Our hospital staff work very hard to provide the best care possible but, like hospitals all over the country, we face challenges, which include:

• Increasing demand for A&E, ambulances and urgent treatment.
• An ageing population needing support for long-term and often complex conditions.
• Difficulties with staff recruitment and retention.
• Some out of date buildings and equipment and limited access to the investment we need to improve or replace them.

A clinical review, led by local hospital doctors and nurses, looked at the services you currently receive. The review found that:

• Our staff are spread thinly across hospital sites, with relatively small services provided from a number of different hospitals. This means that we are not always able to meet clinical standards set nationally and that jobs for our staff are tougher than in other parts of the country.
• Our patients spend longer in hospital to get the same care and treatment than in many other parts of the country.
• We struggle to provide support services such as diagnostic tests quickly enough, causing treatment delays.

This all makes it harder to ensure everyone receives the same high-quality care, no matter where they live. By changing how services are organised, we can make them work better for patients. Read more about our challenges and the reasons for the proposed changes in our Case for Change document on our website.

Our priority will always be to keep you safe and provide excellent standards of care, when you need us. That’s why in recent years we’ve had to make some really difficult decisions to change how we do things to make sure we can keep providing care that is safe. Whilst we work hard to ensure our services remain safe today, we need to plan for the longer term recognising some of the challenges we have now and others that are coming over the horizon so we can ensure our services will continue to be safe for the longer term.

The proposal we are consulting on, is about future-proofing services so they can continue to be delivered safely in the long term.

Our health and care system is facing unprecedented challenges. We face significant shortages of doctors, nurses and hospital support staff. Despite our best efforts, we can’t recruit enough new staff or support our existing staff to keep up with the specialist skills required to provide the quality and safety our patients and staff deserve.

Our staff are spread too thinly across hospital sites, with relatively small services provided from a number of different hospitals. This means that we are not always able to meet clinical standards set nationally and that jobs for our staff are tougher than in other parts of the country.

Nearly a third of our staff are eligible to retire within the next 5 to 10 years. National shortages mean we still struggle to recruit enough skilled staff for our speciality services. Potential recruits tell us that roles are not attractive because low numbers of patients mean they can’t keep up their specialist skills, and can limit opportunities for research, education and training.

As a result, vacancy rates in some specialisms were approaching 30% in 2022/23, leading to gaps in rotas which put pressure on existing teams and increasing our reliance on expensive locums and agency staff. This can make it harder to provide continuity of care for patients.

Last year (2022/23) we spent over £37 million on temporary (agency and locum) staffing to cover gaps in rotas to ensure services continue to be delivered safely.

We want to continue to provide the best care for those living in our region and invest in the many specialist services our hospitals provide. As a collective of hospitals working better, together, we can provide improved services and care for all. But to do so, things need to change.

Our health and care system across the Humber needs to change. As it is currently designed, it is struggling to meet the needs of all local people and the way services are set up means it is not equipped to do so in the future.

This proposal is about putting in place a robust plan to ensure hospital services, and care that is provided in local communities, are the best they can possibly be – now and for the long term.

We would like to hear what you think about our proposal to change the way some more complex medical, urgent and emergency care and paediatric (children’s) services are delivered at our hospitals in Scunthorpe and Grimsby (Scunthorpe General Hospital and Diana Princess of Wales Hospital, Grimsby).

The services we are considering changing are primarily for patients who need more complex emergency diagnosis, treatment and care after receiving an assessment through one of our Emergency Departments. The proposal also covers paediatric (children’s) inpatient services, where a child would need to be admitted to hospital for a period over 24 hours.

The aim is to improve services for those with the most urgent and complex needs, keeping them safe and of high quality in the long term.

It is proposed that these services would be brought together at one hospital:

• Trauma Unit – for people with injuries requiring specialist care (typically brought by ambulance) and who might need an operation or observation by a trauma team.
• Emergency surgery (overnight) – for people who need an operation in the middle of the night or who need to stay in hospital overnight and be looked after by teams with surgical expertise.
• Some medical specialities (inpatient) – for people who need a longer stay in hospital (more than 3 days) and to be looked after by a specialist team for their heart, lung or stomach condition.
• Paediatric overnight (inpatient) care – for children and young people who need to stay in hospital for more than 24 hours.

No.

24/7 Emergency Departments (A&E) would continue to be delivered at both Diana Princess of Wales Hospital, Grimsby and Scunthorpe General Hospital. We have recently invested £35 million to build new Emergency Departments and Assessment Units in both hospitals.

No, this is not true. Our proposal relates only to trauma, overnight emergency surgery, longer-stay patients (more than 72 hours) who need to be looked after by a specialist team for their heart, lung or stomach condition and paediatric overnight (inpatient) care for children and young people who need to stay in hospital for more than 24 hours. We believe the proposal we’re putting forward will impact around 14 patients a day. The majority of patients who use our hospitals would continue to be seen and treated in the same hospital they are now (around 400 a day who need urgent and emergency care and more than 1,300 a day with planned appointments or operations).

Under the proposed changes, you would still take your child to the same local hospital as you would today. 24/7 Emergency Departments (A&E) and Paediatric Assessment Units (PAU) would continue to be delivered at both Diana Princess of Wales Hospital, Grimsby and Scunthorpe General Hospital.

If you need help today, call NHS 111 or go online https://111.nhs.uk/. Call 999 in a life-threatening emergency.

In developing the proposal, we carefully studied the likely impacts of bringing these services together on patients, staff and visitors.

The services we are considering changing are primarily for patients who need more complex emergency diagnosis, treatment and care after receiving an initial assessment through one of our Emergency Departments (A&Es) in Scunthorpe or Grimsby.

The vast majority of patients who use our hospitals would continue to be seen and treated in the same hospital they are now (around 400 a day who need urgent and emergency care and over 1300 a day with planned appointments or operations). Those who have a more complex medical need would be treated at a different hospital (Grimsby) and would arrive in an ambulance or be taken by free inter-hospital transport after having received their initial medical assessment at Scunthorpe.

The proposed changes – if implemented – would impact around 14 patients each day, who would be transferred to Grimsby (either directly by ambulance or by inter-hospital transfer after an initial assessment at Scunthorpe) to receive more specialist medical treatment. The number of patients affected is expected to be lower in the longer term as services adapt to new and improved ways of working.

In short, no. As mentioned, above, the majority of patients who use our hospitals would continue to be seen and treated in the same hospital they are now (around 400 a day who need urgent and emergency care and more than 1,300 a day with planned appointments or operations). Only those who have a more complex medical need would be treated at Diana Princess of Wales Hospital in Grimsby and they would arrive in an ambulance or be taken by free inter-hospital transport if they have received their initial medical assessment at Scunthorpe.

For patients travelling to hospital (A&E) themselves, there will be no change – our proposal is that a 24/7 Emergency Department would remain at both sites and people would continue to go to their local hospital. This proposal will only affect people transported by ambulance or those who need more complex emergency diagnosis, treatment or care after receiving an assessment through one of our Emergency Departments. They would be transported to Grimsby by a free inter-hospital transfer service.

We do, however, recognise that in some cases there will be an impact on relatives, families, carers and loved ones having to travel further. A transport working group was set up during the development of the proposals and this will continue to work on developing solutions together. We are working with our transport group on this to mitigate any potential impact on travel for visitors, carers, families and relatives and are keen to hear ideas and suggestions through the consultation.

We already have strong mechanisms in place for helping to ensure people can be discharged from hospital quickly and without delay, working through our integrated discharge hubs. We do recognise the importance of getting people back to their local communities, homes and families. We will be continuing to work closely with local councils to make sure that this flow is not impacted so that we do not cause any delay in discharging people from hospital.

We have established a transport group, building on the work done while we were developing the proposal, to work with patient and representative groups as well as partners (local authorities, transport providers, voluntary sector) to look at how we respond to a range of transport needs that are arising through this consultation. We will be exploring different ideas and potential solutions to transport challenges during the consultation and are keen to hear ideas from local people.

Over the past two years a dedicated planning team, including hospital doctors, nurses and therapists, GPs and planners has focused on developing options for change to tackle the challenges faced locally and deliver improved care for patients.

To ensure any proposed changes are in the best interests of local people, we listened to the views of 12,000 local people, including NHS staff and community organisations, through a mixed approach of surveys, workshops, focus groups and one-to-one discussions.

In developing the proposal, we explored over 120 different ideas. We carefully studied the likely impacts on patients, staff and visitors of bringing these specific services together at Scunthorpe General Hospital or Diana Princess of Wales Hospital, Grimsby by asking questions like:

• How many people would have to go to a different hospital if services moved?
• How close should these services be to communities that are most vulnerable to changes, like those living in the most deprived areas?
• Which option would have the least impact on ambulance services?
• Which option would mean the fewest patients having to move between hospitals during their stay?

We also had to consider important practical and financial issues:

• How much would it cost and is it affordable?
• How long would it take to make the changes and improve services, including how much building and renovation would be needed?

For some specialities, there are reasons why certain services have to be located together at the same hospital. For example:

• Surgical specialities that need to treat patients in an emergency all need to be located in the same hospital because they need access to operating theatres, anaesthetics and theatre teams 24/7.
• A Trauma Unit requires access to surgical teams 24/7 (although due to the small number of operations taking place overnight, these teams are currently not being used very effectively).
• Specialist medical services are dependent on certain other facilities and therefore need to be located together with other services.

In developing the proposal, we carefully studied the likely impacts on patients, staff and visitors of bringing these services together at Scunthorpe General Hospital or Diana Princess of Wales Hospital, Grimsby.

We are proposing to bring these services together at Diana Princess of Wales Hospital, Grimsby because:

1. It will directly affect fewer people:
   1. It is closer to more patients who have poorer health outcomes, who would otherwise have to travel further and may not have access to transport.
   2. It would have the least impact on ambulance services.
   3. Fewer patients would have to be transferred between sites if they needed to stay in hospital overnight.
2. Overall, it would have a lower impact on journeys to and from hospital:
   1. Fewer people would have to go to a different hospital site.
   2. Fewer people would have longer journeys to and from hospital.
3. It makes the best use of our financial resources:
   1. It is the only option that is affordable – it would cost three times as much to make changes to the buildings at Scunthorpe General Hospital to bring services together there.
   2. While it would cost £16 million to implement the proposed changes at Diana Princess of Wales Hospital, Grimsby, it would cost £57 million to implement these changes at Scunthorpe General Hospital.
4. Delivering the services at Diana Princess of Wales Hospital, Grimsby would allow us to make the changes within the money we have available and improve services far more quickly.

No.

This is about providing the best clinical care and achieving the best health outcomes for our patients by making sure services are fit for the future.

We also expect this proposal to help us to use our financial resources in the most efficient way. For example, we expect the proposal to help reduce our reliance on agency and locum staff, reducing the ‘premium’ we pay in for these temporary staff and helping to improve continuity of care for patients.

The proposal also helps us to organise the staff we do have more effectively to make best use of the workforce we do have. For example, there are around 370 emergency overnight operations across in Scunthorpe and Grimsby. Across the two sites, this is about one operation per night, yet fully staffed 24/7 on-call rotas need to be maintained at both hospitals.

This is not an effective or efficient use of NHS resources. Bringing overnight emergency surgery together on one site would mean some staff who are currently on-call overnight could work during the day, providing more capacity overall.

These changes mean the services at Scunthorpe General Hospital – both the Emergency Department and other services – remain fit for the future.

If the changes we are proposing are implemented, it will provide the opportunity to address our workforce challenges, while enabling most people to be cared for at the same hospitals as they are now.

24/7 Emergency Departments (A&Es) will continue to be provided at both Scunthorpe and Grimsby hospitals, with trained Emergency Department teams available around the clock. This means there would be the skills and expertise available to safely assess and stabilise patients at Scunthorpe Hospital, even if they subsequently needed to be moved elsewhere for ongoing treatment.

We have recently invested £35 million to build new Emergency Departments and Assessment Units in both hospitals and the proposal has been designed to maximise the benefit of those investments.

In addition, there are services for which Scunthorpe General Hospital is the specialist centre. For example, Scunthorpe provides the Hyper Acute Stroke Unit (HASU) for all of Northern Lincolnshire, where patients are taken for immediate treatment following the onset of a stroke. This would remain at Scunthorpe in the proposal that is being put forward.

The option that’s proposed is the only one – out of more than a hundred that were considered – that we think can meet staffing pressures and deliver key national standards, whilst having the least impact on patients. Other potential solutions were looked at but were ruled out because, either:

• They could not be delivered safely.
• They would not address the workforce challenges.
• They had a very significant impact on patient travel time for a large number of patients.
• They could not be delivered due to building issues and limitations of existing hospital sites.

The proposals we are consulting on have been supported by the Clinical Senate, a group of independent senior clinicians who don’t work in our area. The Clinical Senate confirmed the model will provide better, more sustainable services for our population. Legally, we are not allowed to put forward options for consultation that are not viable or realistic.

Even where a single option consultation is proposed, it would be wrong to approach the process with a closed mind. It is quite possible that during consultation, feedback might be received which will change the proposal or how it is implemented. Any changes made following consultation will be carefully planned and be implemented over a period of time.

We are therefore focused on ensuring everyone has an opportunity to have their say, and that we listen carefully to the consultation responses.

We have been listening to patients and staff for some time now, to help us design plans with patients and staff in mind. The conversations we have had so far have been really useful and they have helped prepare for and plan our consultation. We have done our best to ensure that we make it as simple as possible for people to be involved and to be heard.

We have planned a wide range of consultation activities and listening events, aimed at reaching as many organisations and residents as we can, all with the express aim of listening to what people are saying about our proposal.

We are planning to reach people, through:

• Online questionnaire
• Social media (including paid-for advertising)
• TV, radio and local newspapers
• Newsletters
• Roadshows
• Exhibitions
• Online meetings
• Focus groups
• Drama workshops
• Door-to-door leaflets.

In addition, we have launched a dedicated website to provide up-to-date information, a link to the consultation questionnaire, and a place where people can sign up to make their views known: https://betterhospitalshumber.nhs.uk.

We have sent printed copies of our summary leaflet to a wide range of community locations, including libraries, GP practices and children’s centres all across Northern Lincolnshire and Goole. We can also provide information in a range of formats and languages on request. We have a telephone helpline people can call to request information or leave feedback: 03033 306666. People can also send their views in directly to FREEPOST SS1018, PO Box 530, Swansea, SA1 1ZL.

Our approach to planning the consultation was based on extensive data analysis. The recent Census data shows us which neighbourhoods are most affected by digital exclusion. In those areas, we are making sure that people have access to hard copies of information – posters, printed copies of the information in libraries and other accessible places and holding targeted outreach events.

Yes.

This public consultation is a genuine listening exercise – a decision about the way forward will only be made after the consultation responses have been fully considered.

That’s why it is really important that we hear from as many people as possible. Find out how you can give your feedback on our website.

We have already engaged widely as we worked on the proposal. More than 12,000 people – patients, staff, carers and other local stakeholders – have been involved in developing the proposal. You told us:

• being seen and treated quickly is the most important thing for local people.
• getting to and from hospital is a concern for many of you.
• for maternity services and paediatric (children’s) care, safety is people’s number 1 priority.
• children and young people told us that feeling safe and their physical surroundings matter a lot to them.
• having the right workforce – and enough of them – is important to staff and patients alike.

We have listened to these views in developing the proposal, and we will continue to listen through this consultation to ensure that our health services meet our local needs.

The consultation closes on 5th January 2024.

We will listen to what people have to say and consider all viewpoints put forward. It is important to reflect that public consultation is not a vote, it is there to help us understand the impact of any possible changes on individuals and/or groups in our area so that we can make the right decisions based on a fuller understanding of what people think about the proposal.

If the public really don’t like our proposal – it is important for us to hear that.

As part of the consultation process, it’s also important for us to try and understand in detail the reasons why people might not like the proposal or parts of it. This will help us consider if there is anything more we can do – or anything new we can introduce – that might address people’s concerns.

Our hospital services face significant challenges so we must make some changes – we cannot stand still and keep things as they are. But it is equally important that we make the right changes that bring about the best for our patients and staff, which is what this consultation can help us to do.

Once the consultation closes – on 5th January 2024 – all the information and feedback we’ve received will be collated, independently analysed and compiled into a feedback report by an independent research organisation, Opinion Research Services (ORS). This report will tell everyone, including decision-makers, what the public and all our stakeholders have told us.

We will use this information to help us write our Decision-Making Business Case, which will make a recommendation or series of recommendations on how we should proceed.

We will consider the views and evidence provided during this public consultation alongside other material information – such as changes to policy, regulations or clinical standards and any updated activity or workforce modelling – before making our decision on how these services should be delivered in the future.

The Decision-Making Business Case will be presented to the NHS Humber and North Yorkshire Integrated Care Board to make the final decision on how to move forward.

The proposal we are consulting on is about a small number of specialist inpatient hospital services. Outpatient appointments are not affected by the proposal and will happen in the same way as they are now.

Let’s take ‘Alexis’ – a 66-year-old grandmother of five who lives in Scunthorpe. She arrives at Scunthorpe General Hospital on a Friday afternoon complaining of chest pains and a minor heart attack is suspected.

She needs to see a specialist cardiologist to decide on a treatment plan and perform a procedure called angiography.

National guidance says this should happen within 72 hours. However, the way services are organised now means Alexis will wait on a hospital ward until Monday morning to be seen by a cardiologist, when a decision will be then made for further investigations and a referral made to the cardiology lab. She may then have a few further days of waiting before having the procedure.

Under the proposed change, Alexis would have initial tests in the Emergency Department at Scunthorpe General Hospital and then be transferred via a dedicated inter-hospital transport service to the cardiology ward at Diana Princess of Wales Hospital in Grimsby to be seen by a cardiologist on site, even on a Saturday or Sunday.

Alexis will have her procedure within the required timeframe because consultant-led care would be provided seven days a week on that site. Alexis would be treated more quickly and then be able to go back home, hopefully within 24 hours of the procedure.

In actual fact, last year year (2022/23) we spent more than £37 million on temporary (agency and locum) staffing to cover gaps in rotas to ensure services continue to be delivered safely.

We face significant shortages of doctors, nurses and hospital support staff. Despite our best efforts, we aren’t able to recruit enough new staff or support our existing staff to keep up with the specialist skills required to provide the quality and safety our patients and staff deserve.

Our staff are spread too thinly across hospital sites, with relatively small services provided from a number of different hospitals. This means we are not always able to meet clinical standards set nationally and that jobs for our staff are tougher than in other parts of the country.

Nearly a third of our staff are eligible to retire within the next five to 10 years. National shortages mean we still struggle to recruit enough skilled staff for our speciality services. Potential recruits tell us that roles are not attractive because low numbers of patients mean

they can’t keep up their specialist skills, and can limit opportunities for research, education and training.

As a result, vacancy rates in some specialisms were approaching 30 per cent in 2022/23, leading to gaps in rotas which put pressure on existing teams and increasing our reliance on expensive locums and agency staff. This can make it harder to provide continuity of care for patients.

In truth, some of the specialist clinicians we would like to recruit find it more attractive to work in places where they will see enough patients to be able to maintain and improve their skills. The way our specialist services are configured at the moment, means teams working out of Scunthorpe Hospital or Grimsby Hospital are not seeing enough complex cases to meet the requirements of their training.

Bringing specialist teams including surgeons, theatre teams, nursing staff together at one hospital will support the future sustainability of our workforce, by making it a more attractive place to work.

There are a number of factors which contribute to the difference in building costs between the two site options that were looked at. These include:

• If the proposed services were brought together in Scunthorpe rather than Grimsby, the total number of patients needing to be transferred between sites would be higher and therefore the increase in beds on the Scunthorpe site to make the change possible would be greater.
• The way in which the current buildings are set out means that much more significant changes would need to be made to bring the right departments together within the Scunthorpe hospital site, compared with minimal changes required at the Grimsby site.
• The current state of existing buildings and available space. To bring the services together at Scunthorpe rather than Grimsby would require additional investment to increase theatre space and undertake enabling works.

Additional information on the factors that were considered when evaluating the different possible ideas is provided within the Pre-Consultation Business Case.

The proposals would not impact the system’s ability to respond to major incidents. Ambulance services would follow existing protocols to deal with major incidents and contingencies such as road closures and the most seriously ill patients would go to Hull (as they do now).

An EPRR (Emergency Preparedness, Resilience and Response) impact assessment of the proposal has been undertaken and shared with the Local Resilience Forum (LRF), who have not raised any concerns regarding the proposal. Furthermore, the new-build Emergency Departments in Scunthorpe and Grimsby have significantly increased our capacity (e.g., decontamination suites) and improved our ability to respond to major incidents.