Lancashire's hospitals changes on cards?

Dr Sakthi Karunanithi, the county council’s Director of Public Health and Wellbeing, predicts such changes are possible as the county comes to grips with a health crisis which extends far beyond the recent closure of the Accident & Emergency department at Chorley’s Hospital.

The Chorley and South Ribble A&E department was closed down six weeks ago due to an acute staffing crisis. Lancashire Teaching Hospitals Trust says that the closure is temporary. Speaking on the eve of a new public consultation about what the public wants from its health services, he revealed how many changes are in the pipeline for health care.

Dr Karunanithi, who recently published his own hard-hitting report on the health crisis facing Lancashire, said: “The next step is how the NHS and local authorities as well as the wider public services work with our local communities and residents. There is a big change programme being designed across Lancashire and South Cumbria.”

The aim of the programme will be to address what has been dubbed a triple gap – in funding, in health and wellbeing across the population and in quality of care.

The gap is a predicted £805m-plus shortfall by 2020/2 in health, social care and public health budgets.

Much research has been done to determine the causes of differences in health care across the county and the next step is to do something about it.
One of the key questions asked was how much of that gap is caused by people getting sicker and how much due to cuts in funding.

Dr Karunanithi said: “We know that about £400m to £500m is about ageing population and increasing illness, the rest about reduction in income.”

Rumours abound about the creation of super hospitals, including a possible new one in central Lancashire and further relocation of services.

Now local councils and the county councils are to join forces with the NHS to test local opinion. He said: “There will be a big engagement programme with the local community as a joint exercise between the NHS and local authorities. First making people aware of those challenges, secondly asking their opinions and views about how we can address some of those challenges – fundamentally how we are going to reorganise our health services.”

That reorganisation would take in everything from GP services to hospitals and associated health services.

As the senior officer for the prevention element of the new health vision he says he is ready for a “big conversation” with the public about “our NHS”. That conversation will start later this summer.

Digital revolution to speed up system

Dr Sakthi predicted new services would develop and there will be new ways of delivering care.

He said: “Without proper engagement we can’t really solve this.”

Some of those new ways will rely on harnessing digital technology.

”You could be speaking to your doctor over Skype, you will have access to your own health records,” said Dr Sakthi. “So we are using technology to avoid delays and increase access – because we can’t simply increase the numbers of doctors and nurses as there’s no money.”

There are already pilot schemes in the county.

He revealed: “The first clinical digital pathway is being tested in East Lancashire for substance abuse.”

But he is aware many kinds of care could not be delivered online. He acknowledges this would mean looking at the way the NHS is organised and could mean decisions to “potentially relocate hospitals.”