[Linda Sanders, Strategic Director - People and Steven Marshall, Director of Strategy & Transformation, Wolverhampton CCG, to jointly present a report]

Stephen Marshall, Transformation and Strategy Director, introduced the report and outlined the process which has led to the development of Black Country System Transformation Plan (BC STP) in its current format. The document details the how the health needs of the people living in the geographical ‘footprint area’ covered by BC STP will be met in the next 4 – 5 years.

The Transformation and Strategy Director explained the funding challenges facing the health and social care sector and need for way current services are managed and delivered to change. The Transformation and Strategy Director commented that the areas included in the ‘footprint’ do present a number of complexities that have to be managed. The boundaries of the footprint has led to discussions between all 16 organisations represented about how the required savings will be achieved and how they can work together to improve health outcomes. The Transformation and Strategy Director briefly explained that the draft plan is being developed along four key themes, which were outlined to the Board.

The Chair welcomed the report and commented that there had been discussions about funding and also the opportunity for horizontal integration and the provision of localised services. The Chair commented that the local authority is committed to extending and improving the quality of health care and managing the public demand on services.

Linda Sanders, Strategic Director – People, commented the process used to develop the BC STP has not been locally driven and there has been some discomfort about the limited level public involvement. However, the publication of the plan does provide the opportunity to consult the public about significant service changes. The Strategic Director supported earlier comments that the area of the footprint brings benefits of closer working with partners and encouraged organisations across the region to have one conversation and to listen to different views on the proposals. The plan is focused on shared principle of looking for alternatives to hospital admission. The gap in funding for adult social care is an issue and there was acceptance of the impact of reduced funding in this area will have on wider health sector.

David Laughton, Chief Executive, The Royal Wolverhampton Hospitals NHS Trust, commented on the viability of maintaining the current number of acute hospitals across the region given the reported levels of budget deficit, for example, Cannock Hospital has budget deficit of £13 million. The Chief Executive added that the extent of the budgetary challenges facing the health sector should have been set out more clearly in the document.

The Transformation and Strategy Director commented that the risk of hospital closure due to budget pressures has been highlighted in the plan. The financial gap faced by the local NHS is estimated to reach £512 million by 2020/21, which will be challenge for partner organisations across the ‘footprint’ area.

The Transformation and Strategy Director commented that more work will need to be done on the consolidation of acute care provision and also the consideration of the impact of demand on acute hospitals that border the footprint area and how such changes will affect Wolverhampton. The Transformation and Strategy Director commented on the pressure on the demand for neo-natal services and how these services can be funded in the future.

Robin Morrison, Healthwatch Wolverhampton, expressed similar concerns about the implications of the predicted budget shortfall and that the public do want to know how the savings will be achieved. At a recent public meeting 500 people met to consider the future of Staffordshire Hospital.  The public were also concerned about the lack of information in the draft plan about the funding pressures in social care provision.

The Board discussed the major challenges of recruitment staff needed to deliver safe services - it was stated that the lead in time for training GPs is 10-15 years and there was a need for a national strategic manpower plan to meet the challenges, such as an ageing workforce and how to recruit staff to fill vacancies for specialist. There was concern about the demands on current staff who are working to deliver healthcare and how to recruit the estimated 5000 extra GPs that will be needed for by 2020.  

The Board suggested that the BC STP should be presented to Health Scrutiny Panel for consideration. The plan will also be presented to Cabinet at some stage in the future.

Resolved:

1.    The Board comments on the BC STP to be included as part of the consultation on the draft document.

2.    The Health Scrutiny Panel to be invited to consider proposals detailed in the BC STP.