What does the NHS long-term plan mean for Norfolk and Suffolk?
PUBLISHED: 09:24 07 January 2019 | UPDATED: 11:39 07 January 2019
Up to 500,000 lives could be saved under plans for the NHS in England over the next decade, health chiefs claim. But what does the announcement mean for Norfolk and Suffolk? Health correspondent Geraldine Scott explains.
It is an ambitious plan which focuses on GPs, mental health, and community care - with the three areas getting the largest increases in funding.
And a number of the priorities set out in Theresa May’s new 10-year long term plan for the health service are pertinent for our region, especially as they are reflected in the plan already put forward by local bosses.
The aim is to reduce the reliance on hospitals, which may be welcome news for the three in Norfolk who last week were seeing the pressure of winter stack up at the front door.
Reduce pressure on hospital beds
For those who do need emergency care, one of the major short-term priorities is understood to be a new target to “ensure every hospital with a major A&E department has ‘same day emergency care’ in place” - largely understood to ambulatory care units.
In these units, which are available in varying guises in all Norfolk’s hospitals, patients are assessed, diagnosed, treated, and then able to go home the same day - keeping them out of hospital and freeing up beds for those who really need it.
The James Paget University Hospital (JPUH), in Gorleston, opened their ambulatory care unit in November. Joanne Segasby, associate chief operating officer, last week attributed some of the success the JPUH has had with keeping ambulance handover delays the lowest in the county to the unit.
Focus on heart attacks, stroke, and dementia
The full details of the plan are to be unveiled later today (Monday) by NHS England chief executive Simon Stevens and prime minister Theresa May.
But ahead of full publication the NHS said the plan would prevent “150,000 heart attacks, strokes and dementia cases”, plus ensure an extra 350,000 children and young people get mental health help.
More money to prevent heart attacks will be welcome in the county, as one of the areas of focus in the Norfolk and Waveney Sustainability and Transformation Partnership (STP) - the region’s health plan - is to improve cardiology.
In Norfolk and Waveney demand for cardiology services is high and there is a shortage of cardiologists.
Improvements in stroke will also be relevant for the county, as it was announced in September that pioneering treatment which “brings patients back to life” from stroke to be launched at the NNUH.
And with an aging population and a high prevalence of dementia, extra help for those services will be welcomed.
Improved mental health care
The long-term plan also said there would be more support for mental health in schools, and 24 hour access to mental health crisis care via the NHS 111 service.
The latter is unlikely to soothe the fears of patients in Norfolk who already struggle to get crisis support, as revealed in the most recent inspection into Norfolk and Suffolk Foundation Trust.
And the proposal has been criticised as not being a substitute for properly funded and professional care.
Labour MP Luciana Berger said: “There’s no use directing people in #mentalhealth crisis to a helpline to signpost care that either doesn’t exist, or they will struggle to access quickly.”
Last year an inquest found NHS 111 hung up on Norwich man John Worthington when he was in crisis on June 6.
A pathways advisor terminated the second call and during the fourth call John, who had Asperger’s and emotionally unstable personality, made an attempt on his life.
John was resuscitated and taken to the intensive care unit at the Norfolk and Norwich Hospital (NNUH). But the brain injury he had sustained was so severe he did not survive.
Number 10 also said the NHS was going to “for the first time ever… test and introduce comprehensive access standards for mental health”.
There has not been much more detail added to this as of yet, but if specific waiting time targets, such as those for A&E, and cancer treatment, were introduced, it could have a big impact on services in Norfolk and Suffolk where in some cases waiting times for help has stretched to five years.
The plan will also look at mental health care for new and expectant mothers - something bosses will keep a close eye on considering the Kingfisher Unit, provided by NSFT at Hellesdon Hospital in Norwich, is due to open soon.
It will mean new mothers with serious mental health problems will soon be able to receive specialist inpatient treatment closer to home.
New testing centres for cancer patients
Early prevention of cancer is also high up on the agenda - with a hope more people can be cured if it is caught earlier.
Earlier detection of the disease was one of the ambitions of the NNUH when they launched a bid to become a cancer centre of excellence in 2017.
At the time NNUH cancer manager Matt Keeling said: “We want diagnoses as early as possible so that their outcome is better. The cancer strategy is about how we are going to meet that challenge.”
Consultant urological surgeon and cancer clinical lead Vivekanandan Kumar said they were aiming to “reach the top of what we can deliver nationally within the NHS”.
There will also be DNA testing for children with cancer and those with rare genetic disorders to help select the best treatment.
When West Suffolk MP Matt Hancock became health secretary last year, it was expected he might use some of his experience as minister for digital and culture to try and revolutionise the NHS’ technology.
His support for bringing more up-to-date technology into the NHS was clear from his support of GP app GP at Hand and his announcement to scrap fax machines in the health service.
So the announcement that everyone in the country will have digital access to their GP, including being able to make appointments, manage prescriptions and view their health records online.
But what about the money?
The government said NHS spending in England is increasing, however chancellor Philip Hammond said the NHS needed to ensure care was provided “efficiently”.
Writing in the Daily Mail, he said: “The public hates waste in the NHS and quite rightly want to know that their taxes are spent effectively, to deliver excellent front-line services to patients.”
NHS England chief executive Simon Stevens told the Todsay programme: “He is quite right about that. The good news is we have one of the most efficient health services in the world, but that doesn’t mean we can’t do better.”
He added: “Productivity in the NHS has been growing faster than across the economy as a whole over the last several years.
“We have a very efficient health service, but everybody can see we can be more efficient.
“Some of that is going to come not just from the £700 million reduction in administrative costs we are going to be bringing in over the next several years, it’s actually going to be by working differently.
“That’s why today we are setting out detail over how, for example, you are going to be able to see every GP practice offering digital consultations (and) 30 million outpatient appointments we won’t need in the future, freeing up £1 billion we can use in other ways.
“A very big programme of change and service redesign, using technology and innovation to do it. That will clearly make us more efficient and responsive.”
What has the reaction been so far?
Prime Minister Theresa May said the 10-year plan would “provide the best possible care for every major condition, from cradle to grave”, using the £20.5 billion a year funding boost promised by 2023/24.
But shadow health secretary Jon Ashworth said “the Tories have spent nine years running down the NHS, imposing the biggest cash squeeze in its history” and now “need 10 years to clear up the mess they have made”.
The plan was welcomed by campaigners, but experts warned that implementing it would be difficult.
Kay Boycott, chief executive of Asthma UK, said smart inhalers were “game-changing devices” that “track how often and well people are taking their asthma medication so that those most at risk of asthma attacks can be identified and helped before they need hospital treatment”.
Stroke Association chief executive Juliet Bouverie said the plan makes tackling stroke a “national priority”, adding: “We know this plan can and will ensure that more lives are saved and more people spared from serious disability.”
But Nigel Edwards from health think tank the Nuffield Trust said that while the plan’s aims were right “there are several big pitfalls ahead”, with the extra funding still below what experts thought was needed and a lack of key staff presenting “the biggest obstacle of all”.
Local Government Association spokesman Ian Hudspeth said the plan’s goals could only be fully realised if councils were properly funded to deliver social care and public health services.
“To help the NHS make its extra funding go further and alleviate the pressures on the health service, it is essential that the government plugs the £3.6 billion funding gap facing adult social care by 2025 and reverses the £600 million in reductions to councils’ public health grants,” he said.
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