Changes to vascular services in Norfolk
06:30 12 September 2012
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Patients in west Norfolk may have to be transported miles because the Queen Elizabeth Hospital at King’s Lynn faces losing its 24/7 emergency vascular call-out service in a reorganisation of services.
The review of operations and procedures on blood vessels has been carried out by the Midlands and East of England Specialised Commissioning Group (SCG) and now the Norfolk and Norwich University Hospital (N&N) and Addenbrooke’s in Cambridge will become the vascular centres which will perform all such surgery.
The review said that as the QEH carries out a very low number of procedures each year it cannot meet the required standards and will not be able to provide full 24/7 care on its own.
However, the QEH already has 24/7 emergency call-out service for vascular emergencies and it argues that transferring emergency patients 45 miles or more to the N&N or Addenbrooke’s will take a minimum of one hour.
It also says the consultation did not stress the fact that the loss of a local service “will be most felt by patients from West Norfolk and North Cambridgeshire”.
The QEH will still be able to perform minor procedures, but major procedures will be transferred from King’s Lynn to either the N&N or Addenbrooke’s, depending on which is easiest for a patient to access.
Conditions affected by the proposed changes include abdominal aortic aneurysm, lower limb blood flow problems, carotid artery intervention and some renal-related conditions.
Dr Geoff Hunnam, medical director at The Queen Elizabeth Hospital, said: “This will mean that patients needing complex elective vascular surgery will go to a specialist centre and to some extent this is already happening.
“The question of what will happen to emergency patients is not yet resolved. We have responded to the consultation and given our views.”
The decision to go ahead with the changes has been taken, but now QEH clinicians will have to work with their counterparts at Addenbrooke’s and the N&N on what will happen to its emergency vascular service for patients with a view to implementing the changes next April.
In his written response to the review, Dr Hunnam stressed that although the QEH supports the view that centralising elective vascular surgery will improve clinical outcomes for elective cases, any new service “should not be at the expense of a deterioration of the service to our local patients”.
He said the risks and costs of transferring sick patients with vascular emergencies need to be taken into account in planning a new service. This would include, for example, providing additional anaesthetic staff to accompany unstable patients on their ambulance journey.
His letter concluded: “The trust would wish to work closely with our local tertiary centres to ensure continuation of a high quality vascular service to our local patients. This plan should consider the provision of a local emergency vascular on-call service, manned by local consultants, who also work at the ‘hub’.
“Because of our remoteness, we would stress that the solution to ensure a safe, local service must be tailored to local need.”