South Downs A&E is at risk after new contract

Health chiefs this week said the decision could threaten the future viability of A&E services at Chichester and Worthing hospitals.

Coastal West Sussex Clinical Commissioning Group (CCG) – led by local GPs - has handed a £235m contract for musculoskeletal (MSK) services to a new private partnership between Bupa 
and Central Surrey Health, called Bupa CSH Ltd.

The two main NHS trusts which were outbid and lost the contract were Western Sussex Hospitals, which runs St Richard’s Hospital at Chichester and Worthing Hospital, and Sussex Community Trust, which oversees the majority of NHS services outside the hospitals.

Both trusts last week expressed their disappointment, and Western has gone further by saying the loss of this contract could well threaten the very viability of its two A&E services.

The reasons are twofold. MSK services are some of the most lucrative that exist in the whole NHS. Other services, often including those in A&E, lose money, so the profit-making elements are crucial to balance out those that don’t make profit to sustain the complete services.

Secondly, many surgeons who carry out planned orthopaedic procedures such as hip replacements are the same who would do emergency treatments, for example if an elderly person slipped and broke their leg and needed an emergency operation.

The planned procedures are covered in this MSK deal, the emergency ones are not, and Western is calling for clarity over how this will affect its deliverance of the combined services.

A spokesperson for the NHS Coastal West Sussex Clinical Commissioning Group (CCG), insisted patient choice ‘will not be affected’.

But the decision has been criticised as ‘privatisation by stealth’ by the vice chairman of West Sussex County Council’s health watchdog, Dr James Walsh.

Dr Walsh, a Lib Dem councillor, is calling for the Health & Adult Social Care select committee (HASC) to hold an emergency meeting discussing the decision to hand control of all orthopaedic services to the private sector.

He said: “When HASC looked at the plans several months ago one of the conditions was that the CCG should conduct a full assessment of how any of the existing services would change and I don’t believe that has been done.”

A spokesperson for Coastal West Sussex Clinical Commissioning Group (CCG) said it had conducted detailed focus groups with patients and clinicians over a three-year period.

But speaking generally about the deal Dr Walsh said: “It’s another layer of management which won’t have any perceived benefits.

“My understanding is it will bleed some £30m away from Western (Sussex) Hospital Trust which runs Worthing and St Richard’s and put severe pressure on maintaining existing orthopaedic and trauma services.

“Therefore it could lead to cuts in those services at either or both hospitals.

“It’s a private company and I have serious concerns about this privatisation by stealth.”

Service concern: page 11