HELEN PUTTICK  HEALTH CORRESPONDENT

18 Feb 2011

SENIOR health service staff are calling for a radical shake-up of hospital services and a rethink of waiting time targets as budget cuts bite.

Calls for a shake-up of Scotland's hospitals as departments face axe under proposals

In a hard-hitting report being sent to Health Secretary Nicola Sturgeon, senior managers with NHS Scotland say some hospital departments, including A&E, should be axed and other services centralised.

The unprecedented document lists a range of specialist treatments – including head injury care and organ transplants – which they say many managers and clinicians believe should be offered on fewer sites.

It demands an urgent review of the strategy to cut waiting times, revealing some senior officials believe the drive to slash the delay between GP referral and hospital treatment to 18 weeks this year will cost a lot without achieving much.

Screening men for a deadly weakness in the artery wall – which was due to be introduced this year – should also be reconsidered, according to the managers.

They stress changes are needed in order to avoid compulsory redundancies, pointing out recruitment freezes and reducing staff numbers through natural wastage will not deliver the shake-up required on their own.

It is rare for top NHS staff to say anything in public that might be seen as criticising ministers. However, the Institute of Healthcare Management (IHM) Scotland, which represents 90% of chief executives in the Scottish health service, has produced the report amid concern that people do not realise how tight NHS finances will become because politicians talk about “protecting” the health budget.

Rising expenses, including an annual hike of around 10% in the cost of prescription drugs and growing demand from an ageing population, mean health boards are facing real-terms budget cuts.

The report, which has already been sent to Derek Feeley, acting chief executive of NHS Scotland, says: “All of this will mean changes to the way the NHS operates on an unprecedented scale.”

Reconfiguring hospital services is repeatedly mentioned in the report, which notes consultants are concerned some specialist services do not treat enough patients or attract enough staff to meet quality and safety standards.

Martin Hill, secretary of IHM Scotland, said the way medicine was delivered had changed. He said some patients, such as the elderly, were being cared for at home more regularly, and that medical advances were making some forms of treatment highly specialised.

Click this link to find out more about the IHM in Scotland

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The full text of the key paper Getting into Shape click the link below  [mc id=”775″ type=”file”]Getting into Shape [/mc]