Keeping the 'General' in Cheltenham General Hospital

In basic mechanics there’s a moment of maximum leverage. It’s that short period before a beam tips on its pivot, when a small effort can make a big different.

In relation to the future of Cheltenham General Hospital I believe we are nearing that moment now. 

That’s because last week local Trust bosses announced plans for a major reconfiguration of so-called ‘general surgery’ under which all emergency and elective general surgery would be transferred to Gloucestershire Royal.

The problem with these announcements is that you need a medical dictionary to understand what on earth they mean. ‘General surgery’ in this context relates to upper gastro-intestinal (GI) and lower GI medicine, including colo-rectal surgery. Basically it’s all about the gut. 

Now, ordinarily, focusing services on one particular Gloucestershire site need not ring alarm bells. It’s been happening for years, as clinical disciplines become more specialist. It cuts both ways too. Cheltenham hosts Gloucestershire’s main vascular centre for example, and gastroenterology (stomach and intestinal complaints) will be sited in CGH’s Snowshill ward this winter – helpful if you are struck down by a winter vomiting bug. And come what may, CGH will continue as the centre of excellence for the whole of Gloucestershire and beyond for cancer treatment.

But ‘general surgery’ is different. General surgeons are the ones who intervene when a patient is bleeding into the abdomen. And many clinicians will tell you that their presence is the hallmark of a truly ‘general’ hospital. The clue’s in the name, you may think. They also provide the platform for other specialist services.

So before these changes go out for consultation next year, I have asked Trust planners to think again; specifically, to work up proposals to ensure that, if emergency general surgery moves GRH, the quid pro quo is that all elective (ie scheduled) interventions are based here at CGH. That way, we can keep a critical mass of general surgeons on-site.

I believe in keeping the ‘general’ in Cheltenham General. And the moment of maximum leverage is fast approaching.