Healthcare in Cheshire

Healthcare in Cheshire is the responsibility of Eastern Cheshire, South Cheshire, Vale Royal and West Cheshire clinical commissioning groups.

The Cheshire Care Record, an electronic health record, was implemented in 2016, across acute, primary, council, community, mental health and cancer data with a total 44 million clinical records, but needs further finance for its development.[1]

History

From 1947 to 1974 most NHS services in Cheshire were managed by the Manchester Regional Hospital Board, apart from those in part of Chester (borough of Bebington); the urban districts of Ellesmere Port, Hoylake, Hoole, Lymm, Neston, Runcorn, and Wirral; and the rural districts of Chester, Runcorn and Tarvin which were managed from Liverpool. In 1974 the boards were abolished and replaced by regional health authorities. The whole of Cheshire came under the Mersey RHA. Regions were reorganised in 1996 and Cheshire came under the North West Regional Health Authority. Cheshire from 1974 had an area health authorities, divided into six districts: Chester, Crewe, Halton, Macclesfield, Warrington and Wirral. The area health authorities took over responsibility for many of the health services previously managed by local authorities including vaccination, health centres, family planning, school health, health visiting and home nursing. In 1993 four new district health authorities were established covering Central and Eastern Cheshire, Warrington, Western Cheshire, Birkenhead & Wallasey, and Bebington & West Wirral. In 2006 the last two were merged into Wirral Primary Care Trust. They were managed by the Cheshire and Merseyside Strategic Health Authority until 2006 and then by the North West SHA from 2002 until 2013.

Commissioning

The clinical commissioning groups for West Cheshire, South Cheshire, Vale Royal and Eastern Cheshire agreed to establish a unified health commissioner in April 2017. This may lead to a merger of the organisations.[2] In November 2018 they appointed a single accountable officer and planned to merge completely by April 2020.[3]

Sustainability and transformation plans

Cheshire is part of the Merseyside and Cheshire sustainability and transformation plan area, which is facing £909m cuts by 2020.[4]

Four accountable care organisations are proposed for Cheshire and the Wirral, and some services would be moved from Macclesfield to Stockport. The plans envisage a total of £755 million in capital funding, but it is not clear where this might come from.[5]

Primary and community care

There are 22 general practices in Eastern Cheshire, 39 in West Cheshire, 18 in South Cheshire and 12 in Vale Royal. According to the WhatClinic website, there are 229 Private General Practices in Cheshire, but the vast majority of those which are not NHS GP services offer only chiropody, physiotherapy or sports injury services.[6]

Out-of-hours services are provided by East Cheshire NHS Trust and the Western Cheshire GP Out of Hours Service.[7]

Community care is provided by Bridgewater Community Healthcare NHS Foundation Trust and Cheshire and Wirral Partnership NHS Foundation Trust.

The practices in east Cheshire started a campaign for fairer funding in 2017, asking all residents to write to all their prospective parliamentary candidates. They claim that NHS funding doesn't take age into account[8] and that patients in the area are on average older and more in need of healthcare.[9]

Mental health

Cheshire and Wirral Partnership NHS Foundation Trust, 5 Boroughs Partnership NHS Foundation Trust are the main NHS providers. A document seen by, The Guardian maintains there are plans to cut costs over mental health care which could harm patients. If these plans are acted on there is concern psychiatric patients will get expensive but inappropriate care in A&E instead of more suitable care in specialist mental health facilities.[10]

Hospital and acute care

Clatterbridge Cancer Centre NHS Foundation Trust, East Cheshire NHS Trust, Countess of Chester Hospital NHS Foundation Trust and Mid Cheshire Hospitals NHS Foundation Trust are all located in the county. Specialised hospital services are provided by NHS trusts in Stoke-on-Trent, Liverpool and Manchester. According to a document seen by Guardian reporters endoscopies are to be reduced by 25% among other cost-cutting measures. Cost-cutting proposals in Cheshire could delay the start of treatment for cancer patients and lead to them dying sooner.[10]

West Midlands Ambulance Service had a 5-year patient transport contract for Cheshire, Wirral and Warrington, at a cost of £25 million from 2016 but decided to hand it back in May 2018 because centralisation of secondary care services meant it was not sustainable because that resulted in longer journeys. [11]

See also

References

  1. ↑ "Digital Roadmap Focus: Cheshire". Digital Health. 31 October 2016. Retrieved 21 April 2017.
  2. ↑ "Four CCGs to create 'unified commissioner' and consider merger". Health Service Journal. 12 April 2017. Retrieved 21 May 2017.
  3. ↑ "Four CCGs appoint single leader". Health Service Journal. 19 November 2018. Retrieved 25 December 2018.
  4. ↑ "Merseyside and Cheshire NHS: Plans to downgrade three A&Es considered". BBC News. 4 November 2016. Retrieved 21 November 2016.
  5. ↑ "Sustainability and Transformation Plans: Find out about your STP". NHS Support Federation. March 2017. Retrieved 30 March 2017.
  6. ↑ What Clinic: Private General Practices Cheshire
  7. ↑ "New out of hours GP service telephone number launched". Chester Chronicle. 28 June 2010. Retrieved 21 November 2016.
  8. ↑ "East Cheshire GPs fear further cuts as auditors are called in". Knutsford Guardian. 19 May 2017. Retrieved 20 May 2017.
  9. ↑ "GPs call on patients to lobby for fairer deal as more cuts expected". Wilmslow.co.uk. 19 May 2017. Retrieved 20 May 2017.
  10. 1 2 Cheshire cancer patients 'could die sooner' if NHS cuts are forced through The Guardian
  11. ↑ "Operator to quit non-emergency ambulance service covering Cheshire, Wirral and Warrington". Chester Chronicle. 3 May 2018. Retrieved 26 June 2018.
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