Home » Your Questions
The answers to the most common questions are under Frequently Asked Questions.
We are also continuing to publish the questions and answers you have sent in so will update the document below as and when required.
Please note: where a query has been submitted without permission to publish as an individual response, we have included the questions and answers in the document ‘Questions submitted from the Public’.
These are questions, not comments, which have been submitted via email, letter and those that we have been asked to take back from Information Sessions.
Latest update: 8 July 2016
We have also published transcripts of the Public Meetings.
1. Who led the public consultation?
NHS Calderdale Clinical Commissioning Group (CCG) and NHS Greater Huddersfield CCG, as the organisations responsible for planning and buying health services in Calderdale and Greater Huddersfield, led the public consultation supported by Calderdale and Huddersfield NHS Foundation Trust. Read more under About us.
2. What services could change?
Under the proposed changes, all emergency, acute and high risk planned care would be brought together at Calderdale Royal Hospital (CRH) and the Acre Mills, Huddersfield site, would be developed as a hospital dedicated for planned care.
The proposed new model of care is supported by further strengthening and considerable investment in community services.
3. How long did the public consultation last?
The consultation is now closed. It started on Tuesday 15 March and ran for fourteen weeks, until midnight on Tuesday 21 June 2016 (with an extension for online surveys to 24 June due to a technical error).
4. Where can I find information about the proposed changes?
The consultation is now closed, but you can still find out more about the proposed changes. You can:
5. What will happen at the end of the public consultation?
The consultation is now closed.
The Governing Bodies of NHS Calderdale and NHS Greater Huddersfield met on 20 October in public in parallel to decide on the outcome of consultation and deliberation. They both individually and unanimously decided to move to the next stage – exploring implementation of the proposed changes in a Full Business Case.
6. What would the proposed changes mean for patients?
We are not closing services – we are changing the way we deliver services to improve services, quality of care and outcomes for patients. The proposed changes would also help to save more lives, improve experiences, provide long term clinical and financial sustainability and ensure that we are able to maintain two thriving busy, local hospitals.
7. Is this about saving money?
No. The number one priority is to save more lives, keep people healthy, make services safer and improve quality of care. The proposed changes are also designed to bring services in line with national care standards and make them sustainable, in terms of money and staffing, into the future.
If we do nothing, we will not have sustainable services for the future. Our proposals would be a significant investment significant additional financial investment in facilities, equipment and staffing over the next five years and will see new, modern healthcare facilities being built in both Halifax and Huddersfield.
But we think it is important to provide you with the best care at the right place at the right time and we believe these proposals will help us to do that.
We are proposing to change the way we treat people – not close services. This will improve quality and safety of services for the future.
There are new names for some services, for example, Urgent Care Centre, and Emergency Centre. These descriptions are replacing familiar names like ‘Casualty and A&E departments.’ The public consultation is an opportunity for us to describe these services.
Currently, we have problems finding and keeping staff in some areas and we are struggling to meet national guidance and recommendations of the Royal College of Emergency Medicine. This is harder because we deliver the same services over two sites with the same staff.
Additionally, a national shortage of middle grade doctors means that consultants increasingly have to provide cover overnight, which then reduces the number of consultants available during the day.
There is new national guidance for urgent and emergency care and for seven day working in the NHS. In developing our new model for hospital and community services we have been following this guidance.
If we do nothing, we will not have sustainable services for the future. We are facing a very difficult financial situation and if we do not change our system it will become financially unsustainable. This means we will not be able to afford the improvements needed to deliver consistently safe, high quality, sustainable care.
9. How will I know which hospital to go to if the proposed changes are implemented?
If the proposed changes go ahead, we would continue to encourage you to:
If the advice was to go to an Urgent Care Centre, appointments would be made directly by NHS 111.
Or you would be able to go directly to an Urgent Care Centre yourself. If our proposals go ahead, there would be an Urgent Care Centre at both Calderdale and Huddersfield.
If you became a patient as a result of a serious or life-threatening illness or injury, the ambulance staff who respond to your emergency will take you to the most appropriate hospital for your needs. This could be the proposed Emergency Centre at Calderdale or, like happens now for patients with serious multiple injuries, heart attacks or burns, to a Specialist Emergency Centre such as Leeds or Wakefield.
We have looked very closely at the different ways that we could use our two hospitals to address the challenges we face and ensure high quality, safe, sustainable and affordable services going forward.
The range and extent of challenges facing Calderdale and Huddersfield NHS Foundation Trust, other providers and local commissioners (the organisations who plan and buy hospital services) and public engagement has helped us to shape a future model.
In order to appraise our options, we applied a number of criteria: quality of care, access to care, value for money, deliverability, sustainability and co-dependencies with other strategies. Our appraisal supported the case for acute and emergency care services to be delivered from Calderdale Royal Hospital.
We looked at a number of ideas and ‘tested’ them against various criteria which you can read in detail in Options Criteria.
We started with the clinical standards we needed to achieve and then identified the outcomes & benefit for patients we needed to deliver. We then involved clinicians from hospitals and CCGs and developed a potential clinical model. To find out more about this, read our pre-engagement information and what we did before we began the Consultation.
We then looked at how we could deliver this model and started with 11 options (that you can read about in this 11 options – PCBC extract) from minimum change to reconfiguration.
We then looked at the three viable options in greater detail against the criteria we designed to ensure we delivered against both clinical standards and the outcomes and benefits we need to achieve for patients.
We want to be honest with local people and are clear that our assessment shows that doing nothing would not achieve the improvements in quality and safety needed. Other alternatives to the proposed changes would be much more expensive and would be unlikely to attract the funding we would need to develop both hospitals.
We believe our proposed changes would result in the greatest overall benefits for people living across Calderdale and Greater Huddersfield.
We asked an independent body to help us understand the impact of our proposals on the Yorkshire Ambulance Service (YAS). This work concluded that there was no disproportionate impact on the Yorkshire Ambulance Service arising from choice of site. Any discussions on whether or not a reconfigured hospital service resulted in a requirement for ‘extra’ ambulance resources would be managed through the Clinical Commissioning Group (CCG) and YAS’s contractual discussions. As part of this, consideration would also be given to reductions in ambulance journeys arising from a reduction in the significant number of transfers that occur between our hospital sites on a daily basis at present.
The assessment of additional ambulance hours is summarised in the Pre-Consultation Business Case and the full report detailing how these figures were determined is also available (under Travel & Transport and in Hospital Services Reconfiguration Travel Analysis report -November 2015 and Hospital Services Reconfiguration Travel Analysis – supplementary report – November 2015).
YAS NHS Trust has been fully involved and engaged with the programme and therefore fully informed of the potential changes within the local health economy. The subsequent travel analysis was designed around YAS NHS Trust specification as well as the programme board’s requirements.
YAS has identified the additional resource that would be required to meet these hours and this was presented in public to the Calderdale and Kirklees Joint Health Scrutiny committee by YAS on 19th April, 2016.
A detailed analysis was undertaken as part of the Pre-Consultation Business Case which considered evidence available in relation to protected characteristic groups, for example, age, ethnicity, sexual orientation, and carers. This did not identify any high risk impacts. In delivering the consultation, we intend to further understand transport issues and consider what actions we could take to mitigate any adverse impacts identified.
Our proposed changes would ensure that our population lives in reasonable distance of an Emergency Centre. We continue to have discussions with neighbouring Clinical Commissioning Groups (CCGs) and Yorkshire Ambulance Service about how our plans align.
Our aim is to secure safe, quality services that meet the needs of local people now and into the future.
No redundancy costs have been included in reconfiguration costs in the financial case despite the projected reduction in whole time equivalents arising from the proposed service changes. It is assumed that business as usual turnover of staff, currently 15.4%, will be sufficient to achieve the necessary reduction in whole time equivalents.
By making these changes, we would make the NHS in Huddersfield and Calderdale a desirable place to work, so we can attract and retain the very best staff to provide the right care, at the right time in the right place. Our people would be involved planning new services and proud of the changes we propose.
Population growth across both Calderdale and Huddersfield is expected to be in the region of 13%. We have taken into account the expected increase in population as part of the demand profile that we used to understand the potential future pattern of service use and access to services. We have also undertaken a comprehensive transport analysis and we have also aligned our plans with both local Joint Strategic Needs Assessments (JSNA).
A detailed analysis was undertaken as part of the Pre-Consultation Business Case which considered the travel impact of our proposals on patients.
In addition to the details contained in this work, we have made a commitment in our consultation document to establish a travel group which includes patient representatives, so that we can consider what more we can do to address people’s concerns regarding travel between the two sites.
Importantly, there are plans for a £4.5 million road improvement scheme to ease congestion on the A629 between Jubilee Road and the junction with Free School Lane in Halifax.
The proposals include widening the highway and upgrading the traffic lights system to reduce journey times, ease traffic flow and improve air quality. Work is scheduled to start on site in autumn 2016. More information can be found on Calderdale Council’s website. Yu can also read more detail in the Travel and Transport analysis.
18. There will be longer travel times – in emergencies people will die
Travel and transport are important issues that we consider very carefully when there are any proposed changes to health services.
In the case of an emergency the most important thing is having the right people and equipment available to patients at the right time. Often this means in the ambulance before any journey starts.
Ambulance staff priorities start with stabilising a patient before a journey starts and the right decision in an emergency can be to take seriously ill patients to a specialist hospital, with specialist staff and the very latest equipment – even if it is some distance away. For example, heart attack victims and those with serious head injuries are stabilised before they are taken to Leeds by ambulance.
Read more in our Travel and Transport analysis.
The land and building are owned by Pennine Property Partnership – which is a joint venture between Calderdale and Huddersfield NHS Foundation Trust (CHFT) and Henry Boot. CHFT pays rent on the half that Henry Boot own. It’s like a shared ownership scheme on a house.
Subject to the outcome of the consultation, the potential new hospital development would be built on land wholly owned by CHFT.