More mums giving birth at home, merging services between three Norfolk hospitals and treating more patients in the community.
These are among the first details revealed of how a revolution sweeping through the region's NHS will affect patients.
Health chiefs in Norfolk and Waveney have earmarked £300m of savings between now and 2021 as the cash squeeze tightens and demand for services increases.
They have also come up with £150m of proposed investment under their Sustainability and Transformation Plan (STP). The savings plan was first published in November after being approved by the Department of Health.
It revealed there would need to be massive savings over the next five years from our NHS which would mean the way patients are treated would have to radically change. But until now there has been no detail of what those changes might mean for patients.
Some health campaigners fear there will be massive cuts to services through STPs which have been drawn up in every area of England. And today Jane Harper Smith, STP programme director, unveiled more detail to the county's Health and Wellbeing Board.
The main aim is to keep patients out of hospitals by expanding community health and GP services. Here is how it affects three areas:
Care in the community
New centres would see a host of services under one roof combining GPs with community services, pharmacists, mental health and social care. Other aims include:
• Improving the prevention, detection and management of major chronic illnesses
• Improving access and capacity to GP surgeries, as well as addressing the retention and recruitment of doctors
• Roll-out of online 111 service, where patients enter their symptoms and receive advice or a call back
• A seven-day GP service.
Hospitals
More services will be delivered in the community, including ear, nose and throat and dermatology. But some procedures could be cut if they are found to have 'limited clinical value'.
Health chiefs also hope 25pc of births will be at home by 2021 rather than in maternity units.
Other aims include:
• More collaboration between the Norfolk and Norwich University Hospital, Gorleston's James Paget University Hospital and the Queen Elizabeth Hospital in King's Lynn. That could include 'efficiencies' for radiology and cardiology
• Combining back office departments between hospitals, mental health service and community health services
• Reducing emergency hospital admissions and cutting the length of time patients stay in hospital.
Mental health
More mental health provision would be provided at an early stage, including community-based treatment for children and young people. The aim is to reduce hospital use for people of all ages. Other aims include:
• Reducing the rise in number of bed days spent out of area
• Increasing the recording of dementia and improving access to support.
But concern was raised about consultation on the plans. Those behind the STP said the health service will be £416m in the red in Norfolk and Waveney by 2021 without changes. But MPs and campaigners have been critical.
At the meeting, councillor Bill Borrett said: 'I think we need to hear the voices of everyone. The STP service seems to be a backdoor way of reorganising the health service without consulting with anyone.'
Jane Harper Smith, STP programme director, said she could not agree more and a communications director had been appointed. She added: 'I think it is critical and vital that patients and users are informed.'
The money available to deliver the STPs nationally was also under scrutiny, which according to the British Medical Association was £1.6bn for this financial year.
Asking a public question Jan McLachlan, from the NHS Action Group, said: 'It's obvious the money is not available. At what point do we have to put the cards on the table and say services will have to be cut?'
Ms Harper Smith acknowledged budgets were tight, but was optimistic about other funding sources. She said: 'There's not very much money nationally,. We have to be realistic about that national pot of money.'
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