I WRITE in response to Dorset CCG’s recent letter to the Echo (Aug 24) to address the claims that the plans will bring benefits, in order.

1) There is no clinical evidence that the plans will support healthier lives. There is no evidence base to support reduction of A&E and Maternity locations in a rural area like Dorset, however there is clear evidence of increasing fatality with distance to care, and no proper risk assessment of the plans has been carried out.

DCCG calculated for the High Court that 132 ambulance emergencies over four months, or 396 per year, would be put at ‘potential clinical risk’ due to longer journey time under the plans. This does not include the risk to the vast majority of maternity and child emergencies, who self present to hospital. Dorset CCG state in their Equality Impact Assessment that longer travel in labour, birth and child emergency is a significant risk.

2) State of the art facilities. What we need is more staff and more beds. New buildings do not solve these issues and the trusts will have to repay £5 million per annum in ‘dividends’ for the Govt’s £147 million ‘investment’.

3) The ‘integrated community services’ on which the cuts to A&E and Maternity departments and acute beds are predicated, will be funded out of a revenue deficit – none of the £147 million is for these services – and DCCG calculated a staff shortfall of approx. 900 staff for these services in 2017. There is in any case no clinical evidence that integrated community services, however welcome, can reduce demand for acute services and beds below baseline.

4) Many staff do not in fact support these changes, they believe the changes are dangerous, and staff, including senior staff, gave this feedback to the CCG during the consultation process, but it was ignored.

5) The plans are currently being reviewed by the Independent Reconfiguration Panel, following referral from Dorset County Council, supported by eight other Dorset Councils (Poole Borough, Weymouth and Portland Borough, Purbeck District, Swanage Town, Portland Town, Langton Parish, Corfe Parish and Worth Parish) due to concerns about risk to life due to longer travel to access care in emergency and that community hospitals and beds were being closed but there were no replacement ‘integrated community services’.

6) The 24/7 Consultant delivered care claim was denied by the CCG in the High Court. There are no plans to provide 24/7 consultant delivered care in the foreseeable future, and this claim is highly misleading.

7) The plans will lead to MORE transfers between the hospitals because people will self present to the UCC who need A&E care or admission, and who will have to be transferred to RBH.

8) Outcomes will worsen for cardiac patients as the plans essentially involve closing Poole cardiac department, which treats some types of heart attacks. A FOI shows that in 2017 127 heart attacks were treated at Poole, 102 of which were taken there by ambulance, and 38 cardiac arrests were treated at Poole, all taken there by ambulance, in fact more cardiac arrests than the 30 that were taken to RBH that year. The Ambulance Trust’s triage tool tells them to take patients to the nearest A&E where there is danger of loss of life. What will happen to these patients when Poole A&E is no longer there?

9) Outcomes are likely to worsen for stroke patients as there is no clinical evidence base for centralisation in rural areas where longer times to care outweighs any benefits.

10) Given that 245 acute beds will close, and the reduction in beds at Poole from 654 to 247, it is extremely unlikely that it will be quicker to access a bed for a planned operation than it is at present.

11) It is not clear on what basis shorter waits for cardiac treatment and reduced length of stay can be related to any hospital location. It is difficult to see how the same number of staff with more patients and less beds will provide a better service. Putting all the staff on one site does not increase the number of patients any single staff member can deal with safely.

12) The claims for ‘new’ services at RBH are again highly misleading and these services are simply those closing at Poole. The ‘new’ Urgent Care Centre is a downgrade from Poole A&E. A UCC treats a narrow range of health issues, the same as those treated by a Minor Injuries Unit, and can be Nurse led.