A LONG-awaited specialist review on the future of Worcestershire's hospitals is recommending vital services are centralised at Worcester.
But it has not backed the closure of the A&E department at Redditch Alexandra Hospital - something that has been of grave concern to campaigners in the north of the county.
They have been lobbying for a full range of services to be retained at the Alexandra.
But the independent clinical review says consultant led maternity services and paediatric inpatients should be centralised at Worcestershire Royal Hospital.
However it is not supporting the closure of A&E - saying instead that a a new networked ‘Emergency Centre’ should be created in Redditch.
This would work in tandem with a new 'Major Emergency Centre' at Worcestershire Royal Hospital, where the most seriously injured or unwell patients would be taken.
The recommendation echoes the 'two-tier' plans outlined by NHS Medical Director, Sir Bruce Keogh, in his recent report into urgent care.
The review says consultant-led maternity services should be centralised at Worcester but that commissioners in Redditch and Bromsgrove should consider investing in a stand-alone midwife-led birth centre for North Worcestershire.
Paediatric inpatients should be centralised in Worcester, the review says, but a day-time consultant-led paediatric assessment unit at the Alex would accept referrals from GPs and other professionals.
The review also calls for clinical commissioning groups and Worcestershire County Council to review the public transport links between north Worcestershire and the Worcestershire Royal Hospital.
Under the recommendation, the Alexandra Hospital would become a county-wide centre of excellence for orthopaedic services and would continue to be a centre of excellence for urology services.
An alternative option - for another provider to take over control at the Alex from Worcestershire Acute Trust - was dismissed by the clinical review panel.
It said this route would result in "a significant inequality in the provision of safe and sustainable services to the population of Worcestershire".
Nigel Beasley, Chair of the Independent Clinical Review Panel, said, “We were consistently impressed by the focus on the best interests of patients described by commissioners and provider teams that we met during the review and we hope that by bringing an independent expert clinical voice to the programme we can contribute in a positive way to the future of acute hospital services in Worcestershire."
"We believe that our recommendations support the development of clinically safe and sustainable health services both now and in the future.”
Dr Jonathan Wells, chair and clinical lead of NHS Redditch and Bromsgrove Clinical Commissioning Group, welcomed the report.
"It provides compelling clinical reasons for the reconfiguration of acute hospital services across Worcestershire and secures the future of the Alexandra as a vibrant local hospital," he said. "The range of services recommended is significantly better than was initially proposed last year."
Penny Venables, chief executive of Worcestershire Acute Trust, said, “I would like to thank the members of the independent clinical review panel for the work they put in to evaluating the options for the people of Worcestershire.
"I believe they have described a very workable solution which will serve Worcestershire for many years.”
The clinical recommendations will now be considered by the three Worcestershire clinical commissioning groups and Worcestershire Acute Trust.
If all the boards support them, they will be put out for public consultation in the autumn.