Proposals for five specialist hospital services were considered by Greater Manchester’s Joint Commissioning Board on Tuesday, September 17, as part of a wide-ranging programme to improve patient care and make the services more sustainable.
In total eight specialist hospital services are being reviewed under the “improving specialist care” programme, which was launched by the Greater Manchester Health and Social Care Partnership as part of its 2015 devolution vision to bring about the “greatest and fastest improvement” to the health of local people.
This review does not affect any “core” hospital services, such as accident and emergency and maternity. All hospitals will retain a broad range of services and Greater Manchester is committed to keeping a local general hospital in each of our towns and cities.
Since the “improving specialist care” programme began clinicians and NHS commissioners have been considering how these eight services could be provided better, taking into account the views of patients, carers, voluntary and community sector representatives. Local Healthwatch organisations have also been involved in reviewing the proposals.
Now Greater Manchester’s health and care leaders have agreed to develop a “pre-consultation business case” for five of the eight services over the coming months.
This means detailed work will be carried out to develop specific proposals for each of the services.
It is not a final decision on the five services, but it is an important milestone.
A full business case has already been approved for one service, while “pre-consultation business cases” for two other services will be developed at a later date.
The services, and the stage each has reached, are:
- Neuro-rehabilitation (treating injury or disease of the nervous system). The service is further ahead. In March 2019 it was agreed that Salford Royal would be the single provider of in-patient neuro-rehabilitation services in Greater Manchester and in June 2019, the business case was approved by the Joint Commissioning Board. An implementation plan is being produced and it is anticipated that the new model of care will go live during 2020.
- Benign urology (treating disease of male and female urinary system and male reproductive organs) – “pre-consultation business case”
- Respiratory (lungs and structures associated with breathing) – “pre-consultation business case”
- Paediatric surgery (surgery for infants, children, and adolescents) – “pre-consultation business case”
- Breast services (diagnostic and surgical services, not screening) – “pre-consultation business case”
- Vascular (treating conditions of the blood vessels, for example arteries and veins) – “pre-consultation business case”
- Cardiology (heart) – the review of this service is at an earlier stage and will begin a similar process later this year
- Musculoskeletal/orthopaedics (treatment of muscles, bones, or joints) – the review of this service is at an earlier stage and will begin a similar process later this year
Each of the eight services are proposed to be reorganised into a series of Greater Manchester-wide “single, shared services”.
This means the resources needed to run services will be pooled together, for example by sharing staff and expertise across different hospitals. This is different from the way services are provided now.
It will mean that people, irrespective of where they live or access these specialist services, will be able to receive the highest possible quality treatment, under the right clinical team, in the right place.
The “single, shared service” is a similar approach to the way major trauma and stroke services have already been reorganised.
Under this arrangement people who have suffered a major trauma are now taken directly to the hospitals that specialise in this, while people who have a stroke now go to one of three specialist centres. The changes to these two services save around 220 lives every year in Greater Manchester.
The changes to the eight services are being proposed because:
- These services, as they are now, are increasingly under pressure because of difficulties recruiting and retaining the highly trained clinicians who provide the services.
- There are significant differences in the quality and outcomes of these services, as they are delivered now. That means patients with the same severity of condition receive a different type, quality and experience of service depending on where they receive it.
- These services need to adapt to meet the needs of the increasing numbers of people who are living longer, have long term conditions or are frail.
- The hospital buildings these services are provided in are of variable quality, so we want to the best use of the facilities we have.
When the “pre consultation business cases” have been prepared they will be reviewed by NHS England and the Greater Manchester Joint Health Scrutiny Committee before being reconsidered by the Joint Commissioning Board. A formal public consultation may then be held on the proposed plans.
The Joint Commissioning Board is made up of the chief officers and clinical leaders of Greater Manchester’s 10 clinical commissioning groups, plus the political leaders of its 10 councils.
An animation that explains the programme can be viewed on our YouTube channel.