Risks of Newham healthcare proposals discussed

The risks of radical plans which could transform the way people in the borough are cared for have been discussed by councillors.

Under the proposals, developed by the NHS and Clinical Commissioning Groups, Newham will pool services with boroughs across east London, including Barking and Dagenham and Tower Hamlets, to form a “footprint” in an effort to save £928m, reduce the demand for hospital beds and cope with a population set to increase by 345,000 over the next 15 years.

NHS sustainability and transformation plans (STPs) could lead to more patients in Newham being seen by GPs and physician associates – graduates qualified to take medical histories, perform examinations, diagnose illnesses and analyse test results under supervision – instead of going to hospital first.

The draft STP also includes proposals to improve outpatient care and GP services to ensure hospital beds are for people “who truly need them” as well as encouraging people to care for themselves more.

Commenting on the risks posed by Newham’s growing population, Newham Clinical Commissioning Group’s chief officer, Steve Gilvin, said: “It’s fair to say the plan we have is challenging and there are a number of risks.”

However, following a pledge to secure the future of Newham University Hospital, he added: “This plan is our best option.”

Highlighting the risks, Vivek Kotecha from thinktank the Centre for Health and the Public Interest, warned councillors the plans are untested and it was hard to see how elderly people in a “deprived” area would be able to take care of themselves as the planners expect.

He warned: “You have to be very careful because if you cut beds, but people don’t change their habits, you’re going to end up with a reduced service.”

Considering whether or not the council should support the plan, Cllr Susan Masters, of East Ham South, said: “Isn’t it like Brexit? If we don’t sign up, we could be signed up anyway.”

Cllr Clive Furness, mayoral advisor for health, said the STP is not intended to solve all the problems of the NHS and welcomed its head Sir Simon Stevens’s pledge not to cut beds until alternatives had been agreed.

But he warned that attracting medical staff to the area and PFI costs would hinder Newham’s ability to deliver the plans.

“We’re going to be taking some risks,” he said. But he added that the council and Newham CCG would work together, saying: “We will not be fighting each other to see who will be paying.”

Answering a question about the consequences on future healthcare funding of rejecting the plans, Cllr Furness said: “At the moment nothing is conditional. However, this appears to be the game that’s in tow. In the future one could imagine a circumstance when government would link any future funding to the provision of the STP. But that’s not the case now.”

Newham CCG’s Steve Gilvin rejected the idea of whether a new hospital was necessary in the borough, claiming community based services would offer a better alternative.

In reply to Plaistow North Cllr James Beckles’s question whether there was any evidence the proposals would work, Mr Gilvin said: “We will be looking at things that haven’t been piloted. We will be in financial trouble if we don’t achieve these savings.”

But according to Mr Gilvin, ideas to use apprentices, recruit local people and build key-worker housing would tackle the biggest risk to the plan’s delivery - the ability to attract staff to Newham.

Further public consultations will be carried out in the coming weeks.