(Updated 22 May 2018)
1. What is the ‘Fit 4 the Future’ programme for Whitby?
As a CCG that is at the heart of the local healthcare system, our ambition for Whitby and the surrounding area is to increase years of healthy life and reduce the social isolation that unfortunately is experienced by so many people in later life.
• Adapt to the changing health needs of the local population.
• Accessible services across a rural community.
• Fit for purpose facilities by the redevelopment of Whitby Hospital.
• Engage with patients and members of the public.
• Value for money.
• Innovation in healthcare.
One aspect of the programme is to transform community and out of hours services for the area. After a long and detailed process, a seven year contract has been made with Humber NHS Foundation Trust. They provide a range of services including district nursing, community rehabilitation (physiotherapy and occupational therapy), community hospital inpatient services, minor injuries, GP out of hours services and specialist nursing.
The biggest and most exciting project for this area is the redevelopment (remodelling) of the Whitby Hospital site which is owned by NHS Property Services. There are a number of key milestones for the hospital project which the CCG and NHS Property Services (who own the site) will update on as the project progresses.
2. What is the latest on the timescales for the project?
In 2017, the CCG shared details of an unexpected issue with the redevelopment project due to a change in national policy related to ‘market rents’ and the application of VAT, which meant that the costs of the project needed to be reviewed. Given the current NHS financial challenge and before giving approval to go ahead, the CCG’s Governing Body had to ensure that the preferred option for the project was still affordable.
The NHS regularly changes, as do the internal rules which apply to it and as a result this scheme has needed to flex to respond to those changes.
In November 2017 the CCG’s Governing Body unanimously agreed to move forward with the plans. The next steps were for NHS Property Services as owners of the site to secure funding from the Department of Health.
Earlier this year, the CCG confirmed that NHS Property Services was in the process of agreeing its capital budget for 2018/19 with the Department of Health and Social Care (DHSC). They have now confirmed that further to a review of its investment plans with the DHSC, it can commit to funding the construction phase.
A construction partner has now been formally appointed to carry out the full detailed technical design phase while comprehensive work will also start on how the newly developed hospital would operate. These processes, which will continue throughout this year, will support the development of the CCG’s full business case. This must then be approved by the CCG’s Governing Body to allow the project to further move forward.
We are looking at 2019/20 for the hospital opening. Further information on timescales will be shared with the community as soon as it is available.
3. Who needs to approve this capital budget?
It is the responsibility of NHS Property Services as owners of the Whitby Hospital site to agree capital funding from the Department of Health and Social Care (DHSC). They do this annually across all the properties they are responsible for, this includes funding for general refurbishment and updating properties for Health and Safety compliance in additional to major development schemes, such as Whitby Hospital. The CCG is required to underwrite the planning and development capital costs for this project until final approval is received from DHSC and this therefore requires approval from our Governing Body. Each partner needs to ensure that the business case for this project is subject to the necessary internal governance arrangements and approval process before the project can progress.
4. Will the move to ‘market rents’ price out voluntary agencies and charities on the site?
The specification of buildings/rooms used by the NHS is usually much higher so if they are looking for office space this is likely to be the case. The issue of markets rents being introduced was of concern for the CCG last year but we have now confirmed that we will be funded to enable us to pay the market rent.
The extra care housing will be built to ‘Lifetime Home’ standards and will therefore not be as expensive as the hospital. There may be capacity for co-location of voluntary organisations with social workers and occupational therapists – but this needs to be considered nearer the time. If voluntary organisations are putting on services in the extra care facility, they are unlikely to be charged for this.
5. What has changed with Whitby Hospital outpatient services?
A range of organisations currently provide services from Whitby Hospital. One of the providers of outpatient services, York Teaching Hospital NHS Foundation Trust gave notice of their intention to cease providing some outpatient services from 20 May 2018; however clinics run by other providers would remain unaffected.
Although we were very disappointed, we have been working hard to find a new provider and used the opportunity to look at the clinics in order to ensure they are right for our patients.
As this is quite a complicated process and to ensure we get it right, it means that we were unable to find a provider before 20 May. Some patients will therefore have to temporarily choose to have some outpatient clinics at either Scarborough General Hospital or The James Cook University Hospital in Middlesbrough until we can find an alternative solution.
Watch this interview with Dr George Campbell, local GP and CCG Governing Body member for more information: https://youtu.be/kq1YfaXmETo
6. How have you taken into account what the public want/ say about plans for Whitby and the surrounding area?
As a CCG, we undertook extensive engagement in 2013 and 2015, developing a Vision which has since been refined based on more recent public views.
Engagement includes face-to-face meetings, stands in local community centres and meetings in Whitby Hospital. A summary of the reports on engagement can be found on our website.
We try to regularly communicate with our stakeholders including GP practices, NHS staff, MPs, councillors, parish councils, Patient Participation Groups (via the GP practices), our Health Engagement Network members, the media and the wider public. There are a number of ways we try to communicate including:
• Monthly GP and public newsletters
• WhitbyHealthNews newsletter
• Face-to-face events and meetings
• Via the media using media releases and statements
• Briefings to key stakeholders
• Social media (Facebook and Twitter)
• CCG website
• Direct emails to our stakeholder list (including PPGs via the GP practices as the CCG does not have direct communication)
We are continuing with public engagement throughout the programme of work and value the input we receive from members of the public. If you would like to join the CCG’s Health Engagement Network or join the distribution for WhitbyHealthNews, please email email@example.com
7. Who owns the land of the Whitby Hospital site and are there any plans to sell it off?
The site is owned by NHS Property Services. Under the redevelopment proposals, about half of the current site, including the tower block, would be retained for healthcare use.
The remainder of the remodelled site would no longer be required for healthcare purposes. Any land deemed to be surplus to NHS requirements by healthcare commissioners (CCGs and NHS England) can be sold by NHS Property Services.
NHS Property Services is currently considering options for the part of the site not required for the healthcare redevelopment. This process does not directly involve the CCG.
8. Will there be private housing on the redeveloped site?
North Yorkshire County Council has confirmed that mixed tenure Extra Care Housing will be developed rather than private housing. The land will be held by the housing association that develops the extra care. The accommodation for sale will be leasehold. The Housing Association is a public body and will have set criteria to ensure the extra care is appropriate and the mix of needs makes the scheme viable. It will not be possible for people to buy property and then convert it to holiday accommodation.
9. How many extra care facilities/ beds will there be on the site?
We understand from North Yorkshire County Council that it is expected there will be 50 to 60 apartments or equivalent built on the remaining site.
10. With the extra care units as well as the hospital, what about car parking provision?
The Council is looking to maximise the number of spaces but there are rules that they have to keep to. They are hoping to keep a similar number to what is on the site currently, but they will need to factor in the size of cars amongst other things.
They will also look at ways to safeguard spaces for hospital users and not others like tourists or shoppers. Both NHS Property services and the Council are developing travel plans to integrate travel and transport services that facilitate access from the town centre to the hospital.
11. There is concern about the closure of Larpool Lane Care Home – is there enough provision without it?
The Council shares the concerns about access to social care residential bed provision as there is difficulty in recruiting staff. There is currently no agreement or decision to close Larpool Lane Elderly Persons Home. Any decision to re-provide this facility via extra care will only be considered once the extra care housing is up and running and an assessment of need has been made. They will not leave services that are inadequate and unsafe. The Council has done this in Pickering where the plan was to re-provide a residential unit but, as a result of a needs assessment the residential home is being retained and they are increasing provision.
12. Has a decision been made about how many beds will be in the remodelled hospital?
The CCG has been working with Humber NHS Foundation Trust (as the provider of community and out of hours services) and the appointed architects, Medical Architecture to look at options for the number of beds in the new hospital. It is anticipated that 19 beds will be available in the redeveloped hospital (there are currently 24) and these will be supported by transformed services being delivered in the community enabling more people to be cared for in their own home.
The reduction is also because space standards have increased and 50% of rooms will be en-suite. Draft drawings of each floor space have been developed and will be shared very soon.
The CCG has invested into community services in line with what patients have told us - we know that our patients want to be treated as close to home as possible.
13. How did you arrive at the number of beds? Will there still be palliative care beds? The NHS constitution says we can choose our place of death and we need to be able to stay in Whitby.
We know that a majority of people want to die at home. Now we have district nurses 24/7 we are looking to increase the provision of palliative care at home. However, where Whitby Hospital is the preferred place of care for someone reaching the end of their life, a quiet, en-suite room can be used at the hospital.
It’s really important that people are not in hospital unnecessarily. Every 10 days in hospital, a person loses 10% of muscle mass and that can mean the difference between being independent and not – particularly for older people. Part of the decision to have 19 beds reflects the need to get people home.
14. Will there be an A&E or maternity unit at the new hospital?
There has never been an A&E department at Whitby Hospital. Some years ago, inpatient maternity was withdrawn following a review from the Department of Health which included the Royal College of Obstetricians and Gynaecologists and Royal College of Midwives.
Maternity outpatients and Minor Injury Services are currently available at Whitby Hospital; however a full A&E and maternity service is not part of the remodelling plan for the hospital site. Care and treatment will continue to be provided in the surrounding areas where the right facilities, specialist skills and services are available, ensuring the best possible outcome for patients.
The priority for the Whitby Hospital site is to ensure services reflect integrated community, health and social care requirements in order to make the hospital safe and sustainable for residents of Whitby and the surrounding area.
The CCG has a job to commission health services that give good outcomes. We know from statistics that smaller maternity and surgery units do not necessarily give the best outcomes. We would not be doing our jobs to provide services that are not as safe as they could be.
We are committed to services closer to home but that does not necessarily mean all services will be nearest to home. We are strengthening community services to make sure people do not use hospital services when they don’t need to.
15. Will the War Memorial element remain?
The CCG respects the history of Whitby Memorial Hospital and are linking in with Whitby Civic Society to see how we can maintain this history in the new hospital.
16. Is there still a palliative care service at the hospital?
The CCG has a contract in place with St Catherine’s Hospice to work alongside Humber NHS Foundation Trust to provide specialist palliative care, both in the hospital and in the community.
This arrangement will remain in the place for the new hospital.
17. Have you considered the needs of tourists for health services?
We have, although tourists rarely use inpatient beds. If they become seriously ill they are usually treated in Middlesbrough and then return to their home area. However, we know that the minor injuries unit does get much more use in the tourist season.
18. Is there a restriction on who can be admitted to Whitby Hospital as an inpatient?
Whitby Hospital provides an inpatient facility for medical and nursing care to patients who are not medically fit to return to their usual place of residence, but whom do not need specialist or acute services.
There are currently no restrictions in place for these beds.
19. Two wards have now merged in Whitby Hospital. Why did you decide to merge the two wards into one?
The provider of community and out of hours services, Humber NHS Foundation Trust took the decision to merge the two wards. This was to ensure patients are cared for in a better environment; the provider can maintain safe staff levels and create opportunity for training/support for clinicians.
20. What are the current opening hours for the Minor Injuries Unit (MIU)?
The current opening hours are 8am to 8pm, seven days a week. It’s a nurse-led Minor Injuries Service - no appointment necessary. Should you wish to call, the main hospital number is 01947 899200. Alternatively for other advice, please call NHS 111.
21. I have heard the telephone number for Whitby Hospital has changed. What is it now?
The telephone number for Whitby Hospital is 01947 899200.
22. Have workforce issues been considered in any plans?
Workforce is a national issue of concern in the NHS. Workforce planning is a key theme to ensure our providers of care services understand the workforce issues and they have robust plans.
We know that Humber NHS Foundation Trust is committed to workforce development and aware of recruitment and retention issues across the wider area.
23. If an ambulance picks me up, why can’t I have a choice where I go?
Providers of care have a legal duty to ensure patients are taken to the nearest appropriate A&E for their condition.
24. Will the CCG fund a bus service?
We have no plans to provide a bus service. More information on transport can be found on our website: https://www.hambletonrichmondshireandwhitbyccg.nhs.uk/transport
25. Who provides the out of hours care now?
Humber NHS Foundation Trust has an agreement in place with a specialist provider of out of hours called – Prime Care who will deliver local out of hours care under the management of Humber Foundation Trust.
Primecare were previously delivering these services from the Malton area, but have now moved to Whitby and the surrounding area. They are familiar with the locality and services required.
26. What’s the difference between a community and acute hospital?
Acute care is where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery. There are two acute hospitals accessible from Whitby and the surrounding area – James Cook University Hospital in Middlesbrough and Scarborough General Hospital.
A community hospital is a non-specialised hospital serving a local area. Whitby hospital is a community hospital providing short term rehabilitation and nursing care.
27. What services are available at Whitby Hospital?
• Minor Injuries Unit (MIU)
• Community dental services
• Adult ear, nose and throat (ENT)
• Improving access to talking therapies known as psychological therapies (IAPT)
• Sexual health
• In patient care
• Out-patient department providing clinics for a range of specialities (please see question 5)
• Maternity outpatients
• Physiotherapy and occupational therapy
• District nurses providing care in the community
• Radiology (x-ray and ultrasound)
• Retinal screening
• Abdominal aortic aneurysm (AAA) screening
Do you have a question you would like to ask us about health care services in Whitby and the surrounding area?
Please email firstname.lastname@example.org or write to us: NHS Hambleton, Richmondshire and Whitby CCG, Civic Centre, Stone Cross, Northallerton DL6 2UU.