Healthcare in Cumbria

Healthcare in Cumbria is now the responsibility of Cumbria Clinical Commissioning Group. From 1 April 2017 32 GP practices will leave the CCG and merge with Lancashire North CCG to form Morecambe Bay CCG.[1]

History

From 1947 to 1974 NHS services in Cumbria (which did not then exist) were managed by Newcastle Regional Hospital Board which covered Cumberland, and the part of Westmorland covered by the Borough of Appleby and the North Westmorland Rural District and the Manchester Board which covered the remainder. In 1974 the Boards were abolished and replaced by Regional Health Authorities. The whole of the newly created Cumbria came under the Newcastle RHA. Regions were reorganised in 1996 and North Cumbria came under the Northern and Yorkshire Regional Health Authority. South Cumbria came under the North West (Mersey & North West) RHA. Cumbria from 1974 had three District health authorities South, East and West In 1993 South Cumbria was renamed Morecambe Bay District, which also included Lancaster. One Primary care trust was established covering the whole the county in 2002. It was managed by the North West Strategic health authority from 2002 until 2013.

Cumbria CCG took on the responsibilities of the former PCT on 1 April 2013.

Sustainability and transformation plans

There are two plans for the county, one for West, North & East Cumbria, and one for Lancashire and South Cumbria. In March 2016 Amanda Doyle, Chief Clinical Officer of Blackpool Clinical Commissioning Group was appointed the leader of the Lancashire and South Cumbria Sustainability and transformation plan footprint.[2] The West, North and East Cumbria plan is more advanced than most as it has been built on the Success Regime project. Some consultant-led maternity care services may move from the West Cumberland Hospital to Cumberland Infirmary Carlisle. [3]

Maintaining services in Whitehaven has long been a problem. It is not clear whether maintaining a consultant led maternity service there will be possible. In March 2017 it was agreed to reduce the number of community hospitals and develop more care at home. The proposed merger of North Cumbria University Hospitals with Northumbria Healthcare Foundation Trust was abandoned in April 2017.[4] A merger between North Cumbria University Hospitals and Cumbria Partnership is now planned, and the two organisations started to share a chief executive in September 2017, with plans to create an accountable care organisation.[5]

In April 2018 it emerged that there were proposals to merge the STP for Northumberland, Tyne and Wear with those for North Cumbria and Darlington, Teesside, Hambleton, Richmondshire and Whitby; this would create the largest STP in the country with a population of 3.2 million. North Tees and Hartlepool NHS Foundation Trust chief executive Alan Foster was made lead for all three STPs in October 2017. The 12 CCGs involved have set up a joint commissioning committee with delegated decision making powers.[6]

The West, North and East Cumbria sustainability and transformation partnership was one of four new integrated care systems established by NHS England in May 2018.[7]

Public health

Suicide rates in the county are very high. In 2010-12, Copeland had the second-highest suicide rate in England, 15.5 per 100,000 people. The average rate in England was eight people per 100,000. In 2013-4 Barrow saw 251 admissions for self-harm, a rate of 372.9 people per 100,000.[8]

Primary care

There are 82 GP practices in the county. Out-of-hours services are provided by Cumbria Health on Call Ltd. Rent-free accommodation for GP trainees is provided in Workington by Allerdale Borough Council and Impact Housing. Because of difficulties accessing secondary care, GPs are supported by the practice and community to manage more complex conditions within primary care than in more urban areas.[9]

Community Care

Palliative care is provided by Hospice at Home West Cumbria, St Mary's Hospice, Ulverston and Eden Valley Hospice, in Carlisle which also runs Jigsaw, Cumbria's Children's Hospice. The governors of Cumbria Partnership NHS Foundation Trust accused the success regime in April 2016 of seeing services at their community services trust as “a cash cow to solve problems in the acute system” after it was suggested that inpatient beds at community hospitals could be focused on a smaller number of sites or developed as community hubs without inpatient facilities.[10]

Healthwatch Cumbria is an organisation set up under the Health and Social Care Act 2012 to act as a voice for patients.

NHS providers

Mental health services in the county are provided by Cumbria Partnership NHS Foundation Trust. Acute hospital services are provided by North Cumbria University Hospitals NHS Trust and University Hospitals of Morecambe Bay NHS Foundation Trust though some specialist services are provided in Newcastle and Manchester. The North West Ambulance Service covers the county. The low density of population causes great difficulty in acute services. Hugh Reeve,Chair of Cumbria CCG expressed the problem: "If you put the world’s best obstetricians in Barrow, in five years’ time they’ll become deskilled because there isn’t enough work for them."[11] The Furness General Hospital scandal has dominated discussion of maternity services in the area for several years.

Cumbria was named one of the 11 most financially challenged health economies in England in 2014.

In February 2015 it was announced that the Clinical Commissioning Groups planned for inpatient elective surgery at Westmorland General Hospital to be transferred to Royal Lancaster Infirmary and Furness General Hospital. Up to six GP practices will be brought together with community services in Barrow at a cost of £12m.[12]

Lancashire North and Cumbria is one of the areas selected to pilot Integrated primary and acute care systems under the Five Year Forward View. [13]

North Cumbria was one of three areas proposed for the new “success regime” by Simon Stevens in June 2015 in which NHS England will work in partnership with Monitor and the NHS Trust Development Authority to tackle in the local health economy.[14]

Maternity

Maternity services in the county have been a particular problem. There are maternity units in Barrow, Whitehaven, Carlisle, Penrith, Kendal and Lancaster. In November 2014 the CCG invited the Royal College of Obstetricians and Gynaecologists to conduct a review a review of maternity services in Cumbria and the Morecambe Bay area.[15]

See also

References

  1. ↑ "NHS England approves creation of new CCG". Health Service Journal. 3 March 2017. Retrieved 25 March 2017.
  2. ↑ "Leaders named for eight major STP patches". Health Service Journal. 15 March 2016. Retrieved 22 March 2016.
  3. ↑ "Sustainability and Transformation Plans: Find out about your STP". NHS Support Federation. March 2017. Retrieved 30 March 2017.
  4. ↑ "How Cumbria strove for new heights in healthcare". Health Service Journal. 25 April 2017. Retrieved 16 May 2017.
  5. ↑ "Pioneering trust partnership names joint exec team". Health Service Journal. 6 October 2017. Retrieved 8 October 2017.
  6. ↑ "Three STPs to share leader and form integrated care system". Health Service Journal. 10 April 2018. Retrieved 29 May 2018.
  7. ↑ "Four new 'integrated care systems' named". Health Service Journal. 24 May 2018. Retrieved 16 August 2018.
  8. ↑ "CONCERN OVER SCALE OF SUICIDES IN CUMBRIA". North West Evening Mail. 22 July 2014. Archived from the original on 14 December 2014. Retrieved 14 December 2014.
  9. ↑ "Local council funds rent-free housing for GP trainees". GP Online. 23 August 2017. Retrieved 8 October 2017.
  10. ↑ "Success regime rejects trust governors' 'absurd' complaints". Health Service Journal. 10 May 2016. Retrieved 11 May 2016.
  11. ↑ "'Challenged' areas recovery plans demand integration and reconfiguration". Health Service Journal. 12 November 2014. Retrieved 1 December 2014.
  12. ↑ "Westmorland General Hospital to remain open - but could lose overnight surgery". Westmorland Gazette. 12 February 2015. Retrieved 12 March 2015.
  13. ↑ "NHS chief unveils 29 'vanguard' areas in his new reforms". Independent. 10 March 2015. Retrieved 11 March 2015.
  14. ↑ "Regulators to take over NHS services in three English regions". Guardian. 3 June 2015. Retrieved 9 June 2015.
  15. ↑ "MATERNITY SERVICES IN CUMBRIA TO GET INDEPENDENT REVIEW". North West Evening Mail. 12 November 2014. Archived from the original on 1 April 2015. Retrieved 1 December 2014.
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