XXXX
HEALTHIER TOGETHER
Healthier but not Together: service change in Greater Manchester
The consultation currently taking place on a massive review to healthcare in Greater Manchester is intended to bring services closer together but instead it seems to be driving them further apart. Sam McCaffrey reports.
G
reater Manchester is in the midst of a consultation on one of the biggest
reviews to healthcare services the area has seen. The proposals in Healthier Together promise to reshape primary and community care to improve access to GPs and keep more people out of hospitals while also joining up care so that the different healthcare services work better together. The review also proposes some major changes to hospital services across the conurbation and surrounding rural areas, with the centralisation of emergency and high- risk general surgery to four or five ‘specialist’ hospitals.
The proposed changes have proven controversial with clinicians, trusts, CCGs, MPs and councils all having differing opinions – but one point everyone agrees on is the case for change.
Mike Kane, Labour MP for Wythenshawe and Sale East, told NHE: “The aim of Healthier Together, to give patients across the region the
same standard of excellent service wherever they live, is the right one. The challenge is huge. Manchester has the highest premature death rate of any local authority in the country. There can be no doubt that healthcare services in Greater Manchester need to change.”
Variation in quality
There is also a massive variation in terms of quality and outcomes for patients across Greater Manchester, which is a driving force behind the review. Dr Chris Brookes, medical director of Healthier Together, told us: “For me this programme is all about quality, safety and saving lives. The reason we want to do this is because there is variations in quality across Greater Manchester currently. There is variation in terms of second rate services, there is variation in terms of supervisions of junior doctors by consultants, and most importantly there is variation in the outcomes of patients, which is especially the case in emergency surgery.”
The current system is also financially unviable with a funding gap of more than £1bn out of a current spend of £6bn across Greater Manchester.
Specialist vs general hospitals
Where people begin to disagree with Healthier Together is with its proposals to try to solve these problems. The most contentious area is the proposed changes to hospital services with
32 | national health executive Sep/Oct 14
the creation of ‘specialist hospitals’ and ‘local general hospitals’, and combining the medical teams from separate hospitals into ‘single shared services’.
Under the proposals four, or possibly five, specialist hospitals will be created and it is only at these sites that high-risk and emergency general surgery will be performed. The local hospitals will still provide A&E services, planned general surgery, diagnostics and their own specialisms.
The medical staff in the specialist and local hospitals will combine into a single service with the goal of providing a greater consultant presence. The proposals require an A&E consultant to be present 12 hours a day, seven days a week at local general hospitals, and for at least 16 hours a day at specialist hospitals.
No evidence
Andrew Foster (pictured below), chief execu- tive of Wrightington, Wigan and Leigh NHS Foundation Trust, says Healthier Together proposes an “in- flexible, top-down model” and a “one-size-fits- all” solution for Greater Manches- ter, and that it has been designed without the input of the clinicians
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104