The STP's stated aims include:

• To eliminate the projected deficit of £158 million by 2020/21;
• To reorganize primary care services into larger groupings;
• To reconfigure community hospitals to provide more integrated services at scale;
• To reconfigure the three acute hospitals in order to deliver the highest quality of emergency and planned care.

Like other areas this STP aims 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.

A large public consultation was undertaken by Dorset CCG on options for Dorset County, Poole and Royal Bournemouth hospitals (RBH), the configuration of maternity and paediatrics, changes to community services and the redistribution of community beds.

The consultation report was published in June 2017.  There was support for the CCG’s preferred plans to make RBH the county’s major emergency hospital leaving Poole Hospital for planned care with a 24-hour urgent care centre. However there were ‘many concerned with travel to Bournemouth and the accessibility of the major emergency hospital’ as well as comments plans were ‘unsuitable, unsafe and financially motivated.’

An open questionnaire of 7,838 people found 44% would choose the CCG’s proposals while 34% preferred Poole as the major emergency hospital. The remaining 22% said they wanted another option. 

Of a telephone survey, 51% preferred Poole as the major emergency hospital with 40% choosing the CCG’s proposals.

The most contentious proposals were those for maternity and paediatrics and these were reported to have ‘little support’, with many respondents rejecting both the CCG’s options mainly due to accessibility for residents in the west of the county.

In April 2017, Healthwatch Dorset released a damning report of the consultation after claiming many members of the public gave up filling in the ‘full of waffle’ 48-page questionnaire saying it was full of jargon and too long.

The STP includes a major reorganisation of Dorset's acute hospital sector.

The Royal Bournemouth Hospital (RBH) is to be designated as the county’s major emergency hospital leaving Poole Hospital for planned care. Meanwhile Dorset County Hospital would remain both a planned and emergency care hospital with changes to its maternity and paediatric services under discussion.

No preferred option has been set out for the future of paediatric services and maternity services at Dorset County Hospital, with ongoing discussions taking place between the Dorchester hospital and Yeovil District Hospital regarding the possible integration of services.

The STP proposals include:

• Dorset County Hospital would continue to provide surgical treatment and chemotherapy with the addition of radiotherapy.
• Poole Hospital as the major elective care hospital would provide low risk treatment for cancer patients including surgery and chemotherapy.
• Royal Bournemouth Hospital, proposed as the major emergency hospital, would provide emergency and critical care. This will include stem cell transplants and more complicated haematological procedures, provision of an acute oncology assessment unit and service and high risk cancer surgery.

In September 2017,  the CCG gave the go ahead for the proposed changes.

Royal Bournemouth Hospital will become an emergency hospital while Poole Hospital will be the elective centre.

Poole Hospital will have its emergency department downgraded to a 24/7 urgent care centre.

The decision was also taken that consultant led maternity and paediatric services will be delivered at the Royal Bournemouth hospital with an “integrated” model at Dorset County and Yeovil hospitals. This actually means that Dorset County hospital will have to find ways to share its paediatric and maternity departments with Yeovil District Hospital.

The STP involves major changes to services available in the community, in particular to community hospitals. Dorset CCG says it wants 100,000 patients a year to be treated closer to home rather than in hospital, particularly elderly people with chronic conditions "who can be safely managed in the community."

The STP proposes ‘integrated teams' to "deliver more and better services from a fewer number of sites than the 13 community hospitals with beds and 135 primary care sites that currently operate across Dorset." These 135 sites include 98 GP practices, leading to concerns that the number of GP surgeries will be reduced.

Community hospitals at Alderney, Westhaven and St Leonards face closure as services there would move to other 'community hubs.' Community hubs with beds would be located at Poole, Wimborne, Bridport, Blandford, Sherborne, Swanage and Weymouth.

Community hubs without beds would be at Shaftesbury, Christchurch, Dorset County Hospital, Portland and Wareham.

However, the STP recommends that alternative sites for community hubs without beds are found for the Shaftesbury, Portland and Wareham sites. If these are found, these community hospitals will close.

Mental health services are under review in Dorset. Planned changes include “retreats” and “community front rooms” to offer a place for people experiencing poor mental health at an early stage.

NHS England plans for all STP areas to develop into Integrated Care Systems, previously known as accountable care systems.

In June 2017, Simon Stevens announced the first eight “accountable care systems”, which will each receive a share of up to £450m in transformation funding. One of these areas is Dorset.

This new model of care is designed to increase integration between hospital, community and primary care. Further details can be found on our New Models of Care page and Accountable Care Organisation page.

Campaigners fear that the planned closures at Poole Hospital, particularly of A&E, will put lives at risk as traffic conditions can be very poor, especially during the summer holiday season.

By mid-January 2017 a petition against the closure of Poole A&E had reached 20,000 signatures.

Campaigners have also noted that the consultation running on the planned changes in the STP is very complicated and requires in-depth knowledge of current services.

In March 2018, Defend Dorset NHS was granted a full hearing following an application for a judicial review on the changes in the NHS in Dorset.

Although Dorset council's health scrutiny committee had said it had concerns about the loss of beds and services, it voted in December 2017 not to refer the changes to the health secretary for review.