NHS in Crisis? North Herts health and social care providers must meet challenge of huge funding gap but are well placed to begin transformation

The Lister Hospital

The Lister Hospital - Credit: Archant

As the national media reported extensively this week, there is a huge hole in funding for health care which needs to be met by streamlining and transforming NHS care. But with huge changes already having been made, North Herts is better placed to meet the challenges ahead than many areas of the UK.


- Credit: Archant

A report released by the independent health charity King’s Fund this week questioned whether recent plans drawn up by the NHS to meet a 22 billion funding gap by 2020/21 – known as Strategic Transformation Plans would be able to succeed without a lot more investment.

In Herts and West Essex as a whole there is a £3.1 billion spend each year on health and social care and it is estimated there will be a huge £550 million funding gap each year by 2020/21 if big changes are not made.

The transformation plans focus on some hospital closures, centralising care into hospital ‘super hubs’ and making more care available in the community to cut the problem of ‘bed blocking’ – where patients have to stay in hospital even when clinically fit because there are not enough places in social care for them.

But Stevenage’s Lister Hospital is well placed to meet the centralisation challenges. It was at the forefront of a major centralisation programme in 2013 to 2014 which saw emergency services close at the QEII in Welwyn Garden City and major Hertfordshire surgery focussed on the Lister with a new renal inpatient unit, 24/7 heart attack centre and hyper-acute stroke unit

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Plans for a centralised vascular surgery unit and radiotherapy unit for the whole of Herts are also in the works and a decision is expected soon.

The problem of bed blocking and finding more space in social services to take patients who need to be discharged from hospital is less easy to solve.

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East and North Herts NHS Trust which runs the Lister admits it has a problem with ‘bed blocking’ but it says it is working hard with partners in the community to resolve the problem.

The major issue is even if a small number of hospital beds are filled with clinically fit patients, when the rest of the 568 beds in the hospital are full – which they usually are, it creates a much bigger knock on problem throughout the hospital.

The percentage of so called bed days lost to bed blocking remain fairly stable at April 2.5 per cent in April 2016 and an expected 2.3 per cent in January this year. But the hospital says despite the small percentage it is a deceptively big problem.

The hospital is also coping with demand in A&E. While the Trust says the Lister has been ‘very busy’ over the winter period, it has not been forced to suspend treatment of minor injuries which it had to do last year because of pressure on the emergency department.

To alleviate the problem of ‘bed blocking’ in the future, the Trust will be working with the East and North Herts Clinical Commissioning group, GPs and community social care providers to try to change the emphasis of care. The aim will be to make the most of local resources such as children’s centres, schools and leisure centres, to help people improve their health and wellbeing so they require less treatment.

Projects to help prevent illnesses – such as diabetes, heart attacks or strokes – will be extended across the area.

If you have a long-term health condition, you will be encouraged to look after your own health, helped by health professionals, community leaders and supported with new healthcare technology.

The Trust and the CCG will work to deliver care often closer to people’s homes and out of hospitals. It will create local health and wellbeing centres – bringing together the expertise of health and care professionals to cater for residents’ physical, social and mental health needs. Where there are health benefits for patients, more services will remain open at the weekends.

At the other end of the hospital in admissions to the emergency room, the Lister also appears to be coping as well as can be expected.

In January 2017 83.4 per cent of patients were seen, treated and a decision taken to discharge or admit them within the four-hour limit set nationally.

Whilst lower than the 95 per cent expected standard, it is also better than the figure for the corresponding figure the Trust achieved in January 2016 – 80.5 per cent – despite a rise in both attendances and admissions over the intervening 12 months.

Time will tell if the new system will deliver the savings needed and prove effective.

Experts at the health charity the King’s Fund this week said a lot more investment is needed in social care to bridge the funding gap and make the transformed service work.

Ultimately the ‘bed blocking’ figures and the standards of care in the future will be the judge.

What’s your experience of ‘bed blocking’, treatment at the Lister Hospital and social care for children, adults and the elderly in North Herts? You can email your views to news@thecomet.net, comment on the story on the Comet’s Facebook page or call us on 01438 866209.

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