Major NHS shake-up facing £100m plus shortfall

Sustainabiltity and Transformation Plans are set to be implemented across the country
Sustainabiltity and Transformation Plans are set to be implemented across the country
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A major shake-up of health services across East Sussex is planned -but NHS organisations face more than a £100m funding shortfall.

That was the conclusion of the British Medical Association’s analysis of the Government-ordered ‘Sustainability and Transformation Plan’ for the area.

Dr Mark Porter, BMA Chair of Council

Dr Mark Porter, BMA Chair of Council

According to the organisation’s figures, Sussex and East Surrey needs £491.5m to deliver its plan, which is one of 44 being delivered across the country.

The shortfall includes a £100m funding hole across by the East Sussex Better Together footprint, which covers the area served by both the Eastbourne, Hailsham, and Seaford Clinical Commissioning Group (CCG), and the Hastings and Rother CCG.

Meanwhile the Central Sussex and East Surrey Alliance, which includes the High Weald Lewes Havens CCG area, needs £277m to deliver capital expenditure projects listed within the STP.

Mark Porter, BMA’s council chair, said: “These figures are especially concerning given that everyone can see a huge crisis unfolding within our NHS, with record numbers of trusts and GP practices raising the alarm to say they already can’t cope.

“The NHS is at breaking point and the sustainability and transformation plan process could have offered a chance to deal with some of the problems that the NHS is facing, like unnecessary competition, expensive fragmentation and buildings and equipment often unfit for purpose - but there is clearly nowhere near the funding required to carry out these plans.”

Health providers, including those running A&E departments, are having to cope with rising demand for NHS services due to an ageing population on top of a huge shortfall in funding and workforce issues, with the plans aimed at encouraging more community care and the integration of health and social care.

In East Sussex and Surrey alone NHS organisations are facing a £864m funding gap by 2020/21 under a ‘do-nothing’ scenario, with £530m of savings planned in the STP.

Collaborative working has started prior to the implementation of the STPs as East Sussex Better Together was formed in 2014 to galvanise the transformation of health and social care services, while a similar programme called ‘Connecting 4 You’ has been developed for the High Weald Lewes Havens area.

According to health officials in East Sussex this means that details of the STP in the county have already been set out in the two programmes with ‘no surprises’ because of a ‘commitment to transparency’.

The East Surrey and Sussex STP is being led by a ten-member executive, while East Sussex County Council has a seat on a 23-strong programme board.

Alongside the £450m transformation of Brighton’s Royal Sussex County Hospital site, the STP includes almost £500m of capital projects to improve the NHS estate and digital infrastructure that ‘our transformative new models of care need to thrive’.

The plan says: “Acknowledging the shortage of centrally-held capital, we are planning an innovative and diverse range of capital sources.”

These include a mix of commercial capital partnerships and commercial loans.

Last month East Sussex Healthcare Trust, which runs Conquest Hospital in Hastings and Eastbourne District General Hospital, was praised for making ‘significant improvements’, but the organisation remains in special measures following the latest inspection from the Care Quality Commission (CQC).

It is now graded as ‘requires improvement’ overall - up from the ‘inadequate’ rating received in September 2015.

Meanwhile late last year Brighton and Sussex University Hospitals NHS Trust entered into an agreement where it will share the leadership of Western Sussex NHS Foundation Trust in a bid to improve its performance and escape from special measures.

Campaigners including the National Health Action Party have raised concerns about the speed, transparency, and accountability of the changes laid out in the STPs.

Last month, Wendy Carberry, accountable officer for High Weald Lewes Havens CCG, said: “We are working very hard across the STP on that to ensure that we are engaging with our population and stakeholders both providing information, where we are now and they are engaged in the development of the options and services going forward.”

A spokesman for the East Surrey and Sussex STP programme said: “(The plan) brings together all organisations involved in delivering health and care services and represents a real shift in the way that the NHS works, with organisations collaborating to respond to the challenges facing local services and communities.

“This work will involve some costs because it involves working at a regional scale – something we’ve never done before – across multiple organisations, delivering hundreds of different services, to tens of thousands of different patients.”

A Department of Health spokesman said: “We are committed to the NHS — that’s why we have invested £10 billion in its own plan to transform services and improve standards of care, including almost £4 billion this year.

“NHS England are introducing Sustainability and Transformation Plans to help ensure the best standards of care, with local doctors, hospitals and councils working together in conjunction with local communities for the first time.”

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