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A  major reconfiguration which promised to save 300 lives per year – and bagged its region funding off the back of its claims – has been “quietly dropped”, sources tell HSJ.

The landmark consolidation of high-risk general surgery in Greater Manchester, which was subject to an unsuccesful judicial review in 2016, will not go ahead, with providers agreeing to drop the plans.

The attitude was that the “world has changed” and patient outcomes had already improved, said the sources. There is also understood to be a reluctance to create additional complexity for ambulance crews at the current time.

The plans, which were the central aspect of the Healthier Together consultation, would have consolidated all high-risk general surgery at four hospitals and ceased this activity at five others.

HSJ has asked the Northern Care Alliance, which runs both sites, if there would be implications of not delivering some of the key changes outlined in their business cases, but has had no reply.

Danger still present

Ambulance handover delays are rarely out of the news in the NHS – yet the problem never seems to go away. Last year was exceptional, with A&E capacity reduced due to social distancing and hospitals under tremendous pressure, leading to issues with handovers in many areas.

Ambulance trusts have repeatedly warned of the dangers of long waits in the back of an ambulance – both for the patient concerned and those waiting for an ambulance in the community. In the West Midlands, those warnings turned out to be prescient when an elderly lady died from the complications of a nosebleed after a 32 minute delay in transferring her from an ambulance to A&E.

She had deteriorated rapidly while in the ambulance and the crew had made what sounds like desperate attempts to get her admitted.

The death – on 1 October 2020 – came just two days after West Midlands Ambulance Service University Foundation Trust had sent a warning letter to three local trusts over their performance on ambulance delays, saying that lives would be put at risk. Sadly, that turned out to be the case – although it has not been revealed which trust was involved - but, as HSJ has reported, long delays have continued.