Board Meeting 28th May 2002

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					Board Meeting 2nd March 2006



   Consultations on the Management Arrangements and Reconfigurations of
     Strategic Health Authorities and NHS Ambulance Trusts in England


Purpose of the Report
To seek the Board’s views on the proposals contained within the consultation documents
relating to the Management Arrangements and Reconfigurations of Strategic Health
Authorities and NHS Ambulance Trusts in England, and to consider a PCT response.



Summary

Public consultations on the Management Arrangements and Reconfigurations of Strategic
Health Authorities and NHS Ambulance Trusts in England run from 14 th December 2005 until
22nd March 2006. Consultation documents for both consultations were issued at the PCT
Board meeting on January 26th 2006.

This paper summarises the 2 public consultation documents and presents some issues for
the PCT to consider in preparing their response.



Recommendation

The Board is asked to receive and debate this report and to consider its response on behalf
of Oldham PCT




Nina James
Associate Director, Service Development                                       23rd February 2006




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Document Reference: 06/03/0644                              Oldham PCT Board meeting 2 March 2006
   Consultations on the Management Arrangements and Reconfigurations of
     Strategic Health Authorities and NHS Ambulance Trusts in England


Ensuring a patient-led NHS – Consultation on the new Strategic Health
Authority arrangements in the north west of England

The consultation document for this consultation was made available to Board
members for the Board meeting on January 26th 2006.

Summary of the Consultation Document
The consultation for strategic health authorities runs from 14 th December 2005 until
22nd March 2006. The document outlines plans to create a new single North West
Strategic Health Authority from the present three in the region – Cheshire and
Merseyside, Cumbria and Lancashire and Greater Manchester. The new SHA would
share the same boundary as the Government Office of the North West. It will have
a population of 7.1 million and cover a geographical area of 5,500 square miles.

The document acknowledges that there will be implications for staff, with a reduction
in the number of staff employed. The SHA proposal is for a North West Strategic
Health Authority that should cost less overall to run than the existing three SHAs,
although there may well be one-off costs in managing staff redundancies and in
establishing the new organisation, but it is anticipated to make cost savings of £8.5
million to the national savings target of £250 million that will be invested locally in
patient care.

Should local consultation support the establishment of a new North West Strategic
Health Authority, it is anticipated that the new SHA would be established during the
period 1st July 2006 to 31st March 2007.

The Proposal
In the north west it is proposed to dissolve the existing 3 Strategic Health Authorities:
    o Cheshire and Merseyside
    o Cumbria and Lancashire
    o Greater Manchester
And to create a new North West Strategic Health Authority covering the area of the
existing three SHAs and the government regional office boundary

Potential Implications for consideration
Some issues cannot be resolved until the conclusion of the consultation, in particular
relating to the location of any new single SHA – if that is the outcome. It is important
that any new structure can support the development of strategic partnerships across
the public and private sector, mirroring partnership working at the local level.




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Document Reference: 06/03/0644                              Oldham PCT Board meeting 2 March 2006
Configuration of NHS Ambulance Trusts in England

The consultation document for this consultation was made available to Board
members for the Board meeting on January 26th. At that meeting it was noted that
the document would be discussed in detail at the next Professional Executive
Committee meeting where both clinical and patient implications would be considered

Summary of the consultation document
This consultation which runs from 14th December 2005 until 22 nd March 2006,
concerns proposed changes to the organisational structure and management of
ambulance trusts in England. It does not involve changes to service provision.

This consultation document considers the need for changes to the structure of NHS
ambulance services in England.            It proposes that in place of the current
31ambulance trusts there should be 11 large, integrated ambulance trusts organised
around Government Office of the Region boundaries, and the rationale is that these
organisations will be operationally fit for future challenges and which have a strategic
link with health and regional/local government organisations

Benefits anticipated to result from the implementation of this reconfiguration include:
       o More investment in front-line services and new technologies
       o More opportunities for staff, with a better equipped workforce and the
           ability to adopt best practice
       o Improved contingency planning to ensure control room services will stay
           fully operational regardless of any information technology or service
           disruption
       o Improved planning and ability to handle major incidents including terrorist
           attacks and natural disasters
       o Financial savings through greater purchasing power and economies of
           scale
Proposal
In the northwest it is proposed to dissolve the four existing ambulance trusts of:
    o Cumbria,
    o Lancashire,
    o Mersey (including Cheshire)
    o Greater Manchester
And to create a single Ambulance Service NHS Trust for the north west covering the
area of the existing four Ambulance services NHS Trusts and the same footprint as
the regional government office.

Potential implications for consideration
Members of the Professional Executive Committee have considered the proposals
and have raised some issues for debate:
   o This structure would appear to be a common-sense solution and will support
      the delivery of service improvements, assist in the development of strategic
      partnerships and generate savings to reinvest in front-line services
   o There is a danger that a larger organisation and concomitant loss of local
      identity may have an effect on the quality of provision
   o Uncertainty about source of funding for transition costs and the investment in
      creating and running the new Trust



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Document Reference: 06/03/0644                              Oldham PCT Board meeting 2 March 2006
    o It will be important to ensure that local knowledge of communities and
      services is maintained, and that ambulance trust staff are able to engage
      effectively with healthcare partners at a local level in the planning and
      implementation of coordinated service developments.
    o Telecommunications and technology is increasing in resilience, but it will be
      essential for this to be maintained
    o There needs to be an assurance that there will be a continuation of close
      partnership work currently ongoing with the Greater Manchester Ambulance
      Trust. This relates particularly to the development of robust plans for
      ambulance services relating to the consultations: “Making it Better, Making it
      Real” - Changes to Healthcare Services for Children, Young People, Parents
      and Babies in Greater Manchester, East Cheshire, High Peak and
      Rossendale and “Healthy Futures” – The future of health care in the north
      east of Greater Manchester.


Conclusion

The PCT Board is invited to consider and agree whether it wishes to support the two
proposals, and also whether assurances should be sought on any issues
surrounding either or both of them.




Nina James
Associate Director, Service Development                                  23rd February 2006




Page 4 of 4                 Consultations on the Management Arrangements and Reconfigurations of SHAs,
                                                                    and Ambulance Service NHS Trusts
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Document Reference: 06/03/0644                              Oldham PCT Board meeting 2 March 2006

				
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