Hospitals at Hastings and Eastbourne ‘are no longer mirror images of each other’

Conquest Hospital, Hastings. SUS-181008-112146001
Conquest Hospital, Hastings. SUS-181008-112146001

Hospitals at Hastings and Eastbourne are ‘no longer simply mirror images of each other’, according to health bosses as a shake-up of some specialist services is being proposed.

East Sussex Healthcare NHS Trust (ESHT) is planning to consolidate more of its Ear, Nose and Throat (ENT) services.

Councillors heard this week how the proposed move, which is expected to affect around 494 patients per year, would see all the department’s day cases and planned surgeries moved to Eastbourne DGH with a reduction of the service at the Conquest Hospital in Hastings.

Responding to concerns health bosses explained how they are committed to providing hospital services across the two major towns of East Sussex, but ‘it is no longer the case that each hospital is simply a mirror image of the other’.

Adrian Bull, chief executive of ESHT, said: “Any fear or suggestion that this is somehow a brick being taken out, which will cause the collapse of hospital services at the Conquest, I can absolutely refute.”

Introducing the proposals at a health and overview scrutiny committee meeting on Thursday (November 29),  ESHT’s chief operating officer Joe Chadwick-Bell said: “We’ve used the word reconfiguration but really the reconfiguration took place several years ago. This is really a second step towards sustainability.

“Clearly our overriding position is that we want to deliver sustainable care. That very much is driven by workforce.

“We currently are experiencing really severe shortages of staff around ENT and that has been the case for a number of years.”

“We have three consultants at the moment covering two sites. Ideally we would have five or six, because we have to run rotas and it is incredibly difficult to recruit to a consultant’s post where you have to be on call on a one-in-four or a one-in-three basis.

“Of those three consultants, one is retired and has returned on an almost full time basis.

“You can see we are quite slim in our resources.”

Ms Chadwick-Bell said the service was also staffed by two trainees at junior doctor grade, but that the staffing shortages had made effective training and supervision difficult and the trust is at risk of losing the trainees as a result.

The proposals had also been put forward with a view to making joint ENT appointments with Brighton and Sussex University Hospitals NHS Trust, Ms Chadwick-Bell said, leading to concerns that working in all three areas would put off candidates.

She said: “This is just a medium-term solution. ENT is a challenging speciality to recruit to, especially in the south.

“What we are looking at a Sussex-wide level is what a potential solution might look like for a Sussex-wide service, because we are not the only ones who are struggling to recruit.”

The proposals however came in for criticism from Labour’s Mike Turner, Hastings Borough Council’s representative on the committee.

Cllr Turner said: “It would be removing a service from the most deprived borough in the whole of the county. It runs contrary to the CCG’s policy to reduce health inequalities, I believe.”

He added: “What worries me is where this could end. You could say, ‘well Hastings is farther away, let’s take another service and then another and another.

“That is something that is paramount in my concerns.”

In response, ESHT chief executive Dr Adrian Bull said: “I don’t think the deprivation point is relevant to this service. Because the commitment that we have is to provide an ENT service that is of the right standard and right quality for the people of East Sussex and to make sure they have access to that service.

“Outpatient services will continue in full at the Conquest. Access to ENT for people in Hastings – and to an ENT consultant’s opinion, an ENT diagnosis and an ENT assessment – remains as it is.

“The difference is [when] someone needs to be admitted. Let’s be clear, when people are admitted for surgery a large proportion are a day case and for those which comes in as an inpatient the average length of stay is a couple of days.

“It is only for their planned surgery that [patients] will be coming to Eastbourne and that is the particular change that is involved in this [proposal].”

Dr Bull also addressed concerns about the loss of services from Conquest to Eastbourne DGH, and vice versa.

He said: “It is interesting to hear you say that, because I was at the meeting yesterday of the Friends of Eastbourne DGH’s AGM.

“The concern they expressed time and again was that all the services would go to Conquest and that Eastbourne hospital would disappear. We are seeing this at both ends.

“Our commitment is that we are providing hospital services across two major towns of [East] Sussex. It is no longer the case that each hospital is simply a mirror image of the other. We have to provide the services across the two.

“Any fear or suggestion that this is somehow a brick being taken out, which will cause the collapse of hospital services at the Conquest, I can absolutely refute.”

Following discussion the committee agreed to note the proposals, declining to set up a review board to scrutinise the proposals in more detail.