What is Healthier Together?

Healthier Together is our Bristol, North Somerset and South Gloucestershire (BNSSG) Integrated Care System (formerly known as a Sustainability and Transformation Partnership).

Ten local health and care organisations sit on the Healthier Together board, but the partnership goes beyond just these organisations. The views of the public, patients, staff and voluntary sector form a significant role in shaping the future of our local health and care services.

Our Integrated Care System has a Memorandum of Understanding, or ICS MoU, agreed by all partners to set out the details of our commitment to work together to realise our shared ambitions to improve the health and wellbeing of local people. You can read, print and download the ICS MoU along with the ICS MoU annexes.

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Click on the video to play

In October 2014, NHS England published the Five Year Forward View (5YFV).

The 5YFV has three key aims:

  • Improved health and wellbeing for everyone
  • Better quality of care
  • Sustainable finances

To help make the Five Year Forward View a reality, in autumn 2015 NHS England announced plans to create 44 Sustainability and Transformation Planning (STP) areas across England. These became known as Sustainability and Transformation Partnerships (STPs), and many (including BNSSG) are now Integrated Care Systems.

You can learn more about STPs by watching this short video.

What do we want to try and improve?

Almost 1million people live in Bristol, North Somerset and South Gloucestershire, and similar to other areas of the UK, our local population is expected to grow significantly in the next few years (around 35,000 by 2020). This includes a large increase in people aged over 75 (10,000 more in the next four years).

Our area is relatively affluent and people’s health is good, but there are significant pockets of deprivation – with around one in ten people living in a deprived location.

Some people within our area do experience high levels of illness linked to low income, poor housing or disability. Average life expectancy varies between those living in the most and least deprived areas by around six years, with some places seeing a startling 15 years difference.

These health inequalities are unfair and more needs to be done to support those affected by many of the circumstances that are beyond an individual’s control.

There is however, much more we could all do to look after ourselves, our families and our friends.

Did you know?

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2 out of 3 adults are overweight or obese and 1 in 3 year six children (10/11 year olds) are overweight or obese

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Around 44,000 people over the age of 17 have diabetes

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1 in 10 15 year olds smoke

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1 in 10 pregnant women are smokers at the time of giving birth

9% of the adult population have a diagnosis of depression

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There are around 6,000 alcohol-related hospital admissions per year and 25% of the population report that they binge drink

We know that common risk factors such as drinking too much alcohol, smoking and poor diet are causing conditions such as cancer, heart disease and stroke, liver disease and lung disease. These conditions result in early deaths that could be avoided.

We want to do more to encourage people to help themselves – from support to stop smoking, to signposting the right treatment early on. This would be better for people and also ease the pressure on our busiest services such as GPs and accident and emergency departments.

Staff work very hard to provide good and safe care. The Care Quality Commission (CQC) is an independent regulator of health and social care and their inspections rank four of our local health providers as overall ‘outstanding’ or ‘good’.

However, we know there is a struggle to meet some of the NHS constitution standards, such as waiting times in accident and emergency departments, waiting times for cancer treatment and planned operations.  This is generally because of the high numbers of people we are trying to treat.

There are an estimated 150-200 people in a hospital bed every day that don’t need to be there. Last year we know 22% of our 75+ population had at least one emergency hospital visit, many of which could have potentially been avoided if there were the right services within the community.

86% of the population rate their overall experience of GP surgeries as very good or fairly good, but there is increasing pressure on GPs. Our community of GPs in BNSSG see around 60,000 patients every week, but their current workload is unsustainable. Lots of GPs will retire in the next few years, but not enough new GPs can be recruited. GP practices need support to change so that they can cope with the demand they are experiencing in a different way. We also know there are around 1,300 care worker and 700 nurse vacancies across our area, which we need to fill so we have the workforce required to meet the demand.

The combination of an aging population and current fragmentation of services contributes to increasing demand and costs. Older age tends to result in multiple or more complex illnesses, like dementia, heart disease and cancer. These require long term treatment and care which results in increasing demand on services, including more people needing long-term care in a residential or nursing home which is very costly.

Our annual BNSSG health budget is around £1.5bn. Funding for the NHS is growing year on year but it is not able to keep pace with current demand for services.

Continuing as we are is not an option and we need to work together to build an improved health and care system that meets the needs of everyone that lives in BNSSG. If we don’t address this, the NHS in BNSSG will be £325m overspent by 2021.