Fairfield Hospital decision: what it will mean for you

Many involved in the three-year campaign were shocked by the final decision to axe medical-led maternity services and the special care baby unit (SCBU) at Fairfield General Hospital.

Bury will also lose its children's ward and all emergency surgery.

The Independent Reconfiguration Panel (IRP), which examined the plans on behalf of health secretary Alan Johnson, revealed its decision to back the closure at a press conference last Friday.

The huge shake-up will be implemented within three to five years.

The Fairfield Baby Lifeline Society is to hold a meeting at the Rochdale Old Road hospital on Monday to discuss possible further action, but members have admitted that their fight is probably over.

Sharron Entwistle said: "We're absolutely devastated. Some people thought the appeal would fail but many of us were shocked by the outcome. We thought we had good grounds for overturning the decision and our meeting with the IRP seemed to go very well. We don't know whether there will be a next move; it is unlikely. We could not have done more than we did.

"We put together the biggest protest campaign Bury has ever seen and it has been ignored.

"We've put so much of our time into this battle over the past three years that now everyone feels completely deflated over not pulling it off."

But the society will not disband or halt its fundraising activities for Fairfield's maternity unit until it closes. Mrs Entwistle said: "We've got another five years to go before the unit actually closes.

"If anything comes along that could allow us to challenge the decision then we will do."

Dr Said Hany, chairman of the society, said: "This was going to be our last chance and it has been destroyed. We're not very optimistic about finding any further avenues.

"We have fought as much as we can. I'd hoped they would listen to reason but I think everything was pre-planned a long time ago.

"I think the consultation was just a sham designed to give the impression that we would be listened to. I don't think anyone ever had any intention of listening to us."

As a result of the IRP's decision to back the proposals for Making it Better and Healthy Futures, Bury will have: l No maternity unit l No special care baby unit l No children's ward l No emergency surgery Dr Peter Barrett, chair of the IRP, said: "Members of the IRP agreed unanimously that changes to existing services must be made for the benefit of people across the whole of Greater Manchester. The existing configuration of services is unsustainable and modernisation of services is long overdue.

"Throughout our review we have focused on ensuring the people of Manchester have access to high quality services. Subject to successful implementation, the planned changes, together with our additional recommendations, will ensure that care is safe and sustainable and is provided in the most appropriate locations."

The Making it Better programme was set up in 2004 to improve children's, maternity and neo-natal healthcare in the area.

Under the plans, Fairfield's maternity unit and special care baby unit (SCBU) will be axed, along with units in Salford, Rochdale and Trafford.

Consultant-led maternity care will instead be provided at eight hospitals in the area, with three of those - Royal Bolton Hospital, Royal Oldham Hospital, and St Mary's in Manchester - becoming "centres of excellence" to provide intensive care.

Expectant mothers will have to travel from Bury to one of the eight hospitals in Greater Manchester with a maternity unit to give birth.

However, they will still be able to access pre-natal and post-natal services at Fairfield.

Although women would not be able to give birth at the hospital under the plans, a midwife-led unit will be opened in the borough.

The stand-alone unit would be operated by Bury Primary Care Trust (PCT) and staffed by midwives. There would be no consultants at the centre and no 24-hour paediatric cover.

Mothers expecting a healthy birth could choose to deliver at the unit with the support of midwives. If problems arose during the labour, she would be transferred to a consultant-led maternity ward at another hospital.

As well as the huge shake-up of maternity services, paediatric care is also set to be affected by the plans.

Fairfield's children's ward will be closed and all in-patient services for under 18s axed. Instead, any child who needs to be admitted to the hospital overnight will be transferred to either North Manchester General or the Royal Oldham Hospital.

Out-patient children's services will continue at Fairfield and a new observation and assessment unit will be created in the accident and emergency (A&E) department. This will allow staff to keep a close check on children to ensure their condition does not deteriorate.

Health chiefs believe that concentrating services in this way will ensure that the children's, maternity and neo-natal units can remain open 24 hours a day, rather than closing on an ad-hoc basis due to staff shortages.

It would also allow staff to improve and maintain their skills, therefore providing a higher level of care.

It is hoped that the improved standards of care will save the lives of 20 to 30 more children each year.

Around 10,000 babies are born annually at hospitals run by the Pennine Acute Trust - Fairfield, North Manchester, Rochdale and Oldham.

Dr Anthony Emmerson, consultant neo-natologist at St Mary's Hospital and lead clinician for the Greater Manchester Neo-natal Network, said: "As time has gone by, more very tiny, very premature babies are being born. Whereas in the past it was possible to care for those babies across all 12 units, as they have got smaller and more premature, then it has become more difficult. It's about moving forward and improving outcomes for these tiny infants."

Health chiefs have dismissed concerns about the length of time taken to travel between Fairfield and the hospitals with a maternity ward, as the average labour is estimated to last around 18 hours.

Dr Egware Odeka, consultant paediatrician and divisional medical director for women and children's services at the Pennine Acute Trust, said: "Changes to maternity and children's services will always have a high profile. Change has been talked about in Greater Manchester for nearly 20 years and working patterns, legislations and expectations have changed in this period. In line with other areas of the country, services need to be configured to meet the needs of our population. By making these changes we are in the best position to offer mothers, babies and children the highest quality of care in the most suitable clinical settings."

As well as examining the Making it Better plans, the IRP also examined the Healthy Futures proposals across the Pennine Acute Trust.

They agreed to support the concentration of accident and emergency services at Fairfield, North Manchester, and Royal Oldham hospitals. Rochdale Infirmary's A&E department will be downgraded to an urgent care centre.

All emergency surgery would be axed at Fairfield and instead carried out at North Manchester and Oldham.

Planned surgery, planned medicine, rehabilitation, day-case surgery, and out-patient clinics would still be available at Fairfield.

Each hospital would develop its own specialisms and become "centres of excellence" for different types of surgery.

As part of the proposals, there will be greater focus on the care provided at community-based health centres, such as the LIFT centre which is currently being built in Radcliffe. As well as traditional GP surgeries, the centres will offer assessment, diagnostics and treatments currently only available in hospitals.

Neil Hulton, consultant vascular surgeon and divisional medical director for surgery for the Pennine Acute Trust, said: "This decision means we will be able to provide patients with the specialised care they deserve 24 hours a day. Because we have been trying to provide all services from four hospitals it is difficult to ensure access for patients to a specialist team at all times.

"For instance I operate on blood vessels during the day, but out of hours when on-call, I have to carry out operations on the stomach and bowel. As I qualified a number of years ago I had a broad training which means I can still do this, but it is not the best option. Surgeons today train in specialist fields so grouping them together allows the development of modern therapies and the highest possible standards for patients. We now have an opportunity to develop centres of excellence for the people of north-east Manchester."

Despite the loss of services in Bury, health chiefs say that the plans are not a cost-cutting exercise but will actually require investment.

A total of £2.2 million will be used to fund an extra 79 nurses in neo-natal care and £60 million will be spent on new buildings and refurbishments, including a new block at North Manchester.

An extra £3 million a year will be given to Greater Manchester Ambulance Service to invest in transport to and from all the sites.

Health chiefs have promised that no staff will lose their jobs, though some may be relocated within the trust.

The news that the plans will definitely go ahead has been welcomed by healthcare providers in the area. Various agencies are set to join forces to oversee the implementation of the plans.

Dr Ruth Jameson, medical director of the Pennine Acute Trust, said: "This decision is good news for all patients - it means that we are able to move forward to give patients access to specialist care 24 hours a day, providing centres of excellence and safe sustainable services."

Stephen Mills, chief executive of Bury PCT, said: "Locally the PCT will be working with clinical colleagues across the borough to examine and implement the models of care announced. We are already building up our capacity in the community to care for poorly children, the setting up of a dedicated paediatric nursing team working in children's own homes is an example of this. These developments and proposals to bring some services into the community in child development centres will reduce the reliance on hospital based care that we have traditionally seen. The most poorly children will of course still be cared for by specialist teams within a hospital setting.

"We will be putting our energies into a range of activities to ensure that Bury people can receive the level of care from the NHS that they expect and deserve. This includes the development of a birthing centre offering a range of birthing choices for local women. The new paediatric observation and assessment unit in A & E will similarly receive the required level of investment to ensure that these important new facilities are in place."

Sir David Henshaw, chairman of NHS North West, said: "The decision signals the start of the next phase in the improvement of children's and maternity services in Greater Manchester and health services in general for people who live in the north-east of Greater Manchester. This will lead to the provision of better and safer healthcare for everyone.

"We will now being the process of implementation. This will take time and investment. For these improvements to take place there will be full and continued involvement of everyone, including staff, patients and their carers."