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175. The future delivery of Hospital services

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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY THE DEPUTY OF ST. JOHN

ANSWER TO BE TABLED ON TUESDAY 28TH MARCH 2017

Question

Further to the Assembly's approval of Future Hospital: preferred site' (P.110/2016), will the Minister set out the range of services that the Department of Health and Social Services will provide from the new Hospital and explain how the Department will ensure that sustainable and accessible transport links are maintained (or improved) for specialisms required off-Island?

Answer

The new hospital will broadly provide all that the existing hospital provides. The new build will not prevent us from doing anything that we currently do or automatically allow us to do more. We will continually seek to undertake treatment on island where clinically safe and cost effective to do so.

Services in the New Hospital will include all of the following:

24/7 services

Emergency Department

Emergency in-patient facilities and 24/7 medical staff for Medical, Surgical and Paediatric care Maternity Unit, Obstetric Theatre and Special Care Baby Unit

Emergency Theatre

Intensive Care Unit and High Dependency Unit

Imaging

Pathology

Pharmacy

Physiotherapy

Medical Records – with out of hours retrieval

Estates and Facilities

Planned/elective/out-patient services Renal dialysis

Oncology unit with chemotherapy provision Medical Day Unit

Day of Surgery Unit

Elective in-patient beds

Orthopaedics

Breast Surgery

Colorectal Surgery

General Surgery

Urology

Vascular Surgery

Ears Nose & Throat

Ophthalmology

Cardiology

Gynaecology

Oral surgery

General Medicine

Neurology

Pain Management

Diabetes

Rheumatology

Nephrology

Paediatrics

Haematology

Gastroenterology

Cardiology

Respiratory

Infections and Blood borne diseases Genital Urinary Medicine

Off-island provision

Emergency and urgent transfers for conditions such as multiple trauma, head injuries, burns, cardiac interventional care etc. will be flown urgently to a specialist centre by our contracted air ambulance and this will continue to be the case in the future.

Across the whole spectrum of elective services there will be cases that are rare or complex and that are best managed in specialist centres. These cases will be referred off-island and include services such as:

Radiotherapy Neurosurgery

Complex Spinal Surgery Transplant Surgery Complex Paediatric cases Cardiothoracic Surgery Second opinions or advice

It is highly unlikely that we will undertake these services on-island due to the low number of patients requiring these treatments and the need for specialist skills and equipment.

Off-island transport and access

We have partnerships, via contracts, with key UK Specialist Centres. In recent years, these contracts have also required the UK centre to provide transport links from airports to their hospitals. The vast majority of our patients fly to airports where there are multiple daily flights and reasonable road/rail transport to the hospital (Southampton/Gatwick).

If flights are added or removed by the airline companies we will reassess the logistics hospital by hospital and adjust our patient flows accordingly.

The emergency transfers are undertaken via a contract with a specific provider. The current contract is due for renewal and will be finalised later in the summer. The sustainability of the service is a key element of the service specification.

Occasionally, due to adverse weather conditions, a helicopter is required to transport a patient off-island. This method of transport will be used if the patient's clinical condition cannot be safely or appropriately managed on-island whilst waiting for the weather to improve so a standard emergency flight can be undertaken.