9. South Yorkshire and Bassetlaw
What concerns have been raised about your STP?
Health planners are trying to reduce NHS deficits and think about ways to re-organise care. However getting the large deficit under control could prevent facilities being developed that can cope with the health and care social needs of local people.
All Sheffield hospitals are under review as health bosses try to find £232 million in savings.
Merging of A&E, walk in centre and GP out-of hours into a single integrated Emergency Centre in Rotherham.
Closure of Rotherham Institute for Obesity due to a lack of funds.
Cutbacks at the children's ward at Bassetlaw Hospital; the ward will be closed to new admissions overnight and at weekends due to staffing shortages. 10,000 people have joined a campaign in opposition to the move.
Closure of hyper-acute stroke units at Barnsley and Rotherham hospitals.
- Elimination of a projected deficit in 2020/21 of £571 million;
- Development of accountable care organisations (ACO) in the footprint area;
- Increased emphasis on preventive health;
- Simply urgent and emergency care pathways;
- Integration of health and care services.
Like other areas this STP aims to transfer services out of hospital and into the community. The concern is that cuts in hospital care will be made, helping to achieve savings, but without proper investment in community health services.
The published STP was light on details of changes that the area will undergo, but since then more information on new care models for the area have been released. The STP mentions that development of accountable care organisations is underway across the region, but they were at different stages of development in Barnsley, Doncaster, Rotherham and Sheffield. In June 2017, Simon Stevens announced that South Yorkshire and Bassetlaw STP will be one of the first eight “accountable care systems”, and will be given control of a share of up to £450m in transformation funding. According to an article in the HSJ, the ACS's have ”agreed with national leaders to deliver fast track improvements” and in return will receive “more freedom on decisions over how the health system in their area operate”.
According to the STP new models of care are being developed for several clinical areas, including hyper acute stroke services, children's services and anaesthesia services, vascular services, specialist mental health services and chemotherapy.
A review is also looking at staff numbers and patient attendances while establishing what is ‘unsustainable’.
The STP does not contain exact details on the changes planned for hospitals in the area, but the plans will need a capital investment of £200 million.
There are consultations about stopping childrens operations in Barnsley, Chesterfield and Rotherham.
Following a consultation, in November 2017, the decision was taken to close the hyper-acute stroke units in Barnsley and Rotherham hospital. Stroke patients will instead be taken to Pinderfields, Doncaster, Sheffield or Chesterfield for the first 72 hours of care.
The plans for urgent care in Sheffield include the closure of the urgent care centre in the centre of Sheffield and of the A&E at the Royal Hallamshire Hospital. Urgent care services will be centralized at the Northern General in the city. A public consultation found little support for these plans and the CCG announced that they would make a decision later autumn 2018.
Changes to primary care focus on prevention and early intervention in order to reduce A&E visits and hospital admissions. The STP includes plans to increase telehealth to monitor people who have long term conditions, such as diabetes, chronic obstructive pulmonary disease, arthritis and hypertension.
The STP has been criticised by Bassetlaw MP John Mann who told Parliament that the plans designed to close a £571 million budget black hole are a “smokescreen for cuts”.
Sheffield City Council has criticised the plans for lacking transparency and for not involving the public enough in discussions. (More information below)
The following response to a question asked by Douglas Johnson to Councillor Cate McDonald (Cabinet Member for Health and Social Care) at a meeting of Sheffield City Council on 7 December 2016 was noted:
The Administration does not intend to approve the NHS’s local Sustainability and Transformation Plan (STP)......
- believes that the way that STP has been developed has led to it becoming a mechanism for implementing the Five Year Forward View, which includes £22 billion of efficiency savings or cuts;
- believes that the STP process has lacked transparency and should have been conducted in a more transparent manner with a broad conversation with the public about the challenges facing the NHS and how to tackle them; and
- resolves to continue to oppose the Government’s cuts to NHS and local government funding, which are already leading to a crisis for adult social care, and to make the case for the extra investment that is desperately needed for these vital public services and resist further cuts to the NHS and social care on the back of STPs.
A public consultation took place in Sheffield over the plans to move the minor injuries unit at the Hallamshire Hospital and the walk-in centre in the city centre to the Northern General Hospital, Sheffield. The CCG will make a decision later in the year on what changes will be made.
Areas of particular concern from the consultation included: issues related to services at the Northern General Hospital, due to transport, journey times, parking and access for people in the south of the city; GPs’ capacity to cope with more urgent patients; and loss of services in the city centre. There was a strong feeling that urgent care services are needed in the city centre.
The consultation offered three options, none of which was keeping the current services. The majority of people responding to the consultation opposed the plans and suggested alternatives to reinstate the A&E at the Royal Hallamshire Hospital, building an urgent treatment centre in the south of Sheffield or generally keep the services as they are.