Community health plan pitched to councillors - but some remain unconvinced about how to make it happen

Neighbourhoods will become the new focus for health services in Lancashire
Neighbourhoods will become the new focus for health services in Lancashire
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Councillors have warned NHS bosses not to “go round in circles” in reshaping healthcare in Lancashire.

The county’s health scrutiny committee was discussing how community services could be improved in response to the publication last month of the government's long-term plan for the health service. The document restated a commitment to focusing on so-called “neighbourhoods” - localities made up of between 30,000 and 50,000 patients.

Lancashire is currently piloting a project in four areas - Blackpool, Burnley, Chorley and Skelmersdale - to assess what can be done to tackle the issues which have the biggest effect on health in communities.

The £471,000 scheme will focus on patients with multiple conditions and how services can be co-ordinated by GPs to reduce the risk of complications and keep people living independently.

But several councillors spoke of their “frustration” at existing attempts at neighbourhood working in recent years.

“These [local] groups come out with the same worthy reports and the same conclusions, year in year out,” Lancashire County Councillor Cosima Towneley said.

“It’s not only confusing and repetitive, but dispiriting for the communities - which is why there is no co-operation from them. You have a table full of local voluntary services and NHS groups,” she added.

The meeting heard that Lancashire’s expected share of an extra £20.5bn for the NHS by 2023 will see each of the 44 designated neighbourhood areas in the county receive £600,000 every year for the next five years.

“If we’re going to be putting a lot more money into these areas, we’ve got to understand how best to use [it],” Gary Raphael, finance director for the Lancashire and South Cumbria Integrated Care System (ICS), said.

“That’s why these pilots are so important. I think there’s a quite a lot at stake in our collective working as a system [and] we are going to be held to account for how that extra money is spent at the neighbourhood levels.”

But County Coun Nikki Hennessy said that the gap in life expectancy between Skelmersdale and her own Ormskirk division had actually widened from seven years to 10 since the late 1990s.

“Can you put your hands on your hearts and say you have never done anything to increase health inequality?” she asked NHS bosses.

Andrew Bennett, the commissioning director for the ICS, said he hoped improvements would come as the health service began to be held accountable for more than just traditional targets.

“A lot of honest NHS leaders would say that they have been challenged about waiting times, but not about a 10-year difference in life expectancy between an area of high deprivation and low deprivation - which is why its is good to see [that issue] in the long-term plan.

“We can only tackle some of those generational problems if we work in partnership. We don’t think we have got it taped or we have made enough progress - but we are seeing green shoots,” he added.

Committee member and Burnley councillor Margaret Brindle said that the work to develop community services needed "focusing".

"The intentions are very well laid out - but have we not heard them all before and is this just another way of going round in a circle?" she asked.

Mr Bennett promised to ask neighbourhood teams to discuss specific concerns about the development of community services in the Ribble Valley and Burnley.