What is the West, North and East Cumbria Success Regime?
The WNE Cumbria Success Regime is a locally-led initiative, with support from national bodies, which has been established to help create the right conditions for high quality health and social care to develop in Cumbria. Its aim is to secure improvement by introducing new care models where appropriate, developing leadership capacity and capability across the health system and ensuring collaborative working. These improvements will best be achieved by involving doctors, nurses, other health staff and members of the community.
What local health organisations are involved?
The WNE Cumbria Success Regime includes the following partners:
- North Cumbria University Hospitals NHS Trust
- Cumbria Partnership NHS Foundation Trust
- NHS Cumbria Clinical Commissioning Group
- Cumbria County Council
- North West Ambulance Service NHS Trust
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust
- Northumbria Healthcare NHS Foundation Trust
- Healthwatch Cumbria
The Success Regime is chaired by Sir Neil McKay and its medical director is Dr Stephen Singleton.
There have been plans to improve health and care in the area before. What will be different this time?
There has been a lot of hard work in West, North and East Cumbria over many years to develop the best possible health and care services for local people. However, it is clear that more support is needed if we are to make the necessary rapid progress. The Success Regime brings that support to the local health community.
Why has the West, North and East Cumbria been identified as a Success Regime?
West, North and East Cumbria has been chosen as one of three areas in the country because it faces some of the most serious health challenges, including difficulties recruiting key healthcare staff, ensuring access to care for people living in isolated, remote communities, and financial challenges. The local NHS in this part of Cumbria is likely to be overspent by around £70million this year, and this figure is likely to double within five years – and could well more than double – if we do nothing.
While some of these issues are common across the country, in Cumbria they are evidently greater, and in September 2015 the Care Quality Commission rated urgent and emergency services at North Cumbria Acute Hospitals Trust (NCUHT) as ‘requires improvement’, with general medical services at West Cumberland Hospital rated ‘inadequate’. As a consequence, the Chief Inspector of Hospitals required the local health system to produce a clinical strategy by March 2016 and to begin the move towards a new organisational form by September 2016. NCUHT has been in special measures since 2013 and the health system regularly fails to achieve the key waiting time requirements in A&E, cancer and diagnostics and recently the number of delayed transfers of care has increased significantly.
The Success Regime’s Progress Report includes a number of options for health services: are these the only solutions you are considering and have decisions already been made?
No. The ideas contained in this Progress Report are simply our emerging thinking. No decisions have been taken. We are now in a period of reflection and engagement with patients, public and staff. We are encouraging everybody to get in touch with us to help shape these options, whether by attending our engagement events, filling out the Have Your Say form on this website, by post, email or via social media.
We are asking people:
- What do you think of the emerging options outlined in this progress report?
- How can we shape and improve them?
- What other options do you think we should be considering?
Will I be able to further shape ideas once proposals become more concrete?
Yes. Once we have considered all responses and feedback given to us through our engagement programme, any proposals involving significant change will be subject to a full public consultation, giving you further opportunity to have your say.
What is the timeframe for delivering the Success Regime’s improvement plans?
We are currently undertaking a thorough engagement programme with patients, public and staff. We will only place proposals into the public domain when we have considered all responses we have received during this period of engagement and, of course, any proposals involving significant change will be subject to public consultation.
We do not expect to be in a position to publish proposals and begin public consultation until at least the end of June. Implementation of any services changes would begin from September 2016 onwards.
What about the expected population increase due to the new Sellafield nuclear power plant? Will this be taken into account in any proposals, when they are made?
Yes. We will absolutely factor in population growth, as well as other factors including, but not limited to, population demographics and the rurality and geography of Cumbria.
Not enough has been done to recruit and retain staff previously. Shouldn’t more efforts be made before any proposals are drawn up?
Great efforts have been made to recruit and retain staff over recent years without the desired effect. We can and will do more, but we also need to understand that there are long term, national shortages of key staff that mean it will be difficult to recruit certain staff for some considerable time to come. This is why we may need to change and develop services.
As such, more of the same cannot be the answer. With the development of a clear strategic plan and ambitious vision for health services in Cumbria, including the development of a new workforce strategy and investment plan, the Success Regime aims to help solve the historic recruitment issues that have blighted the area.
Will the Northumbria Healthcare NHS Foundation Trust acquisition of North Cumbria University Hospitals NHS Trust still go ahead?
There is a consensus that the original plan for a full acquisition of NCUHT by Northumbria Healthcare FT is no longer appropriate because of the risks associated with the acquisition of an organisation with a major financial deficit, poor performance and some services which are not sustainable in their present form. However, discussions on this matter are continuing and no decisions have been made.
I have heard the phrase ‘heli-medicine’ used a lot as a potential option being looked at. What is meant by this?
This is a colloquial phrase used to describe a primary method of emergency retrieval medicine, or pre-hospital critical care. Retrieval medicine is the concept of having a centrally located critical care team which can be rapidly deployed to assess, resuscitate and stabilise critically ill and injured patients prior to transfer to definitive care.
In primary retrieval, the team is sent directly to a critically ill or injured patient at the site of their accident or to the location where they have become unwell. Following stabilisation they are transferred directly to a hospital capable of providing definitive care. This can be done by car, ambulance or helicopter, and the Success Regime is looking at all of these as potential options.
Retrieval medicine is used to provide an effective resource to respond to major incidents, particularly in rural areas. It also means that a single hospital is not depleted of essential staff.