Cornwall and the Isles of Scilly Sustainability and Transformation Plan: key themes

Here’s what an analysis of the NHS plans for Cornwall and the Isles of Scilly shows:

Financial

The April Checkpoint Submission indicated there would be a circa £50 million overspend in health and social care in 2016/17.

However, in the Summary of the draft Strategic Outline Case document published in September 2016 this deficit figure was given as £140 million (for 2016/17, increasing to a £277m ‘do nothing’ deficit by 2020/21) — it is unclear why the figure was revised

Service reconfigurations

In the context of shifting resources to a GP-led model of care the Strategic Outline Case gives as an example — “trading hospital beds in the acute and community sector for more care at home (which may lead to some hospital closures)”

This is more definitive language than the April checkpoint submission which flagged a shift of resources into the community

Public Engagement
The Cornwall and Isles of Scilly STP appears to have a strong record on engagement activities with a public survey and outreach events.

Recently the STP footprint published a document that offers an overview of the public engagement activity to date. Feedback included:

The public rated ‘access’ as their key priority, people wanted quick, prompt, convenient access to services. It is unclear how this public priority has informed the STP (see below).

A briefing paper presented to Kernow CCG (dated to May 2016) also provides a summary of engagement, including the following activity:

(i) Public survey with 2435 responses
(ii) Open provider forum events with 250 representatives from over 100 organisations
(iii) Community events with 450 participants

***

Cornwall and the Isles of Scilly STP — available information

April 2016 checkpoint submission (April 2016):

– Named “Shared plan to rationalising estate” as an emerging priority

– The checkpoint discusses that a “change in the model of care will necessitate a shift in the allocation of resources away from acute care into communities, and a move from traditional bed-based care to care wrapped around people in their homes”

– Circa £50m pound deficit in 2016/17

STP briefing to Health Overview and Scrutiny committee (dated to July 2016):
– Provides broadly similar information to the above

Summary of the draft Strategic Outline Case (September 2016):
– Appears to be an iteration of the April Checkpoint submission, the document specifies that it is “a summary of the draft Strategic Outline Case currently being worked on by health and care organisations (NHS and councils) serving Cornwall and the Isles of Scilly to transform local services in the next five years” — suggesting that plan is still being refined

– Provides some more detail (for example, on possible hospital closures) — see above

– The conclusion states — “Citizens will be able to access many services close to home but where necessary may need to travel to specialist centres further away from home than now to ensure the very best outcomes.” Given that the public rated “access” as their key priority for the STP it is unclear conclusion conforms to the outcomes of the public consultation

Cornwall Council Health & Social Care Scrutiny Committee and Health and Adult Social Care Overview Committee (September 2016):
– These papers outlined the background to the STP and the Cornwall Council’s role. They have similar content to the Strategic Outline Case