4. Lancashire & South Cumbria
What does the STP mean for your area?
Health planners are trying to reduce NHS deficits and think about ways to re organise care. However getting the large deficits under control could prevent facilities being developed that can cope with the health and care social needs of local people.
Possible downgrading or closure of Southport and Formby District General Hospital A&E department.
Closure of GP-led walk-in centre at Accrington Victoria Hospital.
Lack of investment
In Lancashire and South Cumbria alone, it is estimated a staggering £264m capital is needed to deliver the STP projects. The government has promised £10m - £30m of new funding to modernise mental health facilities and improve A&E facilities at two of the area’s hospitals.
Changes in who organises our care
In June 2017, Simon Stevens announced that Blackpool and Fylde coast area is to be an Accountable Care System, with this model of care spreading to the entire Lancashire and South Cumbria STP at a later date.
What are the proposed aims of the STP
- Eliminate the projected 2020/21 deficit of £572 million;
- Development of new models of delivery for vascular; cancer; maternity; neonatology; paediatrics; critical care; end of life care; and orthopaedics;
- Transformation of primary and community services with a 20% increase in these services.
Like other areas they plan to transfer services out of hospital and into the community. The concern is that financial pressure will mean that cuts in hospital care will be made, helping to achieve savings, but without proper investment in community health services.
The STP notes that £160 million is required over the next two financial years to make the key changes to the services in the area.
This includes about £95 million for hospital specialties to be consolidated, and £65 million for community premises to be built or adapted to allow a transformation of primary and community services.
In an announcement in July 2017, as one of the more advanced STPs, this area will receive £10m - £30m to be invested across Lancashire and South Cumbria to modernise mental health facilities and improve A&E facilities at two of the area’s hospitals.
The STP does acknowledge that there are tight constraints on capital but says the option of “non-NHS sources [of funding] will be examined carefully”.
Some funding for changes could also come from the transformation funding available to eight areas designated in mid-2017 as accountable care systems; Blackpool and Fylde coast are among the eight designated ACS and could receive a share of £450m in transformation funding.
The ACS is designed to "break down barriers between primary, secondary and social care." The ACS model could spread to the rest of the STP at a later date.
The STP footprint is divided into four areas with differing plans:
The STP contains a “redesign of urgent and emergency services” across Blackpool and the Fylde, and plans to “lay the foundations for the development of an accountable care system/organisation” by 2019.
The STP document refers to a “solution design programme to develop the best possible business case for the transformation of services”, but does not offer details around this.
The STP submission refers to the “new community provider model (akin to multispecialty community provider model)” from April 2017 as “the cornerstone of [West Lancashire] CCG’s out of hospital strategy and also includes joining up out of hospital urgent care”.
The STP outlines the ongoing work to develop an accountable care model.