The NHS in West, North and East Cumbria has launched a public consultation on a number of possible service changes.
The NHS in West, North and East Cumbria launched a public consultation for a number of possible service changes on Monday 26th September 2016. The wide-ranging consultation covers maternity services, children’s services, community hospital inpatient beds, emergency and acute care and stroke services. It also covers some recent temporary changes in emergency surgery, trauma and orthopaedic services.
Launching the consultation Sir Neil McKay, chair the local Success Regime said:
“The health and social care system in West, North and East Cumbria faces a number of major challenges. During this consultation we will be explaining these challenges and some of the changes we may need to make if we are to address the challenges and provide high quality care for our local communities.”
“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. There is a strong feeling locally that in this area, in recent years, there has been a lot of talk but not enough action. Our focus is now upon action.”
The consultation document explains how some services could change in our communities and in our hospitals. In the case of most services the document offers a number options for change and invites the public to express its views on these options.
Challenges
The key challenges outlined in the consultation document include:
- Difficulty in attracting doctors, nurses, paramedics and other staff to live and work in Cumbria.
- Hospital stays that are longer than they need to be or hospital admissions that are unnecessary.
- A significant NHS overspend.
- Some services which are described by the Care Quality Commission as being either inadequate or in need of improvement.
Vision for the future
The consultation document says, however, that the NHS can tackle these challenges but only if we change our behaviour and change the way in which we deliver services.
Building on the development of ideas that has taken place over recent years and engagement with local communities such as the “Closer to Home” consultation of 2007/8, the consultation document outlines a new vision for health and social care – developed and agreed by all the local health and care bodies – that could help attract the right staff and enable the NHS to deliver services that are tailor-made for communities in West, North and East Cumbria. The vision is to create…
“A centre of excellence for integrated health and social care provision in rural, remote and dispersed communities”
Integrated Care Communities
At the heart of this new vision is the development of Integrated Care Communities designed to deliver joined up care from the NHS, social care providers and the voluntary sector. West, North and East Cumbria has been organised into eight areas – based on natural communities of between 20,000 and 70,000 people – to start working in a joined-up fashion. These are our Integrated Care Communities.
It is clear that people want care to be properly coordinated between health and social care, and between their GP and hospital specialists. This is what Integrated Care Communities are for. They will reduce the need for people to attend or stay in hospital, reduce the length of time people spend in hospital, plan care properly to prevent problems before they arise, make greater use of technology and home adaptations and thereby enable more people to remain independent for longer.
The case for change and next steps
The consultation document also lays out the national and local case for change and it explains how people can have their say. More information is available on the consultation website at www.wnecumbria.nhs.uk
Consultation responses will be analysed independently and an analysis report will be presented to the NHS North Cumbria Clinical Commissioning Group in early 2017. NHS North Cumbria Clinical Commissioning Group and other local NHS organisations will consider the report before taking any decisions on service changes.
In the spring of 2017, working in partnership with other local NHS organisations and the NHS Northern England Clinical Senate, the Governing Body of NHS North Cumbria Clinical Commissioning Group will then take a number of decisions on the matters detailed in the consultation document.
Finance
In addition to outlining a number of possible service changes the consultation document also offers some information about NHS finances in West, North and East Cumbria. It says that in the last financial year (2015/16) local NHS organisations had a combined overspend of around £70m. This is projected to rise to £163m a year by 2020 if we do nothing and in order to address this the local health community will need to make efficiency savings of around 6.5% a year over the next five years.
The document says that by 2020 the NHS anticipates it will be able to make efficiency savings of £85m a year through things like reduced agency staff costs, more collaborative working with other health providers and more effective purchasing arrangements and that a further £42m a year can be saved by 2020 with new ways of working. This includes providing more services in the community, more cost effectively, to help relieve the pressure on our local hospitals.
The document also explains that the direct savings from service changes in maternity services, children’s services, community hospital inpatient beds, stroke services and emergency services are unlikely to be more than £2.1m a year. The main reason for proposing change in these areas is not money but rather the inability to recruit key staff.
Options for change
The main options for change outlined in the consultation document are:
Children’s services
- OPTION 1 – Full inpatient services for children at Cumberland Infirmary Carlisle (CIC) but low-risk inpatient services only at West Cumberland Hospital (WCH)
- OPTION 2 – Full inpatient services at CIC with a short stay children’s assessment unit at WCH
- OPTION 3 – Full consolidation of children’s inpatient services at CIC
Maternity services
Antenatal and postnatal care would continue at WCH and CIC with all options
- OPTION 1 – Consultant-led maternity care at CIC and WCH
- OPTION 2 – Consultant-led care at CIC with a midwife-led unit at WCH
- OPTION 3 – Full consolidation of maternity services at CIC
Community hospital inpatient beds
- OPTION 1 – Consolidation of community hospital inpatient beds onto six hospital sites (Brampton, Cockermouth, Keswick, Penrith, Whitehaven, Workington)
- OPTION 2 – Consolidation of community hospital inpatient beds onto five hospital sites (Brampton, Cockermouth, Keswick, Penrith, Whitehaven)
- OPTION 3 – Consolidation of community hospital inpatient beds onto a different five hospital sites (Brampton, Keswick, Penrith, Whitehaven, Workington)
- OPTION 4 – Consolidation of community hospital inpatient beds onto three hospital sites (Carlisle, Penrith, Whitehaven)
Emergency and acute care
Outpatient care and elderly care would continue at CIC and WCH in all options
- OPTION 1 – 24/7 A&E would continue at CIC and WCH
- OPTION 2 – 24/7 A&E would continue at CIC with a 24/7 Urgent Care Centre and daytime only A&E at WCH
- OPTION 3 – 24/7 A&E would continue at CIC with a 24/7 Urgent Care Centre at WCH
Hyper-acute stroke services
Rehabilitation services would continue at both CIC and WCH with both of the options
- OPTION 1 – Five day a week stroke services would continue as at present at both CIC and WCH
- OPTION 2 – The NHS would develop a dedicated hyper-acute stroke unit at CIC
Download the presentation from the launch event.