AN expansion of Worcestershire Royal Hospital is on the way - with the final details of a huge £29 million county-wide health shake-up today being revealed.

Worcester's under-pressure hospital, which has been dogged by lengthy A&E waits and patients left on trolleys, is going to get more car parking, extra beds and a new 'urgent care centre' under the massive overhaul.

The pledge forms part of the final plans to revamp hospital services across Worcestershire, which have now been published in a wide-ranging blueprint.

The final changes, which are subject to a 14-week period of winter consultation and several forthcoming public debates, includes:

- A&E at Redditch's Alexandra Hospital will be for "adults only" on a permanent basis, with Worcestershire Royal taking in children from around the county

- All hospital births permanently centralised in Worcester as well as emergency surgery

- The Alex will take on "most" pre-planned orthopaedic surgery like bones, joints, ligaments and tendons, leaving people in parts of south Worcestershire facing round trips of nearly 60 miles

- More ambulances will be diverted away from Worcestershire Royal to Redditch, with the Alex also doing breast surgery for people across the county

- Worcestershire Royal will become a county-wide 'centre of excellence' for specialist surgery, an open up an 'urgent care' centre to ease some of the burden off A&E

The shift away from planned operations at Worcestershire royal follows a torrid few years when it has been battling with a record £50 million deficit and serious complaints about frail patients left on hospital trolleys for hours.

It has also continuously missed national Government targets for dealing with A&E visitors within four hours.

A draft document has been sent to some Worcestershire councillors revealing the final consultation, which has already sparked concern over congestion.

It has been circulated now because Worcestershire Acute Hospitals NHS Trust is submitting a vital 'pre-consultation business case' to NHS England on October 5, a process it has to go through to unlock the money.

It reveals how bosses are asking for £29 million to expand car parking at Worcestershire Royal and increase the number of beds at the Aconbury East section of the site, as well as revamp operating theatres at the Alex for pre-planned surgery and make the other big vital changes.

The scale of the extra car parking and capacity at the royal has yet to be confirmed, with acute trust chiefs yesterday urging patience, but at the moment it has roughly 500 beds.

It comes after a public meeting took place in Redditch on Wednesday night in which MP Karen Lumley was heckled by furious protestors, angry about the A&E proposals.

Despite the Alex A&E becoming "adults only" the final blueprint says the site would still take in "a seriously sick child if they arrive unexpectedly", and have arrangements to transfer them across to Worcester later.

The document, seen by the Worcester News, admits "some people will not be happy" they are consulting on just one option for the county.

It states: "We recognise some people will not be happy that we are only consulting on one option, but we believe it is the only clinical solution for Worcestershire."

The plan is to get the new operating model fully in place with the funding after the May 2017 local elections at Worcestershire County Council.

Peter Pinfield, from the watchdog Healthwatch, said: "I think it takes a broad view of Worcestershire - it was always going to be controversial, it's a change for all of us.

"We've got to approach it in a common sense way - I know there's a lot of passion in the north of the county but if you live in parts of south Worcestershire like Pershore, you'll have to travel too."

HAVE YOUR SAY

THE final consultation document is expected to be made available by the end of November, triggering 14 weeks for people to have their say.

During the consultation around seven public Q&A meetings are expected to take place across Worcestershire including venues like Worcester Racecourse, Malvern Cube and Evesham Town Hall, with the dates still to be confirmed.

Next spring the final changes will then be sent to the county's clinical commissioning groups to be rubber-stamped and launched, as long as NHS England delivers the money.

The draft document goes into tremendous detail over the final changes, including expanding facilities at both sites to include new 'urgent care centres'.

The Alex will also open up a new 'women's centre' for breast and gynaecological procedures.

At Kidderminster Hospital most services will stay the same, meaning it will still do foot and hand surgery for the whole county while the five small 'community hospitals' in Evesham, Malvern, Pershore, Tenbury Wells and Bromsgrove are unaffected.

Much of the final clinical model makes permanent a raft of well-published temporary changes done in recent months on safety grounds like centralising births, emergency children's surgery, blocked bowel operations and inpatient children's services to Worcester.

The draft document was debated during a meeting of the health, overview and scrutiny committee at County Hall this week.

Councillor Anne Hingley said: "To me it's a good plan, it's well balanced but the biggest problem is transport issues "Unless we have a better road system it will never improve, perhaps the trust can pressure the Government to invest in better roads for Worcestershire."

Simon Trickett, chief operating officer at the South Worcestershire Clinical Commissioning Group, said: "There doesn't seem to be a 'golden bullet' for transport - there's not one single thing we can do to make it ok but there are some interesting options like community transport."

KEY CHANGES AT A GLANCE

ALL births for the county will take place at Worcestershire Royal Hospital in Worcester, including parents from the north of the county.

People needing hip replacements will be sent to Redditch's Alexandra Hospital, as well as knee replacements.

The A&E at the Alexandra Hospital, in Redditch, will become 'adults only', with child inpatients sent to Worcester.

The majority of planned surgery, such as bones, tendons, ligaments and joints, will take place at the Alex.

Women needing breast surgery and gynaecological procedures will also be sent to the Alex, rather than Worcester.

Blocked bowel operations will take place in Worcester, as will emergency children's surgery.

More ambulatory care - where people need care within the confines of an ambulance - will be sent to Redditch's Alex to ease the burden on Worcestershire Royal.