In recent months the District Council has made strong representations to the West Sussex Primary Care Trust (PCT) and to the Joint Health Overview and Scrutiny Committee (JHOSC) on behalf of local residents to object to the downgrading of St Richards Hospital.

Leader of Chichester District Council, Councillor Myles Cullen, said: “We have also been working with expert counsel and health consultants to prepare a potential legal challenge, called judicial review, against the decision made by the PCT. We are pleased to see the formal reference by the JHOSC to the Secretary of State for Health for him to make the final decision, and within that process the District Council intends to make its own submission to the Secretary of State.

“The reference by the JHOSC to the Secretary of State may make an application for judicial review unnecessary.  It is prudent that both the Council and the PCT avoid incurring unnecessary public expenditure on court proceedings especially as permission to pursue a judicial review case is usually refused if there is another statutory process which is underway or could be used as an alternative.”

However, the rules of the High Court require an application for judicial review to be submitted within certain timescales.  On advice from Counsel, the District Council has written to the PCT informing them that the Council is willing to postpone making a decision on judicial review for a period of two months to allow for progress to be made on the reference to the Secretary of State. 

In view of this the PCT has been asked to confirm that if the Council subsequently commenced the judicial review process, the PCT will not claim that the Council is out of time with its application.

Depending upon the response from the PCT it may be necessary to convene a special meeting of the Full Council to consider whether an application for judicial review should be made.

A Joint Health Overview and Scrutiny Committee (Joint HOSC) has been set up to scrutinise West Sussex and Brighton & Hove City Primary Care Trusts' (PCTs) proposals to change local acute (i.e. hospital) services and plans for community services.  

As the PCTs' proposals have an impact on more than one Health Overview and Scrutiny Committee (HOSC) area, the Joint HOSC is made up of representatives from the relevant local authorities, as set out below:
West Sussex County Council , East Sussex County Council , Hampshire County Council , Brighton and Hove City Council , Surrey County Council , Portsmouth City Council

23 rd July 2008: Agenda Item 8: Joint HOSC Conclusions

On the evidence available, the Joint Health Overview and Scrutiny Committee believes that the decisions made by West Sussex PCT regarding the future configuration of acute services for the people of West Sussex and surrounding areas, are not in the interests of the health service in this area. The Committee will therefore refer the PCT's decisions to the Secretary of State for Health.

The Committee has made this decision on the following reasons:

1. There remains insufficient clarity about the way in which the service model of one Major General and two Local General Hospitals (LGH) within West Sussex will be implemented, in particular exactly which services will be provided at each hospital and the impact on services provided at hospitals outside West Sussex.
2. There is a lack of clinical consensus for the proposals, which makes it impossible for the Committee to be assured that the proposals are clinically safe and sustainable – key objectives identified by the PCT at the outset of its consultation on the changes
3. The decision leaves the Royal West Sussex NHS Trust (St Richard's Hospital) in a position which the PCT considers may not be financially sustainable and unlikely to meet the standards required of a Foundation Trust in breach of government policy. This would also have applied to Worthing and Southlands Hospitals NHS Trust, had Worthing Hospital been chosen as the LGH.
4. The PCT has failed to satisfy the Committee that it has fully explored alternative options for the retention of consultant led maternity services at Princess Royal and St. Richard's Hospitals. The PCT has not taken into full account recent evidence regarding the potential clinical and financial sustainability of smaller consultant-led obstetric units (CLU) which could make CLUs at Royal West Sussex (St Richard's Hospital), Worthing Hospital and Princess Royal Hospital viable.

Agenda Item 9: Stand-alone Midwife Led Unit (sMLU) – Public Engagement

The Committee is unable to discuss proposals for further consultation on the location of stand-alone Midwife-led Units in the north of the County as this element of the PCT decision is subject to the Committee's referral to the Secretary of State for Health.

Agenda Item 10: Future Role of Joint HOSC

In making a referral today, this Committee has concluded this phase of its work and no further meetings are scheduled. Any exchange with the Independent Reconfiguration Panel required as part of its consideration of the referral will be with HOSC support staff at West Sussex County Council, who will consult the Committee's Vice Chairman. Should the Vice Chairman consider a further meeting of the Joint Committee is required both during the IRP process or once the response is received from the Secretary of State, officers will make the necessary arrangements.

Message from the Support St Richard's Campaign
On Thursday 10 th July, the Primary Care Trust voted that the decision they have made to downgrade St Richard's is reasonable.

We know that the decision is not only unreasonable but will prove unsafe for patients.

On Wednesday, 23 rd July at 11am in County Hall, West Street , Chichester the Joint Health Overview and Scrutiny Committee (JHSOC) will meet to decide whether to refer the decision to the Secretary of State for Health for an Independent Reconfiguration Panel.

We are strongly requesting that the JHSOC do this and have made several submissions to them with evidence as to why the decision is flawed and unsafe.  For more information, please visit www.supportstrichards.co.uk

If you are able to attend the JHSOC meeting on Wednesday 23 rd July, we urge you to do so.  The meeting is held in public but the public will not be invited to speak.  However, we do have two hospital consultants who will be speaking on behalf of the campaign.

Thank you very much for your continuing support.

The Leader of Chichester District Council has said the public does not trust the West Sussex Primary Care Trust to make a decision about the future of healthcare in the District.

Councillor Myles Cullen was left angered and frustrated by the lack of responses given by the PCT at the Joint Health Overview and Scrutiny Committee (JHOSC) on June 25.

He said JHOSC were given nearly 300 letters by members of the public, and listened to submissions from local authorities and other interested bodies, but the PCT did not have any answers to the concerns raised.

He said: “The PCT came to this meeting totally unprepared, and did not have any of the necessary evidence to back up their decision to downgrade St Richard's Hospital.

“Their plans for the future of the ambulance service and maternity services are all aspirational – there doesn't seem to be worked-up proposals to ensure the provision of health services at current levels, should St Richard's be downgraded.”

Cllr Cullen said that while he acknowledged JHOSC had a process to follow, he thought the PCT's decision should be referred to the Secretary of State for Health.

“At the beginning of May , Lord Darzi, the Parliamentary Under Secretary of State at the Department of Health, stated on a national broadcast that the public will be the decision makers on hospital closures,” he said.

“The public have spoken, but the PCT has not listened. How can such a strong, evidence-based argument, from the District Council, the campaign groups, the hospital workers and the wider public, be ignored by the PCT?

“It is madness to downgrade a hospital of the standard of St Richard's. It already has the services of a Major General Hospital, including a Class 2 neo-natal unit. Worthing would need major investment to bring it up to the same quality as St Richard's, which is ridiculous when you consider that the PCT's justification for this process was to save money, not spend it.”

Cllr Cullen also told supporters of St Richard's not to give up hope about the future of the hospital: “Elsewhere in the country, other proposals being considered by the Secretary of State's Independent Reconfiguration Panel are being thrown out, so the fight isn't over yet. The people of this District will be disadvantaged if these proposals go ahead, and we will be exploring every possible avenue to make sure local healthcare services are not downgraded.”

The decision to centralise hospital services in Worthing will be scrutinised at the next meeting of the Joint Health Overview and Scrutiny Committee set up to examine the Fit for the Future health proposals.

The Committee will meet at County Hall in Chichester on Wednesday June 25, at 11am. The meeting will also be webcast online via the West Sussex County Council website. Representatives from the three hospitals affected, St Richard’s Hospital in Chichester, Worthing Hospital and Princess Royal Hospital in Haywards Heath, have been invited to attend the meeting and give their views to the Committee.

The meeting will focus on the decisions made by West Sussex Primary Care Trust (PCT) on future health services and the location of centralised hospital services.

The Committee will examine how the PCT reached its decisions, including the choice of Worthing for the major general hospital. Particular attention will be paid to the PCT’s response to the Committee’s Report and whether it took the Committee’s recommendations into account.

Committee Chairman Peter Griffiths said: “We will be examining the PCT’s decision-making process very carefully. If we are not satisfied with the final decisions, the Committee retains the right to make a referral to the Secretary of State for Health.”

The webcast of this meeting will be available via a link from the County Council website at www.westsussex.gov.uk, or directly from the host website at www.westsussex.public-i.tv/site/ where a guide will be found to opening the link.

Notes

A Joint Health Overview and Scrutiny Committee (JHOSC) is formed when NHS proposals affect more than one area and in this case comprises those local authorities consulted by the West Sussex and Brighton and Hove PCTs. The JHOSC has the power to scrutinise the proposals, make recommendations to the PCTs and if not satisfied by their response, to refer the disputed issues to the Secretary of State for Health.

The JHOSC is made up of councillor representatives from the following local authorities:

• Brighton & Hove City Council
• East Sussex County Council
• Hampshire County Council
• Portsmouth City Council
• Surrey County Council
• West Sussex County Council

ST RICHARD'S TO LOSE FULL SERVICES.

We are devastated that the West Primary Care Trust (PCT) is recommending St Richard's to be a Local General Hospital .  The Board of the PCT will be voting to accept this recommendation next Wednesday, 4th June at the Copthorne Hotel, Effingham Park near Gatwick.
By St Richard's being recommended to be a Local General Hospital , it means that patients will LOSE full emergency A & E, consultant-led maternity and in-patient paediatrics in Chichester .  If you need emergency A & E you will have to travel to Worthing or Portsmouth .
There are many reasons that we believe the PCT should be making St Richard's the Major General Hospital and not downgrading it and we urge you to contact them immediately as they will be voting to accept their recommendations next Wednesday at 2pm .  We have less than a week to make them see sense and recommend St Richard's to be the Major General Hospital .  The following are just some of the reasons why we must keep full services at St Richard's, Chichester .
* ACCESS .  St Richard's catchment area is approximately 441 square miles, compared to 188 square miles for the Worthing catchment area.  Journey times to St Richard's as the MGH will be a maximum of 47 minutes, compared to 63 minutes if Worthing were to be the MGH.  If you live on the Manhood Peninsula or in the Downs you will have average journey times of over an hour which could be the difference between life and death.  Ambulances are not meeting their target times in rural areas and therefore people are being disadvantaged who live in the more rural areas of the county.  The PCT decided that blue light times should not be part of the decision making process, and yet it is patients in the north of the downs, West Wittering and the more rural areas who will not only be picked up late by the ambulances but will have further to travel for emergency care.  The PCT also decided that seasonality should not be part of their decision making criteria so when you are sitting in a traffic stand still on the A27 in the Summer trying to get to the beach, remember their recommendations!  The PCT have also decided that there will be no extra pressure on the police and fire services as a result of a downgrade on St Richard's even though the ambulances could be out of area for an hour or more transporting patients.
* MATERNITY AND PAEDIATRICS .  As a Local General Hospital , St Richard's will have NO consultant-led maternity unit and NO in-patient paediatrics.  Mothers and children will have to travel to Worthing and Portsmouth for care.  Patients choose to come to St Richard's to have their babies from outside the current catchment area and therefore their Patient Choice will taken away.  St Richard's has a dedicated paediatric A & E department and this will be lost.  Developing the paediatric unit at St Richard's would provide the most sustainable configuration for paediatric services across Sussex , why has the PCT chosen to downgrade us?
* DEPRIVATION .  Deprivation affects rural West Sussex as much as the urban areas in the county and St Richard's provides the best access to hospital care for the isolated rural communities in West Sussex .  So why are the PCT making life even harder for patients in the more rural areas, many of which have inadequate public transport.  They believe that deprivation in rural areas is as thin as confetti falling and therefore there is no evidence that people in rural areas will be affected by downgrading.
* GROWING POPULATION .  The population in Chichester is growing faster than anywhere else in the county.  There are three key groups within the population for whom good access to emergency healthcare and specialist services are essential:  the very young (aged 0-4); women of childbearing age (aged 15-44); the very old (aged 85+).  For each of these age groups the population is growing more rapidly within the St Richard's catchment areas than in that for Worthing .
* STAFFING .  St Richard's currently has 5 top consultants in it's A & E department compared to Worthing 's one consultant.  Worthing has been unable to fill its vacancies and yet St Richard's always has high calibre staff applying for any vacancy that may arise.
* TOURISM .  There are an estimated 6 million visitors per year to the St Richard's catchment area, with more visitors going to West Wittering beach than to Windsor Castle !  Many of the visitors are children and they will not be able to receive A & E treatment in Chichester , they will have to travel to Worthing or Portsmouth when the roads are clogged up in the summer months.  It is ludicrous to take away the full A & E department in Chichester .  The PCT decided that tourism was not a problem with regards to access in their decision making.  They need to be told again what the roads on the Manhood Peninsula and on the A27 are like in the summer months.
* STUDENTS .  Chichester College and the University of Chichester have 21,900 students between them of which only 4,300 originate from the Chichester area.  Both institutions have ambitious plans for expanding the numbers of staff and students in Chichester and Bognor Regis which will result in an increasing call on the services of a Major General Hospital .  Students will have to be transported to Worthing or Portsmouth and many of them do not have their own vehicles so there will be a greater call on the ambulance service.
* OLYPMIC TRAINING CAMPS .  The Chichester Gold Consortium has successfully bid to host Olympic Training Camps for the 2012 Olympic Games.  The bid was successful as the Consortium was able to demonstrate, amongst many things, close access to a major hospital and A & E department.
* HOSPITAL SITE .  St Richard's is situated on 35 acres and has 60,000 square metres of buildings.  Unique in the county is has the only helicopter landing pad always available for immediate access which does note require an ambulance transfer to A & E.  Why downgrade a hospital which has the perfect room for expansion at very low capital outlay?  Worthing Hospital is already surrounded by heavy development with no room to expand other than upwards, at huge cost.
* TOP HOSPITAL .  St Richard's is a top hospital winning many awards for its excellence including Top 40 Hospitals at the CHKS award ceremony in April for the eighth consecutive year, the only hospital in England to have achieved this.  The awards are based on the evaluation of around 20indicators, developed by CHKS, covering clinical effectiveness, health outcomes, efficiency and patient experience and quality of care.  St Richard's is also rated among the top 20% of NHS Trusts in England for its overall patient care.  Why downgrade such a fantastic hospital with top calibre staff?
* WHO MADE THIS RIDICULOUS DECISION?   The Non-Executive Directors of the Primary Care Trust who have taken part in the decision are the following:
1. Mike Harris, newly elected Chairman, lives in the north of the county.
2. Brian Angers, lives in Storrington in the Worthing Catchment Area.
3. Margaret Bamford, lives in Findon in the Worthing Catchment Area.
4. Jean Barclay, lives in Worthing .
5. Barabara Wilkins, was once Chairman of Worthing Community Health Council.
6. David King, a former Borough Councillor for Worthing .
7. Malcolm Liles, lives in Crawley .
8. Norman Robson, the only Non-Executive who lives in the West of the County in Sidlesham.
The Board has a huge bias to Worthing and we don't believe that they will not have been able to exercise complete neutrality in reaching their decision.

PLEASE CONTACT THE PRIMARY CARE TRUST NOW AND GIVE THE ABOVE REASONS FOR THEM TO RECONSIDER THEIR RECOMMENDATION.  

Email:  john.wilderspin@westsussexpct.nhs.uk or
mike.harris@westsussexpct.nhs.uk or
Phone:  0800 707 6975

Protest with us at the meeting at the Copthorne Hotel at 2pm on Wednesday, June 4th.  We have a limited amount of seats available on our coach.  Please contact info@supportstrichards.co.uk or phone:  07802 783604.

Thank you to everyone for your constant support over the last two years.  Nearly 140,000 people signed our petition, over 15,000 wrote personal letters to the PCT and 15,000 took to the streets in support of our fantastic hospital. 
Please support us again, we must not have St Richard's downgraded.

The Royal West Sussex NHS Trust, St Richard's Hospital is disappointed that West Sussex PCT has made the recommendation to its Board to locate the larger hospital as proposed in the PCT's plan for the future delivery of health services for the county in Worthing.

Chief executive, Andrew Liles said:

“Of course we are very disappointed with this decision. However, we will now get on with making this new model work for patients and staff by working with our colleagues in Worthing to identify the distribution of healthcare services across the two hospitals which will deliver the most effective care for the people of West Sussex.

“I want to reassure our patients, staff and wider public that our priority will continue to be the well being of our patients. I also want to thank the public and the campaign group for the tremendous ongoing support they have shown the hospital throughout this difficult period.”

After the public consultation ended in November 2007, the proposal was made that:

• A&E services, intensive care, routine elective surgery and acute medicine should be maintained at all three acute hospitals.

• Along the south coast - there be a staged centralisation to one hospital (the major general hospital) of consultant-led maternity services, inpatient children's services and emergency surgery.