A troubled foundation trust has been taken out of special measures, the support mechanism for struggling NHS organisations, after it agreed to undergo a radical transformation to achieve savings of £28m by 2020.
Tameside Hospital NHS Foundation Trust is set to become an integrated care organisation, following recommendations made to the regulator by an independent review.
“Staff at Tameside have worked incredibly hard to turn this organisation around and improve things for patients”
Under the Contingency Planning Team plans, the Greater Manchester trust’s budget would more than double to £414m, after it takes on social care workers. It currently employs around 2,400 staff.
The proposals have been supported by local clinical commissioning groups, who have now been asked to progress the plans.
The review report, published today by the regulator Monitor (see PDF top-right), said the trust would become the first “fully integrated care organisation with a capitated contract”.
In future, the trust would include:
- Five locality teams, to bring together GPs, mental health, community care, social care, hospital doctors and the voluntary sector.
- GPs potentially joining the trust as salaried staff after 2016-17.
- The development of new care professionals called “extensivists”, who would specialise on caring for patients with complex problems.
- An integrated urgent care service with a single point of access. A&E would be retained.
The trust was placed in special measures in 2013 following a national review of organisations with high mortality rates by NHs England medical director Sir Bruce Keogh.
It has a projected deficit of £23m, while the health and care economy in Tameside and Glossop is set for a combined annual deficit of £70m by 2020, largely due to “underfunding” in social care, the review found.
The review predicted that £28m of health and social care savings could be achieved through the new integrated care model, making the trust financially sustainable and closing the borough’s combined deficit to £42m.
The new model would bring major changes to planned care at the trust.
For example, “all sub-specialty services in both medicine and surgery” would be provided on a networked basis with other hospitals, and outpatient services in dermatology, breast surgery, ENT, and ophthalmology provided by visiting clinicians within the network.
These changes will complement the Healthier Together plans, which will see emergency and high risk general surgery patient diverted to Stockport, review report said.
“I look forward to establishing the first truly integrated care organisation in the country”
On maternity services, which currently incur “very high” clinical negligence premiums, the review said potential savings from closing the unit would be “marginal”.
It said any decision over its future should be made after the national maternity care review is published, but warned that new guidelines due to be published by the Royal College of Obstetricians and Gynaecologists may render the service “unviable”.
The review believes new services could be launched within 12 months, but said the councils’ scrutiny panels should determine whether a public consultation should take place, which could delay this.
David Dean, senior director of transformation and turnaround, at Monitor, said: “Staff at Tameside have worked incredibly hard to turn this organisation around and improve things for patients.
“It is good news we have been able to take the trust out of special measures and our decision reflects the progress that’s been made,” he said. “However, there is still a lot of work to do and we will continue to support the trust to ensure that its progress maintains.”
Chris Mellor, chair of the Care Together Programme in Tameside and Glossop, welcomed the report, saying that “hard work” could now begin to implement plans to improve health and social care services.
“I look forward to establishing the first truly integrated care organisation in the country,” he said.
“The news that the hospital trust has been taken out of special measures is also great news for local people and gives us an excellent platform to move forward,” he added.
Information provided to HSJ