Healthcare In Yorkshire
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Healthcare in Yorkshire from 2016 was the responsibility of 19
clinical commissioning group Clinical commissioning groups (CCGs) were National Health Service (England), National Health Service (NHS) organisations set up by the Health and Social Care Act 2012 to replace Strategic health authority, strategic health authorities and NHS pr ...
s, which were replaced by integrated care systems in July 2022.


History

From 1947 to 1974 NHS services in Yorkshire were managed by the Leeds and Sheffield regional hospital boards. In 1974 the boards were abolished and replaced by regional health authorities. Yorkshire came under the Leeds and Sheffield RHAs. Regions were reorganised in 1996 and most of Yorkshire came under the Yorkshire Regional Health Authority. South Yorkshire was under the Trent Regional Health Authority. In 1994 the Yorkshire RHA merged into Northern and Yorkshire. Yorkshire from 1974 had 17 district health authorities. Barnsley, Sheffield and Rotherham each had their own DHA. In 1994 the 17 in Yorkshire were merged into seven: Bradford, East Riding, Grimsby and Scunthorpe, Leeds, North Yorkshire, Wakefield, and West Yorkshire. Thirteen
primary care trust Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May ...
s were established covering the whole of the county in 2002. They were managed by three strategic health authorities: West Yorkshire, South Yorkshire, and North and East Yorkshire and Northern Lincolnshire. They were merged into one, Yorkshire and the Humber, in 2006. The CCGs took on the responsibilities of the former PCTs on 1 April 2013. As of 2016, the CCGs were: *Airedale, Wharfedale and Craven *Barnsley *Bradford City *Bradford Districts *Calderdale *Doncaster *East Riding of Yorkshire *Greater Huddersfield *Hambleton, Richmondshire and Whitby *Harrogate and Rural District *Hull *Leeds *North Kirklees *Rotherham *Sheffield *Vale of York *Wakefield Subsequently, there were a series of amalgamations.


Sustainability and transformation plans

There are three
sustainability and transformation plan In England, a sustainability and transformation plan (STP) is a non-statutory requirement which promotes integrated provision of healthcare, including purchasing and commissioning, within each geographical area of the National Health Service (Engl ...
s for the county: *West Yorkshire formed a sustainability and transformation plan area in March 2016 with Rob Webster, the Chief Executive designate of South West Yorkshire Partnership NHS Foundation Trust as its leader. It intends tackle the projected deficit of £1.07 billion by 2020/21. Councillor Peter Gruen, chair of the Leeds Health Scrutiny Board, expressed concern about the West Yorkshire and Harrogate
Sustainability and transformation plan In England, a sustainability and transformation plan (STP) is a non-statutory requirement which promotes integrated provision of healthcare, including purchasing and commissioning, within each geographical area of the National Health Service (Engl ...
, which in January 2017 had not been published. He said current efforts focused too much on short-term solutions and were failing to address the root causes. It hopes to save £50 million a year by standardising policies in elective care, starting with elective orthopaedics and ophthalmology, as the existing 11 CCGs policies vary widely. It is to be known at the West Yorkshire and Harrogate Health and Care Partnership, and in February 2018 it was planning a formal governance and accountability structure and setting up 50 integrated neighbourhood teams providing community, primary, mental health and social care for populations of 30,000-50,000. The West Yorkshire and Harrogate sustainability and transformation partnership was one of four new integrated care systems established by
NHS England NHS England, formally the NHS Commissioning Board for England, is an executive non-departmental public body of the Department of Health and Social Care. It oversees the budget, planning, delivery and day-to-day operation of the commissioning si ...
in May 2018. *South Yorkshire and Bassetlaw formed a separate sustainability and transformation plan area with Sir Andrew Cash OBE, the Chief Executive of
Sheffield Teaching Hospitals NHS Foundation Trust The Sheffield Teaching Hospitals NHS Foundation Trust is a combined acute and community NHS foundation trust in Sheffield, England. Founded in 2001 and awarded foundation status in 2004, the trust covers most of Sheffield's adult community servi ...
as its leader. The deficit here is £571 million and it is proposed to tackle it by developing accountable care organisations. The South Yorkshire and Bassetlaw Integrated Care System, as it is now called, was one of the biggest beneficiaries of
Boris Johnson Alexander Boris de Pfeffel Johnson (born 19 June 1964) is a British politician and writer who served as Prime Minister of the United Kingdom and Leader of the Conservative Party (UK), Leader of the Conservative Party from 2019 to 2022. He wa ...
's announcement of capital funding for the NHS in August 2019, with an allocation of £57.5 million for investment in primary care. *The East Yorkshire area of Coast, Humber and Vale will be another sustainability and transformation plan area. It has a deficit of £420 million. It proposed to set up "new integrated multi-disciplinary locality teams" leading to a re-configuration of community care.


Commissioning

The Vale of York CCG was put in
special measures Special measures is a status applied by regulators of public services in Britain to providers who fall short of acceptable standards. In education (England and Wales) Ofsted, the schools inspection agency for England and some British Overseas Ter ...
after it forecast a £6.3 million deficit in 2015-16. Non-elective admissions at York Teaching Hospital NHS Foundation Trust were 14% more than planned and emergency department attendances 17% more. There have been ongoing financial problems in York since the year 2000. Harrogate and Rural District CCG decided in October 2016 that anyone who smoked or had a
Body Mass Index Body mass index (BMI) is a value derived from the mass (Mass versus weight, weight) and height of a person. The BMI is defined as the human body weight, body mass divided by the square (algebra), square of the human height, body height, and is ...
of more than 30 would be referred to a weight management or smoking cessation service for six months before they would be considered for elective surgery. Ian Eardley of the
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations ...
said, "The policies for smokers and overweight patients that Harrogate and Rural District CCG intend to impose ignore the public outcry that surrounded similar plans." North Kirklees and Greater Huddersfield CCGs decided in January 2017 that they would stop most individual funding requests, and stop prescribing gluten-free products, sunscreens and multivitamins, hoping to save £750,000 over the next 18 months. The two CCGs started sharing the same chief officer, Carol McKenna, in October 2017. They were already sharing some other staff. The three CCGs in Leeds West, Leeds North, and Leeds South and East, with a joint population of 860,000 and more than 100 GP practices merged in April 2018. In 2020 they initiated an innovative advertising campaign with temperature-triggered advertising on bus shelters, urging people to safeguard their health with different messages for different temperatures.


Primary care

Out-of-hours services are provided by Humber Teaching NHS Foundation Trust (York), Yorkshire Doctors Urgent Care, Care UK (Rotherham),
Yorkshire Ambulance Service Yorkshire Ambulance Service NHS Trust (YAS) is the NHS ambulance An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to ...
, Local Care Direct (West Yorkshire and Craven), Nestor Primecare Services Limited (Hambleton, Richmondshire and Whitby). West Wakefield Health and Wellbeing Ltd is a Multispecialty community provider established in 2015. In January 2017 the clinical commissioning groups in Leeds agreed to suspend 80% of the
Quality and Outcomes Framework The Quality and Outcomes Framework (QOF) is a system for the performance management and payment of general practitioners (GPs) in the National Health Service (NHS) in England, Wales, Scotland and Northern Ireland. It was introduced as part of a n ...
targets for the rest of 2016/17. A similar strategy was adopted by
NHS Wales NHS Wales () is the publicly-funded healthcare system in Wales, and one of the four systems which make up the National Health Service () in the United Kingdom. NHS Wales was formed as part of the public health system for England and Wales crea ...
. The Haxby Group, which operates from 11 sites in York and Hull, with a list of 60,000 patients was rated outstanding and praised for building multidisciplinary teams by the
Care Quality Commission The Care Quality Commission (CQC) is an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom. It was established in 2009 to regulate and inspect health and social care providers in England. It ...
in 2019.


Community care

Leeds Community Healthcare NHS Trust and Locala are NHS providers of community services. Humber NHS Foundation Trust won a contract for community and out of hours services in Whitby in March 2016 after there were problems with a bid from Virgin Care. The 7-year contract is worth £45 million. Wakefield - Connecting Care, one of the
NHS England NHS England, formally the NHS Commissioning Board for England, is an executive non-departmental public body of the Department of Health and Social Care. It oversees the budget, planning, delivery and day-to-day operation of the commissioning si ...
Vanguard projects has established a team of clinicians, community and social care staff to provide care to elderly people in care homes and supported housing which has reduced emergency admissions by 27%.


Mental health services

Mental health services in the county are provided by Bradford District Care NHS Foundation Trust, Humber NHS Foundation Trust, Leeds and York Partnership NHS Foundation Trust, Rotherham Doncaster and South Humber NHS Foundation Trust, South West Yorkshire Partnership NHS Foundation Trust, and
Tees, Esk and Wear Valleys NHS Foundation Trust The Tees, Esk and Wear Valleys NHS Foundation Trust is an NHS trust that provides mental health, learning disability and eating disorders services. It serves a population of around two million people living in County Durham, Darlington and most ...
. Bradford District Care NHS Foundation Trust, Leeds and York Partnership NHS Foundation Trust, Leeds Community Healthcare NHS Trust and South West Yorkshire Partnership NHS Foundation Trust agreed to form the West Yorkshire Mental Health Services Collaborative in April 2018. It hoped to eliminate non-specialist out-of-area placements within 12 months, reduce unnecessary emergency attendances by 40%, and form a single acute bed base for the region with a single bed management function.


Acute hospitals

Acute hospital services are provided by: * Airedale NHS Foundation Trust * Barnsley Hospital NHS Foundation Trust * Bradford Teaching Hospitals NHS Foundation Trust * Calderdale and Huddersfield NHS Foundation Trust * Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust * Harrogate and District NHS Foundation Trust * Hull University Teaching Hospitals NHS Trust *
Leeds Teaching Hospitals NHS Trust Leeds Teaching Hospitals NHS Trust is an NHS hospital trust in Leeds, West Yorkshire, England. The Trust was formed in April 1998 after the merger of two previous smaller NHS trusts to form one citywide organisation. The former trusts were Unite ...
* Mid Yorkshire Hospitals NHS Trust * Rotherham NHS Foundation Trust *
Sheffield Teaching Hospitals NHS Foundation Trust The Sheffield Teaching Hospitals NHS Foundation Trust is a combined acute and community NHS foundation trust in Sheffield, England. Founded in 2001 and awarded foundation status in 2004, the trust covers most of Sheffield's adult community servi ...
* Sheffield Children's NHS Foundation Trust * York Teaching Hospital NHS Foundation Trust. The
Yorkshire Ambulance Service Yorkshire Ambulance Service NHS Trust (YAS) is the NHS ambulance An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to ...
covers the county. The Working Together vanguard established in 2016 includes Barnsley Hospital NHS Foundation Trust, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield Children's NHS Foundation Trust, Rotherham NHS Foundation Trust, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Mid Yorkshire Hospitals NHS Trust and also Chesterfield Royal Hospital NHS Foundation Trust. It has established a federation board which will make decisions about services ceded under delegated authority. It is chaired by Sir Andrew Cash. The West Yorkshire Association of Acute Trusts (WYAAT) was established in 2016 as "an innovative provider collaborative which brings together six NHS trusts across West Yorkshire and Harrogate to deliver joined up acute hospital services". It is made up of the Airedale, Bradford, Calderdale & Huddersfield, Harrogate & District, Leeds Teaching Hospitals and Mid Yorkshire Teaching trusts. It was agreed in 2019 that the acute stroke services in Rotherham and Barnsley would close, and services would be concentrated in Sheffield, Doncaster and Wakefield. The Vale of York CCG set up a randomised control trial with Health Navigator which used artificial intelligence to identify patients at high risk of unplanned hospital attendance. They were given a referral to the company’s ‘Pro-active Health Coaching’ service. There was a 36% reduction in A&E attendances among those supported. In 2019 the service was extended to 1,800 patients. North Yorkshire County Council and City of York Council sponsored an expansion of the CareRooms scheme in
Selby Selby is a market town and civil parish in North Yorkshire, England, south of York on the River Ouse. At the 2021 Census, it had a population of 17,193. The town was historically part of the West Riding of Yorkshire; from 1974 until 2023, ...
and
York York is a cathedral city in North Yorkshire, England, with Roman Britain, Roman origins, sited at the confluence of the rivers River Ouse, Yorkshire, Ouse and River Foss, Foss. It has many historic buildings and other structures, such as a Yor ...
in 2021 to help people recover after being discharged from hospital. Tele-care and monitoring equipment is fitted in the rooms to ensure guests vital signs are checked and there is 24-hour video access to a GP service. It was said to make use of the "resources that exist within local communities" in a report proposing further expansion to Richmond, Scarborough and Whitby.


References

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External links


Local Care Direct

Nestor Primecare Services Limited
*
York York is a cathedral city in North Yorkshire, England, with Roman Britain, Roman origins, sited at the confluence of the rivers River Ouse, Yorkshire, Ouse and River Foss, Foss. It has many historic buildings and other structures, such as a Yor ...