Over the years, the hospital's role has been gradually stripped away – one example being the downgrading of its A&E unit to minor injuries only. Now with the Doncaster and Bassetlaw Hospitals Trust faced with
making £38m worth of budget cuts and debating the future of local healthcare, The Times team has moved in to find out just what is going on. And lee peace and sally burton have EXCLUSIVELY uncovered a raft of changes on the way, for patients in the Don and Dearne.

HUNDREDS of seriously-ill patients a year will no longer be offered acute emergency treatment at Montagu Hospital, if new plans by health bosses come to fruition.

The scheme means some emergency patients – such as those who have suffered heart attacks – will instead be taken directly by paramedics to Rotherham, Doncaster or Barnsley hospitals.

People who are taken by ambulance on emergency blue-light calls are currently offered initial treatment at the Montagu.

But the proposals mean that some Dearne Valley patients will be taken further afield – to one of the three other hospitals in our area.
Health chiefs estimate that two acutely ill patients a day will be affected – averaging more than 700 a year.

Currently patients classed as direct medical acute admissions are treated at two 26-bed wards at Montagu.

Although hospital chiefs have confirmed that the wards will NOT close under their plans, they admitted that such acute patients would no longer be treated there.

Health bosses say that hospitals in neighbouring Rotherham, Doncaster or Barnsley can offer specialist intensive care and coronary care facilities which are not available at Montagu.

The plans are part of a wider project which could see rehabilitation facilities extended at Montagu.

Hospital manager Roy Tyson was keen to stress this week that nothing is finalised, and the public will be consulted next year. He said: "There are questions that have yet to be answered.

"People will want assurances, and rightly so. I do not yet have all the answers.

"We must enter the consultation process openly, but this is all about giving patients the best opportunity for the best outcome.

"Over two years has been spent musing over this. It is one of a number of ideas. We hope it will make sense to the public we serve to have our own centre of excellence for rehabilitation."

The Acute Medical Admissions Unit serves the Dearne Valley including south-east Barnsley and eastern parts of Rotherham.

It has three consultants providing an integrated acute medical service with Medicine for the Elderly.

Under the new terms, people from Wath needing urgent medical attention may find themselves taken to Barnsley Hospital, and people from Swinton to Rotherham. Previously they might have gone straight to Montagu.

Those taken to Rotherham and Barnsley are, where appropriate, expected to see out their treatment there.

But those taken to Doncaster, could then be referred back to Montagu after their initial treatment.

The other proposed changes could see the closure of three inpatient rehabilitation wards in Tickhill Road Hospital, and the reduction of long-term rehabilitation care from Doncaster Royal Infirmary.

Those services would then be transferred to Montagu to create a centralised "centre of excellence" rehabilitation facility.

Patients whoh would be treated there include stroke victims, people recovering from a heart attack, joint replacement operations and amputees.

Physiotherapists will be on hand to help patients regain physical movement, occupational therapists to help patients get back home and speech therapists will help stroke victims.

Staff will also make sure that, where appropriate, patients' homes are modified with such aids as ramps and grab rails.

Despite the proposed rehabilitation cutbacks at Doncaster and Tickhill Road, hospital bosses said there will be no redundancies as staff will work from Mexborough instead.

And rehabilitation services would be available 24-7, an improvement on the current system which currently only operates five days a week from nine to five.

The extension of services may be housed in a newly built centre at Montagu, and if not, existing facilities will be fully utilised to accommodate the extra staff.

The plans to re-organise services will be made available for public viewing early next year during a three month consultation process.
It is anticipated that this consultation will include at least one public drop-in session in Mexborough. The re-organisation is not expected to go ahead until 2011/12.

Rumours of further cuts to major services at the hospital have been quashed by Roy Tyson.

He said: "The change will ensure the future of Montagu with a wider portfolio of services including the vibrant minor injuries unit that is one of our ongoing major success stories."

The proposals are part of the Ambitions for the Future scheme, which aims to look at ways to improve working practices under the Delivering Better Health programme.

One of the major reasons the programme has been created is because the Doncaster and Bassetlaw NHS Found-ation Trust must save £38 million from their budget over the next three years due to Government cutbacks.
The measures outlined on the list aim to reduce waste and improve efficiency, as well as reduce costs to make up the cash shortfall.
Other measures include:-

• Making visitors to DRI pay for parking, and the introduction of a free park and ride scheme from the racecourse


• The possibility of having a central switchboard for all three hospitals


• A review of cleaning, linen and laundry services


• Reducing inpatients' length of stay


• The introduction of a Productive Ward scheme to make working practices more efficient


• Reducing theatre cancellations and the cost of recruitment advertising, and


• A review of administration across all sites

We asked the Yorkshire Ambulance Service NHS Trust how it might be affected by the proposed changes – and particularly what difficulties could be posed to acute medical admissions, that may be redirected to Doncaster, Rotherham or Barnsley.

Alan Baranowski, assistant A&E operations director would only say: "We will be working closely with our healthcare partners in Doncaster throughout the consultation process to ensure ambulance services are unaffected."