07.10.16
Success Regime region consults on major services restructure
NHS services in West, North and East Cumbria are consulting on the possibility of closing some services in order to meet financial and services pressures.
NHS organisations in the area had a £70m overspend in 2015-16, and this could rise to £163m a year by 2020 if they do nothing.
The health economy will have to make 6.5% efficiency savings a year, and even with planned savings and service reforms, is still facing a £30m shortfall.
Sir Neil McKay, chair of the local Success Regime, said: “Throughout my career in the NHS I have had to deal with a number of difficult and challenging issues but the issues we face in West, North and East Cumbria are the toughest I have ever faced.”
Services in the area are under pressure because of the ageing population and challenging geography, and NHS organisations are having problems recruiting staff.
North Cumbria University Hospitals NHS Trust has a consultant vacancy rate of more than 20%, while almost 24% of Cumbria Partnership NHS FT clinician staff are locums or from agencies.
In the early part of this year, 88% of A&E patients at the North Cumbria trust were seen within four hours against a national standard of 95%. The most recent national average was 90.5%. Health inequality is high across the region, with life expectancy varying by up to 20 years.
NHS services in Cumbria have already begun introducing reforms, including using electronic referrals and tele-consultations by phone or video link, developing eight Integrated Care Communities to deliver joined-up care, and working to establish Newcastle upon Tyne Hospitals NHS FT as the region’s lead provider of specialised oncology, radiotherapy and chemotherapy services.
However, it is considering a number of options to deliver further savings, including abolishing consultant-led maternity care at West Cumberland Hospital (WCH).
The consultation document said the preferred option was to leave a midwife-led unit at WCH, but it may have to move all services to Cumberland Infirmary Carlisle (CIC).
It is also proposing reforming inpatient paediatric services so that low-risk services are only available at WCH and high-risk services are only available at CIC, and moving all acute stroke services to a single hyper-acute stroke unit at CIC.
The consultation said the NHS wants to maintain acute and emergency services at both hospitals, but this would require developing “a radically new way for staff to work”, with advanced clinical practitioners and clinical associates replacing doctors in some roles. Otherwise, 24/7 A&E may have to close at WCH and be replaced with a 24/7 Urgent Care Centre.
It will also need to consolidate beds at the WCH inpatient unit and eight community hospitals so that the number is reduced from 133 to 104.
The NHS as a whole is facing intense pressures, with the Royal College of Physicians warning in a recent report that it is “underfunded, underdoctored and overstretched”.
The new sustainability and transformation plans (STPs) are intended to help local health economies gain control of their services, but they were criticised recently after it emerged that they could involve hospital services being closed or merged in some locations.
To view the consultation website, click here.
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