Why do we face a £572m funding shortfall in Lancashire and South Cumbria... despite having poorest health in the country?

Protect Chorley and South Ribble Hospital against cuts and privatisation Group  protests outside County Hall
Protect Chorley and South Ribble Hospital against cuts and privatisation Group protests outside County Hall
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Health and care bosses have predicted a £572m spending shortfall in their budgets across Lancashire and South Cumbria by 2020/21.

At the same time they acknowledge the region has ‘some of the poorest health in the country’.

Coun Steve Holgate

Coun Steve Holgate

Now the team at Healthier Lancashire and Cumbria hope to persuade the public of the need for a radical overhaul of services to improve them, save costs and boost people’s health.

But their ambitions fell at the first hurdle last week when angry county councillors complained the organisation’s draft sustainability and transformation plan for 2016-21 was impossible to understand.

The plan has already gone to NHS England for approval, prior to public consultation, but was criticised by members of Lancashire County Council’s health scrutiny committee.

After the meeting, committee chairman Coun Steve Holgate said: “You can’t have a proper conversation about an issue if nobody understands what it says.

The biggest concerns about the plan are there is no indication it can be funded effectively and there seems to be no time scales

“The biggest concerns about the plan are there is no indication it can be funded effectively and there seems to be no time scales.

“Nobody is happy about the way the process has taken place so far.”

He added there were fears that plans to avoid ill health and create a wellness service were now being ‘driven by a need to balance budgets’.

Councillors also criticised health bosses for not having a clear timetable for the introduction of any changes to services or providing details of any cutbacks.

Hospitals across the country often report heavy pressures on A&E departments over the festive period.

Hospitals across the country often report heavy pressures on A&E departments over the festive period.

Coun Gina Dowding said: “There are going to be cuts for some services. We need to have the full facts.”

Samantha Nicol, director of Healthier Lancashire and South Cumbria, told the meeting the draft plan had been written in line with central guidelines about the way the information should be presented.

She added work had already started to make it more accessible to the public.

Afterwards she said: “We are already underway with translating this technical document into something people can easily understand and will allow them to be part of a meaningful conversation.

“We are currently working with groups of local people to test the language and presentation of these plans and will be sharing these in the coming weeks to encourage people to have their say on how we can work together to improve health outcomes and health and care services across Lancashire and South Cumbria.”

The intention is for radical changes to the health and care service to be developed and implemented over the next four years, with councils and the NHS working much more closely together.

The report warns of catastrophe ahead unless the service is reorganised and the public recognise they and their communities must also take a key role in maintaining good health.

There are 1.7m patients registered with 226 GP practices in Lancashire and South Cumbria and there will be a major emphasis on preventing ill health, so hopefully easing pressures on hospitals.

Read more here:

‘We are keen to improve local services’

‘Maintaining current system is unrealistic and dangerous’

Gobbledegook: Could you understand this?

Here are three examples of the language in the report which so confused councillors:

• “Ensure sustainability is achieved through implementation of standardised RightCare approach, with effective out of hospital management of Ambulatory Care conditions and minimal interventions of limited clinical value (ILCV) activity.”

• “Implement short term high-impact secondary prevention measures to reduce demands on services, whilst mobilising our population health model to implement primary prevention initiatives.” 

• “Our financial strategy will focus on the delivery of sustainability in 2016/17; early investment in enabler and double running to support transformational change; and the ultimate reinvestment of current spend to maximise health gain generated.”

Facts and figures

• In 2016/17 health and care services in Lancashire and South Cumbria forecast a £91m shortfall.

• Shortfall could grow to £572m - £443m for health and £129m for social care - by 2020/21.

• Potential savings of £176m from acute services and £118m across Clinical Commissioning Groups have already been identified.

• All our accident and emergency departments are failing to meet four hour treatment targets.

• 25-50% of hospital beds are used by people who don’t need to be there.

• 30% of attendances at accident and emergency units could be avoided with support from community or primary care services

• 27% of patients seeing GPs could have been helped in other ways.

• Increasing incidents of young people self harming.