Leaked STP document reveals A&E downgrade plans

The sustainability and transformation plan for Cheshire and Mersey includes the downgrade of at least one accident and emergency department, along with a major consolidation of elective care, according to a document obtained by HSJ.

HSJ has seen a version of the region’s STP 21 October submission to NHS England, which outlines a range of projects to close a financial gap of around £900m by 2021.

The document, which appears to be the final submission, refers to the downgrade of the emergency department at Macclesfield District General Hospital to a minor injuries and illnesses unit as part of a “remapping” of services at East Cheshire Trust.

The document says there will be a formal “major service review” at Southport and Ormskirk Hospital Trust, and includes options that could reduce the number of 24 hour A&E departments across three acute trusts.

It also refers to major service reconfigurations between Countess of Chester Hospital Trust and Wirral University Teaching Hospital Foundation Trust, including a project to consolidate all elective inpatient care at Clatterbridge Hospital.

The submission, which is described a ”live document subject to regular revision”, acknowledges that many of the plans could face “public resistance and political challenges”. The plan says there will be a focus on demand management and prevention schemes, with an ambition to tackle high rates of respiratory disease, obesity, alcohol abuse, teenage conceptions, mental health problems and diseases associated with ageing.

Meanwhile, a range of future collaborative models are being considered across the different support services in the region, ranging from “setting up a single wholly owned subsidiary organisation for manufacturing and dispensing medicines” to outsourcing dialysis services to a satellite provider.

NHS England has told STP leaders not to publish their full plans, but some areas have defied this instruction.

The Cheshire and Mersey region has been divided into three “local delivery systems”, called North Mersey, Cheshire and Wirral, and the Alliance. The detailed sections of the STP document are split between the three areas.

Full story in The HSJ 3 November 2016