A few days ago I was sent a press release from NHS England which suggests that something of a breakthrough is happening. It began “We need an NHS ready for the future, with no one falling between the cracks. To do this, local service leaders in every part of England are working together for the first time on shared plans to transform health and care in the communities they serve, and to agree how to spend increasing investment as the NHS expands over the next few years.
I suspect this is code for some sort of specific activity, rather than an admission that after 68 years, the NHS has finally worked out that it must work together at a local level, or that up until now it was OK for people to fall between the cracks. It also seems strange in the context of an NHS which is essentially under huge financial pressure to refer to it as expanding and increasing. However the press release goes on. “This is a unique exercise in collaboration. It is hardly a secret that the NHS is looking to make major efficiencies and the best way of doing so is for local doctors, hospitals and councils to work together to decide the way forward in consultation with local communities. Proposals are at a draft stage but we expect all local leaders to be talking to the public and stakeholders regularly – it is vital that people are able to shape the future of their local services. No changes to the services people currently receive will be made without local engagement and, where required, consultation. There are longstanding assurance processes in place to make sure this happens.”
I read a bit further and then followed a link to another page on the NHS website which refers to a call that was made last December for every health and care system in England to produce a multi year Sustainability and Transformation Plan (STP). It explained that “To deliver plans that are based on the needs of local populations, local health and care systems came together in January 2016 to form 44 STP ‘footprints’. The health and care organisations within these geographic footprints are working together to develop STPs which will help drive genuine and sustainable transformation in patient experience and health outcomes of the longer-term.”
It is inevitable that when drawing lines on a map, that folk who are near the edges of the line will feel that it was drawn in the wrong place. One of the ways of reducing that effect is to allow for some duplication of relationship and overlap of areas (or footprints). To draw up a map that links East Surrey to Sussex, while seperating that part of Surrey from what is called the Surrey heartlands seems very odd. Equally for many people living in the North Eastern parts of Sussex, their focus in terms of healthcare relates to Kent rather than to Sussex. It appears that when surveyed recently for the Nuffield Trust that a poll of 100 health and social care leaders revealed that just over half felt the footprint areas adequately capture the services used by their community and local working relationships. Perhaps this suggests that some of the areas need to be changed before things go much further. However if as the press release suggests, that people are working together for the first time, we do need to give this process our best wishes and presumably wait patiently to be engaged with and in time consulted and hope by the time we do get to hear from more than a press release that the impact of working together will have ensured that a lot more than half of the people involved are happy that the areas are correct!