17. Birmingham and Solihull
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.
The downgrading of Sandwell Hospital A&E, with services being transferred to the new Midland Metropolitan Hospital due to open in Spring 2019. Sandwell Hospital will retain an urgent care centre.
In early December 2016, Birmingham City Council published a report which concluded that the STP risked side-lining social care and pushing more costs onto hard-up councils.
What are the proposed aims of the STP?
- Eliminate a projected 2020/21 deficit of £712 million;
- Merger of back-office functions;
- Reduction in the use of the acute sector;
- More patients treated in the community.
- The STP states it has an overall "Triple Aim - Better Care, Better Health, Lower costs"
Like other areas this STP means 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.
The STP aims to keep patients out of expensive hospital wards and A&E by providing better access to GP and community services, including social care, but the city council health scrutiny committee report says there is no indication of how social services will be able to afford this.
According to the Birmingham and Solihull STP document, it will:
- Establish a single “lead provider” for maternity care across Birmingham and Solihull;
- Look to “immediately” implement a shared service for back office functions across its four main acute providers and create a centralised laboratory for routine pathology work;
- Support a phased implementation of a multispecialty community provider model across the patch over the next five years.
- A “universal offer for enhanced general medical practice” will also be made available to GPs.
Under the STP there will be the development of 4/5 urgent care centres/integrated service hubs across the area. These hubs will provide immediate access to urgent primary care, diagnostics, pharmacy, treatment of minor ailments, and minor procedures.
University Hospitals of Birmingham and Heart of England FT is to provide back office functions to Birmingham Children’s Hospitals and Birmingham Women’s. This will include finance, HR, IT, procurement and payroll services.
There are plans to merge Birmingham Women’s and Birmingham Children’s Hospitals by 2018 (announced previously), while University Hospitals of Birmingham and Heart of England FT announced in September 2017 the intention to create a “single organisation”.
Sandwell Hospital's A&E will be downgraded to an urgent care centre when the Midland Metropolitan Hospital opens in Spring 2019. This will reduce the number of A&Es in the area.
GPs will also be embedded in A&E units to reduce waiting times and free up emergency teams.
The STP document states that a “lead provider” will be established for maternity care. Under the lead provider model, a single organisation becomes responsible for all services within scope of the contract, but is able to subcontract to other providers. This STP has been chosen to test a range of innovative practices to transform maternity services. As one of the Early Adopter sites, this STP will try out several new ways of working, such as using small teams of midwives, creating single points of access to maternity services and better use of electronic records.
In August 2016, prior to the publication of the STP, LMC leaders in Birmingham accused local NHS bosses of planning ‘far reaching changes’ to general practice in the city without properly consulting GP provider representatives. The Birmingham LMC had obtained a draft of the plans for GP services being developed as part of the STP. The proposals include new seven-day primary care hubs that would serve populations of 40,000 to 100,000 and provide specialist outpatient appointments; virtual beds supporting patients discharged earlier from hospital, primary care appointments available within 24 hours and seven-day GP appointments.