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Reporting Back Strategic Commissioning Board

by timpickstone on 21 October, 2019

Earlier this month was the first meeting of Bury’s ‘Strategic Commissioning Board’. This is a completely new meeting which brings together Bury Council and NHS Bury in one decision making structure to make sure that the work that both organisations are doing in Bury is fully integrated. Significant steps have already been taken to achieve this, for example we now share a single Chief Executive and single Director of Finance, and there are more joint workings to follow.

The meeting is made up of the CCG (NHS Bury Clinical Commissioning Group) with 50% of the votes with the remaining 50% of the votes being the six Labour councillors who make up the Council’s Cabinet. The two opposition Leaders are invited to attend and contribute, but cannot vote (though the Conservatives didn’t turn up). Liberal Democrat Group Leader Tim Pickstone reports on the two main items which will be of interest: 

Health Needs in Bury
The Director of Public Health presented a paper summarising people’s health in Bury. Headlines included: 

– Historic increases in life expectancy are stalling
– People are generally living for moreyears in poorhealt

– The poorer people are, the shorter their lives and the more of those years are spent in ill health. There is a 15 year gap in healthy life-expectancy between the most and least deprived areas of Bury
– Bury’s rates of preventable mortality are significantly worse than England as a whole and among the worst compared to our statistical neighbours. Musculoskeletal conditions are the prime driver of poor health followed by depression and anxiety. These conditions often go hand in hand.
– Around 50% of the burden of disease is associated with smoking, excess alcohol consumption, poor diet and low levels of physical activity.

There are significant differences between different parts of Bury (e.g people expect to live 8 years longer in the better off areas of Bury, than in the worse off areas of Bury.

It was interesting to note that Bury is worsethan similar areas in:
– smoking rates
– diet (number of people who eat our ‘5 a day’ is significantly worse than in similar areas
– high body mass index (BMI)
– drug use
– physical exercise
(We were better than similar areas in terms of alcohol consumption). 

Bury is currently looking at developing a ‘Bury 2030’ plan about what we want to our priorities to be over the next decade, and the Board needs to identify which health priorities form part of that plan. 

I made the point that it was very disappointing that there had been no significant change in the last 15 years in the differences between the health of the poorer areas of Bury compared to the more well off areas of Bury, and that we should be critical of ourselves for failing to achieve this change. I also made the point that we need to identify a small number of priorities for making improvements in, to make a real difference to people’s health in Bury.

Urgent CareReview and Redesign 
The second important issue was an update on the review of ‘Urgent Care’ services in Bury. 

A review is tasing place with the following objectives: 
– Improve performance of 4 hour waits to reach 92% at Fairfield by March 2020 
– Reduce Non-Elective Admissions at Fairfield 
– Deliver £2.6m savings from current spend from Urgent Care Services 
by April 2020 
– Redesign to simplify access points to improve patient experience

The following services are being considered as part of the review: 
– Accident and Emergency at Fairfield 
–  Urgent Care Treatment Centre at Fairfield 
– Walk in Centres at Moorgate and Prestwich 
– GP Out of Hours Service (BARDOC) 
– GP Extended Access and GP Extended working Hours 
– GP in hours – availability of appointments 

This is a very sensitive topic. People will, no doubt, recall the public anger at the plans to close the walk-in centres a few years ago. I asked: 
– When the decisions would be made (December 2019)
– Whether the proposed model which was promised to replace walk-in centres ‘locality hubs with some element of walk-in access to GPs’ was still the aspiration, or if things had moved on from this promise (things have moved on from this promise).

Papers for the meeting are here. Any questions please ask! 

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