold at the existing Leicester General hospital site to create essential affordable housing for key workers including nurses and other healthcare staff. Money from the sale would be reinvested into hospital services.

We know from our discussions with the local council that affordable housing in this area is badly needed and we are working closely with them on for this for the benefit of the local community.

The Trust still has 33 acres of developable land at the Glenfield Hospital site should it be needed in the future.

You say leaflets about the proposals and the consultation was sent to 444,000 homes but we haven’t received ours? Doesn’t this undermine the principals of the consultation?

In terms of the actual consultation, we commissioned a solus delivery of an information leaflet to around 440,000 homes but we have been made aware that a number of residents may not have received theirs. We have raised this with our delivery partners who have provided us with GPS tracking information for their agents, as well as feedback from telephone calls to a sample of homes within each of the postcode areas to validate delivery.

However, the information leaflet is just one aspect of the consultation. As well as this we have:

  • Worked with community groups to engage with seldom heard groups.
  • Worked with the media, to gain extensive coverage across print, radio and TV.
  • Had full page adverts in newspapers across the area as well as six-week advertising campaigns on commercial and community radio stations.
  • Held targeted TV adverts.
  • Used our own social media channels and that of our partners to raise awareness of the consultation.
  • On-line engagements meeting and discussion to capture feedback.

The consultation closes on the 21st December. Having read the information, we encourage local residents to fill in the questionnaire. To request a paper copy to fill in at home, call 0116 295 0750 or email beinvolved@leicestercityccg.nhs.uk