WEAK clinical evidence surrounding plans to downgrade the Alexandra Hospital was partly behind a decision to block proposals being put to the public.
Commissioners had hoped to go out to consultation on the reconfiguration plans in September – which include centralising consultant-led births, inpatient paediatrics and some A&E services into Worcester.
But NHS England rejected the plan at an assurance check in August, at the time saying the business cased needed more work.
However the Standard has obtained a copy of the NHS England report, using the Freedom of Information Act, which shows the reconfiguration plan failed seven of eight key tests, while officials expressed a number of concerns.
Commissioners were told there was a ‘clear lack of clarity’ around the clinical evidence behind the review while legal advice suggested it was not strong enough to pass the NHS check.
West Midlands Clinical Senate has been asked to review the proposed clinical model and is due to start work this month.
Commissioners were also told they had not demonstrated how patient choice for elective care would be enhanced, there was no evidence of engagement with the public or patients since March 2013, no coherent consultation plan and no clear idea on how the changes would be implemented or how services would be kept safe while they were being made.
The report also warned further consideration of the impact on people with mental health conditions was needed, the fact black and minority ethnic groups would be ‘disproportionately disadvantaged’ and greater clarity was required on proposals resulting from the review of transport arrangements.
The financial case was also questioned including how much money would be needed to increase capacity at both the Alex and Worcestershire Royal to accommodate the changes. At a meeting with NHS England in May it was suggested the figure was £35million, but by August it had risen to £47million. If the costs go above £50million approval from the Treasury will be needed.
Officials also wanted assurances from providers including Birmingham Women’s Hospital, University Hospitals Birmingham and Birmingham Children’s Hospital they had the capacity to cope with the impact of the changes.
A spokeswoman for the review said verbal feedback they had received suggested they had only narrowly failed to meet the tests needed to go to public consultation and they were confident they would now pass the assurance check when the business case was re-submitted.
She added pre-consultation was taking place with a number of local groups, including those most likely to be affected by the changes, while the the consultation plan – which was not submitted to NHS England – would be reviewed by councillors on the county council’s health overview and scrutiny committee.