For-ward thinking

THE full details of Hinchingbrooke Hospital's rescue package will be unveiled tomorrow (Thursday).

It will guarantee services on the site for the next 15-20 years.

The Hunts Post has been given an exclusive preview of how the Huntingdon hospital will be remodelled to ensure it is clinically and financially sound.

Hinchingbrooke chief executive Mark Millar, along with other members of NHS staff, has been working on detailed plans for the hospital following the three-month public consultation exercise earlier this year.

While the basic plan for the hospital has never been in doubt - retaining core services and allowing others to be provided in the community - implementing the scheme was always going to be the difficult bit, said Mr Millar.

However, the Hinchingbrooke team believes it has cracked it and has arranged a number of pilot schemes to run at the hospital that could provide a model for hospitals countrywide.

One of the first phases of the plan is the reorganisation of the hospital site. The six wards at the front of the hospital will be revamped by the end of next year, adding en suites, and the wards at the rear of the site will close. Other services, such as renal, will be shuffled around the hospital, bringing them closer together.

This move will see the rear of the hospital made redundant and will give Hinchingbrooke an asset capable of being sold and raising money that may no longer have to be put towards its predicted £40million debt.

"To get the hospital developed for the next 20 years means we're going to need to spend capital," said Mr Millar, 53. "With any refurbishment of wards there's going to be money spent on it and that financially has been accepted by the Strategic Health Authority.

"It's quite possible that the proceeds from the back of the site could be used to fund the refurbishment for the front of the hospital. However, the refurbishment is not dependent on this."

With the back of the hospital being closed down, many patients will be seen in the treatment centre. All out-patients and all elective surgery will be sent to the centre, increasing its usage. However, Mr Millar said there would still be capacity for private work, which brings in additional revenue, and capacity for local growth.

Work to remodel maternity services is already taking place. Midwives from Hinchingbrooke have taken over the responsibility for Cambourne's expectant mothers, meaning many of the new children in the villages will be born in Hinchingbrooke rather than Addenbrooke's Rosie Hospital in Cambridge.

Mr Millar said the result is likely to provide a "greater" number of deliveries than Hinchingbrooke needs to make the unit sustainable, but they would know more in "about nine months".

The agreed option for Hinchingbrooke following the consultation did not propose any major changes to emergency services (A&E and emergency surgery), cancer services or general surgery.

However, Mr Millar said there were some plans he would reveal on Thursday which would see Hinchingbrooke pilot new ways of working for the hospital - and the NHS.

One example is operating theatre timetables. Gone will be the rigid structure that allows theatres to be used for 3 only.5 hours a day, and in will come new flexible working patterns.

Moving some services (dermatology, gynaecology, dressing clinics, etc) into the community is also beginning to help the hospital - and a lot quicker than expected, said Mr Millar.

The hospital is seeing fewer people in its emergency unit thanks to schemes that allow patients to be seen by GPs and not admitted to hospital unless it is necessary.

This effectively decreases the hospital's work, but also saves money and unnecessary expenditure. All of these changes will help Hinchingbrooke save £14.5million a year and see its work reduced by about 20 per cent.

And so to the huge Hinchingbrooke debt - estimated to soon have reached £40million (50 per cent of the hospital's turnover). A national problem, that needs to be solved nationally, said Mr Millar.

There are other hospitals that have been left in a similar situation to Hinchingbrooke, and all of these are part of ongoing national negotiations with the Department of Health to determine how the debt can be repaid as part of a national solution.

The turnaround in Hinchingbrooke's fortunes has also seen its staff turnover start to decrease, and the hospital is once again recruiting new staff - four consultants have received job offers in the past week.

Work has also been carried out in most areas of the hospital to determine the staffing levels and skills needed to provide the remodelled services. While the proposals suggested 200 jobs would have to be cut, Mr Millar is certain staff turnover will account for the majority, if not all, of these, and many have gone already.

Over time, and with details of the rescue package being finalised over the coming months, Mr Millar is hopeful staff turnover will continue to fall, and staff morale will continue to build as they discover more about the detailed plans for Hinchingbrooke and take part in the ongoing consultations.

Mr Millar added that he hoped his plans for a sustainable hospital will finally convince the doubters that there can be a long term future for Hinchingbrooke.

"This will put some certainty back into the where the hospital is going," he said.

INFORMATION: Mark Millar will give his talk, Building a Sustainable Hospital, at a board meeting of Hinchingbrooke Hospital at 11am on Thursday in the conference room at the hospital. This will be followed in the evening, starting at 7.30pm, by the AGM in the out-patients' department.