LETTER: Hospitals’ fears

THE recent decision of the Coastal West Sussex Clinical Commissioning Group (CCG) to hand the provision of musculoskeletal (MSK) services to Bupa and Central Surrey Health (CSH) came as a real surprise to me.

That was not just because I believe Western Sussex Hospitals submitted a high-quality and joined-up bid of its own, but also because I feel very strongly that it will threaten continuity of care for patients and may ultimately put some important hospital services at risk.

I know many health care professionals and patients share the same concerns and feel equally strongly about them, with a number of GPs having already written to the CCG raising these same points.

There is still much we do not know about the Bupa/CSH alternative to our own proposal but there is an indication it will see rheumatology, pain services and physiotherapy transferred in their entirety to the private organisation, which then intends to sub-contract an element of the surgical part of the service back to Western Sussex Hospitals.

In my opinion, and in that of many clinicians too, this will create a fragmented service that is likely to struggle to meet the complex needs of the largely elderly patients who are the main users of MSK services.

It will also raise significant uncertainty around our ability to continue to run emergency trauma and orthopaedic services at both Worthing and St Richard’s Hospitals, and questions how we will maintain non-MSK provision in rheumatology, pain services and physiotherapy after staff who work across multiple specialities have been transferred to Bupa/CSH.

As far as emergency trauma and orthopaedic services are concerned, NHS hospitals are only able to fund current levels of provision by absorbing the higher cost of these through the type of elective care involved in this contract.

That means if we are unable to provide planned orthopaedic surgery on the same basis as at present it is unlikely that we will be able to maintain the same level of emergency trauma and orthopaedic services either.

This decision is not solely about quality of a single service – although I am very happy to be judged on the recent record and future plans of a hospital MSK team of which I am very proud.

It is also about the impact it has on the wider health services on which local people depend.

Handing MSK to an organisation with no local experience and no responsibility for wider health care provision here risks exactly the fragmentation the CCG seeks to avoid, and poses a real threat to the full range of services our community has supported so hearteningly in the past.

We will now be seeking further talks with the CCG to explore ways in which the improved MSK services we both desire can be provided without any negative impact on other types of hospital and community care for local people.

In the meantime, I would like to thank your readers for the continuing support they offer our staff.

Mike Viggers


Western Sussex Hospitals NHS Foundation Trust