NHS Experts Oppose Plan To Centralise Care
Brain surgery services are to be kept in hospitals across Scotland after a panel of experts rejected a plan to centralise care.
The case for cutting the number of units, which threatened the status of several high-profile hospitals, is overturned today with the publication of the official report into the proposal. The review for the Scottish Government deals another blow to the centralising agenda within the NHS.
It concludes “there is no clear evidence” to support the strategy of concentrating treatment currently offered in Glasgow, Edinburgh, Aberdeen and Dundee into one unit.
The experts, who were brought in by Andy Kerr when he was health minister and include 14 consultants in neuromedicine, do back the creation of a single neurosurgery centre for children – which could threaten the level of care available in three of the four cities.
However, it is understood the Scottish Government, which has a presumption against the centralisation of hospital departments, is unlikely to sanction such a move. For the 25,000 people who petitioned the Scottish Parliament, demanding to keep neurosurgery in the north-east, the long-awaited report should represent a victory.
There is also a campaign at Edinburgh’s Royal Hospital for Sick Children, with fears that stripping the hospital of brain surgery and child cancer care could lead to the closure of the hospital. It was thought likely the single centre of excellence would have been in Glasgow.
David Allan, director of the Queen Elizabeth National Spinal Injuries Unit in Glasgow and a member of the expert group, said: “There is a recognition that we do have to provide high-quality, local care. I think that is the message that we have got from patients, staff and families. Wherever we can, that will be provided at the four major centres.”
Charities and medical experts welcomed the report.
Jenny Hill, project manager of the Child Brain Injury Trust in Scotland, said: “We support the creation of a single national service as long as it sustains the high level of acute care that families always tell us about and does not reduce the access to local treatment.”
David Currie, consultant neurosurgeon in Aberdeen Royal Infirmary, said: “I think it is an eminently sensible thing to do. I think it provides a good future for the whole of Scotland.”
A blueprint for the future of the NHS in Scotland, published in 2005 by cancer expert Professor David Kerr, had recommended providing neurosurgery at one main site.
The following year Mr Kerr wrote to MSPs saying that under the proposed changes “the most highly specialised adult and child neurosurgery would be concentrated on a single prime site” and this centre would provide “services where that sort of concentration means patients would get the best outcome”.
A panel, called the Neuroscience Implementation Group, was launched to plan the details of how this would work. This report has been leaked to The Herald ahead of its release today.
The document notes there are studies that show neurosurgeons who perform operations more often in bigger hospitals have better results. However, the experts found: “Studies demonstrating a clear volume/outcome relationship relevant to the Scottish service are few, and currently provide inadequate evidence in favour of concentrating activity.”
Concerns raised by patients and protesters about having to travel further for treatment are also recorded.