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Statement on the future of musculoskeletal services at Western Sussex Hospitals

Tuesday September 16, 2014

Earlier this year the Coastal West Sussex Clinical Commissioning Group (CCG) sought bidders for a contract to become a new prime provider of musculoskeletal (MSK) services in our area.

These services comprise elective orthopaedic surgery (planned operations such as knee and hip replacements), rheumatology, pain services and community physiotherapy, as well as imaging and pathology work related to these.

A prime provider takes responsibility for the whole commissioning budget and the design of the care pathways within that service. We, in partnership with Sussex Community Trust and other not-for-profit organisations, submitted a bid to become the prime provider.

Unfortunately, we were very disappointed to learn that we were unsuccessful in that bid, and were informed by the CCG on September 2 that BUPA, in consortium with Central Surrey Health (CSH), is due to be awarded the contract from January 1, 2015.

Our proposed model of care was very similar to that being implemented in East Sussex and Brighton and Hove, and we were confident we had tendered a strong and realistic bid.

It benefited from our considerable experience of the healthcare needs of our local communities, was totally focused on our patients and shaped by direct feedback from them.

The trust board was therefore very surprised by the decision to award the contract to BUPA CSH Ltd.

There has subsequently been a ‘standstill period’ in which we have sought to learn more about the implications of this decision for our patients and our staff before making a public statement of our position.

There are still a large number of uncertainties surrounding the award of this contract, as well as around the way in which the new service is expected to function.

We are also seeking more information and assurances from the CCG over the impact the decision will have on hospital services more widely, including emergency trauma and orthopaedic surgery, and will respond to these issues as they evolve.

However, it is important to reiterate that our bid was a very strong one and is based on our unique understanding of the broader healthcare issues facing our community and our track record as one of the country’s highest performing trusts.

For example:

  • Outcomes for our patients continue to improve, with mortality rates now standing at 87.6, against a national average of 100
  • Maternity services have achieved the CNST Level 3 standard of patient safety with the highest score in the country
  • We have reduced incidence of Clostridium Difficile infections by 50% in the last three years
  • Our results in the national ‘Family and Friends’ test are 9% above the national average, with the latest month’s figures showing every patient on our orthopaedic ward at St Richard’s would recommend its care
  • Our orthopaedic service has reduced the time patients have to spend in hospital from seven to four days on average and have reduced the proportion of patients needing a blood transfusion from 16.5% to just 3.1%
  • And at the beginning of September the Trust received a commendation from the National Hip Fracture Database in a report by NHS England for the major improvement we have made around mortality for fractured neck of femur incidents.

Although there are still many questions to which we await answers, the trust and its employees remain utterly committed to putting our patients first throughout this process and beyond.

The individual services affected will of course communicate any forthcoming changes that affect patients as soon as the impact of these is clear.

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