12. Derbyshire

What concerns have been raised about your STP?

Health planners are trying to reduce NHS deficits and think about ways to re-organise care. However getting the large deficit under control could prevent facilities being developed that can cope with the health and care social needs of local people.

Proposed changes

Bed numbers will be cut by 535. The acute sector will lose 400 beds, 85 will be lost in community hospitals and 50 mental health beds. In terms of wards, this 12 acute wards cut; 4-5 community wards lost; and there will be 1-2 fewer specialist mental health wards and one fewer dementia care ward.

There are concerns that Burton Hospital could lose its A&E; it now appears likely that Derby Teaching Hospitals will merge with Burton Hospitals Trust, which could mean Burton's A&E remains open.

Community hospital sites Newholme Hospital in Bakewell and Bolsover Hospital are set for closure; others will either follow suit or be integrated into community hubs.

 

What are the proposed aims of the STP?

  • Eliminate a projected 2020/21 deficit of £355 million;
  • Encourage prevention and self-management, to increase the number of people "managing with minimum support";
  • To reduce infrastructure costs by 10%;
  • To reduce care in specialist settings, through the development of place-based 'community hubs/networks' fully integrated with primary care;
  • Overall the aim is to eliminate the deficit by moving care from bed-based hospital care to the community/primary care.

Like other areas the STP aims to transfer services out of hospital and into the community. The concern is that cuts in hospital care will be made, helping to achieve savings, but without proper investment in community health services.

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Further information

Proposals put forward in the public consultation procedure run by the STP included:

  • Expanding ‘care at home’ teams - community-based teams of health and care staff who will work together locally to care for older people in or near their own homes;
  • Permanently closing 16 beds at Bolsover, 16 beds at Clay Cross, 16 beds at Newholme, 20 beds at Whitworth, 16 beds at Cavendish;
  • Providing 8 specialist rehabilitation beds in the west of North Derbyshire and 20 at Chesterfield Royal Hospital;
  • Permanently closing older persons’ mental health community hospital beds; 10 beds at Cavendish, and 10 beds at Newholme;
  • Establish a centre of excellence at Walton Hospital.

In July 2017, the North Derbyshire CCG together with other NHS bodies in Derbyshire agreed these changes and announced the setting up of a Better Care Closer to Home (BCCTH) implementation group to implement the ward and hospital closures and setting up of community services.

Stand-alone minor injuries units (MIU) or walk-in centres are likely to close or be integrated with other primary care facilities.

Major changes to the workforce are planned with a move to 2,500 more staff delivering care outside of the acute sector, around 10% of the current workforce.

There is considerable overlap between Derbyshire's health system and neighbouring Staffordshire. Under Staffordshire's STP the A&E at Burton Hospital may be downgraded or forced to close and this will have implications for Derbyshire as the hospital serves a large part of South Derbyshire. In June 2017, the boards at Burton Hospitals Foundation Trust and Derby Teaching Hospitals Foundation Trust approved the business case for a merger of the trusts. This could improve the sustainability of each hospital, including Burton's A&E department.

Criticism

Campaigners have launched a petition against the closure of Queen's Hospital, Burton's A&E and enlisted the support of local MP Andrew Griffiths.

There has been criticism about the planned closures of community hospital beds and eventually the closure of community hospitals at Bolsover and Newholme. Campaigners are concerned that the closures are taking place before adequate services have been set up in the community.