Radical health service shake-up to stave off £500m cash shortfall

NHS news
NHS news

People facing major illness or injury in Crawley, Horsham and Mid Sussex could end up having to travel further for specialist treatment in future in a major NHS shake-up.

But, say health officials, others would be treated nearer to home - and be given more community care to help keep them out of hospital altogether.

It’s all part of a radical government-ordered ‘Sustainability and Transformation Plan’ aimed at saving the NHS billions.

Crawley Clinical Commissioning Group and the Horsham and Mid Sussex Clinical Commissioning Group - responsible for paying for local health services - say they will face a massive £500 million deficit over the next few years if major reforms are not made.

One proposal under consideration is turning the Royal Sussex County Hospital in Brighton - currently under ‘special measures’ after a damning report last summer from the Care and Quality Commission - into a major trauma, teaching and tertiary centre.

Some patients would face longer journey times to get there - and ambulance services are already under pressure with the South East Coast Ambulance Service also being placed in ‘special measures’ in September after being rated inadequate.

But the CCGs say that those patients would receive better specialist care once there. However, they say that no definite decisions about the locality of major trauma and speciality centres have yet been made.

However, in a separate move, proposals have already been outlined to close the emergency stroke unit at the Princess Royal Hospital in Haywards Heath and move treatment to a specialist stroke unit in Brighton.

Meanwhile, Crawley, Horsham and Mid Sussex Clinical Commissioning Groups have banded together with East Surrey Brighton and Hove, and High Weald Lewes Havens commissioning groups to form the Crawley, Sussex and East Surrey Alliance which revealed first glimpses of the sustainability and trandformation plan back in November.

It seeks to integrate community health, mental health, social care and ‘third sector’ support to transform the wellbeing, early detection and diagnosis of illness “so people can manage their own health more effictively.”

But Horsham and Mid Sussex Clinical Commissiong Group accountable officer Geraldine Hoban said this week that the sustainability and transformation plan included “no plans to cut services. They are not looking to close A&Es or close beds. We’re looking to promote growth but we can only do that by supporting people better in the community.”

She said there were a number of options about where services would be located throughout Sussex but they had not yet been decided.

She gave an overview of the sustainability and transformation plan - covering the whole of Sussex and East Surrey and one of 44 such plans across the country - at a joint meeting of Crawley, Horsham and Mid Sussex Clinical Commissioning groups on Wednesday.

“There is recognition that the NHS is facing some really difficult challenges,” she said. “And doing more of the same is not going to cut it in future years. We are having to work together in different ways and work with partnership organisations.”

She said the aim was for health workers to work as a team around individuals, co-ordinating care by GPs, social workers, community nurses, pharmacists, paramedics and other health professionals in an integrated way.

She said that currently the quality of care in different areas was variable. “There are inequalities of health and life expectancy across Sussex. Centralising specialisms will improve care for individuals.”

And, she said, people would be encouraged to take more control of their own health with local councils helping to promote ways to improve healthy lifestyles.

New health risk factors would also be identified such as loneliness, along with more public education on known risks such as obesity and smoking.

She said: “We have to shift our vision away from purely medical to social and wellbeing. We should have a decreased demand on acute services.” Hospitals, she said, had to be ‘right-sized’ and the ‘new models’ should change the level of demand for hospital beds.

There would be GP-led ‘communities of practice’ - two in Crawley and four in Horsham and Mid Sussex - each caring for around 50,000 patients. Teams would co-ordinate care around individual patients leading, in theory, to less need for patients to require hospital treatment.

Two pilot sites focusing on community support are already in operation - one in Crawley and one in East Grinstead.