44. Buckinghamshire, Oxfordshire and Berkshire West
What does the STP mean for your area?
The STP plans to replace nine community hospitals with four community hubs, although there are very few details on the hubs.
The future of Horton Hospital in North Oxfordshire is under review, with changes to urgent care, obstetric and paediatric services likely. Options also include moving stroke services and some critical care patients from the Horton General Hospital to the John Radcliffe in Oxford.
The document includes a plan to reduce a projected workforce growth of 4,526 staff to an increase of just 978, despite admitting staff will have to manage “approximately 15% more patients”. (Continued below)
There are campaigns against changes to the Horton Hospital that would see a reduction in services.
What are the proposed aims of the STP?
- Eliminate the projected 2020/21 deficit of £479 million;
- Reduction in the use of acute services;
- to create out-of-hospital services operating from community hubs via a single point of access, integrated with primary and social care;
- Improve the health of the population, including reducing adult and child obesity, avoidable admissions through falls, and targeting alcohol, hypertension, and smoking.
- Overall the STP aims to move care out of hospitals and into the community.
The STP is short on detail as to how its aims will be achieved and the deficit eliminated.
Workforce (continued from above)
The STP contained details of workforce changes in the area designed to save around £34.2 million. The STP said savings would be achieved by the “use of generic support workers (across health and social care), reduction of nursing grade input, increased use of healthcare assistants and physicians associates and more flexible uses of emergency care practitioners and advanced nursing practitioners”.
The plans for a change in workforce mix have attracted criticism; an article in The Nursing Times noted that the details of the change in workforce mix in the STP was released the day after a major new study highlighted an increased risk of death from diluting the skill mix of registered nurses with more support staff, sparking warnings about the risk of the new nursing associate role being used as a substitute for nurses.
The lack of transparency and the consultation procedure has been criticised by councils and MPs in the area. Oxfordshire's Health Overview and Scrutiny committee has criticised the STP and the consultation. Oxfordshire Clinical Commissioning group was hauled before representatives of the Oxfordshire Health Overview and Scrutiny committee to answer questions on how it had consulted on the STP. The consultation was described as "chaotic" by campaign groups.
In December 2016, Oxfordshire City Council overwhelmingly adopted a motion calling for moves to rein in the STP project.