Better Care Together – next steps

timline: {}

The NHS organisations in Leicester, Leicestershire and Rutland (LLR) have confirmed that during July they will mark the 70th year of the NHS by publishing a document setting out the Next Steps for Better Care Together in the local area.

Back in November 2016 the local NHS organisations published draft proposals to improve health services for patients in our area. That was as part of a national initiative to produce what were called Sustainability and Transformation Plans (or STPs for short) for 44 areas across the country.

Known locally as Better Care Together, we engaged with local people and staff on these draft proposals. The overall direction of improving care quality and safety while integrating services by breaking down artificial organisational barriers was welcomed.  However people told us they had concerns about the number of hospital beds and the capacity of general practice and community services in particular to support the new service models.

Since then national policy has refocused these STPs, moving the emphasis on from being about producing plans to concentrating on ongoing partnership working to improve services and care for patients through more integrated care in local places.  In some parts of the country, STPs have moved on to now be referred to as Integrated Care Systems (or ICSs for short), and it is NHS England expectation that all STPs will move towards this more integrated model, of commissioners and providers working together for patients in local places.

Whatever acronym is used, locally the NHS partners in Better Care Together have taken forward a significant amount of work over this 18 month period.  We’ve launched an enhanced NHS111 service which provides more access to clinicians.  We have also secured funding for priority areas like cancer, mental health and diabetes, as well as capital funding for new hospital facilities. We’ve also started changing the way that the NHS organisations work together, so that we operate more as one team working for the people of Leicester, Leicestershire and Rutland in a less fragmented way.

However, the last 18 months have also seen local NHS finances and performance stressed in many services and organisations, particularly over what was one of the most pressurised winters for many years.

Nationally, the Government has recognised the pressure local NHS services are under - and so we welcomed the announcement in March this year to develop a long-term plan and funding settlement for the NHS over the next 5-10 years.  It is widely expected that there will be a national announcement in the coming weeks followed later in the year by a more detailed plan on what the NHS can – and can’t – do for any increased level of funding.

Set against this context, the local NHS partners have decided that our Better Care Together partnership needs to continue its ongoing work to improve care for patients. But we’ve also decided that now is not the time to produce a detailed long-term ‘blueprint’ for all NHS services by creating a ‘final’ version of our original STP plan.  This is because the outcome of the national funding review could have a direct and significant impact on what it is possible to afford – and therefore some of the choices that we may need to make. 

In the meantime we do think it is important to update local people and partners on the work that is being done by the Better Care Together partners. This is why we have decided to publish the Next Steps document.

The Next Steps publication will:

  • provide an update on the progress we have already made to deliver high quality, sustainable services, such as the new NHS111 clinical triage service which uses clinicians to provide advice and guidance to patients over the phone
  • set out our refreshed strategic direction which responds to the feedback on our initial proposals and the actual experience of services
  • summarises our plans for our priority areas like cancer, mental health and general practice
  • explain how we are working together across NHS organisations, and in partnership with others, in a more integrated way that is focused on doing the right thing for local people not necessarily individual organisations
  • be open about those areas where we are still doing ongoing work to develop care models and the implications of these for local services, for example some community services and hospitals.

One of the key elements that our draft STP proposals focused on in 2016 was the need for improvement in our NHS buildings.  We’ve already had some success in securing £48 million for the new A&E department at Leicester Royal Infirmary as well as commitment of around £2 million for improvements to general practice premises.  Last year we also secured £8 million for a purpose-built ward for children and young people with a focus on eating disorders and £30 million for new intensive care units and a new ward at Glenfield Hospital.

However, work continues on business cases totalling more than £350 million for the configuration of services provided by University Hospitals of Leicester, maternity services, and some community hospitals. We will be applying for national funding in July to support these schemes and, if successful, under national NHS capital guidance we will then be able to undertake formal public consultation, on some of our proposals, as early as the end of this year and on others in 2019.

With so much happening across the work of the Better Care Together Partnership, we are also taking the opportunity over the summer to review our local leadership and governance arrangements to make sure that these are effective going forward. This is important for overseeing our improvement programme and supporting delivery of improvements to front line services for patients.

If you would like more information on the work of our BCT Partnership, visit www.bettercareleicester.nhs.uk and subscribe to our mailing list to receive future information about the Leicester, Leicestershire and Rutland Better Care Together Partnership.