Northumberland, Tyne & Wear
What concerns have been raised about your STP?
Closure of Rothbury Community Hospital in Northumberland
Merger of South Tyneside and Sunderland NHS Trusts. Possible downgrading of acute services at South Tyneside Hospital including the stroke and maternity units. The plans have been described as “unsustainable” by hospital bosses.
Lack of investment was highlighted by Dr George Rae of the British Medical Association stating in March 2017 that the Northumberland, Tyne and Wear STP would need an extra £76.6m in capital funding in order to successfully deliver the STP plans.
Closure of wards and theatres, staffing cuts, the ending of funding for some treatments and delays in funding newly approved treatments have all been suggested as cost-cutting measures, leaked to the HSJ and the Independent. Local NHS commissioners have described the plans as “thinking the unthinkable”.
What are the proposed aims of the STPs?
- Elimination of a projected 2020/21 deficit of £641 million
- Scaling up the new care models, including the Northumbria accountable care organisation (ACO) vanguard.
- Reducing acute admissions.
- Bringing care closer to home.
- Increasing prevention services - reducing smoking and obesity - to produce a healthier population.
The STP contains a re-configuration of the hospital sector, that will lead to a reduction in acute sites in the region.
The North East commissioning support unit will be turned into a community interest company owned by its 11 CCG customers.
In June 2017 documents leaked to the HSJ revealed discussions between NHS Improvement and NHS England on what certain over-spending areas will be required to do to enable them to spend less money and remain within a budget known as a 'control total' for 2017/18. The target areas include Northumbria. The measures under discussion include the following:
- Limiting the number of operations carried out by non-NHS providers so the funding stays within the NHS. Considerations differ between areas but include both limiting patients’ choice of providers, and reducing work which is outsourced by NHS trusts. In some cases it would require the NHS to find the capacity to carry out more operations.
- Systematically drawing out waiting times for planned care, including explicit consideration of breaching NHS constitution standards. Some plan to target delays at specialties/areas where waits are currently lower than average.
- Stopping NHS funding for some treatments, including extending limits on IVF, adding to lists of “low value” treatments, and seeking to delay or avoid funding some treatments newly approved by the National Institute of Health and Care Excellence.
- Closing wards and theatres and reducing staffing, while seeking to maintain enough emergency care capacity to deal with winter pressures.
- Closing or downgrading services, with some considering changes to flagship departments like emergency and maternity - though these would normally take too long to deliver savings this year.
- Selling estate and other “property related transactions”.
- Stopping prescriptions for some items, as suggested by NHS Clinical Commissioners earlier this year.
The commissioners in the area told the HSJ that they have been told to examine “difficult decisions” and “think the unthinkable”, including modelling changes which are normally avoided as they are too unpleasant, unpopular or controversial.