July 2014

The news from yesterday about the Midland Metropolitan Hospital is as good an excuse as I need to get my blogging fingers back in action after a few months break.  In truth, the first few months of the public sector financial year have been tough ones at the Trust, and so this decisive announcement is a huge boost for colleagues, and I hope for local residents.  I want to explain what I think it means for care locally.

Right Care, Right Here – the successor project to Towards 2010 – promised to change the shape of health services.  By investing in community based premises, like GP practices, Leasowes, and Portway Leisure Centre, the intention was to create alternatives to large acute hospitals.  At the same time, the commitment was to make sure that if a patient did need specialist care, especially emergency care, they would have access to the very best facilities and expertise.  In 2007, during the widespread public consultation, the proposition was that such care could only be delivered by creating one acute site for the half a million people we serve.  A site in Sandwell was chosen, at Grove Lane in Smethwick.  In 2011 that site was purchased.  In 2013 the necessary actions were taken to vacate it and earlier in 2014, our Board voted the money to undertake demolition work, which is nearing completion.

The Chancellor has now publicly confirmed the decision made by his own department, and the Secretary of State for Health, that Right Care, Right Here and the specialist acute hospital which we chose to call the Midland Met, are now a funded, approved plan.  A fixed point in a landscape of change across the NHS in Birmingham and the Black Country.  Taxpayers will contribute £100m, and the balance will be paid by the Trust as a unitary payment (annual charge) – as we do currently for the Birmingham Treatment Centre.  Of course to meet that liability we will need to retain local confidence – patients trusting our care, GPs believing in our expertise, and the Trust working together with commissioners, in whose financial wellbeing as our funders we have an abiding interest.  We have now advertised for a PF2 partner for Midland Met.  Our timetable sees us select a final partner not later than autumn 2015, sign a contract in early 2016, and look to open in Smethwick in 2018/19.

That means we have four years to deliver all of the promises made over the last ten.  There are examples of terrific progress since the original consultation.  Demand for emergency care has risen less here than in some other parts of the region, a lot more day surgery is undertaken, and we have reduced the time spent in hospital for most inpatients considerably.  That has allowed us to reduce hospital beds and also to open intermediate care beds where previously acute facilities existed.  We should however be frank about where plans have yet to be achieved.  Referral rates from GPs to hospital specialists have not fallen and in fact continue to rise.  It was only in 2013/14 that we took our first very large scale steps to transfer long-term conditions clinics into primary care settings, with our DICE project for diabetes.  We will need to do much more of that each year that lies ahead.

The nature of the plan now sees old certainties change.  Even if you have not been to A&E at Sandwell for many years, you probably recognise where it is and how to get there.  The Midland Met is a new location, but also for many patients, services provided in a community setting are less visible, less well known.  I can quote examples of services, like our partnership with GPs in Rowley Regis, where satisfaction levels with those using the primary care assessment and treatment service (PCAT) are very high.  But we need to do a better job of explaining that and having neighbour talk to neighbour about what is being put in place.  I hope you feel that the Trust and CCG have a track record of accomplishing change well.  Certainly the recent stroke reconfiguration whereby services were centralised at Sandwell is a case in point.  We are now among the regional leaders in the indices of good care measured nationally.  Importantly, our Early Supported Discharge team for stroke care reaches across West Birmingham and Sandwell providing consistent outreach without boundaries at the edge of each Local Authority.

We are determined to make sure that we sustain and build public confidence over the next four years.  That is why we have committed to publish an audit of progress in our annual report each year from 2015.  It is why we have agreed to publish jointly with the CCG in 2017 a readiness assessment focused on the size and scale of the hospital, while there is still time to adjust and put our contingencies in place if we are off track.  It is also why as a Trust, we are developing our 2020 vision – due for launch this coming autumn – with at least twenty integrated care pioneers.  These are services that are clearly coordinated around patients’ needs without gaps across general practice, social and acute care.  Services that may be located at your home, or in your neighbourhood, or in a hospital, but which are judged by you to be integrated services organised around your needs.

The statement below is the vision statement for patients adopted by our Trust Board to describe integrated care.  It could equally describe what we want to achieve when the Midland Met opens her doors.

“I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.”

If you have any questions about the new hospital or the Trust, you can always email me on Tobylewis@nhs.net or contact me through twitter @Toby_LewisSWBH.  There is also a new section on the Trust website devoted to the Midland Met athttp://www.swbh.nhs.uk/midland-metropolitan-hospital/.