5. West Yorkshire & Harrogate
What issues have been raised about this STP?
Closure of Huddersfield Royal Infirmary; a new hospital will be built but without an A&E meaning the closest A&E would be at Calderdale Hospital. This move has been criticised by GPs as putting lives at risk.
Controversial downgrading of services at Dewsbury Hospital including A&E, with a major A&E centre in Pinderbury.
Potential closure and transfer of stroke services at Calderdale and Harrogate.
The North Yorkshire County Council Scrutiny of Health Committee raised a number of concerns with the plans, warning of an over-emphasis on deficit reduction coupled with a lack of understanding about the impact of the cuts. The cuts could see the downgrading of ‘consultant-led maternity and paediatric services’.
What are the proposed aims of the STP
- Elimination of the projected deficit of £1.07 billion by 2020/21;
- Increased focus on self-care and prevention;
- Increased access to primary care and new models of community care, with an emphasis on improved mental health services;
- Increased integration of services;
- A reduction in use of acute services;
- Overall the STP aims to improve the health of the local population and move care away from the acute sector to the community sector.
In November 2016, the leaders of five councils in west Yorkshire wrote to NHS England to voice concerns they had not been given proper scrutiny of the West Yorkshire and Harrogate STP.
Councillors have warned that the targets for savings outlined in the STP will be impossible to achieve.
There has been criticism over the use of management consultants to help produce the STP. The board is reported to have spent £378,000 on consultants.
The STP lacks detail on how things will change and how the finances will enable services to transform to achieve the aims in the STP.
A report by the North Yorkshire County Council Scrutiny of Health Committee dated 18 November 2016 highlights a number of concerns raised about the STP process. This include:
- A lack of governance and democratic accountability
- A lack of engagement of non-NHS organisations and the general public
- An over-emphasis upon deficit reduction
- A lack of understanding of the impact of funding cuts in other areas for partners, such as public health, social care and housing
- Doubts as to whether the STPs will be able to deliver the promised financial and performance improvements
- A shortage of the capital funding needed to transform and modernise health services, especially in 2017/18 and 2018/19
Specific local concerns include:
- 'could result in the downgrading of accident and emergency, consultant-led maternity and paediatric services......
- accessibility to specialist health services and increased journey times. '
Changes to the way services are commissioned fall into three areas:
- Strengthening the region-wide committee of CCGs to commission some specialist services at a West Yorkshire and Harrogate level;
- Bringing together CCGs, councils and NHS England to integrate commissioning in the local authority area; and
- Set up new “accountable care organisations” to manage capitated budgets for their local populations.
Specifically the STP refers to setting up ACOs in Airedale, Bradford and Craven, and Wakefield; and a primary and acute care system in Harrogate.