On 4th November, the Wider Devon Sustainability and Transformation Plan (STP) was published setting out plans to improve health and care services across Plymouth and Devon.
Speaking about this latest draft plan to reshape healthcare in Plymouth, Torbay and across Devon by 2021, Johnny Mercer MP said:
‘I welcome this draft plan as the first step towards securing the transformation and sustainability of healthcare in Plymouth by 2021.
We have made significant progress already in delivering this in Plymouth. Our integrated health and social care system is leading the way in this across the county. This means that the services provided in the city are responsive to provide the right care, in the right place and at the right time.
The report highlighted the existing ‘health inequalities’ in Devon which means that there is as much as a 15-year difference in life expectancy between Plymouth and other areas in Devon. This is an aspect that I have been working on since I was elected and I believe it is important that the STP factually accepts this and recognises the need for this to be addressed.
Equally, we see a lower per head spend on health and social care than others areas – as much as 10% less. I am delighted that the the STP is determined to equalise the funding available so that people in Plymouth have access to the same levels of funding as other areas, again, something I have already been working on in terms of public health spending. I will keep pushing to achieve this.
Crucially, the STP is prioritising acute hospital and specialist services and primary care such as GP services. These essential services are the way most of us access the health system and ensuring it is modern, value for money, and equipped to serve the people of Plymouth in the long term is vital. I am delighted that as part of this Plymouth Hospitals NHS Trust is going to become the lead centre in Devon for trauma, cardiac arrest, neurosurgery and neonatal intensive care.
I am equally pleased that one of the priorities is Mental Health and services for those with learning difficulties. The plan seeks to create a parity of esteem between physical and mental health, ensuring they are equal terms of funding and provision. This highlights that setting the bar high for provision in these areas in Plymouth is absolutely the right thing to be doing.
Senior leaders from Plymouth Hospitals NHS Trust and Plymouth City Council represent the interests of the city in the STP process, but a key part of the process is engagement with local patients and the wider public. I will make sure you are kept up to date so that you can have your views heard and addressed.’
The Sustainability and Transformation Plan (SLP) is looking at how health services across Plymouth and Devon need to develop between now and 2020/21.
Summary Principles for the Review:
- Improving the health of the population
- Improving the quality of care delivery
- Achieving better value by reducing the cost of care
- Improving experience of staff – increasing the attractiveness of a career in the Devon health and social care system
Case for change: A number of issues have been highlighted across Devon. Specifically relating to Plymouth, it identified the current health inequalities which the city experiences compared to other areas, with a different of up to 15 years in life expectancy between some areas. The spend per person differs markedly across Devon and is 10% less in the most deprived areas.
There are significant clinical challenges across the region such as securing staff levels and a need to find a sustainable financial footing for the health service in Devon.
System-wide challenge of £557m is forecast by 2020/21 without transformational change.
The system across Devon has seen collaboration achievements already. The full integration of health and social care commissioning in Plymouth is cited as one of these successes. Foundations like these provide a platform upon which to bring CCGs and the three local authorities together to create strong leadership of the STP agenda.
- Demographic change is driving increased need for treatment and care.
- The current deficit within the acute care service across Devon is £50m, increasing to £305m by 2010/21 if no action is taken.
- Costs of Agency/ Locum staff in Devon was £49.7m (2015-16).
- Hospital Trusts in Devon are failing to deliver the standards required for effective waiting times, assessment, treatment and care.
- All of this points to the need for positive change to ensure a sustainable health system can be provided across Plymouth and Devon into the future.
Seven priority areas identified as key programmes of work – a series of acute and specialist services which need to see transformation to ensure they are sustainable in the future:
- Prevention and early intervention: health care settings, life stages, behaviours, diseases and medical conditions and approach taken to support people. Overlaps with other priorities e.g. mental health, planned care, children and young people. Focus on long term conditions and co-morbidities, scale up lifestyle interventions e.g. Thrive Plymouth.
- Integrated care model: Promoting health through integration – e.g. build on Plymouth’s integrated care model, new care models e.g. reduce reliance on bed based care, wider planning e.g. taking into account the South East Cornwall impact on Plymouth Hospitals NHS Trust.
- Primary care: Building sustainable integrated primary care – prioritising broader integration of primary care into wider care system to help address immediate challenges e.g. workforce sustainability and 7 day working. NEW Devon strategy is in development.
- Mental health and learning difficulties: Putting mental and physical health on an equal footing – benefits for patients and for the system. Case for change has highlighted the prevalence of mental illness across Devon and those with serious conditions experience poorer health outcomes. Joined up with other priorities – prevention, integrated care and specialist services. Seven additional priorities for transforming MH which are attached. For those with learning difficulties, tackling health inequalities, maximise the independence of people, transform care across the service including children and young people.
- Acute hospital and specialist services: Planning for the future in light of demography changes and need to provide affordable and sustainable services. Initially the following services are the priories for urgent review:
- Stroke (review Nov 2016 – Feb 2017)
- Maternity, Paediatrics and Neonatology (review Dec 2016 – Mar 2017)
- Emergency and Urgent Care (review Jan –Mar 2017)
A number of smaller services are also being reviewed due to issues they face in sustainability of workforce and other challenges. The most urgent of these services for review are:
- Breast services
- Interventional Radiology
- Histopathology (examination of tissue samples by Pathologist)
- Interventional Cardiology
- Vascular Surgery
Of these, in Neurology, Vascular and ENT early review work has begun already.
Specialist commissioning – Plymouth Hospitals NHS Trust will be the lead centre in Devon for trauma, cardiac arrest, neurosurgery and level 3 neonatology.
- Once the reviews are complete, they will come to stakeholders – patients, clinicians, community leaders and elected representatives – to consult on the changes required to improve the services.