Transforming care services in north and mid Hampshire

In November 2017, West Hampshire and North Hampshire CCGs and Hampshire Hospitals NHS confirmed that they would continue to work together to deliver their shared vision for care for the north and mid Hampshire area: improved access to high quality, safe and clinically effective services that offer local people convenience and choice, with a greater focus on prevention and early intervention and care increasingly delivered locally.

Specifically, they agreed:

  • to continue to develop and implement plans for rolling out more joined up local health services both in and out of hospital over the next few years;
  • to continue with the current programme arrangements in order to develop proposals for the centralisation of services within the current Hampshire Hospitals’ footprint (Andover, Winchester and Basingstoke), thus ensuring that patients continue to have access to the safest and highest quality care. This will include exploring any necessary capital development to support relocation of services;
  • other options, including a standalone critical treatment hospital, will not be progressed at this time as part of the programme.

Next steps

The two CCGs and the Trust continue to work in partnership with the programme to identify how best to configure services between the three current sites (Winchester, Basingstoke and Andover) with a focus on:

  • High quality care in and out of hospital in line with national best practice
  • Joined up local care close to home or at home, focused around the patient's whole needs
  • Less reliance on acute hospitals
  • Using the benefits of rapidly developing technology.

The NHS Five Year Forward View clearly describes that the NHS and social care needs to fundamentally change how the health and wellbeing needs of local people are met. Likewise, local people have consistently told us that they want to be able to manage their health and wellbeing more effectively with services provided as close to their own homes as possible. We have started to develop a new way of providing care differently which has three key elements – keeping people well; strengthening local primary and community care; and providing specialist care where needed.

The TCS programme focuses on more joined-up local care and builds on the significant enhancements already undertaken locally. For example, patients in Winchester, Andover and surrounding villages are now able to see a GP, nurse and healthcare assistant in the evenings and at weekends, thanks to new services recently rolled out in those areas.

Over the next year, we will develop local health and wellbeing hubs in Andover, Alton, Basingstoke, Eastleigh, Romsey and Winchester. These hubs will bring together health, social and third sector services, including in some hubs co-location of GP practices, to provide a wide range of co-ordinated, joined-up care. Typically, this will include community, mental health and outpatient services, so that patients have their care in one place rather than multiple appointments in different locations. Hubs may also be able to offer a range of diagnostic services that may include X-ray, endoscopy, ultrasound and phlebotomy; physiotherapy; screening and immunisation services and some day-case surgery. Hubs may also provide access to health and well-being services, such as a Citizens’ Advice Bureau and/or a pharmacy.

Patients will also have 24/7 access to consultant advice and support as well as step up/step down community beds for patients with long term or chronic conditions who need short-term urgent care.

A new 10-bed hospice is planned on the site of the Royal Hampshire County Hospital in Winchester to support patients with life-limiting illnesses and their families. The facility aims to open its doors by early 2019. The service will also support increased Hospice@Home care for those who wish to die at home with support.

Providing this wide range of care locally will help ensure that patients have a better experience of health services, with improved local care and proactive and co-ordinated care for people who have complex needs. This will include:support at home, with enhanced community-based care, so fewer people will go to attend or stay in hospital and more people will be able to leave hospital earlier. People will have access to online support and apps for their mobile phones to help maintain their independence and stay at home safely.

The learning from these approaches and others from across the county clearly demonstrate that providing care in this way means that fewer local people need to be seen in hospital and there is the opportunity to develop this even further.

Work continues to identify how best to configure services between the Trust's three current sites (Winchester, Basingstoke and Andover). An independent estates survey of these sites was completed at the end of January. The Trust is currently reviewing some of its clinical services to identify whether there are opportunities for further centralisation of some services. The outcome of these reviews and the proposed next steps will form part of the next programme update to the two CCGs in April.