South Yorkshire NHS Governing Bodies receive final report stemming from review into hospital services

Bassetlaw Clinical Commissioning Group (CCG) will today (13th August 2019) be the first Governing Body in South Yorkshire and Bassetlaw to receive the recommendations in the Hospital Services Review Case for Change Report, via papers that have gone online ahead of the Governing Body meeting on 20th August.

The South Yorkshire and Bassetlaw Hospital Services Review commenced as an independent review in August 2017 looking at how to future proof local hospital services. In May 2018 the independent team made their recommendations to the health and social care organisations which make up the South Yorkshire and Bassetlaw Integrated Care System.

Since May 2018 significant work has taken place by the partners themselves to better understand how the system could take forward the recommendations, in a way that is in the best interests of patients in South Yorkshire and Bassetlaw, takes into account the views gathered in the vast public engagement exercise that has taken place over the past two years, but also addresses the challenges faced by local hospital services, such as for example difficulties recruiting paediatric nurses and A&E paediatric staff.

The paper that will be discussed by Bassetlaw CCG on the 20th is likely to be the final paper with recommendations from the review.

The paper recommends:

  • Carrying on with the development of closer working relationships across all of our hospitals

The report recommended that the hospitals develop a new way to work together through ‘Hosted Networks’. Following the publication of the review in May 2018, in February 2019 each of the hospital trusts in South Yorkshire and Bassetlaw agreed to be the ‘host’ to lead a ‘Level 1’ Hosted Network for one of the five services covered in the review (Gastroenterology, Maternity, Paediatrics, Stroke and Urgent and Emergency Care).

The level 1 networks support Trusts to work together to ensure equal access to services and the same high quality patient care across South Yorkshire and Bassetlaw. The Level 1 Hosted Networks will, for example, develop shared policies and guidelines for patient care, so where there might currently be differences in, for example, the number of follow-up appointments people might have after the same operation, purely because they live in a different town, this would be brought in line across South Yorkshire and Bassetlaw. Each of the level 1 networks will be co-ordinated by one of the Trusts acting as a host for the network, with the role of a host being to support the running of the network, not to provide services at other Trusts.

The level 1 hosted networks are being set up at the moment, with recruitment to some key posts recently underway. The Case for Change Report recommends that the development of these relationships between hospital trusts continues.

  • Exploration of a partnership approach to delivering services for children between Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust and Sheffield Children’s NHS Foundation Trust*

Doncaster and Bassetlaw Teaching Hospitals and Sheffield Children’s Trust have announced plans to work together to explore what the report calls a level 3 Hosted Network, in which the host may play a role in supporting the delivery of services on other sites. Where one of the Trusts in South Yorkshire and Bassetlaw is particularly good at something – like the experience and expertise the Children’s Hospital has in caring for children – a level 3 network is intended to help other hospitals to learn and benefit from this expertise.

Both Trusts are committed to giving children equal access to the best paediatric care and they will look at how by working in partnership recruitment could be strengthened, staff could be better supported and developed, and the standard of patient care could be improved. If successful a Level 3 Hosted Network could see the two Trust sharing ideas, staff and ways of working.

  • Taking forward other elements of transformation

The report explains that each Trust is also taking forward its own internal transformation programme to help address their own issues. For example Rotherham is building its community services for children’s services, and Barnsley is improving its buildings so that the assessment unit for children is next to the emergency department, and children can quickly be seen and monitored.

The report states that by taking these approaches to transforming services through partnership working wider reconfiguration along the lines of that recommended by the independent review in May 2018 may not be necessary in most Trusts. However challenges still remain. Therefore monitoring how far the shared working across the trusts is preventing safety and sustainability issues from arising is also key to future-proofing services going forwards.

Sir Andrew Cash, Chief Executive of the South Yorkshire and Bassetlaw Integrated Care System said: “Over the past two years a substantial amount of work has gone into this work. Significant national NHS recruitment challenges, changing needs of patients and advancing technology meant that together all partners in the Integrated Care System wanted to look closely at how we could work together to learn from each other and really build on the many strengths we have across South Yorkshire’s hospital services.

“In the immediate future our partners are all working together to ensure development of the Hosted Networks goes forwards as quickly as possible. The networks will be a fantastic vehicle for better planning our workforce across the system, and jointly developing new models of care and patient pathways that are better for our patients. I’m pleased to say that health services working more closely together was also strongly supported by the people we spoke to throughout our public engagement exercise.

“I’d like to thank everyone for the tremendous hard work that has gone into getting these recommendations together. I am looking forward to a period of increased collaborative working across all of our partner Trusts, which will clearly be in the best interests of all of our patients.”

The report states that it cannot be guaranteed that partnership working will address all of the challenges, so recommends a monitoring system with early warning signals to help identify where more needs to be done. It states that reconfiguration, which was recommended by the independent review, carries a huge risk of unsettling the workforce and making the challenges local services face worse and recommends that reconfiguration should only be taken forward if there is an immediate risk of safety issues or immediate sustainability issues that justify it.

The report will be discussed at each of the five CCG Governing Body meetings (Bassetlaw 20 August, Rotherham 4 September, Doncaster and Sheffield 5th September and Barnsley 12th September), before a decision is made about taking any recommendations forward at the Joint Committee of Clinical Commissioning Groups (JCCCG) meeting on 24th September.