From April 1, five Clinical Commissioning Groups (CCGs) will take responsibility for the planning and commissioning of health services in Northamptonshire, Milton Keynes, Bedfordshire and Luton. Our local hospitals have also made important decisions about their own future. Bedford Hospital has signalled its intention to find a partner to help it achieve Foundation Trust status and Northampton General and Kettering General Hospitals have announced their intention to hold discussions on partnership working up to and including possible merger.
There is clearly a synergy between service reconfiguration and organisational change and it is planned that these two separate but complimentary streams of work will be taken forward locally by CCGs within the north, middle and south of the South East Midlands.
The CCGs have the support of our local hospital clinicians, who will work closely with them to build on and take forward what has been achieved to date. This includes the clinical working group reports, the collection of national and international evidence and benchmarking and patient and public views gathered as part of an extensive patient and public engagement programme.
The CCGs are well placed, given their clinical expertise and knowledge of local services, patient experiences and community views to ensure that recommendations from the programme’s clinical and patient-led working groups are translated into local public consultations. Local CCGs will primarily focus on local issues and continue to work together where specialist services, such as stroke, cancer and vascular services, are likely to achieve better health outcomes for patients when provided on a bigger scale.
The next step is for each CCG to work with its local health service providers, patients and partners to develop firm proposals and to start the process of public consultation and implementation. The planning starts immediately and consultation, depending on the needs of each health community, is likely to start later this year.
It is clear from the evidence gathered by the six clinical working groups that, in order to deliver the best possible patient outcomes for a growing and ageing population, transformation is needed and this will rely on greater co-ordination between services.
This will mean the development of pathways of care that integrate health services delivered in and out of hospital together with social services. Again, local CCGs are ideally placed to lead this work.
Where there is clinical evidence that improved patient outcomes could be achieved through the concentration of specialist resources at regional centres of excellence, CCGs and hospital trusts will still need to adopt wider scale collaboration.
Yes. There will be no decision about your hospital services without your input. Any proposals to change services currently delivered by hospitals in the area will be the subject of consultation. The intention remains to consult with the public in 2013.
Healthier Together has always maintained that all five hospitals in the South East Midlands should continue as busy, vibrant sites delivering the large majority of services required by the local communities they serve.
However, the reasons why services need to change have not gone away and we still have to work out how to reconfigure many services to secure their clinical and financial sustainability.
We need to meet the health needs of a growing and ageing population. There are still significant shortages of qualified and experienced clinicians in numerous disciplines including A&E, maternity and children’s care. We need to acknowledge that the NHS – like all public services in the UK – faces continuing financial constraints.
As a clinically-led programme, Healthier Together maintains that services should only be reconfigured when improvements in quality and safety of care can be achieved. The programme’s six clinical working groups have identified clear evidence where patient outcomes could be improved through reconfiguration – for example by centralising some resources at specialist centres of excellence.
Healthier Together has always been about providing the right care in the right place at the right time. That fundamental requirement remains.
These are the key outputs since the launch of the clinical working groups in January last year (2012):
More than 200 local clinicians – including hospital doctors and GPs – have worked alongside patient representatives on our six clinical working groups. Together, they have identified opportunities for potential service improvement in the following areas – cancer, long term conditions, maternity, children, planned care and emergency services. The final reports of the clinical working groups contain the clinical evidence, national quality standards and best practice detail which will underpin reconfiguration proposals and secure the future of high quality health services for a population of 1.6 million rising to 1.9 million by 2021.
Healthier Together has extended clinical support and understanding of the programme through a range of activities including two summits for Northamptonshire clinicians, regular internal communications updates and surveys for NHS staff.
Through our communications and engagement programme, Healthier Together has come into direct contact with more than 12,000 local patients and residents and indirect contact with many tens of thousands more. This unprecedented level of engagement has enabled us to develop far wider public understanding and acceptance of the case for change.
Through the feedback we have received from a range of audiences – including BME and disadvantaged communities, dedicated patient groups, young people, pensioners and mothers-to-be – we have developed a detailed picture of how local people view health services at present and their aspirations for future provision. Healthier Together has developed a network of third sector and community organisations with the capability to support continuing engagement on service reconfiguration.
Healthier Together has involved the active participation of 12 NHS partners – five hospital trusts, five clinical commissioning groups and two primary care trust clusters – as well as the support of many stakeholder organisations.
The programme represents the first time that such a collaborative approach to future challenges has been shared by so many participants. Senior management teams involved in the programme have gained valuable insight and experience of the process and practice of closer working. This is particularly significant in light of the need for a more joined-up, streamlined approach to commissioning and delivery of health and social care services in future.
Phase One of Healthier Together means that we are well on the way to meeting the four required tests for any reconfiguration – GP/commissioner support, strengthened patient and public engagement, proposals based on clear clinical evidence and supporting patient choice.
The CCGs are now in a strong position to progress the next phase of the programme in a planned and informed way. The next phase will involve CCGs building upon the strategic clinical models recommended by Healthier Together’s Clinical Senate and exploring how these can be best implemented locally. This will involve GPs working with colleagues from the acute hospitals and with social care and voluntary agencies to develop detailed proposals which address the case for change and ensure that new plans for the local NHS will deliver safe, responsive, high quality and affordable services: services that will see local patients achieve health outcomes up there with the very best in the country.
These detailed local proposals will be the subject of public consultation which is expected to take place later this year.
No. Talks between these hospitals are about closer working arrangements.
Healthier Together’s focus has always been on delivering improvements based on clear clinical evidence which offer the best patients outcomes in terms of levels of quality and safety.
No hospitals will close. Northampton, Kettering, Milton Keynes, Luton & Dunstable and Bedford will all continue to provide most local services
All five hospitals will have an A&E and maternity service
Our first priority is safe, sustainable, high quality services
Our recommendations will be based on clinical evidence and local need
No decisions without full public consultation
Healthier Together Programme Office
NHS Milton Keynes
Bletchley MK3 6RT
T. 01908 278735