24. Milton Keynes, Bedfordshire and Luton
What does the STP mean for your area?
The STP plans could see mergers and cuts at the three area hospitals: Luton, Milton Keynes and Bedford
A&E services could be reduced in at least one of the three hospitals, 'especially overnight';
Consultant-led maternity care could be cut in at least one hospital, meaning only 'low-risk births' could take place there;
Paediatric care at two of the hospitals could be reduced, with care concentrated for the most unwell children at one of the three sites.
A number of "limited clinical value" conditions will no longer be treated which range from Bariatic surgery to female sterlisation to eye lens implants.
What are the proposed aims of the STP?
- Elimination of a projected 2020/21 deficit of £311 million;
- To bring all three hospitals under the same leadership, with integrated management and service delivery;
- Integration across the footprint for urgent care services (including 999, 111 and GP OOH);
- Development of an accountable care system;
- Reviews of all clinical and non-clinical services with a view to reorganisation, in particular maternity and A&E;
- Development of Primary Care Home work package (establishing GP clusters and community and social care teams).
The STP lacks details on the changes that will be needed to eliminate the deficit.
Luton Borough Councillor David Agbley said of the STP: "We have to have a plan. I don't see any plans. I don't see anything."
Changes are planned for the hospital sector with the three hospitals - Luton, Milton Keynes and Bedford - working more closely together, beginning with the introduction of a shared leadership and management. The STP also set in motion reviews of all the services being delivered at each hospital.
Pathology services will be consolidated across the three hospitals.
A 'single point of access' for all 999, 111 and Nurseline calls in the region will be created.
It should be noted that a previous review of services at Bedford hospital and Milton Keynes hospital was abandoned (after costing £8 million), although it did advocate the closure of Bedford's maternity services and its A&E department. There is now concern that the STP review will lead to the same conclusion.
Milton Keynes councillors have demanded that eight key issues are protected or improved. These include maternity, A&E, nurses, GP services, and mental health services.
In early March 2017, Jim Thakoordin, an elected member to the council of governors at the Luton and Dunstable University Hospital criticised the STP. Mr Thakoordin said: “There will be rationalisation that could result in local people from each are travelling to another hospital other than their own to access services and support. I am also worried that some key staff will either leave the NHS; become redundant; become more stressed; and the services will become more difficult to access. I believe there will be a reduction in the number of beds, meaning patients may be forced to return home or in to a care home prematurely.”
The STP includes plans to create a shared citizen record for both health and social services to make integration easier. There is also mention of the creation of an accountable care organisation (ACO) model for the area, which will transform commissioning and the supply chain in the area.