Chamber and committees

I have today written to the Chief Executive of NHS Greater Glasgow and Clyde (NHSGGC) to confirm my decisions in relation to these major service change proposals.

Having carefully considered all the available information and representations, I have decided to approve the Health Board’s proposal to transfer inpatient and day case paediatrics from Ward 15 at the Royal Alexandra Hospital (RAH) in Paisley to the Royal Hospital for Children (RHC) in Glasgow. This has been a difficult decision but in doing so, I recognise that only inpatient and day case paediatrics will be transferred; the majority of patient cases will continue to be seen and treated locally; with the A&E Departments at Inverclyde Royal Hospital and at the RAH continuing to receive paediatric patients who self-present alongside the continuation of outpatient clinics, as well as specialist community paediatric services.

The Board has made a compelling and viable case for these proposals which have attracted overwhelming clinical support. The proposals are consistent with national policy, modern clinical standards and best practice, including the European Association for Children in Hospital (EACH) Charter and the national clinical standards set by the Royal College of Paediatrics and Child Health. This is well summarised by the submission of Action for Sick Children Scotland (now Children’s Health Scotland) to the Health Board’s public consultation. The charity framed their submission under each of the 10 articles of EACH Charter, concluding that “the most compelling argument…is that clinical standards are there to support the best quality healthcare for all children in Scotland and we feel this would be best achieved by moving Ward 15 to the RHC.”

Whilst I am convinced that these proposals are in the best interests of local children, and note from the report of the Scottish Health Council (SHC) that the Board has meaningfully engaged with local stakeholders on their proposals, I recognise from the representations received and the stakeholder meetings I have attended that some local people – from the Paisley area, in particular – will be deeply disappointed by this decision. I know that the service many families have received from Ward 15 at the RAH has been highly valued; and that there are understandable concerns about access to the more specialised services which will transfer to the RHC; how these will be integrated into those outpatient and community services that will continue to be provided locally; and how to ensure there is clarity about what support will be offered to families in respect of these changes. This will include transport advice and whether local families can receive financial support for travel to hospital. The Board have provided assurances that this can be provided via the Family Support and Information Service based at the RHC.

That is why I have been clear to NHSGGC that my approval of these proposals is conditional on (i) the Board maintaining and improving community based services, with the aim of maximising local provision, where it is clinically appropriate to do so; and (ii) working directly with families from the Paisley area on specific, individual treatment/service access plans, to be complete before any service changes are made; ensuring that there is a full understanding of what services and support will be available to them, and from where.

I also recognise the local fears expressed during the public engagement and consultation activity that the approval of these proposals could lead to the ‘downgrading’ of the RAH. This is categorically not the case. The Board of NHSGGC has assured me that it remains absolutely committed to maintaining and developing the services provided at the RAH as the main acute resource for the Clyde area. Indeed, in terms of the ward space vacated by this decision at the RAH, the Board will use the ward to optimally improve patient care on the site.

In respect of NHSGGC’s proposals for rehabilitation services in the North East of Glasgow, including the closure of Lightburn Hospital, and having carefully considered all the available information and representations, I am not minded to approve the proposals.

I have been consistently clear during the Board’s review process that their final proposals had to effectively address the concerns which resulted in the Government rejecting the previous Lightburn closure proposals in 2011. As then, a specific consideration in this case was that approval of the proposals would result in the removal of the only significant, established and highly valued healthcare facility from one of the most deprived communities in the country.

I want to be clear that this has been a difficult decision. Like Nicola Sturgeon before me, I fully accept that healthcare services cannot be static; that reform is necessary as set out in our National Clinical Strategy and Delivery Plan; and recognise that the proposals to further develop community based services are largely consistent with the direction of national policy, including the integration of health and social care. However, in light of all the available information and representations, I remain concerned that the proposed replacement local community and support services are not sufficiently developed to authorise the closure of Lightburn Hospital. Given the general access and public health issues recognised by the Health Board as particularly affecting these seriously deprived communities, I welcome the commitment from the Board and its planning partners to develop, as a priority, a Health and Social Care Hub in East Glasgow. I consider this to be an integral part of the Health Board and its planning partners developing a viable and sustainable case for change. Whilst it is reasonable and right for the local Health & Social Care Partnerships to continue to consider how they can appropriately shift the balance of care in line with national policy, I would expect such services to be developed with local communities before any future proposal is considered.

As a result, I am asking the Health Board to work more closely with the local communities. As part of this further work, I would like to see the Lightburn Hospital site considered as the potential location for the new East End Health and Social Care Hub, or another health care use/facilty, for the benefit of the local community. I expect this work to be taken forward with the full and meaningful involvement of local stakeholders.