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By Ian Dipple Tuesday 21 January 2014 Updated: 21/01 15:06
THE ACCIDENT and emergency department and the vast majority of maternity services should remain at the Alexandra Hospital an independent panel has ruled.
But overnight care for the sickest children and the Alex's consultant led maternity unit will eventually be centralised into Worcester.
A group of experts has been scrutinising the two options for the Woodrow Drive hospital over the last four months and agreed with the majority of concerns raised by doctors, campaigners and politicians about the impact removing vital services could have on the wider health system and on residents in the Redditch and Bromsgrove area.
The panel has ruled option 2 - allowing another hospital Trust to run the Alex - is not viable as it would put services for residents in the rest of Worcestershire at risk.
But it has recommended an improved option one, the key plank of which is the A&E at the Alex will remain but be turned into an 24/7 Emergency Centre, in line with the national Keogh review.
It means it will broadly provide the same range of services as it does now, still have A&E consultants on site and still be able to receive the vast majority of ambulances with only more specialised care delivered at the Worcestershire Royal.
A 24 hour GP led Urgent Care Centre and minor injuries unit will be included as part of the new centre which will treat both children and adults.
Inpatient paediatric services will be centralised to Worcester due to issues around safety and staffing and replaced with a day time Paediatric Assessment Unit which will deal with the vast majority of cases. Only one or two of the sickest children a day are expected to be affected.
The unit will also form part of a networked Worcestershire Children's Hospital together with the main centre in Worcester and improved community services.
But the loss of overnight paediatrics means delivery of babies in a consultant led unit will also not take place at the Alex in future. But the panel has recommended a seven day a week maternity access unit be provided which would allow women to have their scans, ante-natal clinics and post-natal care in Redditch.
Concerns over maternity capacity in the wider region were also recognised and as a result it is recommended deliveries at the Alex should not be stopped until Birmingham Women's Hospital and the Worcestershire Royal have been upgraded to offer women choice. A midwife led unit for those women with low risk births at the Alex or the Princess of Wales in Bromsgrove is also being looked at.
Emergency surgery is likely to be centralised into Worcester because of concerns over safety but the Alex will become the county centre of excellence for orthopaedics and remain the country centre for urology. It is also expected some elective operations carried out in Worcester will also be moved across to make room for the expansion required at the Worcestershire Royal.
The panel has also recommended commissioners and Worcestershire County Council review public transport links between the north of the county and the Worcestershire Royal.
The report has been agreed by key members of the county's health system including commissioners across Worcestershire, Worcestershire Acute Hospitals NHS Trust and NHS England.
Work now needs to be carried out to see if the recommendations are affordable and approved by the boards of the county's various health organisations.
It is expected formal public consultation will take place in the Autumn.
It will take between two to three years to implement the changes once a final decision has been made and signed off by the Health Secretary.
Dr Nigel Beasley, chair of the independent clinical review panel, said: "We have aimed to achieve a balance between access to local services and improving the quality of those services, only supporting proposed changes where we felt this was in the best interest of the whole population of Worcestershire.
"We believe our recommendations support the development of clinically safe and sustainable health services both now and in the future."
Dr Jonathan Wells, chair of Redditch and Bromsgrove CCG, added: "The range of services recommended is significantly better than was initially proposed last year.
"We particularly welcome the panel's firm recommendation an Emergency Department must remain at the Alexandra Hospital and their call for consideration of a midwife led unit."
Penny Venables, chief executive of Worcestershire Acute Hospitals NHS Trust, said she believed the panel had set out a 'workable solution which will serve Worcestershire for many years'.
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