How the NHS is about to undergo a revolution in Norfolk and Waveney

The project to change our NHS called a Sustainabilty and Transformation Plan (STP) is unveiled at Carrow Road. (l-r) Alex Stewart, from Healthwatch Norfolk - Christine Allen, chief executive of the James Paget University Hospital - Wendy Thompson, managing director of Norfolk County Council - Dr Anoop Dhesi, chair of North Norfolk Clinical Commissioning Group (CCG) - Antek Lejk from South Norfolk CCG (Image: Archant)

Faced with what they estimate is a £440m budget deficit by 2020, the region's NHS chiefs have drawn up plans to dramatically change the way our NHS works for patients.

The main aim is to keep patients out of hospitals by expanding community health and GP services - and save around £160m by doing so.

It includes:

Cutting hospital budgets and giving that money to GP and community care services;

All will be done to keep patients out of hospital and care for them in the community instead under the plans unveiled today. (Image: Archant Norfolk Photographic © 2009)

• Using 'Telehealth' so patients can speak to consultants over video link rather than go into hospital;

• Review the way our three hospitals work;

• Create health 'hubs' in the community with a range of services to stop patients heading to hospital;

• Restructure Norfolk's NHS organisations to save cash.

Elderly patients will be cared for at home. (Image: Archant © 2006)

To treat more patients at home, 1pc of the NHS' overall budget for Norfolk and Waveney is going to be moved to GP services and community care. Their budgets will increase by 20pc and 10pc respectively at the expense of hospital budgets.

The ambitions are outlined in a 30-page document called 'Norfolk and Waveney STP Submission' which was first drawn up in June and was released for the first time on Friday. You can read it by clicking on the box above.

The region's 15 health organisations have been working on the plans with Norfolk County Council.

They hope that in future patients will not go to different parts of the NHS to get treatment, but instead have GPs, community nurses, hospital specialists and social care all joined up. They say they will employ more nurses, therapists and social workers to treat people in their homes who may otherwise end up in hospital.

NHS and Norfolk County Council chiefs have outlined why our NHS must change. (Image: Archant)

Alex Stewart, from Healthwatch Norfolk, said it was a chance to change our health services for the better.

But he cautioned: 'There will inevitable be some losers. We don't know what they will be at this early stage.'

The success or failure of this health revolution will depend on how successfully the NHS can move patients from hospitals to GP surgeries and community care.

But the region's GP services are already under immense pressure and Dr Tim Morton, chairman of the Local Medical Committee, said money was needed now rather than in five years time to save doctor's surgeries.

'We need urgent and immediate investment rather than promises for the future,' he said.

Dr Anoop Dhesi, chair of North Norfolk Clinical Commissioning Group, said the plan had been drawn up with patients as the priority, but added that the NHS needed to live within its means and cut the deficit. 'We need a new type of care,' he said.

Former health minister and North Norfolk MP Norman Lamb said the STPs were a move in the right direction.

'We have to shift resource from repair to prevention,' he said.

But he cautioned against stopping patients being treated in hospital before enough care was in place for them in the community.

He also urged the STP to make mental health central to their plans.

'Patients suffering from mental and physical ill health are the most costly to the system and most let down by the system,' he said.

The NHS in Norfolk and Waveney will be given £70m to turn their ambitions into reality under what's called a Sustainability and Transformation Plan (STP), but those behind the project estimate there is still a 'gap' of £162m in Norfolk and Waveney's health budget which will need to be saved by through the STP.

And Norwich South MP Clive Lewis dismissed the STPs as a vehicle for cuts.

'STPs are fundamentally a way of using local NHS organisations as human shields to take the hit for a national £22bn funding gap in our health service,' he said.

'Some of these local plans may look like good ideas at first glance but in reality these STPs are little more than a vehicle to drive through cuts and closures.

'For months the public has been kept in the dark as these secret plans for our NHS have been hastily cobbled together.'

The health groups behind the STP hope changing our many NHS organisations, which could see some merge, will save £14m.

Norfolk's five clinical commissioning groups (CCGs), which buy health services for patients in their areas, could also be reduced.

There will also be a review into all hospital services. It would lead to hospital patients getting treatment with Norfolk's other NHS services rather than their normal hospital.

Asked if the plans would lead to bed closures in our hospitals, managing director of Norfolk County Council and chair of the STP Dr Wendy Thomson, suggested it wouldn't, saying demand was already high on existing services.

But elsewhere in the country the STPs have proposed bed cuts (see panel).

To deal with rising demand and keep patients out of hospitals, health chiefs hope to use a service called 'Telehealth', which gives '24-hour support' through a video link to a medic.

Chief executive of the James Paget University Hospital in Gorleston, Christine Allen, said the plans marked a change in the way care was delivered to patients.

'Despite all the hard work of our amazing staff we just can't manage doing what we are doing,' she said.

'If we did nothing we would have to build additional hospital capacity.'

But former GP Sue Vaughan, from campaign group Keep Our NHS Public, said she doubted whether the plans were achievable.

'They can't have the funding for this until they have made cuts,' she said.

She criticised the focus on keeping patients out of hospitals. 'They see it as a failure if you let someone into hospital,' she added.

All will be done to keep patients out of Norfolk's three hospital unless patients are 'suffering hyper-acute episodes,' the report said.

But it warned of possible difficulties ahead with the project: 'Hospital restructuring cannot happen in isolation but must go hand-in-hand with reinvestment strategies in the community and a clear understanding of the impact of change on the future viability of individual acute trusts.

'Otherwise, there is a possibility of creating a transition gap in service provision, or worse, a non-viable acute unit.'

As reported last week, another way to keep patients out of hospital will be to expand Norwich's walk-in centre on Rouen Road.

And the report describes moving hospital services into 'hubs'.

That could include urgent care, diabetes, dermatology and community mental health services, as well as social care and voluntary agency support all being housed in one place.

But it is not clear yet which services will move out of hospitals.

The plans will go out to consultation with the public, patients and NHS staff.

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