Smaller hospital services ‘will need to change’, councillors told

NHS bosses have warned local standalone services, such as urology, at smaller hospitals will increasingly become a thing of the past partly because many medics do not want to work there.

North Yorkshire’s scrutiny of health committee heard many medics wanted to be part of a bigger workforce than there is at hospitals such as Scarborough and Northallerton as they could get more peer support.

North Yorkshire clincial commissioning group director Simon Cox was speaking to the committee about a fresh health provision strategy for the east coast.

The meeting heard the NHS is developing plans for transport services for patients as the future would involve more integrated services with places such as York Hospital, which is 42 miles from the hospital in Scarborough.

He said: “To be perfectly honest with scrutiny, the sort of model that was in place in Scarborough and indeed in many other smaller hospitals of a largely standalone urology service of four or five consultants is not a model that is sustainable in terms of the development of modern medicine. We are seeing larger groups with more specialisation. In 2000, most of the major urology surgery was done in Scarborough Hospital. Much of that isn’t now.

“The more specialist cancer work goes to Hull and some of the more major surgery that requires intensive care will be done in York. We need to look at a network solution for urology. We are committed to maintaining as much access to urology services in Scarborough as possible and in the new year we will have a clearer view of what in the long term that will be. What it won’t be is going back to how it was 12 or 18 months ago because there aren’t enough urologists around to do that.”

Councillor John Clark said while it was apparent the NHS increasingly was aiming to move patients to regional specialists rather than provide care locally, it was unclear if the environmental cost of the journeys had been examined.

Mr Cox said the travel impact would be assessed with every service change. He highlighted a Royal College of Physicians report which found five per cent of car journeys were related to the NHS. He said: “We recognise we have got a huge impact on the environment and we need to manage it.”

When asked to outline his vision for what hospital services would look like in 20 years time in eastern North Yorkshire, he said: “There will still need to be access to urgent and emergency care, so some kind of emergency department, although the maternity service is one of the smaller ones in the country it is still a long way from somewhere else, so we anticipate there be some kind of maternity and therefore paediatric support.”

He added one discipline the NHS would “want to excel at” in the coastal area, due to the high proportion of elderly residents, would be in care of the elderly.”

Scarborough councillor David Jeffels said the NHS vision was “very encouraging” as a positive future for the hospital would help attract investment for the town.

The committee’s chairman, Councillor John Ennis said while there appeared to be good news in relation to recruitment, there were also significant concerns that NHS bosses would introduce major changes by announcing temporary measures for services before making them permanent.

He said: “I think we are going to need to be watching this extremely closely.”