To ask the Scottish Government whether the Cabinet Secretary for Health and Sport has reached a conclusion regarding NHS Tayside’s major service change proposals for the future provision of surgery, as set out in its Shaping Surgical Services Review.
I have today written to the Chief Executive of NHS Tayside to confirm my decision in relation to these major service change proposals.
Having carefully considered all the available information, I have decided to approve the Health Board’s proposals that all unscheduled admissions and emergencies in Tayside will be directed to Ninewells Hospital in Dundee to ensure that all patients have access to a dedicated Acute Surgical Receiving Unit and a staffed 24/7 theatre for unscheduled surgery. An expanded elective surgical service will be based in the Perth Royal Infirmary (PRI), providing cancer and non-cancer surgical intervention. This will include complex major surgery to fully utilise critical care facilities at PRI and I have been assured by the Board that their proposals will in no way impact the continuing provision of A&E services at the hospital. The Stracathro Treatment Centre will also be optimised to treat patients who meet the criteria for day and short stay surgery, as set out by the British Association of Day Surgery.
The Board has made a compelling and viable case for these proposals which have attracted clinical support. The proposals are consistent with national policy, modern clinical standards and best practice, including the National Clinical Strategy. The implementation of these proposals will provide the people of Tayside with a safer, higher quality surgical service, whilst also minimising the risk of cancelled procedures. As such, I am convinced that these proposals are in the best interests of the people of Tayside.
I note from the report of the Scottish Health Council (SHC) that the Board has meaningfully engaged with local stakeholders on their proposals. However, the SHC has recommended that the Board establishes a stakeholder group, which should include patients, carers, public representatives and the Scottish Ambulance Service (SAS), to consider any remaining concerns around patient and public transport for both scheduled and unscheduled surgery.
That is why I have been clear to NHS Tayside that my approval of these proposals is conditional on: (i) the Board reviewing and addressing any issues with the Scottish Ambulance Service (SAS) around their capacity to meet the proposed models; (ii) identifying how planning partners and third sector organisations could best support patients to access services; (iii) carrying out a review of the Board’s patient booking system for surgical procedure appointments to address concerns about early morning appointments for people living in rural areas; and (iv) providing regular communication on the outcomes of this work and to keep the people of Tayside informed of progress and timescales for implementation of the proposals.
I also recognise the concerns expressed during the public consultation process that the approval of these proposals could impact negatively on the Accident and Emergency Department at the Perth Royal Infirmary. As outlined above, I have sought and received assurances that A&E services will continue at the hospital.