12. REGIONAL SERVICES PROVIDED BY GLASGOW HOSPITALS

Glasgow’s hospitals provide services mostly for Greater Glasgow – people living in the City, East Dunbartonshire, Eastwood, Rutherglen, Cambuslang, Clydebank and Moodiesburn.

There are some specialist services which our hospitals provide for a wider population. Sometimes the services are regional – for the West of Scotland, and sometimes they serve the whole country.

This leaflet tells you about these regional and national services and how they are affected by our plan to modernise Glasgow’s hospitals.

Neurosurgery and neurology

These services for treatment of disease in the brain and nervous system are currently based in modern facilities at the Southern General. Serves Lanarkshire, part of Forth Valley, Ayrshire and Arran, Argyll and Clyde, Western Isles. Sometimes patients may come from other Health Boards.

No change.

Spinal injuries

Currently based in modern facilities at the Southern General. Serves the whole of Scotland.

No change.

Infectious diseases

Based in new facilities at Gartnavel. Mostly serves Greater Glasgow but also sees referrals from other West of Scotland Health Boards, and deals with any cases of infectious diseases found among passengers at Glasgow Airport returning from abroad.

No change.

Homoeopathy

Based in a new hospital at Gartnavel. Mostly serves Greater Glasgow but also sees other patients from neighbouring Health Boards and provides training support in homoeopathy for doctors and other health care staff from throughout Scotland.

No change.

Beatson Oncology Centre

The regional Cancer Centre for the West of Scotland. Provides radiotherapy treatment and other specialist cancer treatments and expertise. Currently based in old but upgraded buildings at the Western Infirmary.

Our plan proposes that its in-patients should move into the relatively modern Phase I ward block at the Western Infirmary once it is vacated by other specialties being brought together at Gartnavel.

In the meantime new linear accelerators (for radiotherapy treatment) are being installed at Gartnavel. At first they will serve out-patients only. In-patients needing radiotherapy will initially continue to get it at the Western Infirmary.

Towards the end of the ten to twelve years of the plan we intend to transfer all of the remaining Beatson Oncology Centre services from the Western Infirmary into modern facilities at Gartnavel. The number of patients affected by this move will be around 6,600 in-patients per year, 7.900 day cases and 21,300 out-patient attendances. Many of these patients will come from Greater Glasgow itself.

Cardiothoracic Surgery

At present cardiothoracic surgery (heart and lung) is provided at both the Glasgow Royal Infirmary (GRI) and the Western Infirmary. These two units provide a service for other West of Scotland Health Boards as well as Greater Glasgow. The GRI also provides a heart transplant service for the whole of Scotland.

We propose to bring the two cardiothoracic units together to form one unit. It will become one of the largest units in the UK. We believe its large size will help it to recruit surgeons in what is increasingly a UK-wide and international labour market for specialists in this service. This is especially important in the field of transplant surgery.

Initially the combined unit will use the relatively modern facilities of the Phase I ward block at the Western Infirmary but towards the end of the ten to twelve years of the plan we intend to transfer the service into modern facilities.

The current number of in-patients per year is some 1,800 at each of the Western and GRI. Out-patient attendances total 3,300 per year at the Western and 3,500 at GRI. Many of these patients will come from Greater Glasgow.

Plastic Surgery and Burns

This service currently has its in-patient beds at Canniesburn. New facilities are being built at Glasgow Royal Infirmary (GRI) and will be ready for use in 2002. Canniesburn Hospital will then close.

The transfer to the GRI will provide a much better link between this service and its staff with the major accident and trauma service which we propose to strengthen at the GRI.

The specialty serves all of the West of Scotland Health Boards.

Currently some 3,500 in-patients, 5,900 day cases and 23,900 out-patient attendances go to Canniesburn each year. Relocation to GRI will make it easier to get to for people relying on public transport. Ambulance access for emergencies will also be more centrally placed.

Artificial Limbs and Wheelchairs – ‘Westmarc’

This service provides specialist support for people who have had amputations or who need wheelchairs or other specialist equipment to maintain their mobility. It is located in modern accommodation at the Southern General Hospital and no change is proposed.

Kidney transplants

This service serves the West of Scotland (and sometimes patients from further afield). It is based in modern facilities at the Western Infirmary. No change is proposed unless during consultation it is suggested that it should be on the same site as the North Glasgow Trust’s Nephrology (Kidney) service – which is itself an issue for consultation.

Specialist Eye Cancer Services

A team based at Gartnavel provides this service for the whole of Scotland. The number of patients is small but treatment is highly specialised. During the consultation period on the plan to modernise Glasgow’s hospitals we do expect there to be some debate about the future location of in-patient beds for eye services generally. Ophthalmology (diagnosis and treatment of eye conditions) is increasingly becoming an out-patient and day care service with fewer and fewer beds. (In Glasgow hospitals in 1998\99 there were 3,274 in-patient cases, 3,159 day cases and 72,380 out-patient attendances in adult ophthalmology. At a length of stay of around 2 days the in-patient bed requirements are currently around 5,000 bed days per year in North Glasgow and 2,000 at the Southern General. There will be a need to concentrate its remaining beds in one or two places so that cover by doctors and specialist nursing and other staff can be organised properly. There is a debate to be had about where these beds should be best placed. It’s a debate that affects North and South Glasgow Trust services. The outcome of that debate will affect where the specialist eye cancer service is located.

Specialist Children’s Services

Although the great majority of patients for the Royal Hospital for Sick Children at Yorkhill come from Greater Glasgow, the hospital provides an important range of highly specialised services for both the West of Scotland and the country as a whole. They include heart surgery for children (serving the whole of Scotland), childhood cancer treatments (treating children from many different parts of Scotland), child psychiatry in-patient services (for the West of Scotland), treatment for kidney disease in children, specialised surgery and intensive care for children – and so on.

At the Queen Mother’s Hospital, Yorkhill there are exciting developments in foetal medicine and surgery (for unborn babies). This service is used for referrals from all over Scotland. It involves obstetricians and children’s specialists working closely together.

We are consulting on a suggestion that as part of the redevelopment of the Southern General Hospital campus we should include a replacement there for the Royal Hospital for Sick Children with strong connections with maternity services that would unite those currently provided at the Queen Mother’s Maternity Hospital (at Yorkhill) and the Southern General.

Our separate leaflet on "Child and Maternal Health" provides more detail of this idea. All the specialist children’s services currently provided at Yorkhill would transfer to the new hospital if this suggestion went ahead. The same services provided by the same staff in a child-centred way but in modern new facilities (most of the buildings on the Yorkhill campus were designed in the 1960s – hospital services have moved on a lot since then).

Other Regional Services

So far in this leaflet we have described those regional (or sometimes national) services for which a whole specialty provides a recognised regional service (such as neurosurgery and neurology) or which are financed nationally by the Scottish Executive (such as the eye cancer service).

There are other services provided in Glasgow which are simply parts of a larger specialty or service but which attract referrals from elsewhere in the West of Scotland or further afield. Sometimes these are set up as organised services (such as the treatment of infertility, provided by the GRI). Sometimes they reflect the specialist expertise of a particular consultant and his\her team, to whom colleagues elsewhere may refer patients for expert advice and treatment (for example, gynaecological cancer at Stobhill). The number of patients involved is usually relatively small. For most of them our proposals do not involve any change since we are not reducing access to existing patterns of out-patient clinics and those hospitals (the Victoria Infirmary and Stobhill) which are likely to host fewer in-patient teams are the ones least prominent in offering these various specialist referral services on a regional or national basis.

Change and Location in a Nutshell

Service

Now

Proposed

Neurosurgery/neurology

Southern General

No change

Spinal injuries

Southern General

No change

Westmarc

Southern General

No change

Children’s Services

RHSC, Yorkhill

Southern General

Fetal Medicine/Surgery

Yorkhill

Southern General

Infectious Diseases

Gartnavel

No change

Homoeopathy

Gartnavel

No change

Eye Cancer Services

Gartnavel

Depends on future of all eye services

Beatson Regional Cancer Centre

Western Infirmary

Initially no change. Gartnavel later

Cardiothoracic Surgery

GRI and Western Infirmary

Initially all at Western Infirmary. Gartnavel later.

Kidney Transplants

Western Infirmary

Probably no change

Plastic Surgery and Burns

Canniesburn (but GRI in 2002)

No change (GRI)

Fertility Treatments

GRI

No change

Accessibility of Glasgow’s Regional Services

The proposed future locations for regional (or national) in-patient services involves the continued use of the Southern General, Gartnavel and GRI, which already cater for people travelling from further afield.

The Southern General and GRI are close to the M8 and so fairly straightforward for those travelling from places whose road systems feed easily into the M8, M77, M74 and M80. The Southern General is immediately next to the Southern end of the Clyde Tunnel which makes it accessible from the West and North-West too. The Southern General also has the most space available for car parking of any of Glasgow’s acute hospitals.

Gartnavel is on the Great Western Road and not far from Anniesland Cross, making it reasonably accessible by road from the city centre, the West, North-West and South (via the Clyde Tunnel).

Yorkhill and the Western Infirmary are in the West End and so not far from the city centre. Car parking for each site is relatively restricted.

As far as public transport is concerned access for people travelling from outside Greater Glasgow by public transport involves them coming into the city centre by rail or bus. Bus routes from the city centre to the GRI, Gartnavel, Western Infirmary, Yorkhill and Southern General are plentiful. Gartnavel has a railway station immediately next to it (Hyndland) with good rail connections from the West, the East (via Queen Street) and the South (via Glasgow Central and Partick). Yorkhill and the Western Infirmary are served by Kelvinhall underground station. The Southern General is close to Govan underground station, where there is a shuttle bus link. The GRI is the least well served by rail (High Street is the nearest station) but has good bus links from the city centre where the main railway stations are.

The most significant travel change arising from people using regional or national services is the suggestion that Yorkhill’s services relocate to the Southern General. An ‘Evening Times’ story on 21st March, 2000 identified that the bus journey from the City Centre to the Southern General (mid-morning) was 23 minutes, which is no more than 15 minutes longer than it would take from the city centre to Yorkhill (where the journey would conclude with a walk up the hill from Argyle Street).

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