FEATURE: Cost of NHS health review in Lincolnshire tops £4.2 million

A Freedom of Information request submitted by us shows the Lincolnshire Health and Care Review, which began in 2013, spent £626,000 in its first year, more than double that – £1.3 million – in 2014/15 and an even larger spike to £2.3 million in 2015/16 up to May 31.

When broken down the money has been spent on:

l £2.1 million on ‘consultancy costs’

l £1.9 million on a ‘new care model’ and ‘new technology’, including backfill to ‘enable the release of staff to take part in the work’

l £67,000 on PR and media

l £148,000 on ‘office accommodation’

The spend has been slammed by campaigner Phillip Bosworth, one of the Boston Focus Group organisers who are running the SOS Pilgrim Hospital campaign in response to the LHAC review.

He said: “£4.2 million, how much care could that buy - even half of it?”

He also accused the review of having ‘precious little activity’ and ‘no pre-engagement or disclosure’ to residents, and questioned where the value for money was.

The review began in 2013 under the Lincolnshire Sustainable Services Review, and seeks to prevent a deficit in the county’s health system which could reach up to £300 million by 2021.

Those behind the review say progress is being made and that benefits are being seen.

Consultancy ‘supported LHAC from the start’

National consultancy firm PricewaterhouseCoopers, which is where the £2.1 million was spent, was brought in at the start of the programme to support LHAC and provide skills those behind it did not already have. This includes financial, workforce and activity modelling.

It supported LHAC to develop the blueprint in 2013/14 and helped with a detailed care model design which involved setting up care design groups to work with clinicians and stakeholders.

An LHAC spokesman said: “Some elements of the new care model are already being implemented. Neighbourhood Teams are operational across the county, bringing together integrated teams of health and care professionals to provide joined up care to individuals and support them to access the right services at the appropriate time. LHAC has also spent the last year developing a strategy for self-care which has a number of workstreams which are already up and running – for instance, the launch of a new community directory of services.

“We have also launched the Clinical Assessment Service to simplify access to urgent care services in the county. The new service will enable patients to speak to a suitably qualified clinician who will be able to access the patient’s summary care record in order to make a referral to the most appropriate place – that could be their GP, their Neighbourhood Team, an Urgent Care Centre or self-care advice.”

According to the LHAC spokesman, some elements of the new model are still to go before NHS England and public consultation later this year.

The spokesman said: “These are the options around possible changes to the services which are provided across our three acute hospital sites, as well as some possible changes to some of the mental health services in the county.

“We are still working on finalising a shortlist of options on these areas.

“It has taken some time to fully evaluate the impact of making some of these changes and the implications for our workforce and how we make best use of our estates.”

system allows access to patients’ records across health service

The new technology includes what healthcare services are calling ‘the Care Portal’ which aims to allow instant access, if a patient gives permission, to a complete set of medical and care records, helping health and care professionals make decisions quickly and appropriately.

The spokesman said: “The new system will also allow patients to access their own records online. This will mean that patients will be able to see their test results and information on medication online. Patients will also be able to choose to share their records with others, such as family members and carers.

“This investment in technology was identified following feedback from hundreds of clinicians and staff who mentioned the lack of access to full medical records emerged as a key problem.

“Medical and care professionals identified the issue as a crucial hurdle to joined up services and a problem which currently wastes valuable staff time.

“Patients also made it clear they were frustrated when they often had to repeat
their story several times to different people during their care.”

LHAC has managed to secure almost £1 million of NHS funding to support the introduction of the Care Portal and implementation has already started and will be phased over the next two years.

‘Insufficient space’ for office accommodation

It was said that in terms of office accommodation, there had been ‘insufficient space to locate the LHAC team within any of the existing buildings’ and so the team had been working out of rented accommodation.

The spokesman said: “When in excess of 50 health professionals and stakeholders come together, there is no NHS estate that can hold this number of people and other accommodation needs to be hired for these large meetings.”

Public consultation

The LHAC review is due to go up for consulation later this year following the release of the Case for Change last month.

LHAC says it has already spoken to more than 15,000 staff, stakeholders and professionals to get their views ‘which have directly fed into the design of a new model of care for Lincolnshire’.

The SOS Pilgrim group has set up a petition.parliament.uk petition entitled ‘Stop United Lincs Hospitals Trust from DOWNGRADING Boston Pilgrim Hospital’ which has hit the 10,000 signatures needed for a Government response.

This was in response to options previously tabled, which included:

l One specialist emergency centre and one consolidated inpatient Women and Children’s Service located at Pilgrim Hospital

l One specialist emergency centre and one consolidated inpatient Women and Children’s Service located at Lincoln

l One specialist emergency centre at Pilgrim Hospital and Women and Children’s at both hospitals

l One specialist emergency centre at Lincoln and Women and Children’s at both hospitals

It was said when the review began in 2013 that doing nothing was ‘simply not an option’ and that by 2018 NHS health and care organisations in the county could have a combined budget deficit of upwards of £100 million per year.