The Royal Borough: Windsor & Maidenhead Health Scrutiny Committee: 3 March 2009

1. Acute medicine and plans for Heatherwood – preparing for consultation The Royal Borough: Windsor & Maidenhead Health Scrutiny Committee: 3 March 2009

2. Berkshire East PCT: Right Care Right Place: Consultation 2008 • Hospitals will change but no plans to close any local • hospitals • More outpatients in the community – eg Bracknell • Healthspace • Urgent Care Centres: St Marks, Bracknell, Wexham • Improving care for stroke & heart attack patients: • thrombolysis for stroke & angioplasty for heart attacks

3. High Quality Care for All – the NHS Next Stage Review • Principles: changes should be locally led, patient centred • & clinically driven • Planned care and outpatients should be more local • Technology allows more & more day and short stay • surgery • Lives will be saved if trauma care, heart attacks and • strokes are treated in more specialised centres

4. Berkshire East PCT – 5 year strategy • Improve the pathway for stroke care • Avoid unnecessary outpatient appointments and • admissions • More and more focus on the quality of care • Plans for new cancer treatment centres in Bracknell & • Slough • New urgent care centres

5. Impact on planned care • More local outpatients; no unnecessary follow ups; • better booking; one stop clinics • Benefits of Heatherwood for surgery: • No emergency surgery – so very few cancellations • Low risk of infection: all patients screened before admission • Planning the future of Heatherwood complementary to the Healthspace

6. More planned care at Heatherwood • Plans: £2m for new orthopaedic theatre & theatre • refurbishment by October • More orthopaedic surgery especially foot & ankle surgery • New Urology diagnostic centre in Ward 5 including biopsies • At least 70% of oral surgery and 80% of plastic day surgery • at Heatherwood • Transfer planned pacemaker implantation from Wexham • Medical Investigations Day Unit

7. Emergency care at Heatherwood • Changes: emergency patients needing admission: • to Wexham Park or Frimley or Royal Berks for specialist • cardiac or stoke care if needed • Rapid Consultant Assessment Clinics at • Heatherwood for patients who may not need admission • Ward 8 to become a Rehabilitation Ward • Intermediate Care Ward under consideration

8. Emergency care numbers • 12 medical emergency patients per day to Heatherwood – • mainly referred by GPs; • 24 per day to Wexham Park – majority 999s • Est 5 patients per day to the Rapid Assessment Clinic • With more medical staff at Wexham Park & despite reduced • hours from European Working Time Directive: • direct admission to the Coronary Care unit at Wexham Park for heart attacks • direct admission to the Acute Medicine Unit – bypassing A&E

9. Heatherwood Hospital – future planned services • Orthopaedics • Day & Short Stay Surgery • Medical Assessment Clinics • Diagnostics & outpatients • Medical Investigations Day Unit • Rehabilitation Ward & Physio/OT • Intermediate Care Ward (under review) • Children’s Assessment Unit • Birthing Centre • GP practice

10. Consultation • Planned period April/May to June/July • What further information is needed for consultation • How best to disseminate the case for change • What process to follow – ?as in the PCT Right Care Right • Place Consultation last year • The pros & cons of including specific questions