The Leeds Teaching Hospitals NHS Trust

Proposed Elective Care Hub and impact on the Endoscopy Unit

Proposed £10m Elective Care Hub investment in Wharfedale Hospital and the closure of the Endoscopy Unit to allow space for new services

To address the planned care backlog of operations caused by the Covid-19 pandemic and to have a sustainable solution for elective care (also known as planned surgery), Leeds Teaching Hospitals needs to increase the number of operating theatres we have. We also need to have capacity which can confidently be used all year round – protected from surges in urgent care in winter time, for example.

One of the solutions to this is our Elective Care Hubs programme – new and protected facilities for elective operating, this is supported by NHS England within their elective care transformation programme. These hubs will enable us to provide increased resilience for our planned procedures and minimise the risk of planned care being cancelled when we have increased numbers of patients with Covid-19 or large admissions coming in through our Emergency Departments and high numbers of patients with no reason to reside in hospital (i.e. medically fit to go home/to their place of residence but challenges such as third party arrangements for home support needed make this difficult). This also reduces the uncertainty for patients around last-minute cancellations and will help to reduce waiting times. We are proposing that one Elective Care Hub will be located at Wharfedale Hospital to provide more extensive care for people from across north West Yorkshire, Leeds and North Yorkshire.

We are currently working on a £10m business case for the development, which if approved will introduce two new operating theatres, new procedures and specialities, and reintroduced overnight stays for those patients who need them. We are looking to maximise Wharfedale Hospital to its best potential and secure its long term future.

The development, within the existing footprint of the hospital, includes two new theatres, a recovery area, admissions and discharge area along with making an existing ward overnight initially 5.5 days per week, forming an Elective Care Hub. The Elective Care Hub will provide operations including minor cancers, urology and benign gynaecology. These are operations where a post-operative stay is required, hence the move to overnight stays seven days a week. As part of the development there will be some other changes at WDH with the day unit and phlebotomy services moving into refurbished areas and a dedicated Hysterectomy treatment suite. Overall, the clinical footprint of the site will increase.

Some positive steps have already been taken. The ward has been opened overnight for three nights a week (up from zero), with the ambition to move to seven nights a week.

In addition, we want to deliver something immediately and therefore we have developed an option for a mobile theatre on the site. While this is a great first step, it is not a sustainable solution in the long term and therefore we will also be developing additional internal theatres as mentioned above.

The aim is for this work to be completed in late 2023/early 2024.

This proposed development of Wharfedale Hospital demonstrates the Trust’s vision of maintaining Wharfedale Hospital as an important and integral part of its hospital estate and delivering patient care.

Closely related to plans at Wharfedale are developments for a hub at Chapel Allerton Hospital, where investment is being made to increase elective care services. Our preferred solution is to develop two additional operating theatres, a 24 bedded ward and four enhanced care area beds These facilities will be used for spinal surgery and along with the existing orthopaedic theatres at Chapel Allerton will create a centre of excellence for MSK for the region. This will have a significant impact on the lives of our patients, many of whom are experiencing pain during their wait.

Closure of Endoscopy service at Wharfedale Hospital

The Endoscopy service at Wharfedale Hospital is small but well thought of service that cares for a relatively small number of patients (who aren’t all exclusively from Otley area post codes).

Endoscopy is a diagnostic service to look inside your body. A long, thin tube with a small camera inside, called an endoscope, is passed into your body through a natural opening such as your mouth. As a diagnostic service, patients do not attend the Endoscopy service at Wharfedale Hospital on an ongoing or regular basis.

The space occupied by endoscopy at Wharfedale will be required for the new theatres as part of the Elective Hub Development and therefore the unit would close, with services being provided from the main Trust acute sites and other providers in the city. The locations of the main sites have good road/bus and train connectivity and are therefore accessible for patients requiring the endoscopy service.

Staffing arrangements

The number of substantive staff remaining at Wharfedale does not allow for safe staffing of the two endoscopy suites and the decision was made in discussion with the team for the staff members to work at LGI whilst this is the case.

The endoscopy suites at the LGI and SJUH are also better equipped to undertake procedures that are not feasible at Wharfedale due to complexity and acuity, and therefore staffing these rooms allows us to provide a more specialist service than would be afforded at Wharfedale.

Your thoughts

We are at the stage of finalising our business case for the elective care hubs development which will need approval through the Trust’s Board of Directors and NHS England. Therefore later in the year, once the Business Case has been signed off by the Trust’s Board of Directors, and in-depth engagement process will be begin to allow anyone who wishes to feedback on the Elective Care Hub proposals at Wharfedale and also at Chapel Allerton Hospital. Please feed back by 21 September 2022. 

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