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STP WATCH: "Time for change" - full plan for future of Wiltshire's NHS to go public in three weeks

It is forecast to be 'fairly uncontroversial', but the Sustainability and Transformation Plan (STP) for the area that includes Wiltshire dominated the AGM of the Wiltshire Clinical Commissioning Group in Salisbury on Tuesday (November 22.)  

We have already had a published summary of the plan, which mainly spelled out the intentions for the NHS across Bath and North-East Somerset (BANES), Swindon and Wiltshire - an area known as BSW.  It remains to be seen how detailed the version to be published on December 14 will be.

The leader of the BSW planning, James Scott (Chief Exec of the RUH in Bath), told a recent meeting of Wiltshire councillors that details will not become clear for six months.  Tuesday's meeting of the CCG was told that BSW is "...at the early stages as regards the maturity of our plan."

The basis of the plan was spelled out to the meeting under the heading: "Time for Change".

Tracey Cox (Accountable Officer for BANES CCG and at present for Wiltshire CCG too) was quite open about the problems the STP team faced: "In an extended period of financial austerity, the resources are not enough for the needs and demands we are facing."  But she described the BSW plan as 'fairly uncontroversial': "If anything our plan isn't radical enough - to be honest."

Tracey Cox gave an outline of work being done on the four main areas of health care the plan addresses: primary care, urgent care, planned care and preventative care.   She leads the work on this last area and explained work planned to combat diabetes.

A member of the public asked why there was no mention in the STP summary of mental health.  The answer was that each area has mental health components within it - and further plans for mental health care in Wiltshire will be announced by the end of next month.

And Dr Chet Sheth, of the CCG's Sarum locality, said that mental health 'is all our concern': "It's not just about the STP working downwards, but about all of us working upwards."

One of the difficulties with the STP policy is finding a balance between what is good for the wider STP area (or 'footprint') and the more locally identified needs and decision making which have been the mainstay to date of Wiltshire CCG's policy making and programmes for community based health care.

This difficulty was acknowledged at the meeting.  It may become more of an issue as procurement of services is going to be done on a 'footprint' wide basis.

Another main topic for the AGM was the unreliability of the Arriva non-emergency ambulance service.  A member of the public said there had been no sign of improvement.  

He had canvassed nurses who were 'unanimous' that it had not improved and that ordering an ambulance by phone sometimes took half-an-hour.  He stressed that the drivers were being put under unreasonable pressure: "Drivers come out of it well - it's the management."

There were reports of patients being kept in hospital for an extra night because an ambulance was not available to take them home.  

For the CCG it was said that the contractual process that was underway to ensure improvements could end in the cancellation of the contract. However: "We can't terminate the contract immediately."  

If a new contractor has to be found for this Wiltshire service will it be drafted purely to suit the county’s rural geography or, if it is an STP-wide procurement, will one contract cap have to fit Wiltshire, BNES and Swindon?

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