NHS CHIEFS have ordered a review of hospital services covering 1.5m people in Yorkshire in a key move to plug an estimated £570m black hole in health and social care spending.
Officials say they need to “totally rethink” how health and care is delivered in South Yorkshire and Bassetlaw under their landmark Sustainability and Transformation Plan (STP), one of four being drawn up covering the region.
They warn health and social care services are failing to meet health needs, prevent ill-health or tackle health inequalities – and predict this will have a worsening impact on future generations and further drive up costs to the public purse.
The independent review of hospital services, due to be completed next year, is likely to lead to potentially controversial reconfigurations officials say will be needed to ensure patients get equal access to treatment and outcomes.
A key part of their plan will require significant investment in GP and community services to reduce demand for expensive hospital care and prevent ill-health.
Without action, they predict a gap of £464m between the costs of NHS care and the funding available by 2021, and further £107m black hole in budgets for social care provided by local authorities, against total spending of £3.9 billion.
In the plan, officials say: “The way we are organised is out of date and out of sync with how people live their lives. We need to totally rethink how health and care is delivered.”
They say their forecasts suggest the financial gap can be bridged to balance the books by 2021.
But they add: “However, there is a very high degree of risk attached to the delivery of some of the changes.”
Among ambitious targets, health chiefs want to reduce the gap in healthy life expectancy in the region from 20 years to 15 years, cut numbers of adults under 65s needing treatment for heart disease and strokes by a quarter and slash numbers of people being admitted to hospital, visiting their GP or requiring medication for all other conditions by 15 per cent.
They also want to cut out-of-area placements for mental healthcare by two thirds and reduce by more than half the number of pregnancies in under 18s.
Under the strategy, there will also be a move towards making decisions over the future shape of some services at a region-wide level.
A provider forum could also be set up bringing together NHS providers with those involved in domiciliary care, private sector health provision, voluntary services and hospices to be part of the development of new models of care.
Some changes to services are already taking place with both Rotherham and Barnsley hospitals expected to cease to provide hyper-acute care to patients in the first 72 hours after a stroke or carry out unplanned surgery on children at night and weekends or if youngsters require an overnight stay.
Work is also getting underway to make savings in back office bureaucracy through joint working across corporate services provided by NHS trusts in the region.
The plans for South Yorkshire and Bassetlaw are less detailed than some others already published among 44 STPs in England. Delays in publishing the plans have attracted heavy criticism in some parts of the country.