The UK’s largest nursing union has warned that there should be enough staff in place ‘with the right skill mix’ to implement proposed changes at Liverpool University Hospitals NHS Foundation Trust (LUHFT).
The Royal College of Nursing (RCN) in the North West made the comments as the Trust launched a public consultation about proposals for services in breast surgery, general surgery, nephrology, urology and vascular surgery.
If the changes go ahead across Aintree, the Royal Liverpool and Broadgreen hospitals, it would mean that in some cases patients would be treated at a different LUHFT hospital than they might currently use.
The Care Quality Commission (CQC), which has previously raised issues about patient safety at LUHFT, published a report in October last year rating the trust as ‘requiring improvement overall’ following an inspection in June and July 2021.
It carried out the unannounced check of the trust’s urgent and emergency care, surgery and medical care services due to continuing concerns about the quality and safety of some services.
Frontline staff revealed they did not feel ‘respected, supported and valued’ by senior managers.
LUHFT was formerly called Aintree University Hospital NHS Foundation Trust and changed its name in October 2019 when it acquired Royal Liverpool and Broadgreen Hospitals NHS Trust.
Inspectors said one of the key challenges the trust faced was preparing for a move to a new hospital building on the Royal Liverpool University Hospital site, due to be completed this year.
The new proposals will mainly affect specialist surgery and inpatient care - where an overnight stay in hospital is required - but there are separate plans for each of the five services.
LUHFT say the changes, which were developed by staff in each of the services, should create more joined up care bringing staff together.
What the RCN has said
Speaking on behalf of the RCN North West region, Senior Responsible Officer for the Merseyside area David Hopton, said: “The Trust as a whole has seen significant change across the past few years as part of the integration.
“It was always inevitable that there would be further adjustments to the operating model to make sure the trust is offering the best service and efficiencies however we would expect this to enhance the nursing role further.
“It is our role at the RCN to make sure our members, their jobs and the integrity of their jobs are all protected. This means making sure that the nursing roles are not diluted, are fit for purpose and are within scope of practice.
“It is also imperative that there are sufficient numbers of staff in place with the right skill mix to operate the service whilst providing opportunities for further training and development. Our feedback will be reflected in our formal response to the consultation.”
What are the proposed changes to NHS sevices?
- Breast surgery – All breast surgery would take place under a single specialist team based at the Royal Liverpool Hospital. Previously, surgery also took place at Aintree Hospital – this was temporarily stopped as a result of COVID-19 measures, but if the change went ahead it wouldn’t return in the future.
- General Surgery (abdominal and intestines, including gastrointestinal tract, liver, colon and pancreas) – Aintree Hospital would focus on providing all emergency surgery, while the Royal Liverpool Hospital would provide planned specialist surgery. Currently, the two hospitals each provide some aspects of both. Planned (elective) care would no longer take place at Broadgreen Hospital.
- Nephrology (kidneys) – All inpatient care would be centralised at a single, specialist kidney centre at the Royal Liverpool Hospital. Currently, some of this care also takes place at Aintree Hospital. Satellite outpatient sites based at Aintree, Broadgreen, St Helens, Warrington, Halton, Waterloo, and Southport would continue to operate as they do now.
- Urology (urinary tract/male genitals) - All inpatient care would take place at a single, specialist unit based at the Royal Liverpool Hospital, which would provide both planned surgery and be able to provide around-the-clock emergency care. Outpatient services and day case procedures would continue to take place at both the Royal Liverpool and Aintree, but would no longer be offered at Broadgreen.
- Vascular surgery (arteries, veins and lymphatic system) - All inpatient care would move to Aintree Hospital, where currently it is also provided at the Royal Liverpool. Outpatient clinics would not be affected and would continue to be offered at Whiston, Southport, and Liverpool Heart and Chest Hospital, as well at Aintree and the Royal.
Dr Tristan Cope, Critical Care Consultant at Liverpool University Hospitals NHS Foundation Trust (LUHFT), explains: “It’s really important that everyone using our services has access to the same, high-quality care – regardless of which of our hospitals they are treated at.
“The proposals set out in this public consultation are about making the most of our specialist staff and resources, so that we can raise standards and ensure that we provide the best care possible.
“We really want to hear what members of the public think about how these proposals might impact upon them. I’d encourage everyone who uses our services, or who might in the future, to take the opportunity to share their views.
“We’ll be using this feedback to make sure that we get it right for our patients and the wider community.”
The public consultation will run from 7 June until 2 August 2022 and a final business case is due to be published in Autumn this year.
How do I contribute to the consultation?
People can find out more and fill out an online questionnaire at: www.futureLUHFT.nhs.uk
Those who need printed information, alternative formats, or languages other than English can call (0151) 247 6406 (Monday to Friday, between 9am-5pm), text: 07920 206 386 or email: [email protected]
Those who would prefer to provide their feedback over the phone can also use the contact details above to get in touch with NHS Liverpool Clinical Commissioning Group (CCG), which is co-ordinating the public consultation on behalf of NHS Knowsley CCG, NHS Liverpool CCG, NHS South Sefton CCG, and NHS Southport & Formby CCG.
In addition, a number of online meetings will take place during June, giving people a chance to hear about the proposals, and take part in focus-group discussions. For details of when these events are taking place and how to sign up, visit: www.futureLUHFT.nhs.uk