Primary Care Trusts across the county yesterday accepted the proposals for change to specialist inpatient children’s services and neonatal intensive care but have asked for further reports on an implementation plan and the development of overnight nurse led care.

The Boards recognised the strength of feeling in particular parts of the county. However they felt that it had not been possible to find alternative solutions to address the problems raised by Gloucestershire Hospitals NHS Foundation Trust, which had prompted the need to review the service. They recognised on balance that it was necessary to compromise on access to services for some in order to ensure a continued high quality specialist service in the county for all children and their families in the future.

However, Boards were clear that they would need to be satisfied that the issues raised during the consultation relating to how the services would operate in the future were fully explained in the implementation plan. On top of this, the Boards have commissioned a detailed option appraisal of how the impact on access for some families could be minimised through nurse led services.

Mr Richard James, Chief Executive, Cotswold and Vale PCT, which led the review and consultation on behalf of the county, said:

“Following the recommendation of the Joint Sub Committee on 19 January, the Primary Care Trust Boards have commissioned an option appraisal to consider how best to care for children and adolescents overnight who do need clinical care but do not require medical supervision. The option appraisal will consider three courses of action, the establishment of an overnight nurse led unit located at Cheltenham General Hospital; a nurse led hospital at home scheme or management through the specialist inpatient service at Gloucestershire Royal Hospital.”

Cheltenham and Tewkesbury PCT, Chief Executive, Caroline Fowles, said:

“The PCT Board has been convinced that the case for change to the way services are provided has been made and has agreed to the package of proposals. However as a result of what we’ve heard during the involvement and consultation period and through the valuable contribution of the ‘Save Battledown Campaign’, a wider range of services for children will be available in the PCT area. Battledown Ward will continue to be an active centre for children’s care with an extended assessment and treatment unit 7 days a week (9am – 10 pm). We will also be investing in additional children’s nurses working in the community."

West Gloucestershire PCT, Chief Executive, Stephen Golledge said:

“Last night, the PCT Board considered carefully the outcome of the consultation and the views of the Health Overview and Scrutiny Committee. The Board agreed that change was necessary and approved the recommendations from the Joint Sub Committee. Board members accepted that on balance it was necessary to compromise on access for some in order to ensure a continued high quality specialist service in the county for all children and their families. The Board will look at the implementation plan and the option appraisal at a later meeting.”



Decisions made

At their three separate Board meetings yesterday, Gloucestershire’s Primary Care Trusts discussed the recommendations from the Joint Sub Committee held on 19 January 2005, and agreed the following:

• to locate specialist inpatient care for children at Gloucestershire Royal Hospital;
  
• to locate neonatal intensive care at Gloucestershire Royal Hospital;
  
• to extend the opening hours of the children’s assessment unit at Cheltenham General Hospital to 9am-10pm, seven days a week;
  
• to recruit six new community nurses to provide more community and home care for sick children in the county.
  
  

Next steps

In the next few months Gloucestershire Hospitals NHS Foundation Trust will produce detailed plans for how the changes will take place. In the meantime, services will continue as they are at both main county hospitals. The progress of the plans will be looked at by the Overview and Scrutiny Committee in March and subsequently the final plans will be considered by the PCT Boards.

One of the issues raised during the consultation was that of providing wider accessto nurse-led overnight care for children across the county. The PCT Boards will receive the option appraisal report and make recommendations on this later this spring.