Memorandum Submitted by Hereford Hospitals NHS Trust (CBPS 83)

Thank you for your letter of 30^th April 2008 regarding written comments made by Lord Livsey of Talgarth to the Chairman of the Welsh Affairs Committee. I am pleased to be able to comment as set out below:-

The planning of the PFI hospital in Hereford (which opened in 2002) was predicated on a reduction in beds against the former bed provision. However, in practice, because of increased patient demand and the drive to reduce patient waiting times, we are continuing to operate with 67 beds more than was planned for in 2002. These beds are currently provided in hutted wards but will be replaced in new build provision over the next 18 months or so.

As a Trust, we consider the services which we provide for Powys patients to be as important as those provided for Herefordshire patients. With bed numbers at the level I have indicated, we are more than able to accommodate the needs of our Welsh patients both currently and in the future. Indeed, our capacity to do so is being enhanced because of the efforts we are putting into speeding patient discharge, thereby reducing overall levels of bed occupancy.

These points made, we acknowledge Lord Livsey's point that the treatment of Welsh patients at Hereford County Hospital is complicated by the different waiting time targets that apply in the two countries. Waiting time targets in Wales are higher than in England and Welsh commissioners (Powys Local Health Board included) generally only commission to these targets and no more. In essence, we would be able to treat Welsh patients to the English waiting time targets (18 weeks maximum from referral to treatment by December 2008) if commissioners in Wales were prepared to pay accordingly.

Matters would also be simplified if the financial regimes were synchronised with the adoption of payment by results in Wales. This would ensure equity of pricing for cross border services whether provided by English or Welsh hospitals.

Welsh patients are hugely important to us at the Hereford County Hospital and we believe strongly that it is in the interests of patients from Powys in particular (but also the Monmouth area) that we continue to provide and develop these services. That is an explicit part of our strategy and we would welcome any initiative by the Welsh Affairs Committee to enhance cross border services.

15 May 2008