Newark Advertiser

Healthcare Q & A				Most Read Most Commented Top Videos
Below are questions sent in by Advertiser readers about the healthcare review and the full responses from NHS Nottinghamshire County. Q: If a patient with a heart attack in Newark is lucky enough to get an ambulance, will the paramedics be able to administer the vital clot-busting drugs? A: EMAS is required to respond to 75% of category A life-threatening calls within eight minutes across the whole area it covers and over a full year. NHS Nottinghamshire County is working in partnership with EMAS to identify what additional resources may be needed under the new proposals to allow EMAS to achieve its performance targets. Paramedics are not able to administer the vital medical attention for specialist and severe conditions. This has always been the case. Such specialist care will only be given by highly skilled and specially trained medical professionals. The Next Stage Review will ensure that people suffering from such severe conditions will get this specialist care when they need it, at specialist centres. They will be taken there directly so not having to endure dangerous transfers between hospitals. Q: It is essential that Newark has 24/7 cover for emergencies. It has already been proved that there is very inadequate ambulance cover. What plans are there for public transport from Newark to the main hospitals to enable all residents, but particularly the frail and elderly, without vehicles or the confidence to drive those routes to visit relatives? Have the carbon footprint and the total length of visiting time been recognised? The decisions always mean the vulnerable are disadvantaged even further. A: 85% of patients would still be treated at Newark hospital. 15%, those with the specialist and more or illnesses and injuries will be taken directly to where they can get the right care, first time. Under Option One in the proposals this would be a 24/7 operation. If the people of Newark choose Option Two or another option it will be important to ensure that further out-of-hours GP services etc are built into provision. EMAS is required to respond to 75% of category A life-threatening calls within eight minutes across the whole are it covers and over a full year. There are no targets in relation to the amount of time taken for patients to arrive at A & E. NHS Nottinghamshire County is working in partnership with EMAS to identify what additional resources may be needed under the new proposals to allow EMAS to achieve its performance targets. We are also working with Nottinghamshire County Council, responsible for highways and transport, to ensure that all transport access issues are considered. The important thing to consider is that people will get the specialist care they need and more people will survive and recover quickly under the new proposals and Next Stage Review findings. After receiving their specialist care, people would also have the option to return to Newark to recover closer to home. We take the green issue very seriously. Thousands of miles will be saved because more planned care (e.g. hip operations etc or surgeries people plan for) will be happening at Newark hospital. If you visit somebody in one of Newark's surrounding hospitals, every day for nine days, this could equal 360 miles. Under the possible future models, depending on where you live there may be no need to travel at all. This means we could reduce car journeys by thousands of miles every year and reduce stress to patients and their carers — as well as the carbon footprint. The decision will significantly improve the lives of vulnerable and disadvantaged people. For example, by supporting those with long- term conditions such as COPD (chronic obstructive pulmonary disease) closer to home or providing more care in people's homes for those with dementia. Q: Dementia is a huge problem for the partner, usually elderly, of the affected person; particularly the nights which are always disturbed so that the carer is always tired. Care in the home means the patient dictates the amount of care received and can refuse hygiene and feeding procedures. If the hospital ward is closed, Woods Court is sold and maybe then closed and sold on for building, what are the definite plans and how much increasing, ring-fenced funding will be set aside to implement them? Again the elderly in Newark will suffer. A: The evidence tells us that people with dementia remain at home for longer if they and their carers are supported in the home and admission to hospital is avoided. This applies to admission to a specialist mental health bed or an acute hospital bed. Services would remain available for the small number of people who require admission in to a dementia bed. Community and other services for people with dementia and their carers will be increased, including psychology and intermediate care in the home. Specialist services into Newark Hospital will also be put in place to ensure that staff are knowledgeable and skilled in looking after people with dementia who have a medical problem. As this is a consultation process the precise funding has not been finalised, however the PCT has made it clear that if Friary Ward closes all resources released will be reinvested in mental health services for older people. Q: Why is it, when the main topic of discussion in this town is the Growth Point and the pressure for more housing, are you prepared to close an essential A & E service that would be needed to service the expansion of the town and local population? In my opinion it appears very short sighted. A: Newark's healthcare review does take the expected growth into account. There will be many additional services, including more care at home for people with long term conditions, more outpatient clinics in Newark, and more day case surgery. It is important to understand what the exact proposals for urgent care are. While the new service would not be called A & E, in effect, it will largely offer the same care as now. The change in the designation of A & E is driven by changes in clinical standards, which make it clear that Newark Hospital is not equipped to deliver a full A&E service. This is already the case, and protocols have existed for some time so that ambulance crews take people with major trauma, for instance, to a centre that can offer the specialist support services, such as an intensive care unit. Patients with serious conditions like strokes or heart attacks will shortly, when the new models of care are established, need to go to specialist centres, with the medical expertise and back-up facilities to deliver the new treatments. Newark Hospital cannot do this. It is important to note, however, that there is NOT a significant reduction in what is being offered at Newark Hospital. 85% of patients will continue to be treated there. It is only the most serious cases that require specialist intervention that will need to go elsewhere. Newark’s population growth will not alter this. So rather than being short-sighted, this is a deliberate attempt to ensure that NHS services in Newark meet national standards AND the future needs of local people. Local doctors agree about this. Dr Andrew Parkin, a GP at Newark’s Lombard Street Surgery said: “Even if there’s a major increase in the population of Newark, there still won’t be sufficient numbers of seriously ill patients going through A & E to maintain the skills of the doctors in post. This review is an attempt to respond to the population increase. At the same time, standards of medical care are rising.” Dr Andrew Molyneux, service director for emergency care and consultant physician, said: “The sickest patients require the highest quality specialist care and facilities. The size of Newark Hospital’s means it would not be possible to develop the required facilities to support a full emergency department. These facilities could not be sustainably developed even with the predicted increase in the population, as the doctors would not see a sufficient number and range of patients to maintain and develop their skills.” Q: We need 24/7 opening hours due to the poor out of hours GP service, which often suggests going to A & E. Could I ask your thoughts on this? A A: We are proposing that there will be additional and enhanced GP services with out of hours cover. And we would like to hear your views on what that service needs to do. If patients have specific problems about the current out-of-hours GP service, they can contact NHS Nottinghamshire County on 0800 028 3693. We want local people to help us decide whether it is worth keeping the Newark Hospital unit open overnight, when the number of patients averages less than one per hour. Q: My own views on the change in services at the A & E are a definite no, but I have poor health, although I can go out and see many people worse than me. I ask what will happen both to them and their families who will have to travel? A: 85% of all patients currently treated at Newark Hospital will continue to be treated there. The only patients to go elsewhere will be those who need to, because their injury or condition is serious, and they require specialist care at a bigger hospital. This is what the national medical guidelines say should happen. If patients with serious conditions arrive at Newark Hospital, they have to be transferred by ambulance. This delays their treatment, and we want to avoid that. Once patients have received their urgent specialist care, they will return to Newark Hospital as soon as possible, to continue their recovery closer to home. Q: I am concerned that the consultation meetings organised by the trust are at times that make it awkward for all people to attend due to work commitments. Would it not be possible to arrange some meetings in evenings? A: We will be holding three public meetings. These are split across December, January and February. Two will run in the evening and one in the afternoon. Details of these can be found on our website, www.nottspsct.nhs.uk, and in our consultation document. We will also be attending local groups and market stalls to listen to public opinion. In addition, the local MP, Mr Patrick Mercer, is holding a public meeting about health on the evening of December 10. We will be participating in that. You can also contribute via our website, www.nottspct.nhs.uk/newark, by Freepost or by phone. Q: What happens if someone breaks a leg or arm or an elderly person has a fall? Do we now have to be transferred to King's Mill? A: Unless the bone fracture is obviously serious (eg the bone is displaced) you will be treated at Newark Hospital. In fact, 85% of people still will be treated at Newark - this will include all minor injuries, including broken bones. If an elderly person has a fall, it all depends on the nature of their injuries. It is possible that an ambulance may take that person straight to King’s Mill, if there is a head wound or the possibility of something serious (eg a damaged pelvis or internal injuries). This is the right thing to do. If such patients were taken to Newark, they would then have to be transferred to King’s Mill, delaying their treatment. So it is better for them to go straight to where they can get the right care, first time. Q: What happens if someone goes into possible early stages of heart attack or stroke? Again, do we now have to go to King's Mill? A: 'Right place, first time' and national research mean that people suffering from heart, stroke and major trauma need to go to specialist units. It may be King's Mill, it may be Nottingham University Hospitals (QMC or Nottingham City) - but East Midlands Ambulance Service will have clear protocols. The issue is that patients get the specialist and life-saving treatment they need and are then returned to hospitals closer to home to recover. It is scientifically and clinically proven this saves more lives. People will be brought back to Newark Hospital to recover, once their urgent treatment has been given and they are well enough. Q: What extra stress will this put on the already very concerned local GPs? A: GPs are in full support of the review and the proposed changes. Indeed, they have helped scope the options and there will be additional services put in place as needed - including extra GPs and additional cover outside GPs’ normal working hours. Q: Why, when Newark is a Growth Point town with three major transport routes intersecting through it, is it having its frontline services reduced? A: The NHS review is taking Newark’s expected growth into account. There will be many additional services, including more care at home for people with long term conditions, more outpatient clinics in Newark, and more day case surgery. The change in the designation of A & E is driven by changes in clinical standards, which make it clear that Newark Hospital is not equipped to deliver an A & E service. Patients with serious conditions like strokes or heart attacks need to go to specialist centres, with the medical expertise and back-up facilities to deliver the right treatment. Newark Hospital cannot do this. It is important to note, however, that there is NOT a significant reduction in what is being offered at Newark Hospital. 85% of patients will continue to be treated there. It is only the most serious cases that need to go elsewhere. Newark’s population growth will not alter this. Q: How much money is spent on health care for a citizen of Mansfield compared to one in Newark? A: On average, expenditure per head figures of £1,632 for High Point (Mansfield & Ashfield) and £1,459 for Newark and Sherwood. This spend is consistent with the fair share funding methodology which shows that High Point have a higher need for healthcare services due to social deprivation factors. Q: How long before an accident occurs on Boundary Road due to the horrendous carparking situation? A: Transport issues will be addressed as part of the consultation. Ultimately, street car parking and traffic issues are the responsibility of the local authorities. We are working closely with the Councils to ensure that provision is put in place. Q: Will the people of Newark now face an arduous thirty minute journey of extra pain and risk to life if these proposals are allowed to go through? How may people have died on route to King's Mill, QMC and Lincoln County Hospital because of a lack of heart attack care at Newark? A: Dr Andrew Molyneux said: "All doctors are in agreement that if a patient suffers a heart attack there is now a better treatment called primary angioplasty. This requires the patient to be in a specialist centre, with state-of-the-art equipment, facilities and with doctors who have unique skills. This saves more lives and improves the patient's quality of life." The trust said it would not be possible to give figures for people who have died on the way to other hospitals specifically because of a lack of heart attack care at Newark, as other factors may have contributed. Q: In essence we are seeing a systematic neglect of the people of Newark by the Nottingham Health trusts, we in Newark are the second class citizens of Nottinghamshire. A: Mr Matt Youdale, the trust's director of communications and engagement, said: "The opposite is just the case. This is about ensuring that Newark’s NHS is even better than it is now. So this is a positive thing for the people of Newark. People need to understand and believe that the review will possibly save more lives because it will ensure patients are taken to the 'right place, first time'. Newark is the lead for projects, such as this review, which will be happening right across Nottinghamshire to ensure that patients are getting the best possible care and treatment." More questions and answers will be added soon.