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Council discharges early and publishes major health plan

Council discharges early and publishes major health plan

🕔25.Oct 2016

Birmingham City Council has taken the unusual and defiant step of being the first local authority to publish its submission on joint working with the NHS, despite a request to hold back. 

Birmingham City Council and Solihull Metropolitan Borough Council have been working with the NHS to to develop a Sustainability and Transformation Plan (STP) to improve the health and wellbeing of people living in Birmingham and Solihull. Mark Rogers, Birmingham’s CEO, acts as ‘system leader’ for the project.

The respected Local Government Chronicle and its sister title the Health Service Journal reported that STP leaders had been told to hold off on publishing their “full” submissions, which were made last Friday, while they are checked by national officials.

Birmingham City Council ignored this request, and published the full 80-page submission yesterday ahead of a Health, Wellbeing and the Environment Scrutiny Committee this afternoon.

The draft Birmingham and Solihull STP says it will:

  • Establish a single “lead provider” for maternity care across Birmingham and Solihull
  • Look to “immediately” implement a shared service for back office functions across its four main acute providers and create a centralised laboratory for routine pathology work
  • Support a phased implementation of a multispecialty community provider model across the patch over the next five years.
  • A “universal offer for enhanced general medical practice” will also be made available to GPs.

Analysis: Birmingham praised for exposing savings, not reform-based, STP pressures.

However, a proposal by system leaders in July to use local Clinical Commissioning Group’s 1% contingency funds to address financial gaps left by underfunded social care will not be taken forward. The STP document states that under “current NHS priorities” it would not be possible to use the funds in this way.

It says even if the contingency fund were used solely to address pressures in adult social care the local system would still be left with a £15M gap.

The document says that if Birmingham City Council reduced social care services, the risk of the health and care system being destabilised could not be mitigated within the system.

The STP also outlines plans for a new a Birmingham and Solihull maternity pathway – to be known as “BUMP” – to create a single point of access to maternity services for all women by 2018.

Both trusts providing maternity services – Birmingham Women’s and Heart of England Foundation Trusts – will to “commit to delivering the [BUMP] programme at pace through a lead provider contracting model.”

The draft Birmingham and Solihull STP plans outline the intention for University Hospitals of Birmingham and Heart of England FT to provide back office functions to Birmingham Children’s and Birmingham Women’s Hospitals.

Plans to merge Birmingham Women’s and Birmingham Children’s Hospitals by next year have already been announced, while University Hospitals of Birmingham and Heart of England announced in September the intention to create a “single organisation”.

Mark Rogers, System Leader, Birmingham and Solihull STP and Chief Executive, Birmingham City Council said:

Both health and council services are facing huge challenges. There are real concerns about the health and wellbeing of our communities, including the effects of poverty, obesity, diabetes, cancer and infant mortality. Like most of the country, it’s an increasing challenge to meet accident and emergency (A&E) waiting time targets, there are variable levels of GPs and nurses for the population size and collectively we aren’t as good as we’d like to be at getting people out of hospital and properly supported in their own homes.

Money is also very tight across the NHS and local government. It is getting harder for councils to continue to provide social care for adults, as budgets shrink and it is getting more difficult for the NHS to continue to meet the rising demand for all of its services from young and old, as people live with multiple conditions and more complex treatments become available. More also needs to be done to support people with mental health issues.

To put this into perspective, if we carry on running our services as they are now we would need an additional 430 hospital beds by 2020 just to meet demand. That equates to the size of a general hospital, and there simply isn’t the money to build that hospital and provide the staff to run it. More importantly, this isn’t the answer anyway because what’s needed is better community services that keep people well, independent and in their own homes.

This situation is set to get worse unless something changes, so organisations have come together in a way they haven’t before, with a real sense of commitment and purpose, to create a draft plan to transform the health and care system.

What is being published today is the draft submission to NHS England, the body which sets the priorities and direction of the NHS. It is not final and no decisions have been made about changing the way services are provided. It is a reflection of current thinking about what needs to be done to address the big gaps that exist in health and wellbeing, care, the quality of services and the financial situation. It proposes what could be done to improve and transform primary care, community care, social care, mental health, maternity and wider hospital services. It is a work in progress.

Now that a high level draft plan has been created, all organisations involved with the STP want to talk to those people who live and work in Birmingham and Solihull about how it can be improved and what needs to be done to make it happen. Those from local government and the NHS services working in partnership on the Sustainability and Transformation Plan (STP) will be running a number of events over the coming months to engage with a wide range of stakeholders, and we will keep you posted about where and when those will be.

Councillor Paulette Hamilton, cabinet member for health and social care at Birmingham City Council, said:

I believe this is the right direction of travel and it is vital that we have a fully integrated health and social care system.

I would like to reiterate on behalf of Birmingham City Council our strongest possible commitment to a collaborative and place-based approach.  The council has consistently made clear that the funding crisis facing the social care system can only be addressed by a more imaginative whole system redesign and the STP I hope will be the starting point, and I urge people to give their views as part of our public and partner engagement.

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