Healthcare in Gloucestershire

Healthcare in Gloucestershire is the responsibility of two clinical commissioning groups covering Gloucestershire and South Gloucestershire. The health economy of Gloucestershire has always been linked with that of Bristol.[1]

Sustainability and transformation plans

The Gloucestershire sustainability and transformation partnership was one of four integrated care systems established by NHS England in May 2018.[2]

Health inequality

People living in the most deprived areas of the city of Gloucester – Barton and Tredworth, Matson, Podsmead, Tuffley and Westgate – live almost 14 years less than those in the most affluent areas like Longlevens and Quedgeley.[3]

History

From 1947 to 1974, NHS services in Gloucestershire were managed by the South-West Regional Hospital Board. In 1974 the boards were abolished and replaced by regional health authorities; Gloucestershire came under the South Western RHA. Regions were reorganised in 1996 and Gloucestershire still came under the South Western Regional Health Authority. From 1974 there was one area health authorities covering the county. From 1982 it was split into two district health authorities, Cheltenham and District and Gloucester. There were four primary care trusts established in the county in 2002: South Gloucestershire PCT, West Gloucestershire PCT, Cotswold & Vale PCT, and Cheltenham & Tewkesbury PCT. They were managed by the Avon, Gloucestershire and Wiltshire Strategic Health Authority and in 2006 three were merged into Gloucestershire PCT while South Gloucestershire PCT remained a separate organization. In 2013, PCTs were abolished and replaced by clinical commissioning groups.

Bristol, North Somerset and South Gloucestershire formed a sustainability and transformation plan area in March 2016 with Robert Woolley, Chief Executive of University Hospitals Bristol NHS Foundation Trust as its leader. The remainder of Gloucestershire formed a separate area under Mary Hutton, the Accountable Officer of Gloucestershire CCG.[4]

Commissioning

The implementation of Transforming Community Services in the county was controversial. The transfer to the community interest company Gloucester Care Services was challenged in the courts by local resident and service user Michael Lloyd on behalf of a well organised campaign, Stroud Against The Cuts, which claimed that social enterprises were a stepping stone to privatisation, allowing the private sector to compete for contracts after only a few years.[5] It was successfully argued in court by David Lock QC that while services could be commissioned from NHS providers without the need for a procurement process, it had been unlawful for them to be transferred to a social enterprise without competition. It was therefore decided to set up a new NHS trust, Gloucestershire Care Services NHS Trust.[6]

Gloucestershire CCG supports an "arts on prescription" service, known as Artlift, to prevent chronic conditions from becoming acute. Patients with long term conditions such as depression or chronic pain are referred for 10 weeks of arts activity. The scheme has better completion and attendance rates than other health referral programmes such as exercise schemes.[7]

The CCGs for Bristol, North Somerset and South Gloucestershire merged in April 2018.[8][9] Gloucestershire Care Services NHS Trust merged with 2gether NHS Foundation Trust (which also covered Herefordshire) in October 2019 to form Gloucestershire Health and Care NHS Foundation Trust.[10]

Service restrictions

In September a survey by the Health Service Journal showed that 34 of 188 CCGs who responded had restricted access to some services. Restrictions were usually introduced by a number of CCGs acting together across an area. Gloucestershire and Bristol CCGs were proposing restricted access to acupuncture, adenoidectomy and post-operative physiotherapy.[11]

It was reported in 2017 that NHS cuts in South Gloucestershire would increase delays to cancer treatment and include cuts to care for children with complex needs. Patients would wait longer for non-urgent operations. Holly Maltby of 38 Degrees said, "These plans shed light on just how seriously patient care in South Gloucestershire could be affected. They also begin to paint a picture for how services in other areas of England are likely to be hit too – with cancer treatment and children in need affected."[12]

Primary care

There are 27 GP surgeries in South Gloucestershire.[13] Out-of-hours services formerly provided by South Western Ambulance Service NHS Foundation Trust were transferred to Care UK in 2017.[14]

Community care

Gloucestershire Health and Care NHS Foundation Trust is the main provider.

Palliative care is provided by Sue Ryder at Leckhampton Court in Cheltenham, Longfield in Minchinhampton, Great Oaks in Coleford, and Longfield's Hospice in Stroud.

Mental health

Gloucestershire Health and Care NHS Foundation Trust provides mental health and learning disability services throughout Gloucestershire and Herefordshire.[15]

Hospital provision

Gloucestershire Hospitals NHS Foundation Trust and North Bristol NHS Trust provide most of the county's acute care. Specialist stroke services in the county were centralised at Gloucestershire Royal Hospital from summer 2012.[16]

See also
  • Category:Health in Gloucestershire

References
  1. "Analysed: procurement of non-acute services in Bristol and Gloucestershire". Health Service Journal. 27 March 2012. Retrieved 21 June 2015.
  2. "Four new 'integrated care systems' named". Health Service Journal. 24 May 2018. Retrieved 16 August 2018.
  3. "Life expectancy by Post-Code: Gloucester shows the future and spending is being cut. What better way to ignore the problem – by not collecting information". NHS Reality. 8 July 2015. Retrieved 17 September 2017.
  4. "The leaders chosen for 41 of England's STPs". Health Service Journal. 30 March 2016. Retrieved 18 April 2016.
  5. "Court date set for NHS Gloucestershire judicial review". Health Service Journal. 13 January 2012. Retrieved 21 June 2015.
  6. "Gloucestershire Community Services to Remain with the NHS". Commissioning GP. 17 October 2012. Archived from the original on 21 June 2015. Retrieved 21 June 2015.
  7. "Use art programmes to treat long term conditions". Health Service Journal. 1 June 2015. Retrieved 20 June 2015.
  8. "Mergers involving 11 CCGs get green light". Health Service Journal. 2 November 2017. Retrieved 25 December 2017.
  9. "Clinical commissioning group details". NHS England. Retrieved 2019-12-28.
  10. "About Us". Gloucestershire Health and Care NHS Foundation Trust. Retrieved 27 October 2019.
  11. "Nearly a third of CCGs consider rationing services". Health Service Journal. 3 September 2015. Retrieved 18 October 2015.
  12. Davies, Caroline (2017-09-26). "Exposed: 'secretive' NHS cost-cutting plans include children's care". The Guardian. ISSN 0261-3077. Retrieved 2019-12-28.
  13. "South Gloucestershire CCG: GP Practices" (PDF). NHS South West Commissioning Support. Retrieved 3 July 2020.
  14. "Gloucestershire campaigners march in mass NHS demonstration in London as part of national protest movement". Gazette. 2 March 2017. Retrieved 10 March 2017.
  15. "About Us". Gloucestershire Health and Care NHS Foundation Trust. Retrieved 27 October 2019.
  16. "Specialist stroke services in Gloucestershire to be centralised". Health Service Journal. 10 February 2012. Retrieved 21 June 2015.
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