B&NES, Swindon and Wiltshire Sustainability and Transformation Plan

All health and social care organisations are working together across Bath and North East Somerset (B&NES), Swindon and Wiltshire on a five year sustainability and transformation plan (STP) to improve our local population’s health and wellbeing, to improve service quality and to deliver financial stability. We are developing a joint approach that will help deliver the aims of the Five Year Forward View and is in line with other important national guidance such as GP Forward View, Mental Health Taskforce Report and National Maternity Review.

Why do we need an STP?

There are growing pressures on the health and care system, nationally and locally. The proportion of older people is rising and there are more people living with complex conditions. This is contributing to an increased demand for services.

Overall across B&NES, Swindon and Wiltshire the standard of health and care services is very good compared to other areas in England.

But some challenges remain. Our hospital Accident &Emergency (A&E) departments are under pressure, in some areas patients are waiting too long for GP appointments and there are gaps in quality with some parts of our region benefitting from better health and care services than others. Additionally, there are increasing financial pressures. Across all our local health organisations there was a collective end of year deficit of £6million for 2015/16 and this will rise to £337million at the end of 2021 across our combined area if we do nothing.

So we are working on a collective plan to drive greater efficiency and improvements in quality across the health and care system. For services to be sustainable, we also need to get better at preventing disease, not just treating it, and encourage everyone to take responsibility to manage their own care.

Our STP partners

Our plan brings together our three hospitals (Royal United Hospital, Great Western Hospital and Salisbury Foundation Trust), the three Clinical Commissioning Groups (CCGs); B&NES, Swindon and Wiltshire Councils, South West Ambulance Service (SWASFT) and Avon and Wiltshire Mental Health Partnership Trust (AWP). The providers of our community services – Wiltshire Health and Care, Seqol and Sirona as well as the West of England Academic Health and Science Network (WEAHSN) and the Wessex Local Medical Committee (representing GPs from across the BSW area) complete our organisational grouping.

Working together to transform services

The health and care needs of our local population across B&NES, Swindon and Wiltshire are diverse and we are developing a joint approach that takes this local variation into account. Our joint work will not replace individual organisational plans or our B&NES, Swindon and Wiltshire Health & Wellbeing Strategies. And it will not stop all the great work already going on locally to improve local services.

The emerging STP focuses on shared challenges and opportunities across the wider geographical footprint. This is ‘place-based’ planning that is not limited by organisational boundaries and covers CCGs, NHS providers, specialised services and primary care. It also includes better integration with local authorities including social care, prevention and self-care. Some of our partner organisations such as AWP, Sirona and SWASFT operate beyond our combined area and so will overlap with other STP footprints.

Our emerging priorities

Based on our knowledge of local need and challenges and in line with national guidance, we have developed three transformational work-streams. Each is led by a CCG Accountable Officer. These are:

  • Preventative and proactive care
  • Planned care
  • Urgent and emergency care

Over the past four months, organisation and service leads have been meeting in work stream groups and together at a number of cross-organisational workshops to explore solutions to the common challenges across B&NES, Swindon and Wiltshire. They have also begun to identify opportunities for innovation that will benefit the local population, agree some collective health outcomes and explore the potential for a standard set of quality and performance measures across the footprint. There are five emerging priorities:

  • To provide improved person-centred care by strengthening and integrating the specialist services that support primary care
  • To shift the focus of care from treatment to prevention and proactive care
  • To redefine the ways we work together as organisations to deliver improved individual/patient care
  • To ensure we offer staff an attractive career and build a flexible, sustainable workforce
  • To strengthen collaboration across organisations to directly benefit acute and urgent care services.

What next and how can I get involved?

Compared to other STP areas, we do not have an established relationship across all the health and care organisations with the B&NES, Swindon and Wiltshire footprint so we are at an early stage of STP development.

We shared our outline proposals for the next five years with NHS England in June and will submit more detailed plans at the end of October. This will enable us to qualify for additional funding through the Sustainability and Transformation Fund from 2017/18 onwards, to help deliver our plans.

Drawing on the experience and clinical expertise of our workforce and those that use health and care services, as well as their carers, will help us to redesign services and to develop new models of care that are sustainable.

Across our combined area, we already have a wealth of patient insight and useful information from recent consultation and engagement activity. However, the STP offers our stakeholders a new opportunity to inform our plans for local health and care services and we are committed to ensuring everyone’s views are taken into consideration at all stages of the process. We are working closely with Healthwatch (the consumer champion in health and care) in B&NES, Swindon and Wiltshire to make sure the voice of local people is represented as our plans begin to take shape.

Updates on our STP will be shared at CCG board meetings, AGMs and Council meetings, please check individual organisation websites for details of these. A wider programme of public engagement will commence in the autumn and more information on this will be available here shortly. In the meantime, if you have any questions or feedback, please get in touch by email to ruh-tr.STP-BSW@nhs.net or contact your local Healthwatch office.