Report to:

East Sussex Health Overview and Scrutiny Committee (HOSC)

 

Date of meeting:

 

12 December 2024

By:

Deputy Chief Executive

 

Title:

University Hospitals Sussex NHS Foundation Trust (UHSx) colorectal surgery potential service change

 

Purpose:

To receive an overview of proposed changes to elective colorectal cancer surgery across UHSx hospital sites and consider whether the plans constitute a substantial variation in services.

RECOMMENDATIONS

The Committee is recommended to consider whether the proposed service change proposals relating to University Hospitals Sussex NHS Trust colorectal cancer surgery set out in Appendix 1 constitute a ‘substantial variation’.

1.            Background

1.1       This report provides information about plans by University Hospitals Sussex NHS Foundation Trust (UHSx) to make changes to the provision of elective colorectal cancer surgery across their Sussex hospital sites. Colorectal & Lower Gastro-Intestinal (GI) is a specialty with growing demand and a long waiting list to receive treatment and colorectal surgery describes a number of surgeries that fix problems in the lower gut.

1.2       Current demand for colorectal cancer surgery at Royal Sussex County Hospital (RSCH) in Brighton significantly outstrips the available capacity. Patients are currently experiencing a sub-optimal service due to lack of capacity resulting in a number of short notice cancellations and increased waiting times for surgery.

1.3       UHSx are proposing to relocate all Elective Colorectal & Lower GI Cancer Surgery and Stoma Reversal Surgery from RSCH to the Worthing site, creating a centre of excellence for Colorectal Cancer Surgery delivered across Worthing and St Richard’s (Chichester) hospitals. Approximately 45% of patients that would be affected by this change live in East Sussex.   Affected East Sussex patients would continue to receive the majority of their care at RSCH or their local hospital and would only be required to go to Worthing for their surgery treatment. These proposed changes will not affect patients treated for colorectal cancer by East Sussex Healthcare NHS Trust (ESHT). More details of the planned changes are included as Appendix 1 to this report.

HOSC’s role

1.4       When planning to make significant changes to services, NHS organisations are required to inform local Health Overview & Scrutiny Committees (HOSCs). Under health scrutiny legislation, NHS organisations are required to consult HOSCs about a proposed service change that would constitute a ‘substantial development or variation’ to health services for the residents of the HOSC area.

1.5       There is no national definition of what constitutes a ‘substantial’ change. Factors such as the number or proportion of patients affected, the nature of the impact (positive or negative) and the availability of alternative services are often taken into account in coming to an agreement between the HOSC and the NHS on whether formal consultation is required. Should a HOSC consider that the plans constitute a substantial variation with the potential to have a negative impact on health services for local residents, it may wish to explore the change plans in greater detail and undertake a review.

1.6       Where the HOSC does not consider a proposal to be a substantial variation to services there are alternative options for further scrutiny work including submitting a written response any public engagement or consultation, and further reports to the Committee as the proposals are agreed and implemented.

1.7       The Brighton & Hove City Council HOSC considered a report on the proposed changes at a meeting on 20 November 2024 and it resolved that the proposals did not constitute a substantial variation in services and would instead represent a service improvement in terms of patient experience, outcomes and waiting times.                                     

 

2.            Supporting information

2.1.        The report, which is attached as Appendix 1 provides an overview of the current service, the proposed changes, the expected impacts and benefits and engagement with patients.

 

3.         Conclusion and reasons for recommendations

3.1.      The HOSC is recommended to determine whether it considers the proposed changes to be a substantial variation requiring further scrutiny.

 

PHILIP BAKER
Deputy Chief Executive

 

Contact Officer: Patrick Major, Scrutiny and Policy Support Officer
Email: patrick.major@eastsussex.gov.uk