Healthy Weston Programme Update – December 2018

Since our last update in October, doctors and local health leaders have continued their work considering what services the population in Weston-super-Mare, Worle and the surrounding areas needs in the future and how they can best be delivered.  Healthy Weston: why our local health services need to change, has been published which sets out the four key issues that need to be addressed:

  • Our population is growing, getting older, living with more long-term conditions, and there are significant inequalities in health amongst our local communities – people have changing health needs we need to meet
  • There is variation in the way GP, primary and community care teams currently provide care across the area, with some patients finding it more difficult than others to access the right care for example
  • Some of our hospital-based services at Weston are not able to consistently meet national clinical quality standards because of low volumes of particular cases and specialist staffing shortages
  • There is a growing financial gap between rising costs and available funding.  We must live within our means, get best value and make sure we use our available financial resources most effectively to meet the needs of the whole population.

As we have already said, we must make some changes across the local health and care system in order to tackle these issues.

Progress being made

We are continuing to make progress against the three areas of change identified through conversations with staff, patients and local people:

  • Changes we can put in place immediately and are getting on with; such as better support for people in care homes, improving home visiting by GPs, and developing a consistent approach to frailty assessments in the community. A recent example is the £400,000 funding received by eleven GP practices in Weston, Worle, Banwell and Winscombe for the Intensive Support Scheme (ISS) project. This will be used to improve and develop services for patients and improve patient care by improving patient access, providing greater continuity of care and supporting recruitment and retention of GPs and nurses
  • Changes we can implement imminently but require further work; for example, developing a business case to establish a mental health crisis and recovery centre in the centre of Weston,  and better integrating children’s services across different provider organisations
  • Changes that would enable us to ensure we have a strong and focused hospital at Weston, with services that can consistently deliver to the highest clinical quality standards  and are affordable for the long-term within our available funding; for example, developing better multi-agency working and identifying new clinical models and ways to deliver services sustainably.

Designing strong and focused services at Weston General Hospital

As we have previously set out, we are continuing to focus on how we can design strong and sustainable services at Weston hospital, to make sure it can continue to deliver high quality services that best meet local people’s needs into the future.  This includes identifying the services that Weston General Hospital is best placed to provide, and which services may be more effectively provided to local people by one of our neighbouring hospitals or in the community.

Similarly, there may be services currently provided in other places which are better delivered and consolidated in Weston hospital. The issues we face here are common to many communities with smaller hospitals across the country and our ambition is that we make Weston Hospital an exemplar of how services can be designed and delivered sustainably by smaller hospitals in the future.

In our October update, we outlined that clinicians had identified six clinically possible models for further detailed analysis and work because they were distinctive and different enough to be explored, tested, analysed and compared further as part of a rigorous process to identify the best potential way of delivering services.   It is important to emphasise none of these models have been selected for Weston.

Since then, clinicians have applied each model specifically to the needs of people in Weston, looking at current services delivered across Weston-super-Mare, Worle and the surrounding area, the workforce needs and costs of each model and so on.

Work has been ongoing too to describe in detail the different elements of each model, how clinical services would work with each other, what the requirements would be to deliver these services, and to identify which different types of patients with different conditions, or severity of condition, would be treated differently under each model compared to now. Across all the models the vast majority of patients who currently use Weston General Hospital would continue to do so.

In late November we tested our work with the South West Clinical Senate – a group of senior doctors and other health professionals from across the south west region set up to give independent clinical scrutiny, advice and guidance to NHS bodies.  They were supportive of our work to date and gave valuable feedback to inform the next stage of our design work.

On 3rd December, we explained our work and gathered feedback and views from stakeholders and members of the public at several events held in Weston.  You can read about the detail of the work in the event presentation slides.

Ongoing engagement

We are continuing to talk with staff, stakeholders, patients and local communities and listen to their views on our work to date to ensure that concerns, feedback, opportunities and benefits from a range of different perspectives are captured and inform the work as it progresses.

We are running a series of roadshows out in the community, have provided information online and through leaflets and posters in GP surgeries, hospital waiting rooms and community spaces, and launched an online survey to hear what people think.

For further information, please contact us on 0117 900 2655 or by email at bnssg.healthyweston.enquiries@nhs.net.

Next steps

Clinicians are continuing their work to determine the best, most viable, workable options that meet local needs and further detailed analysis is being carried out to enable us to identify the preferred option(s) for public consultation early next year.  We will be meeting with the local authority scrutiny committee and our national regulator NHS England before finalising a detailed business case which CCG Governing Body members will use to decide on options for consultation early next year.

No final decisions have been made on the future of services and won’t be until after a formal public consultation next year.

We will continue to give regular updates on this important work and the progress we are making.