Children’s A&E

Southport A&E Southport or Ormskirk

Southport A & E children’s hospital services are looking to merge with Ormskirk, which NHS organisations are involved

The merger discussions between Southport and Ormskirk children’s A&E services involve the Mersey and West Lancashire Teaching Hospitals NHS Trust, along with the Integrated Care Boards (ICBs) for Cheshire & Merseyside and Lancashire & South Cumbria.

🔑 Key Organisations Involved

  • Mersey and West Lancashire Teaching Hospitals NHS Trust (MWL):
    This is the lead provider organisation overseeing both Southport and Ormskirk hospitals. Its Chief Executive, Rob Cooper, has publicly stated that consolidating A&E services onto a single site would improve sustainability and round-the-clock care.
  • Integrated Care Boards (ICBs):
    • NHS Cheshire and Merseyside ICB
    • NHS Lancashire and South Cumbria ICB
      These regional commissioning bodies are jointly responsible for shaping the future of emergency care provision. They are leading the consultation and governance process under the Shaping Care Together (SCT) programme.
  • Shaping Care Together (SCT) Programme:
    A collaborative NHS initiative launched to redesign emergency care across Southport, Formby, and West Lancashire. It is the formal vehicle through which the merger proposals are being developed and consulted upon.

📋 Context of the Merger

  • Children’s A&E services were removed from Southport in 2003, with Ormskirk Hospital providing paediatric emergency care since then. However, Ormskirk’s children’s A&E has been limited, closing overnight since the pandemic, forcing families to travel to Alder Hey in Liverpool.
  • The SCT programme has shortlisted two options:
    1. Co-location of adult and children’s A&E at Southport Hospital.
    2. Co-location at Ormskirk Hospital.
      The Southport option is currently the preferred choice, scoring highest on quality, access, deliverability, and sustainability.
  • Estimated costs:
    • Southport co-location: £44.5 million
    • Ormskirk co-location: £91.3 million

🧭 Why These Organisations Matter

  • MWL NHS Trust provides the operational leadership and clinical expertise.
  • ICBs ensure the proposals align with regional health priorities and funding.
  • SCT Programme acts as the strategic framework, ensuring public consultation and transparency in decision-making.

Together, these bodies are responsible for deciding whether Southport regains children’s A&E services after more than two decades, or whether Ormskirk remains the central site.

Would you like me to map out the decision-making process and timeline these organisations are following, so you can see when and how the final decision will be made?

can you map out the decision making process and timeline

The decision on merging Southport and Ormskirk children’s A&E services is being taken through the Shaping Care Together (SCT) programme, led by Mersey and West Lancashire Teaching Hospitals NHS Trust and the NHS Integrated Care Boards (ICBs) for Cheshire & Merseyside and Lancashire & South Cumbria. The process is structured around staged reviews, consultation, and final ratification, with key milestones already underway.

🗂️ Decision-Making Process

  1. Strategic Outline Case (SOC):
    • NHS leaders identified the need to consolidate emergency services due to workforce shortages, ageing infrastructure, and fragmented care.
    • Two options shortlisted:
      • Co-location of adult + children’s A&E at Southport Hospital.
      • Co-location at Ormskirk Hospital.
    • A new hospital was ruled out due to cost (£1.3bn) and timescale (13–16 years).
  2. Pre-Consultation Business Case (PCBC):
    • Drafted by SCT, setting out the preferred option (Southport) based on quality, access, deliverability, and sustainability.
    • Costs: Southport ~£44.5m; Ormskirk ~£91.3m.
  3. Joint Committee Review:
    • NHS Cheshire & Merseyside and NHS Lancashire & South Cumbria ICBs convene a joint committee to review the PCBC.
    • Meeting held 4 July 2025 at Ormskirk Civic Hall to decide whether to proceed to public consultation.
  4. Public Consultation:
    • If approved, a 13-week consultation begins, inviting input from residents, clinicians, and stakeholders across Southport, Formby, and West Lancashire.
    • Consultation documents outline impacts, costs, and service changes.
  5. Post-Consultation Analysis:
    • Feedback is collated and analysed by SCT and the ICBs.
    • Independent assurance may be sought from NHS England.
  6. Final Decision & Ratification:
    • The Joint Committee makes a formal recommendation.
    • Ratification by NHS England and funding approval via national capital investment streams.
  7. Implementation Phase:
    • If Southport is chosen, building works and service reconfiguration begin.
    • Timeline depends on funding release but typically spans several years.

📅 Timeline of Key Milestones

DateMilestone
2003Children’s A&E removed from Southport; Ormskirk designated site.
2020–2023Ormskirk children’s A&E reduced to daytime only; overnight cases diverted to Alder Hey.
Early 2025Strategic Outline Case published; Southport identified as preferred option.
4 July 2025Joint Committee meeting at Ormskirk Civic Hall to decide on consultation launch.
July–October 202513-week public consultation period.
Late 2025 / Early 2026Analysis of consultation feedback and final decision by ICBs.
2026 onwardsImplementation phase (construction, staffing, service transfer).

🔍 What This Means

  • No final decision has yet been made — the preferred option is Southport, but it must go through consultation and ratification.
  • The public consultation is the critical stage where community voices can influence the outcome.
  • The earliest service changes would realistically begin from 2026 onwards, depending on funding and construction timelines.

Would you like me to map the stakeholder influence (local MPs, councils, patient groups) alongside the NHS bodies, so you can see who is shaping the debate beyond the formal process?

can you map the stakeholder influence

Stakeholder influence on the Southport–Ormskirk children’s A&E merger is shaped by a mix of NHS decision-makers, local politicians, councils, and community voices. While the final decision rests with NHS organisations, public and political pressure is playing a significant role in shaping the debate.

🏥 NHS Organisations (Core Decision-Makers)

  • Mersey and West Lancashire Teaching Hospitals NHS Trust (MWL):
    Provides operational leadership. Chief Executive Rob Cooper has emphasised the need for consolidation to ensure sustainable, round-the-clock care.
  • NHS Cheshire & Merseyside ICB and NHS Lancashire & South Cumbria ICB:
    Jointly lead the Shaping Care Together (SCT) programme. They hold the formal authority to approve consultation and make recommendations.
  • NHS England:
    Provides assurance and ratification of the final decision, including capital funding approval.

🗳️ Political Stakeholders

  • Patrick Hurley, MP for Southport:
    Strongly advocates for Southport as the preferred site, calling it a “once in a generation opportunity”. His influence lies in mobilising parliamentary attention and amplifying local voices.
  • Local MPs in West Lancashire:
    Represent Ormskirk and surrounding areas, pressing for fairness and highlighting the risks of losing children’s services locally.
  • Sefton Council (Southport’s local authority):
    Councillor John Pugh (Lib Dem leader) has pushed for unity and reaffirmed council support for returning children’s A&E to Southport. Council motions and debates add political weight to community sentiment.

👥 Community & Advocacy Groups

  • Residents and Families:
    Their lived experience—long travel times to Alder Hey, limited overnight provision at Ormskirk—forms the emotional and practical case for change. Public consultation is designed to capture this influence.
  • Local Campaign Groups & Media:
    Outlets like Stand Up For Southport and OTS News amplify community voices, framing the debate as a matter of fairness and sustainability.
  • Health Professionals:
    Clinicians and staff provide evidence on workforce pressures and clinical safety, shaping the preferred option in the business case.

⚖️ Balance of Influence

  • NHS Trusts & ICBs: Hold formal decision-making power.
  • MPs & Councils: Apply political pressure and mobilise public opinion.
  • Community Voices: Influence through consultation, petitions, and media campaigns.
  • Clinicians: Provide expert evidence that underpins the business case.

📅 Influence Across the Timeline

  • Pre-Consultation (early 2025): NHS Trusts and ICBs set the options.
  • Consultation (July–October 2025): Residents, councils, MPs, and campaign groups exert maximum influence.
  • Post-Consultation (late 2025–early 2026): NHS organisations weigh public input against clinical and financial realities.
  • Final Decision (2026): NHS England ratifies, with political and community pressure shaping how the outcome is communicated and implemented.

In short, the NHS bodies hold the pen, but local MPs, councils, and residents provide the ink that colours the decision.

Would you like me to sketch a stakeholder influence map diagram (visual chart) showing the relative weight of each group across the decision timeline?

I’ve moved a number of sections contained elsewhere on the site here for easy access. There is quite a lot of information and examples of AI analysis and recommendations, for A & E, elsewhere on this site.

Note: I’ve taken an issue in Southport and used it to demonstrate the different methods of introducing ethical bias into an AI Assistants’ responses. I have chosen to demonstrate Creating an Ethical Hub, and using an Organisations Principles and Policies. Both could be used if appropriate. This was a very quick and simple exercise to illustrate the use of AI. The output should not be taken as advice or recommendations.

Use my EthicalKnowledgeHub document on OneDrive to answer this question: In the UK, A and E departments at Southport and Ormskirk are looking to move children’s A and E to Southport in order to save money and optimise healthcare resources. Ormskirk will have no A and E meaning people may need to travel up to one hour for emergency healthcare. What should be considered by both towns.

Here are the key considerations for Southport and Ormskirk regarding the proposed relocation of children’s A&E services:

🧭 Ethical and Strategic Considerations for Relocating Children’s A&E

1. ⚖️ Equity and Access

  • Geographic fairness: Ensure that children in Ormskirk and surrounding areas are not disproportionately disadvantaged by longer travel times.
  • Socioeconomic impact: Assess how reduced access affects low-income households, those without private transport, and children with chronic conditions.

2. 🏥 Clinical Risk and Safety

  • Time-critical care: Evaluate the risk of delayed treatment for emergencies like asthma attacks, seizures, or trauma.
  • Capacity at Southport: Ensure Southport’s A&E can handle increased demand without compromising care quality.

3. 🚸 Community and Cultural Impact

  • Trust and transparency: Engage both communities in open dialogue, explaining the rationale and listening to concerns.
  • Local identity: Recognise the emotional and cultural significance of local hospitals, especially for families with long-standing ties.

4. 🧠 Strategic Planning

  • Transport infrastructure: Improve ambulance coverage, public transport, and road access to Southport.
  • Digital triage and remote support: Use AI-enabled systems to guide families and prioritise care.
  • Satellite or mobile services: Consider urgent care hubs or mobile paediatric units in Ormskirk.

5. 🧪 Ethical Governance

  • Independent assurance: Establish oversight to monitor outcomes, equity, and unintended consequences.
  • Data-driven evaluation: Use predictive modelling to assess long-term impact and adjust services accordingly.

Would you like help drafting a community briefing, stakeholder engagement plan, or ethical impact checklist based on this? I can also help visualise the trade-offs and mitigation strategies.

Let us do the same thing using Southport’s strategic documents to create a Knowledge Hub

What are Southport Hospital’s key policies and principles

Southport and Ormskirk Hospital NHS Trust—based at Southport District General Hospital—operates under a robust framework of governance, accountability, and patient-centered care. Here are some of its key policies and guiding principles:

🏥 Core Principles

  • Patient-Centered Care: The Trust emphasizes safety, dignity, and respect for all patients, ensuring services are tailored to individual needs.
  • Equality, Diversity & Inclusion: It actively promotes equal access to healthcare and fair treatment for staff and patients, in line with the Equality Act and Human Rights legislation.
  • Transparency & Accountability: Through annual governance statements and performance reports, the Trust maintains public accountability for its decisions and resource use.
  • Integrated Governance: A structured system links clinical, financial, and operational oversight to ensure consistent quality and safety across services.

📋 Key Policies

  • Modern Slavery & Human Trafficking Policy: The Trust complies with the Modern Slavery Act 2015, ensuring ethical practices across its supply chains and employment.
  • Whistleblowing (Raising Concerns): Staff are encouraged to report concerns safely and confidentially, with clear procedures to protect whistleblowers.
  • Anti-Fraud, Bribery & Corruption: There are strict controls and audits to prevent financial misconduct and uphold integrity.
  • Environmental Responsibility: The Trust monitors its carbon emissions and promotes sustainability in healthcare delivery.
  • Information Governance: Policies ensure the secure handling of patient data and compliance with data protection laws.

🧑‍⚕️ Staff & Leadership Ethics

  • Code of Conduct for NHS Managers and Board Members: These codes outline expected behaviors, including honesty, fairness, and commitment to public service.
  • Workforce Strategy: Focuses on staff wellbeing, training, and fair employment practices, including policies on remuneration and exit packages.

If you’re interested in a specific policy—like patient safety, clinical governance, or staff training—I can dig deeper into that area.

What are the key messages from Southport Hospital’s mission statement and vision statement

Here’s a clear breakdown of the key messages from Southport and Ormskirk Hospital NHS Trust’s mission and vision statements, which guide Southport Hospital’s purpose and direction:

🎯 Mission Statement:

“To provide healthcare in hospital and the community to people across Southport, Formby and West Lancashire.”

Key Messages:

  • Community Focus: The hospital is committed to serving not just in-patients but also the broader community.
  • Accessibility: Care is provided across multiple locations, ensuring reach and equity.
  • Continuity of Care: Emphasizes both hospital-based and community-based services, reflecting a holistic approach.

🌟 Vision Statement:

“Delivering excellent care. For every patient. Every time.”

Key Messages:

  • Excellence in Care: A strong commitment to high standards in clinical practice.
  • Consistency: Every patient is promised the same level of attention and quality.
  • Patient-Centered Values: The vision reinforces dignity, safety, and compassion as core principles.

Together, these statements reflect a Trust that’s deeply rooted in its local community, driven by quality, and unwavering in its promise to treat every patient with respect and excellence. If you’d like, I can also unpack how these values show up in their day-to-day operations or strategic goals.

Taking into consideration Southport Hospital’s mission statement, vision and principles answer the following question: Southport and Ormskirk hospitals have an adult A and E at Southport and a children’s A and E department at Ormskirk. They plan to house both at Southport, as this will save money and allow better use of resources. However patients from Ormskirk will have up to an hour journey to receive urgent medical care. What actions should the hospital authority take.

Given Southport and Ormskirk Hospital NHS Trust’s mission to serve the community, its vision of delivering excellent care for every patient, every time, and its principles of equity, safety, and patient-centeredness, the proposed consolidation of A&E services must be handled with great care. Here’s a strategic and ethical response the hospital authority should consider:

🧭 1. Conduct a Comprehensive Impact Assessment

  • Travel Time Analysis: Quantify how many patients will be affected by the increased travel time and assess the risk to clinical outcomes.
  • Health Equity Review: Evaluate whether the change disproportionately affects vulnerable groups (e.g. low-income families, disabled children, rural residents).
  • Public Consultation: Engage with local communities, especially Ormskirk residents, to gather feedback and build trust.

🚑 2. Strengthen Emergency Access for Ormskirk

  • Satellite Urgent Care Hub: Maintain a staffed urgent care center or minor injuries unit at Ormskirk to handle non-life-threatening emergencies.
  • Enhanced Ambulance Services: Increase ambulance capacity and response times, including pediatric-trained paramedics.
  • Telemedicine Triage: Use remote triage tools to assess urgency and direct patients appropriately before travel.

🏥 3. Ensure Continuity of Pediatric Expertise

  • Dedicated Pediatric Transport: Establish rapid transfer protocols for children needing emergency care, with specialized vehicles and staff.
  • Outreach Clinics: Offer regular pediatric clinics at Ormskirk for follow-up and non-emergency care to reduce travel burden.

📣 4. Transparent Communication and Reassurance

  • Clear Messaging: Explain the rationale behind the move—cost savings, resource optimization—but emphasize patient safety remains paramount.
  • Community Forums: Host Q&A sessions with clinicians and executives to address concerns and demonstrate accountability.
  • Feedback Mechanisms: Create easy channels for ongoing public input and complaints, with visible responsiveness.

📊 5. Monitor Outcomes and Adapt

  • Real-Time Data Tracking: Monitor wait times, clinical outcomes, and patient satisfaction post-transition.
  • Independent Review: Commission periodic audits to ensure the consolidation is meeting its intended goals without compromising care.
  • Contingency Planning: Be prepared to reverse or modify the decision if adverse effects emerge.

This approach honors the Trust’s commitment to “excellent care for every patient, every time” while balancing financial realities with ethical responsibility. It’s not just about saving money—it’s about saving lives, equitably and compassionately.

Can you update the response to take into consideration the following strategic functions: Capability Analysis – This is this the scoring of a function or functional area to determine how well it currently operates, what is seen as best practice, the realistic level that should be attained, and the actions required to move from the current level to a realistic level. Capabilities generally range from 1 to 5, with 5 being a greater capability; Affinity Analysis – This which capabilities an action will impact, either positive impacts or negative. It considers the complete range of functions that will be impacted; Capability Timelines – these show how capabilities will either improve or decline 0ver time as actions are taken.

Absolutely, David. Let’s reframe the hospital authority’s response to the proposed A&E consolidation using a strategic lens that integrates Capability Analysis, Affinity Analysis, and Capability Timelines. This approach will help decision-makers evaluate not just the operational feasibility, but the systemic ripple effects and long-term trajectory of their actions.

🧠 Strategic Framework for A&E Consolidation at Southport Hospital

1. 📊 Capability Analysis

Functional AreaCurrent Capability (1–5)Best Practice BenchmarkRealistic TargetActions Required
Emergency Access (Ormskirk)25 (24/7 pediatric & adult ED access)3 (Urgent care + rapid transport)Establish satellite urgent care hub; enhance ambulance services
Pediatric Emergency Transport25 (Dedicated pediatric transfer units)4Invest in specialized vehicles and staff training
Community Engagement & Trust35 (Transparent, co-designed decisions)4Host forums, publish impact assessments, co-create solutions
Clinical Staffing & Resource Use35 (Optimized, cross-site deployment)4Consolidate staffing models; cross-train teams
Digital Triage & Telemedicine25 (AI-assisted triage, remote consults)4Deploy remote triage tools; integrate with NHS 111 pathways

2. 🔄 Affinity Analysis

Proposed ActionPositively Impacted CapabilitiesNegatively Impacted Capabilities
Consolidate A&E at SouthportClinical staffing, resource optimization, pediatric expertiseEmergency access for Ormskirk, community trust
Establish satellite urgent care hub in OrmskirkEmergency access, community engagementMay dilute central resource efficiency
Enhance ambulance and pediatric transportPediatric safety, access equityInitial cost burden, logistics complexity
Launch public consultation and co-design processCommunity trust, transparencyTime-intensive, may delay implementation
Introduce telemedicine triageDigital capability, patient flow efficiencyRequires digital literacy and infrastructure investment

3. 📈 Capability Timelines

CapabilityYear 0 (Now)Year 1Year 2Year 3Trajectory
Emergency Access (Ormskirk)22.533.5Improving with satellite hub and transport
Pediatric Emergency Transport2344.5Rapid improvement with investment
Community Engagement & Trust33.544.5Strengthens through co-design and transparency
Clinical Staffing Optimization33.544.5Improves with consolidation and training
Digital Triage Capability2344.5Accelerates with tech rollout and adoption

🧭 Strategic Recommendations

  • Balance Efficiency with Equity: Use consolidation to improve clinical capability, but offset geographic inequity with urgent care hubs and enhanced transport.
  • Invest in Transitional Infrastructure: Prioritize pediatric transport, digital triage, and community-based care to bridge the gap.
  • Engage the Community as Co-Designers: Build trust through transparent consultation, shared decision-making, and visible responsiveness.
  • Track and Adapt: Use capability timelines to monitor progress and adjust strategies based on real-world outcomes.

Would you like to explore how this framework could be visualized or adapted for stakeholder presentations or policy briefs? I can help shape it into a compelling narrative or toolkit.

Let us use the Ethical Hub and knowledge that Ambulance Services are under severe pressure to review the recommendations.

Absolutely, David. Here’s a fully integrated and expanded briefing paper that combines your earlier insights on ambulance service pressures with the ethical and strategic considerations from the EthicalKnowledgeHub. It’s designed to support regional decision-makers, healthcare leaders, and community stakeholders in navigating this complex challenge.

🧭 Integrated Briefing Paper

Ethically-Governed Improvements to Emergency and Ambulance Services in Southport and Ormskirk

Author: David Sutton MBCS CITP
October 2025

1. Executive Summary

Ambulance services in Southport and Ormskirk are under severe pressure, with long wait times even for emergency care. This coincides with proposals to relocate children’s A&E services from Ormskirk to Southport, raising serious concerns about equity, safety, and system resilience. Drawing on ethical frameworks from the EthicalKnowledgeHub and recent strategic work, this paper outlines a comprehensive response—combining immediate interventions, long-term redesign, and ethical governance.

2. Ethical Foundations

The EthicalKnowledgeHub highlights key principles that must guide any healthcare reconfiguration:

PrincipleApplication
EquityPrioritise underserved areas and vulnerable populations in resource allocation.
Non-MaleficenceReduce harm by addressing delays in life-threatening emergencies.
JusticeEnsure fair access regardless of geography, income, or mobility.
TransparencyPublicly share performance data, risks, and improvement plans.
AccountabilityEstablish independent oversight and community feedback mechanisms.
ProportionalityMatch interventions to the severity of risk and urgency of need.
ParticipationInvolve local communities and clinicians in service redesign.

3. Clinical and Operational Risks

  • Time-to-treatment delays for paediatric emergencies (e.g. sepsis, seizures, trauma) due to longer travel times and ambulance shortages.
  • Ambulance queuing at hospitals, reducing availability for new emergencies.
  • Inadequate surge capacity during seasonal peaks or major incidents.
  • Workforce shortages in paramedics and paediatric emergency specialists.
  • Transport barriers for families without private vehicles or financial means.

4. Immediate Interventions

A. Expand Rapid Response Capacity

  • Deploy community-based first responders with basic life support and AI-assisted triage tools.
  • Introduce paramedic-led urgent care vehicles for non-critical cases.
  • Use AI to optimise dispatch algorithms, prioritising calls based on clinical severity and travel time.

B. Strengthen Clinical Triage and Remote Support

  • Implement AI-enabled triage systems for 999 and 111 calls.
  • Provide remote clinical support via video or phone for low-acuity cases.
  • Establish telemedicine escalation pathways for paramedics and community clinicians.

C. Improve Handover and Hospital Flow

  • Streamline hospital handovers to reduce ambulance queuing.
  • Use predictive analytics to anticipate ED surges and pre-position resources.

5. Strategic System-Level Redesign

A. Workforce Development

  • Invest in paramedic recruitment and retention, including flexible contracts and local training pipelines.
  • Upskill ambulance staff in paediatric, mental health, and complex care.

B. Infrastructure and Transport Planning

  • Map travel times and service gaps using geospatial data.
  • Coordinate with local transport services for backup non-emergency transfers.

C. Integrated Care Pathways

  • Link ambulance services with urgent treatment centres, GP hubs, and community care.
  • Pilot mobile urgent care units in high-demand areas.

6. Ethical Governance and Monitoring

  • Establish an independent ethics and assurance board to oversee changes.
  • Publish real-time response data, disaggregated by geography and demographics.
  • Define red-line thresholds (e.g. maximum wait times) that trigger review.
  • Engage communities through town halls, surveys, and co-design workshops.
  • Include ethical review in all major service changes.

7. Mitigation Strategies for A&E Relocation

If children’s A&E is moved to Southport, the following must be implemented:

  • Satellite paediatric hubs in Ormskirk for assessment and stabilisation.
  • Mobile paediatric outreach units for urgent but non-critical care.
  • Transport support for low-income families (e.g. travel vouchers, hospital transport coordination).
  • Enhanced ambulance coverage with paediatric-trained crews.
  • Community navigators and helplines to guide families through the new system.

8. Data, Modelling and Evaluation

  • Conduct pre-implementation baseline studies on outcomes, access, and equity.
  • Use scenario modelling to forecast impact under different demand conditions.
  • Implement real-time monitoring dashboards with rapid escalation triggers.
  • Partner with academic centres for independent evaluation and publication.

9. Community Engagement and Trust Building

  • Design inclusive consultation processes, especially for vulnerable groups.
  • Communicate clearly in plain English, with translated materials as needed.
  • Recognise the symbolic importance of local hospitals and address emotional concerns.
  • Provide ongoing feedback channels and visible responsiveness to community input.

10. Conclusion

The convergence of ambulance service strain and A&E reconfiguration demands a coordinated, ethically governed response. AI-enabled systems, community engagement, and strategic investment can transform this challenge into an opportunity for innovation and resilience. The Ethical Knowledge Hub provides a vital foundation for ensuring that decisions are not only clinically sound—but morally and socially just.

An example of using AI to build Use Cases

AI an be use to prompt or support the development of “Use Cases”. Actual Use Cases must be designed by professionals but AI can provide support.

We have covered the move of Ormskirk Children’s A and E to Southport Children’s A and E and the potential issues of a move of 8 miles, across roads that have very heavy traffic especially in peak times. This is exacerbated by serious problem with the ambulance services where there can be very long wait times, even for emergency care. Can you use this information to demonstrate an Agile Use Case. Can you provide a detailed Use Case where names are allocated to individuals to focus the Use Case on individuals. The Use Case should cover a family with one child who has special needs. The child needs medical attention and should wait for an ambulance.

Absolutely, David. Here’s a detailed Agile Use Case that centers on a real-world scenario involving the relocation of Ormskirk Children’s A&E to Southport, and the compounded risks for families with children who have special needs. This format is designed to support stakeholder empathy, service redesign, and rapid iteration.

🧩 Agile Use Case: Emergency Care Access for a Child with Special Needs

🎯 Title

Emergency Response Delay for Special Needs Child Following A&E Relocation

👥 Primary Actors

  • Emma (Mother) – Full-time caregiver and advocate for her son’s medical needs
  • Liam (Father) – Works shifts at a local logistics company
  • Oliver (Child, Age 7) – Has autism and epilepsy; requires urgent care during seizures
  • North West Ambulance Service Dispatcher – Coordinates emergency response
  • Southport A&E Paediatric Team – Receives and treats emergency cases

🏠 Context

Emma and Liam live in Burscough, 3 miles from Ormskirk Hospital. Since the relocation of the Children’s A&E to Southport, their nearest paediatric emergency facility is now 8 miles away. The route includes congested roads (A570, A59) with frequent delays, especially during peak hours.

Oliver has a history of seizures that require immediate medical attention. The family relies on ambulance services due to the unpredictability and severity of his episodes.

📌 Trigger

Oliver experiences a prolonged seizure at 5:15 PM on a weekday. Emma calls 999.

📋 Preconditions

  • Emma has Oliver’s medical history registered with NHS services.
  • The family has no personal vehicle available at the time.
  • Ambulance services are experiencing high demand and delays.

🔄 Main Flow (Happy Path)

  1. Emma calls 999 and provides Oliver’s NHS number and seizure history.
  2. Dispatcher prioritizes the call as Category 1 (life-threatening).
  3. Ambulance arrives within 15 minutes.
  4. Oliver is stabilized en route and transferred to Southport A&E.
  5. Paediatric team receives Oliver and begins treatment immediately.

⚠️ Alternate Flow (Realistic Scenario)

  1. Emma calls 999 at 5:15 PM.
  2. Dispatcher confirms high demand; estimated wait time is 45–60 minutes.
  3. Emma attempts to contact neighbors for transport but no one is available.
  4. Oliver’s seizure continues; Emma administers prescribed rescue medication.
  5. Ambulance arrives after 70 minutes due to traffic congestion.
  6. Oliver is transported to Southport A&E, arriving at 6:45 PM.
  7. Paediatric team notes delayed response and escalates for internal review.

❌ Exception Flow

  • If Oliver’s condition worsens and ambulance is further delayed, Emma may be advised to self-transport, which is not feasible due to lack of vehicle and Oliver’s instability.

✅ Postconditions

  • Oliver receives care, but the delay increases risk of complications.
  • Emma and Liam file a concern with NHS Patient Advice and Liaison Service (PALS).
  • Local health board logs the incident as part of service impact review.

📈 Business Goals

  • Identify and mitigate risks introduced by A&E relocation.
  • Improve ambulance prioritization for special needs cases.
  • Explore community-based rapid response alternatives (e.g., mobile paediatric units).

🧪 Agile Testing Scenarios

  • Scenario A: Simulate peak-hour ambulance response times from Burscough to Southport.
  • Scenario B: Evaluate impact of rescue medication administered at home.
  • Scenario C: Test community transport alert system for vulnerable families.

🔁 Iteration Opportunities

  • Co-design with families like Emma’s to prototype local triage hubs.
  • Integrate AI-driven dispatch prioritization based on medical history.
  • Pilot a “Paediatric Rapid Response” unit stationed midway between Ormskirk and Southport.

Copilot Prompt:

Provide a Briefing Paper based on the attached document.

Copilot Response:

You asked for a briefing paper based on the contents of ChildrensAEConversation.docx. I will summarise and synthesise the key findings, strategic context, stakeholder influences, ethical considerations, and operational recommendations, drawing directly from the document’s detailed analysis. [ChildrensA…nversation | Word]

Briefing Paper: Children’s A&E Merger – Southport & Ormskirk

1. Executive Summary

Southport and Ormskirk children’s A&E services are undergoing a major review, with proposals to consolidate paediatric emergency care at Southport Hospital. This process is led by the Mersey and West Lancashire Teaching Hospitals NHS Trust, supported by NHS Cheshire & Merseyside and NHS Lancashire & South Cumbria Integrated Care Boards (ICBs), under the Shaping Care Together (SCT) programme. The preferred option is co-location at Southport, promising improved sustainability and quality, but raising concerns about access for Ormskirk families. [ChildrensA…nversation | Word]

2. Strategic Context & Decision Process

  • Background: Children’s A&E was removed from Southport in 2003; Ormskirk has provided daytime-only paediatric care since the pandemic, with overnight cases diverted to Alder Hey in Liverpool.
  • Options: Two shortlisted—co-location at Southport (£44.5m) or Ormskirk (£91.3m). Southport is preferred for quality, access, and deliverability.
  • Process:
    • Strategic Outline Case (SOC) and Pre-Consultation Business Case (PCBC) developed.
    • Joint Committee of ICBs met on 4 July 2025 to decide on public consultation.
    • 13-week consultation (July–October 2025).
    • Final decision and ratification expected late 2025/early 2026.
    • Implementation from 2026 onwards. [ChildrensA…nversation | Word]

3. Stakeholder Influence

  • NHS Bodies: MWL NHS Trust, ICBs, NHS England (ratification and funding).
  • Political Stakeholders: Local MPs (e.g., Patrick Hurley for Southport), Sefton Council, West Lancashire MPs.
  • Community Groups: Residents, campaign groups (e.g., Stand Up For Southport), clinicians.
  • Influence Timeline: NHS sets options; consultation amplifies community and political voices; final decision weighs public input against clinical and financial realities. [ChildrensA…nversation | Word]

4. Ethical & Strategic Considerations

  • Equity & Access: Assess impact on Ormskirk families, especially those with limited transport or special needs.
  • Clinical Safety: Ensure Southport can handle increased demand; mitigate risks of delayed treatment.
  • Community Impact: Engage transparently, respect local identity, and address emotional concerns.
  • Strategic Planning: Improve transport infrastructure, consider satellite urgent care hubs, and deploy digital triage.
  • Ethical Governance: Independent oversight, data-driven evaluation, and ongoing community engagement. [ChildrensA…nversation | Word]

5. Capability & Affinity Analysis

  • Current Capabilities: Emergency access at Ormskirk (2/5), paediatric transport (2/5), community engagement (3/5).
  • Actions Required: Satellite urgent care hub, enhanced ambulance services, investment in paediatric transport, transparent consultation.
  • Affinity Analysis: Consolidation improves staffing and expertise but risks access and trust; mitigation strategies include urgent care hubs and improved transport.
  • Capability Timelines: Gradual improvement over 3 years with targeted interventions. [ChildrensA…nversation | Word]

6. Ambulance Service Pressures

  • Risks: Longer travel times, ambulance queuing, workforce shortages, and transport barriers for vulnerable families.
  • Immediate Interventions: Expand rapid response, strengthen clinical triage, improve hospital handover.
  • Strategic Redesign: Invest in workforce, infrastructure, integrated care pathways, and ethical governance. [ChildrensA…nversation | Word]

7. Mitigation Strategies

  • Satellite paediatric hubs in Ormskirk.
  • Mobile outreach units for urgent care.
  • Transport support for low-income families.
  • Enhanced ambulance coverage with paediatric-trained crews.
  • Community navigators and helplines. [ChildrensA…nversation | Word]

8. Use Case Example

A detailed Agile Use Case illustrates the real-world impact for a family with a special needs child, highlighting risks of delayed ambulance response and the need for rapid, community-based interventions. [ChildrensA…nversation | Word]

9. Recommendations

  • Balance efficiency with equity: Offset geographic inequity with urgent care hubs and enhanced transport.
  • Invest in transitional infrastructure: Prioritise paediatric transport, digital triage, and community-based care.
  • Engage the community: Transparent consultation and co-design.
  • Monitor and adapt: Use capability timelines and real-time data to adjust strategies. [ChildrensA…nversation | Word]

10. Conclusion

The proposed merger offers opportunities for improved care but must be ethically governed, strategically planned, and responsive to community needs. Ongoing engagement, robust mitigation, and transparent monitoring are essential to ensure the move benefits all children and families across Southport and Ormskirk.