Up to £275m in savings need to be made by the NHS and social services in Northamptonshire between now and 2019.
The stark figure, which represents about 10 per cent of the county’s health budget, means that patients and healthcare professionals may need to shift their perceptions about how services are provided in the next few years, says the chairman of a group tasked with delivering a plan for health and social care.
Paul Blantern is chairman of the Healthier Northamptonshire board and also chief executive of Northamptonshire County Council.
He said the main way the savings will be achieved, from the county’s total health budget of about £2.5 billion, will be through use of prevention strategies.
Dr Blantern said: “We are putting a lot of effort into looking at ways of keeping people from using services they don’t need to.
“Our social care services are also becoming more involved so that better decisions can be made about the type of care that individuals need.
“For example, if an older person falls ill and is taken to hospital a doctor may say that person needs to live in a care home, because they are appraising that person’s acute needs. However, someone in social care may assess them and decide that the person would be better cared for at home, where they might be happier.
“That approach would be right for the individual’s needs.”
Dr Blantern said the ultimate aim would be for people not to have to go to hospital unless their condition was urgent or an emergency.
He added: “That’s almost a utopian vision, however.
“People will always have heart problems or conditions like diabetes which need regular visits.”
According to Dr Blantern, the three key challenges facing healthcare are rising population levels, an ageing population and better medical treatments, which mean the amount of time people are cared for has increased.
He added: “The baby boomer generation are now reaching a more advanced age, which means we have lots of older people who require more care.
“Technology has also improved. Someone may have been born with a particular medical condition decades ago may have died in their 20s. Better care means that person might now live into their 40s, which increases the period of time they need help for.
“There is also an issue with expectation.
“A person might drink a lot or smoke and they are well within their rights to do so, because we don’t want to have a nanny-state approach, but that person has to recognise that at some point, someone, like other taxpayers, is going to have to pay for their care.”
Dr Blantern said the solution lies in re-designing services so that they will cost less to provide, but also be done in a better way.
He said: “Someone suffering from diabetes, for example, might be able to provide their blood readings to their GP online, rather than visiting the practice – which would be better for the patient, who doesn’t have to travel, and the for the surgery, which has freed up an appointment slot.
“We have seen something like this recently, with changes to the county’s podiatry service.
“Previously, there was one location where the service was provided. Now, we provide the service at more locations, like residential homes, and in a different way.”
The numbers game
Paul Blantern said trying to cutting £275m from a £2.5bn budget looks achievable when it is compared to Northamptonshire County Council’s £170m savings in recent years.
He added: “The NHS has never had a budget cut and in fact the latest cut is actually a zero per cent budget increase, so it’s a cut in real terms.
“The local authority members of Healthier Northamptonshire are used to dealing with cuts while still providing the same levels of service.
“Frankly, if we can’t work out ways of making what amount to about 10 per cent of savings, we’re in the wrong job.”
Pressure for A&E
The NHS Nene Clinical Commissioning Group (CCG) says our A&E departments are under increasing pressure as the number of patient visits increases.
At a recent Big Health Conversation Event – aimed at highlighting the current picture of the NHS – the organisation said that in the past two decades the number of people visiting Kettering General Hospital’s A&E department had doubled to about 80,000 a year.
That equates to someone attending the department on average, every six and-a-half minutes.
Northampton General Hospital is under similar pressure, with a patient visiting every four-and-a-half minutes.
Nene CCG said there are also about 120 unplanned or emergency appointments made in GP practices across the county every week and that there has been a 45 per cent increase in the number of patients seen by the Northamptonshire Healthcare NHS Foundation Trust in the last two years.
A spokesman for Nene CCG said: “The increase in demand means the NHS must achieve unprecedented sustained increases in productivity, while the small increase in NHS budgets for this year is outstripped by increasing demand.”
At the event, at the Northampton Saints ground earlier this month, 70 per cent of attendees agreed that the NHS could no longer provide all services in the same way.
Health near homes
Healthier Northamptonshire says the future of the NHS will be “accessible” primary and community care with more people receiving treatment and services closer to their own homes.
A spokesman for the organisation said a number of avenues would have to be explored to ease the pressure on general practices and other frontline services.
Those include integration between medical practices and community and social services so that care can be provided to people closer to their own homes.
In a briefing note provided to stakeholders and for the public, Healthier Northamptonshire said: “We believe this system will be more able to care for our most vulnerable patients and provide care closer to home, as well as making Northamptonshire a good place for staff to come and work.”
The briefing note adds that one of Healthier Northamptonshire’s aims is to attract and retain “the best clinical and social care staff”.
Above all, however, Healthier Northamptonshire says it aims to shape services around the needs of individual patients and communities, and to fully engage the population in the design of services.