Liverpool Women's Hospital (Summer 2016)

In the summer of 2016 we looked at how at how services provided at Liverpool Women’s Hospital could be improved in the future.

We published the results of our findings in September 2016, followed by the draft pre-consultation business case in January 2017 which outlined four possible options (summary version available here).

Below you can find the background information and frequently asked questions that were published as part of the pre-consulation in June 2016.

Documents

Information booklet

Engagement report and appendix

Draft pre-consultation business case

Draft pre-consultation business case - summary version

Engagement plan

Questions and answers from public meetings held during July and August 2016

FAQs (June 2016)

What’s happening?

The NHS is looking at how services provided at Liverpool Women’s Hospital NHS Foundation Trust could be improved in the future.

The services Liverpool Women’s provides include:

  • Neonatology (for premature and poorly newborn babies)
  • Maternity (for pregnant women and new mums)
  • Gynaecology (for women with problems affecting their reproductive system)
  • Anaesthetics, theatres and high dependency unit (supporting women during and after surgery)
  • Reproductive medicine (helping people to conceive – fertility treatment)
  • Genetics (helping people to understand their family medical history through their genes and how this might affect their diagnosis/treatment).

Why do services need to change?

Midwives, nurses and doctors believe women and babies could receive better care if things were done differently because:

  • The needs of patients have changed since the hospital opened more than 20 years ago
  • There are new ways of caring for patients and higher standards for how this care should be delivered
  • The way that services are currently delivered is not affordable

You can read more about the reasons change is needed, including real life examples, in the leaflet available to download here.

How have midwives, nurses and doctors at Liverpool Women’s been involved in the review?

The review was prompted by the clinical case for change that was developed by midwives, nurses and doctors at Liverpool Women’s.

In 2015, there were multiple clinical workshops held for staff from across Liverpool Women’s to discuss how services could be made better for the women and newborn babies they care for. The workshops involved doctors, nurses, midwives and clinical support staff, as well as patients and partner organisations.

Clinical directors (the most senior doctors for each of the hospital’s services) took part in sessions where they discussed the needs of their service, and plans and ideas to improve those services. An internal ‘Clinical Council’ was established, made up of senior doctors, nurses and midwives, to add a further level of scrutiny and to check and challenge the work as it developed.

A clinical reference group has been set up to support the review process by providing clinical expertise and input. This group has an independent clinical chair, and its members include senior doctors, midwives and nurses from across the NHS in Liverpool. 

Will some services have to move from the Liverpool Women’s Crown Street site?

In order to make sure services for women and newborn babies in Liverpool meet national standards, it is likely that proposals will include moving at least some of the care currently delivered at Crown Street to a different location or locations.

Until we have finished assessing the various options – and gathering the views of the public as part of this process – it is too soon to provide more details about which proposals might ultimately be put forward for public consultation. 

Could the review mean that the Crown Street site will close?

There are no plans to close the site and if some Liverpool Women’s services did move it is expected that Crown Street would continue to deliver NHS care in the future.

Will services be cut?

There is absolutely no threat to the services themselves. This process is about making what we have even better and protecting services for the future.

How can I share my views?

There are a number of ways you can get involved.

  • You can complete the online questionnaire available here (no longer live)
  • You can attend one of our public events, which are taking place throughout July and August 
  • You can request a paper copy or alternative format of the questionnaire by calling 0151 296 7537. Paper copies of the questionnaire are available from libraries, Lifestyles centres, GP practices, walk-in centres and children’s centres across Liverpool and various locations across Sefton, Formby and Knowsley.  

Who is involved in this work?

The review is being led by NHS Liverpool Clinical Commissioning Group (CCG), in partnership with Liverpool Women’s Hospital.

Liverpool CCG is responsible for planning and buying hospital and community health services for the people of Liverpool. It is made up of representatives from each of the city’s 93 GP practices.

In addition to Liverpool patients, Liverpool Women’s cares for people living in Sefton and Knowsley, so South Sefton CCGSouthport and Formby CCG and Knowsley CCG are also involved in the review.

A number of other organisations and bodies are involved in the review, including Aintree University Hospital, the Royal Liverpool and Broadgreen University HospitalsAlder Hey Children’s HospitalNHS England, and the Cheshire and Merseyside Women’s and Children’s Services Partnership.

What options are being considered?

This review involves looking at all possible options, then narrowing them down and testing them against key requirements.

The most important of these requirements is whether an option will deliver the very best care for women and newborn babies.

We also need to consider affordability, feasibility, and how different options fit with other local and national plans.

We do know that some services for women and babies need to be delivered alongside other specialist hospital services and intensive care if we are to meet national standards.

But no final decisions have been made yet, and it is too early to talk about specific options.

People will be able to comment on options during the full public consultation. We expect this will be in late 2016 or early 2017. 

Has a decision been taken to close Liverpool Women’s?

No decision has been made to close the hospital.

NHS Liverpool Clinical Commissioning Group, the organisation responsible for planning and buying local health care, has been leading a review into how services could better meet the needs of women and babies, now and for the future. This was announced in March 2016.

This is happening because midwives, nurses and doctors believe that care could be better if things were done differently.

The most important issue for this review is finding an option – or options – that allows patients to receive the very best care.

The health needs of women and babies are not the same as they were 20 years ago. More and more, Liverpool Women’s patients also need care from specialists who are based at other hospitals - this can mean transferring the most poorly women and newborns babies across the city by ambulance.

We need the public to share their views now to help us develop options for the future. People will then be able to comment on these options in a full public consultation. We expect this will be in late 2016 or early 2017.

Is Liverpool Women’s moving to the Royal?

No decision has been made about the future of services, and it is too early in the process to talk about specific options.

It is clear that some Liverpool Women’s services need to be co-located with an adult acute hospital so that they can meet national standards for care, however we need to let this review run its course, and consider all of the potential options for the future.

People will be able to comment on options in a full public consultation. We expect this will be in late 2016 or early 2017.

Is this review happening because of the need to save money?

This is about creating better, safer services.

Yes, Liverpool Women’s has financial problems, but even if this wasn’t the case then midwives, nurses and doctors would still want things to change.

The health needs of women and babies are not the same as they were 20 years ago. More and more, Liverpool Women’s patients also need care from specialists who are based at other hospitals - this can mean transferring the most poorly women and newborn babies across the city by ambulance. This doesn’t meet national standards or give patients the best experience of care. We think the women and newborn babies of Liverpool deserve the best services, which meet the highest standards – if we don’t change we can’t meet those standards.

The main reason for the review of services is to improve the care that patients receive, but we cannot ignore the serious and growing financial issues facing the hospital. We need to make sure that services are affordable if we are to protect them for the future. 

Why is it a problem transferring patients from Liverpool Women’s and the Royal Liverpool Hospital, given that the two hospitals are so close?

This issue affects some of the most seriously ill women and newborn babies, for whom time is critical. The issues are the same whether a patient is being transferred to or from the hospital.

Even if a transfer is over a very small distance – for example, within the city centre – women and babies can’t be moved until their condition is stable. This potentially means greater delays getting them the specialist care they urgently need.

During 2014-15, 451 patients were transferred to Liverpool Women’s and 360 patients transferred from Liverpool Women’s.

Current arrangements don’t meet national standards, and we think women and babies in Liverpool should be able to expect the very best level of care.

How will this review take on board the views of the public?

A really powerful clinical case for why change is needed has been made by the midwives, doctors and nurses who work at Liverpool Women’s, and the most important issue for this review is finding an option – or options – that allows patients to receive the very best care.

We know that people value the services provided at Liverpool Women’s, and listening to the views of the public is a key part of the review process.  

The NHS has a legal duty to do this, but more importantly, listening to people is the right thing to do because it helps us develop services which meet the needs of patients.

Liverpool Women’s first gathered the views of local people last summer as part of its Future Generations programme. Following this, a review of women’s and newborn babies’ services was announced in March.

As part of the latest phase of this review we need the public to let us know what they think of the reasons that change is required, and what things they think are priorities for improving services, to help us develop options.

All of the views received so far, and those gathered during the course of this year, will be fed into the process of deciding what future services might look like. People will then be able to comment on specific options in a full public consultation. We expect this will be in late 2016 or early 2017.

Will Liverpool Women’s Hospital remain on Crown Street?

The most important issue for this review is finding an option – or options – that allows patients to receive the very best care.

To enable services for women and babies in Liverpool to meet national standards, it is likely that proposals will include moving at least some of the care currently delivered at Crown Street to a different location or locations.

Until we have finished assessing the various options – and gathering the views of the public as part of this process – it is too soon to provide more details about which proposals might ultimately be put forward for public consultation. 

What will happen to the building on Crown Street if services move from there?

It’s too early to speculate about what options for the future might come out of the review, but it is likely that any space at Crown Street would be used for other NHS services. 

If change is needed to improve patient care, does that mean that services aren’t safe?

Staff at Liverpool Women’s make sure that care is safe, but in some cases it isn’t in line with national guidance, and doesn’t provide patients with the best possible experience.

We think the women and newborn babies of Liverpool deserve the best services, which meet the highest standards – if we don’t change we can’t meet those standards.

Challenges will grow year on year as more women with existing medical conditions have babies, more babies with complex conditions are born, and more women need complex gynaecological surgery.

To keep services safe for future generations we need to plan changes now.

How long will it take to decide what is happening to these services? If they are moving, how soon will this happen?

NHS Liverpool Clinical Commissioning Group announced a review of services provided by Liverpool Women’s in March 2016. Since then, local NHS organisations have been looking at the challenges facing these services, and considering how they might be delivered in the future. This has involved exploring all of the potential options.

No final decisions have been made yet. We need the public to share their views to help us develop options.

People will then be able to comment on these options in a full public consultation. We expect this will be in late 2016 or early 2017.

 

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