Throughout this process, we aim to keep the public informed about the way we are making progress in deciding what Worcestershire's opportunities and options are. This will give the public the chance to contribute to the thinking that will get 'the best fit' for future health services in the county. Our commitment is for the process to be carried out with integrity - open, honest, inclusive and timely.
Why is there a need to change?
Worcestershire health services are facing the same challenges as the wider NHS, with services needing to change as society changes and public resources come under pressure.
We have a responsibility to local people to ensure that we develop health services that are high quality, sustainable and affordable now and for future years. We believe that we can - and must - do more to improve the quality of care to achieve better outcomes for patients but we face the challenge of achieving this in the face of growing financial pressures.
Despite our focus on driving more efficient and productive services, these measures alone will not be sufficient to address the funding gap across the health economy.
There is agreement across the health economy that 'no change' is not an option and that to ensure the highest quality and safest services that are sustainable for the future we will require transformational change to the local health and care system.
We will need to ensure that the right care is carried out in the right place by the right professionals, with more out of hospital care provision where this is clinically appropriate, and a major focus on optimising the care and management of people living with long term conditions.
For those aspects of care which can only be provided within our acute hospitals, we will consider what configuration of services offers the highest quality and best outcomes for patients, and is affordable.
How will this review work?
We are currently shaping a process to help us to be as objective as possible in understanding what the opportunities and options are, and how to prioritise between them. There is growing clinical evidence of what works and doesn't work in healthcare and we will be informed by this.
We have set out eight basic steps in the work we are doing. We believe that this will take not less than 11 months to complete.
- The first step is to understand exactly why we need to change, and to be able to share that in simple and clear language with all our stakeholders - from patients, professionals and the wider public. We aim to have an engagement process that is 'second to none'.
- The second step is to determine what we need to achieve and what measures we can use to know whether an option will meet these goals or not.
- The third step is for our clinicians to look as openly and objectively as possible at the range of options for sustainable, high quality and affordable services using best available evidence.
- The fourth step brings all these steps together to work out the options which best meet Worcestershire's needs.
- We will then ask an independent clinical group of experts to review what we have developed so that it is as evidence based as possible.
- The next step in the review happens when we have the clinicians preferred options. At this stage we need to demonstrate why we think this is the best way forward and what the benefits and any consequences are.
- The presentation of the options and the debate on the benefits and consequences will then be carried out in a process of open and formal public consultation.
- After public consultation has concluded we will be revising the proposals with view to asking the partner boards to approve the final business case.
We are committed to engaging with patients and the public throughout the process and that will start in Phase 1.
We are keen to have the scrutiny of others throughout this process holding our engagement plans to account. There will be a Stakeholder Reference Board to give additional 'quality assurance' on how we are engaging patients and the wider public.
How and who decides what are the options?
This is a clinically led process and options for change to clinical services will be generated by clinicians who will assess the benefits and consequences against an agreed set of criteria. These will be shared with stakeholders and will be approved by the Joint Services Review Steering Group.
Wherever possible, clinicians will lead the dialogue and debate with local people about the emerging options. There will be extensive consultation on options - both as they are being worked up, and again as they are being developed prior to any formal public consultation.
Health Secretary Andrew Lansley has clearly outlined his four criteria for NHS service change, and when the options are being developed, these criteria will be taken into account.
- There must be clarity about the clinical evidence base underpinning the proposals
- They must have the support of the GP commissioners
- They must genuinely promote choice for their patients
- The process must have genuinely engaged the public, patients and local authorities.
What happens from this point?
We are only at the 'starting point' in doing any of this work and there are no predetermined answers. Our aim is to involve people as early as we can without causing any unnecessary or uninformed speculation. The only thing we know for certain is that we must change - staying as we are is not an option. We also know that the more we involve patients, the public, professionals and our wider partners, the more sustainable any final option will be.
A number of meetings will be held across the county during February and March to begin the discussions.
How do I find out more information?
Following formal approval, a series of public meetings will be held across the county commencing the middle of February (dates to be confirmed). This will be an opportunity to meet the people who will be leading the Joint Services Review, hear more about the aims and process, and ask questions.
Any questions can be emailed to worcsnhsjsr@worcestershire.nhs.uk
