Healthcare in Lancashire

Healthcare in Lancashire is now (as of 2015) the responsibility of 7 Clinical Commissioning Groups covering Blackpool, Chorley and South Ribble, East Lancashire, Fylde and Wyre, Greater Preston, Lancaster North and West Lancashire. From 1 April 2017 32 GP practices from Cumbria Clinical Commissioning Group will merge with Lancashire North CCG to form Morecambe Bay CCG.[1]

History

From 1947 to 1974 NHS services in Lancashire (Including Manchester but not Liverpool) were managed by the Manchester Regional Hospital Board. In 1974 the Boards were abolished and replaced by Regional Health Authorities. Lancashire and Manchester came under the North Western RHA. Regions were reorganised in 1996 and Lancashire came under the North West Regional Health Authority. Lancashire from 1974 had 7 District health authorities, for: Blackburn, Hyndburn and Ribble Valley; Blackpool, Wyre and Fylde; Burnley, Pendle and Rossendale; Chorley and South Ribble; Lancaster; Preston; and West Lancashire. In 1994 4 new District health authorities were established covering East Lancashire, North West Lancashire, South Lancashire and Morecambe Bay District (which extended into Cumbria). 9 Primary care trusts were established covering the whole of the county in 2002: Blackburn with Darwen, Blackpool, Chorley and South Ribble, Preston, West Lancashire, East Lancashire Teaching, Fylde, Wyre, and half of Morecambe Bay. In 2006 they were reduced by mergers to five. They were managed by the Cumbria and Lancashire Strategic Health Authority until 2006 and then by the North West SHA from 2002 until 2013.

The CCGs took on the responsibilities of the former PCTs on 1 April 2013.

Sustainability and transformation plans

Lancashire and South Cumbria formed a sustainability and transformation plan area in March 2016 with Dr Amanda Doyle OBE the Chief Clinical Officer of Blackpool Clinical Commissioning Group as its leader.[2]

The plan for the county proposes to eliminate the projected 2020/21 deficit of £572 million by developing new models of delivery for vascular; cancer; maternity; neonatology; paediatrics; critical care; end of life care; and orthopaedics. It proposes to increase primary and community services by 20%. The hospital consolidation plan needs investment of £95 million with a further £65 million for community premises to be built or adapted. [3]

In February 2018 it was reported that the Better Together project in Morecambe Bay had seen a 7.8% reduction in the emergency admissions rate in the area between 2014-15 and the 12 months to September 2017.[4]

Commissioning

The Clinical Commissioning Groups and local authorities established an organisation called Healthier Lancashire in November 2015 to build a case for “radical” system changes in the county, which faces an annual funding shortfall of £804 million a year by 2020 - 23% of the total forecast funding for health and adult social care.[5]

Primary and community care

There are General Practices throughout the county. The average payment per weighted patient in the county after adjustments for age/deprivation – is £116.69, per year compared to £136.01 nationally.[6]

Out-of-hours services are provided by East Lancashire Medical Services Limited,[7] OWLS CIC Ltd[8] (West Lancashire), Chorley Medics [9] and Bay Urgent Care. Virgin Care won a five-year contract for services previously provided by Southport and Ormskirk Hospital NHS Trust in West Lancashire in 2016.[10]

Community care was provided by Lancashire Care NHS Foundation Trust and Spiral Health CIC. The Fylde Coast Multispecialty community provider has reduced A&E visits from people over 60 with long term conditions by 13%, and emergency admissions by 25%.[11] In December 2018 Lancashire County Council awarded a five year contract, worth £20.8 million a year, for the Healthy Child Programme to Virgin Care. [12] Lancashire Care NHS Foundation Trust and Blackpool Teaching Hospitals NHS Foundation Trust challenged the decision the decision in the High Court and the implementation of the contract was stayed pending a full hearing. The judge described the council's evidence as 'muddled' and noted that the difference between Virgin’s bid and the NHS bid was only 0.07% and stressed the detrimental impact that losing the council contract would have on the trusts’ ability to provide other services.[13]

Hospice care is provided by East Lancashire Hospice, Rossendale Hospice, St Catherine's Hospice, Pendleside Hospice and Derian House Children's Hospice.

Healthwatch

Healthwatch was set up under the Health and Social Care Act 2012 to act as a voice for patients. There is a Healthwatch for each borough.

Mental health

The biggest provider is Lancashire Care NHS Foundation Trust. There are only 16 beds for children available in Lancashire — 10 for children under 16 at The Junction in Lancaster and six for those aged 16 and 17 at The Platform in Preston. 29 children were sent outside the county for treatment in 2016, some as far as Norwich, mostly because there were not enough beds available. It is planned to provide 56 more beds in 2017.[14]

Hospital and acute care

Acute care is provided principally by Blackpool Teaching Hospitals NHS Foundation Trust, East Lancashire Hospitals NHS Trust, Southport and Ormskirk Hospital NHS Trust, Lancashire Teaching Hospitals NHS Foundation Trust and University Hospitals of Morecambe Bay NHS Foundation Trust.

See also

References

  1. ↑ "NHS England approves creation of new CCG". Health Service Journal. 3 March 2017. Retrieved 25 March 2017.
  2. ↑ "The leaders chosen for 41 of England's STPs". Health Service Journal. 30 March 2016. Retrieved 18 April 2016.
  3. ↑ "Sustainability and Transformation Plans: Find out about your STP". NHS Support Federation. March 2017. Retrieved 30 March 2017.
  4. ↑ "Best and worst performing vanguards". Health Service Journal. 26 February 2018. Retrieved 5 April 2018.
  5. ↑ "Lancashire faces £800m funding gap". Health Service Journal. 26 November 2015. Retrieved 11 December 2015.
  6. ↑ "Lancashire GP funding 'among lowest in country'". Lancashire Evening Post. 18 February 2015. Retrieved 11 December 2015.
  7. ↑ "East Lancashire Medical Services - Homepage for East Lancs Medical Service". www.elms-nfp.co.uk.
  8. ↑ Webwizards, Sarah Jones at. "OWLS C.I.C Out of Hours GP service for West Lancashire - Emergency doctor in Ormskirk - 24 hour medical advice in Skelmersdale". www.owlscic.co.uk.
  9. ↑ "Chorley Medics Ltd - Information about the doctors surgery opening hours, appointments, online prescriptions, health information and much more". www.chorleymedics.co.uk.
  10. ↑ "Virgin Care to take over GP out-of-hours services in multi-million contract win". Pulse. 7 December 2016. Retrieved 12 December 2016.
  11. ↑ Clews, Mary-Louise. "\New Models Army". Commissioning Review (Summer 2016): 20–23. |access-date= requires |url= (help)
  12. ↑ "Lancashire County Council award £104m NHS contract to Virgin Care". Lancashire Post. 11 December 2017. Retrieved 13 February 2018.
  13. ↑ "Judge blocks £104m healthcare contract transfer from NHS to Richard Branson's Virgin Care". Lancashire Telegraph. 26 February 2018. Retrieved 10 March 2018.
  14. ↑ "'It's unacceptable for vulnerable children to be far from home'". Blackpool Gazette. 2 May 2016. Retrieved 3 May 2016.
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