future options for Chorley hospital

OPTIONS FOR CHORLEY A&E and OTHER SERVICES

Below is the long-awaited list of 'options' [source LEP] proposed for the future of Chorley A&E and some of the hospital’s other services, which will be discussed by the Our Health Our Care Joint Committee next week on Wednesday 28 August 2019 at 3pm.

Venue: Balmoral Suite, Farrington Lodge Hotel, Stanifield Lane, Farington, Lancashire, Preston PR25 4QR

NOTES: these are the Joint CCGs options based on financial sustainability. They are NOT YOUR OPTIONS* so feel free to comment on them.  *Although Option 3: type-1 A&E is preferred by local people and NHS campaigners as this fully reinstates a 24 hour A&E at Chorley & South Ribble hospital.

• Option 1 - No change but continue with the current 12-hour A&E facility and co-located urgent care centre - and make no changes to other services.
  
  Assessment: not clinically viable - due to staffing issues and absence of other key clinical services in Chorley Hospital.
  
  Recommendation: add to shortlist (as a benchmark for other options)

• Option 2 - No change, but implement wider system transformation
  As above but against the backdrop of continuing to implement policies to reduce A&E pressure - including plans to keep people out of hospital or reduce their length of stay.
  
  Assessment: not clinically viable - for same reasons as option 1
  Recommendation: do not add to shortlist

• Option 3 - Reinstate 24-hour A&E opening/upgrade A&E
  Either reopen the department 24 hours a day at its existing level (a so-called “type 3” facility, without co-located services such as emergency surgery and inpatient paediatrics) or upgrade to a “type 1” facility like the Royal Preston and reintroduce some services at Chorley which have been absent for 10-20 years.
  
  Assessment: not clinically viable - due to staffing
  
  Recommendation: add to shortlist (to “keep an open mind” on the basis of opinions expressed during public engagement)

• Option 4a - Enhanced urgent treatment centre (UTC) with level 3 critical care unit
  
  UTC staffed by “acute medical senior decision-maker” for 12 hours a day and GP-led during evenings/overnight. Plus, observation, medical assessment beds and general/speciality beds provided.
  
  Assessment: clinically viable - investment in workforce required
  
  Recommendation: add to shortlist

• Option 4b - as 4a, but without general/specialty beds
  
  Assessment: not clinically viable - due to delay caused to reviews by specialist consultants
  
  Recommendation: do not add to shortlist

• Option 4c - as 4a, but without medical assessment or general/specialty beds
  
  Assessment: clinically viable
  
  Recommendation: add to shortlist

• Option 4d - Enhanced UTC, without level 3 critical care unit
  
  No medical assessment or general/specialty beds, but an enhanced care unit to deliver level one post-operative care - meaning more planned surgery performed at Chorley.
  
  Assessment: clinically viable
  
  Recommendation: add to shortlist

• Option 4e - as 4d, but without enhanced care unit
  
  Assessment: not clinically viable - due to adverse impact on existing surgical capacity at Chorley.
  
  Recommendation: do not add to shortlist

• Option 5 - Urgent Treatment Centre
  
  24-hour UTC as currently operates on the Chorley site, without the presence of an acute physician.
  
  *There are 5 variants of this proposal, a)-e) - apart from offering a UTC rather than an enhanced UTC, they correspond with options 4a)-4e) above and so the assessments and recommendations for each are the same. Therefore, options 5a), c) and d) are deemed clinically viable, while options 5b) and e) are not.

Download the 'options' [whole document in PDF] from the Joint CCG