Plans to review how patients in north and mid Hampshire will receive more care outside of hospital in future are due to get a further airing in public this week.
Over the past six months, West Hampshire Clinical Commissioning Group, North Hampshire Clinical Commissioning Group and Hampshire Hospitals NHS Foundation Trust have been working together to look at options for ensuring that community-based health services will be both strengthened and expanded.
This review builds on the considerable engagement work that has already taken place locally and reflects the preferences of local people for more health care to be provided near to where they live. The review also had the challenge of ensuring that people living in the north and mid Hampshire area continue to receive safe, high quality services which can be sustained during a prolonged period of pressure on staffing and funding.
The work has looked at the potential for further centralising some hospital services, particularly for patients who need specialised clinical services. It explored a number of potential options and took input from clinicians from the Trust, local GPs and neighbouring NHS Trusts and local authorities. The options included the Trust's original proposal for a new critical treatment hospital on a green field site near junction 7 of the M3.
North Hampshire Clinical Commissioning Group and West Hampshire Clinical Commissioning Group will meet in public in Winchester on 30 November 2017 to review all of the work carried out to date and choose the best way forward.
A detailed appraisal of options concluded that, compared to the current position, all of them would offer better clinical services and some would offer improved access to services and have a positive impact on the workforce. However, it also ruled out a large number of them, including the Trust’s proposal for developing a critical treatment hospital on a new site.
The appraisal concluded that the critical treatment centre was not affordable, given the financial challenges facing the local NHS. Therefore, the recommendation to the two CCG Boards is that it is not appropriate at this time to proceed to formal consultation on a future configuration of acute services for the people of north and mid Hampshire.
"The two CCGs want to focus initially on developing plans to improve care out of hospital. This should help to manage the growing demand on the acute hospitals,” said Dr Sarah Schofield, Chair of West Hampshire CCG.
"While around 80 per cent of patient care and treatment in the north and mid Hampshire area takes place outside hospital, under current arrangements over half of the money spent on the NHS in the area goes on providing care in hospital for patients who need short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery," she added.
Dr Nicola Decker, Chair of North Hampshire CCG, said: "Our local population is growing, getting older and has changing health needs. This means a different sort of care in future to what has been provided in the past. The local NHS's vision is for more joined-up local health and social care services providing more personalised care outside of hospital. Our community and hospital health and social care workforce needs to be more proactive in the care we are offering our population. Working together we can prevent many of the crises that often occur in the emergency department, making these services available for people who really need them. This approach is already making a difference in neighbouring areas.”
Alex Whitfield, Chief Executive of Hampshire Hospitals NHS Foundation Trust, said: "We completely support the commissioners’ focus on improving the care that is available outside of hospital; this is great news for the people of Hampshire. We are naturally disappointed that the recommendation to the commissioners' meeting is not to consult with the public on a critical treatment hospital at this time. The joint work, completed this year, recognised that this proposal would improve quality and accessibility for our patients, but has concluded that it is not affordable with the current ambitious assumptions around spending less on hospital services. There will always be a need for some hospital based services for the seriously unwell, for emergency care, complex surgery, maternity care and children's services. These services are best provided in a facility that is accessible for everyone and is fit for future generations taking into account the planned increase in our local populations.
"In the meantime, our dedicated and compassionate staff will continue to focus on providing great care for our patients within our existing buildings. We are fully committed to continuing to work with our health and care partners in Hampshire to provide the best care we can."
Dr Nick Broughton, Chief Executive of Southern Health NHS Trust, said: “Most people prefer to be in their own homes rather than hospital, so we welcome the focus from our partners on increased community care and support. We know that earlier support and care at home can avoid the need for hospital visits, which is better for patients and eases the pressure on busy hospitals. We are already working alongside all the people involved in health and care in the area to achieve this so people get the right care, at the right time and place.”