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Pioneering plan to join-up health and social care

Plans have been announced today (15 June) to explore new ways to better join up health and social care services.

NHS, local authorities and healthcare providers in Greater Nottingham are to benefit from new national investment to allow them to begin working towards the creation of a shared ‘Accountable Care System’.

Working closely with patients and citizens, the aim will be to find new ways of breaking down barriers between organisations in order to provide a more joined-up approach to delivering healthcare, hospital care, mental health care and social care services to better meet the needs of people locally.

Greater Nottingham – which covers the four CCG areas of Nottingham City, Nottingham North & East, Nottingham West and Rushcliffe – is one of eight areas named in a list of places to be given the freedom as well as financial resources to establish accountable care systems.

In an announcement made today, the Chief Executive of NHS England Simon Stevens, highlighted these areas* that will lead the way in taking more control over funding available to support transformation programmes – with the combined indicative potential to control around £450m of funding over the next four years – matched by accountability for improving the health and wellbeing of the populations they cover. NHS national bodies will provide these areas with more freedom to make decisions over how the health system in their area operate.

Work to develop the new Accountable Care System will be carried out by the Greater Nottingham Transformation Partnership and build on work already underway to better integrate services that provide healthcare.

For patients and citizens, this will eventually mean:

  • More care focused closer to home in the community
  • Hospital care only for those most in need
  • High quality, accessible services
  • Fewer barriers between services from the NHS, local councils and health providers

Involving local people and patients in how this system is developed will be an essential part of the work going forward.

David Pearson, Sustainability and Transformation Partnership Lead for Nottingham and Nottinghamshire, said: “The local Sustainability and Transformation Partnership is delighted to have the mandate and national support to progress its local transformation of the health and care system for the benefit of our population.

“We have come together over the last year to produce a five year plan for health and social care that articulates why change is urgently needed, what that change might look like and how it can be achieved.  The learning from acceleration in Greater Nottingham will benefit the whole STP area and drive innovation.

“We are already making good progress on the national priority areas of urgent care, primary care, cancer and mental health.  With national backing and support, including involvement in the national ACS development programme, we are committed to going faster in transforming care and achieving system-wide resilience and efficiency.  Our aspiration to work as one, accountable system will see the breaking down of organisational boundaries to streamline services and ultimately improve the experience of patients, carers and citizens.”

The funding from NHS England is part of the Next Steps on the NHS Five-year Forward View – an ambitious plan to create the biggest national move to integrated care of any major western country by 2021. The eight ‘accelerator’ sites will have far more local control and freedom over the total operations of the health and care system.

The STP and the Accountable Care Systems aim to improve standards in care as well as addressing the projected shortfall in funds for the NHS and social care as the population continues to grow bigger and as people live longer.

There are significant gaps in the good health of local people, in the quality of care and in the resources to deliver care. The transformation will be funded by:

  • The new funding from NHS England announced today
  • Finding new ways of delivering services that are better quality, more efficient and cost less than they do today
  • Working together to better reduce duplication, waste and inefficiencies on a scale not possible by smaller, individual efforts (economies of scale)

Longer-term, by improving the health of the population, there will be reducing demand for health and social care services.

Dr Stephen Shortt, clinical lead for Rushcliffe Clinical Commissioning Group, said: “I’m really pleased Greater Nottingham has been selected to be part of this programme. It’s the right idea at the right time. We’ve made many changes for the better already, but today’s announcement means we are being encouraged and supported to go further and faster for the people of Greater Nottingham.

“No-one can be unaware of the unprecedented challenges facing the health and care system. Despite making good progress, there are still gaps in care and quality, demand is rising and resources are severely constrained.

“We in Greater Nottingham are clear that no one organisation can solve these challenges on its own. We believe we can bring together all those involved in care: the commissioners (those who plan and pay for care) and the providers, including local government, and to inject a greater urgency into integration and shared responsibility and decision making. This will be better for all of our patients and citizens.”

Greater Nottingham and Mid-Nottinghamshire, covering Mansfield and Ashfield and Newark and Sherwood, together form one of 44 STPs nationally.


*The eight accountable care systems are:

  • Frimley Health including Slough, Surrey Heath and Aldershot
  • South Yorkshire & Bassetlaw, covering Barnsley, Bassetlew, Doncaster, Rotherham, and Sheffield
  • Nottinghamshire, with an early focus on Greater Nottingham
  • Blackpool & Fylde Coast with the potential to spread to other parts of the Lancashire and South Cumbria at a later stage
  • Dorset
  • Luton, with Milton Keynes and Bedfordshire
  • Berkshire West, covering Reading, Newbury and Wokingham
  • Buckinghamshire

In addition, it is expected that West, North and East Cumbria and Northumberland could join the group of accountable care systems later in the year.


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