A few weeks ago, I kicked off this page by stating that you didn’t need a stethoscope to diagnose that NHS Ayrshire and Arran was a very sick patient.
As a result, my email inbox began to hyperventilate. The overall prognosis was that if NHS Ayrshire was sick, then Ayr Hospital itself was dangerously ill . . . perhaps even terminally if the cuts to its services continued untreated.
I was warned that Ayr Hospital is set to become a “cold/day case centre”, losing its acute surgical services, its Intensive Care Unit and eventually its Accident and Emergency services.
“A six-figure patient base will see the removal all the major medical services they’ve been enjoying at Ayr for years,” I was told.
“Thousands in Ayr and Prestwick alone will face having to travel to Crosshouse – either as patients or visitors.
“Ayr Hospital is gradually being reduced to a nurse-led minor treatment centre.”
When Accident and Emergency at Ayr finally shuts – and I’m told it will - there will be outrage.
People will ask ‘why did nobody warn us about this?’
Well good readers, check the date on the top of this page [30/11/22]. And remember, you read it here first!
As most of you will know, my knowledge of the intricacies of NHS management is limited.
As for medical practice itself, I don’t know my appendectomy from my edema.
But I can read.
And three words I’m reading most in a plethora of emails are “single acute vision”.
What does that mean?
It means that some people very high up at NHS Ayrshire and Arran have decided, for reasons they’ve yet to justify, that there’s no room for acute services – essentially the delivery of life-saving surgery and after care – at two Ayrshire sites.
They want it all to happen at one single site – Crosshouse. That’s their ‘single acute vision’.
And the gradual stripping away of acute services at Ayr has already begun.
Last year, the acute orthopaedic service was closed and moved to Kilmarnock Haematology, oncology and stroke services have now also gone to Crosshouse, as many people in Ayr and the southern parts of Ayrshire will have found to their cost.
The Intensive Care Unit is being wound down. Next in line will be acute General Surgery – I understand secret plans are already made so that Crosshouse is the first choice for acute emergencies.
NHS Ayrshire and Arran appear to be using a double edged scalpel here.
Acute surgery cannot go ahead without the required intensivist expertise in areas like anaesthetics, ventilation, intubation and dialysis.
NHS Ayshire and Arran claims closing down Ayr’s Intensive Care Unit is partly a recruitment issue – they can’t fill these vital posts.
But who is going to apply for a job in Ayr knowing that the skills they have trained for will be largely based at Crosshouse?
In one email, it was claimed there was a “systematic drive to dissuade new intensivists to join Ayr”.
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A separate anonymous source went as far as to claim that the Crosshouse ‘bias’ was partly due to many senior consultants living in the south of Glasgow – and it was an easier journey to work!
If that’s even remotely true, and people from covering Ayr having to travel to Crosshouse just to help their clinician’s commute time – it beggars belief.
What it’s all leading to is a medical version of the chicken and the egg.
You deprive Ayr of its emergency surgery and intensive care units.
Then you close its Accident and Emergency. . . because it doesn’t have emergency surgery or intensive care!
It’s not just the people from Ayr and southern Ayrshire who will be hit.
Those who live nearer an already struggling Crosshouse will be subject to delays for treatment and overcrowding. When will all this happen? Perhaps sooner than you think!
A recent vacancy for general manager of acute surgical at Ayr was filled as an interim six month post – covering both sites!
That service could move to Crosshouse at the start of 2023. . . and A&E could be gone by the end of it! I have lived in Ayr for most of my 66 years – and I’ve never been further than 10 minutes in an ambulance from the best emergency care the NHS has to offer.
As an ordinary member of the public, I don’t want that to change. And as an elected councillor representing ordinary members of the public – I’m damned if it’s going to change on my watch!
We need some questions here. . . and some honest answers. I’m asking them through this page – and if I don’t get the answers, I’ll be asking them in South Ayrshire’s Council’s chambers. Hey. . . I might even do both anyway!
To NHS Ayrshire and Arran, the questions are fairly simple . . .
1) What is the “single acute vision”?
2) What is the short/medium/and long term future of acute services, ICU and A&E at Ayr Hospital?
3) Will there be public consultation on any desire to further reduce the quality of services at Ayr Hospital?
4) What happened to the plans for a “Pan-Ayrshire Super Hospital” in the Monkton area of South Ayrshire?
Well, that’ll do for starters anyway!
On that last point, there were rumours of a new £500 million hospital, planned for near the Dutch House roundabout at Monkton.
I’m told these plans were stifled . . . because East Ayrshire Council didn’t want Kilmarnock to lose its A&E! – and didn’t want the investment, construction and jobs that came with the new hospital going to South Ayrshire.
What is the ‘single acute vision’?
NHS Ayrshire & Arran has operated a ‘single acute vision’ over the last couple of years, in that we have one single operating model across all of our hospital sites.
This means that the services collaborate in the areas where they can, irrespective of their site – for example, the Emergency Departments are run under the same management system and share staff across both sites to ensure that patients receive the best services available.
Some services are based only on one site and provide services on other sites as part of their routine service provision. Urology services are based at University Hospital Ayr (UHA) and provide care for all Ayrshire citizens; and Ear Nose an Throat services are based at University Hospital Crosshouse (UHC) and, likewise, provide care for the whole of Ayrshire and Arran.
There has been recent separation of elective and emergency orthopaedic care, with elective care based at UHA and emergency care based at UHC. This has resulted from the changes associated with the implementation of the national Scottish Trauma Network.
All potential stroke patients are transferred to UHC and all definite heart attacks are transferred either to the Golden Jubilee National Hospital or University Hospital Hairmyres. This is the progress that has been made with local, regional and national services to support improvements in patient care.
We employ approximately 6,000 clinical/medical members of staff and many of them already work across both sites. The single acute vision is trying to build on that.
What is the short, medium and long-term future of acute services, critical care services and Emergency Department (ED) services at University Hospital Ayr?
There are no plans to close the Emergency Department (ED) or to remove critical care services at University Hospital Ayr.
It is important to acknowledge that there are staffing challenges across all of NHS Scotland and that NHS Ayrshire & Arran is no exception. The single acute vision, (one team over two sites), aims to offer more attractive teams to join. Cross site working can help take pressure off smaller teams.
Will there be public consultation on any desire to further reduce the quality of services at University Hospital Ayr?
Any core service change would require a public consultation. We can confirm that there are no consultations actively being prepared.
What happened to the plans for a ‘Pan-Ayrshire super hospital’ in the Monkton area of South Ayrshire?
There are historical ambitions for a new hospital. However, there is no timeline for this build programme. Our two main acute hospital sites will remain our primary acute provider sites for the foreseeable future.
I’ll close with a lesson on hospital new-build we can all learn from.
On the holiday island of Mallorca, the Govern Illes Balears took pelters for choosing to build a major new hospital “in the middle of nowhere”. But the important words here were “the middle.”
At Inca, slap bang in the centre of the island, it was accessible within 30 minutes from the largest towns and smallest villages on the entire island.
They purchased hundreds of acres of extra ground to facilitate its gradual but inevitable expansion over decades.
They serviced it with bus routes and a rail link. And they encouraged the building of shops, cafes and hotels nearby for staff, patients and visitors.
If NHS Ayrshire and Arran are serious about delivering “Pan-Ayrshire responsibilities” for the health and well-being of our children and our children’s children – they’ll need to do better than six-month interim contracts.
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