Alexandra Hospital will be downgraded

ACCIDENT and emergency, maternity and children's services at the Alexandra Hospital will be downgraded it has been confirmed.

The Joint Services Review has finally issued its conclusions in a statement yesterday morning (Tuesday) following 13 months of delay and deliberation.

It sets out broadly what Worcestershire Acute Hospitals NHS Trust (WAHT) will be able to offer at the Woodrow Drive site as well as committing to exploring a further option to bring in University Hospitals Birmingham, Birmingham Children's Hospital and Birmingham Women's Hospital to run services.

Under WAHT's proposal A&E at the Alex will be turned into an 24/7 minor injuries unit and a GP service on site which health bosses say would deliver about 75 per cent of what the current department does.

Complex cases such as heart attacks and strokes would be dealt with at Worcester or elsewhere and most patients would travel by ambulance. The A&E department at Worcester will be upgraded to deal with the county's major emergencies including a 24/7 consultant led service with better links to specialist departments.

Health bosses are working with West Midlands Ambulance Service to ensure they can cope with demand.

A midwifery led unit will be created which is only able to deal with normal births. Women deemed at high risk or needing a consultant led service, such as those with pre-eclampsia or high blood pressure, will be dealt with at Worcester or elsewhere.

Children's services will also be downgraded to a paediatric assessment unit. Again health bosses say the majority of children will continue to be seen at the Alex with the very sickest seen at Worcester or elsewhere. Outpatient services will still be delivered at all three sites.

The changes have been backed by doctors on Worcestershire's clinical senate.

Chairman Anthony Kelly said: "The JSR has come a long way. We have eliminated many options by both listening to local people and conducting a critical clinical analysis of what structure produces the best care and outcomes for the patients who we meet and treat every day.

"Keeping all three acute hospitals has been a strong message and we have acted on that .We also recognised from the outset that doing nothing was never an option. Across the country there is a shortage of experienced doctors in some key areas, particularly in A&E, women's and children's services. Without these changes healthcare across Worcestershire would suffer."

WAHT is able to provide more detail about its option at this stage as it was the Trust which asked commissioners for the review over a year ago and it was specifically set up to find a Worcestershire solution.

Changes to the review's governance arrangements are being made over the next few weeks which will allow commissioners in Redditch and Bromsgrove, Wyre Forest and South Worcestershire to take over the review and look in detail at what both WAHT and Birmingham can provide.

Although no information has been released about what Birmingham Trusts could offer, they will not be able to retain services at the Alex in their current format as issues around a shortage of middle grade doctors - one of the reasons for launching the JSR along with the need for WAHT to save £50million - remain.

But it is understood the Birmingham option would at least match the Worcestershire option as regards A&E, maternity and children's services as well as provide a greater range of services overall, including some which have never been provided in Redditch before.

Campaigners say it will also create a formal link with one of the best teaching hospitals in the country, while there are better transport links to the second city.

Lesley Murphy, NHS Worcestershire chief executive, said: "We are finalising options at this stage – not making a decision on who runs which hospital.

"The clinical and financial analysis we have conducted so far supports the proposed changes. We are committed to maximising the number of services available at each hospital site. Worcestershire Acute Hospitals Trust may continue to run all three sites.

"The second option, to work with alternative local NHS providers, requires more work and we are also seeking advice, including from the Department of Health, on NHS competition policy on how we do this."

It is hoped full options from both providers will be put to the public in detail in June. A final decision is not likely until November.

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