Overall, people living in Leicester, Leicestershire and Rutland are living longer and there are fewer people dying from conditions such as cancer and heart disease. However, the number of people ageing with more than one health condition has increased and this puts pressure on health and social care services. Health outcomes across Leicester, Leicestershire and Rutland vary greatly owing to the large differences in income and deprivation levels. We believe our plans to improve services will address some of the frustrations that people have told us about, respond to the health challenges and make a significant contribution to improving the overall health and wellbeing of local people.
We know that the need for healthcare services in Leicester, Leicestershire and Rutland will rise over the coming decade, particularly in light of the health inequalities faced by our population. Leicester’s hospitals are already struggling with current levels of demand and do not have the capacity in the way services are currently set up to cope with the future predicted increase in the need for services.
This increase in need is for both emergency and urgent care services as well as planned care. In addition, the need for maternity facilities has increased. The maternity facilities at Leicester’s hospitals were designed to cater for approximately 8,500 births a year, but the number of births now totals about 10,500 per year.
Health and social care organisations in Leicester, Leicestershire and Rutland are working hard to bring services closer together. Services will be focused around patients and their GP practice, with more care and support delivered in the community through teams of health and social care staff working together.
The aim is to reduce the need for people to travel into hospital for much of their. The new way of providing care is designed to improve people’s health and wellbeing, improve patient, carer and staff satisfaction, and improve access to services, while making sure the NHS is making the best use of its money.
There are many examples of excellent quality care and patient safety. Services such as specialist heart services and children’s surgery. Leicester’s hospitals wants to achieve the highest possible standards and quality of care across all of their services, better supporting patients in areas that can be improved and fit for the 21st Century. Investment in buildings that are well designed for their purpose helps to ensure that services are provided more efficiently and effectively. This will help improve areas such as emergency care and care for people living with cancer or other long-term conditions.
We have a growing population in Leicester, Leicestershire and Rutland and there will be more beds provided in Leicester’s hospitals in future with this investment. Leicester’s hospitals believes there will be a need for another 139 acute beds by 2023-24 - an increase of 7% on the current number. However, we know making patients better and keeping them healthy is not just about having beds in hospitals. We will work to provide a better way of providing care which means we will see more services provided closer to where people live, at home or in the community.
The current way that the hospitals are set up in Leicester means services are sometimes duplicated or triplicated. For example, we have three intensive care units, one at each site but none big enough in their own right. Our doctors and nurses are spread too thinly. Simply employing more staff is not a feasible solution - there are staff shortages locally and nationally. Patients are regularly being moved between the three hospital sites.
Many planned and outpatient services currently run alongside emergency services, and as a result, when emergency pressures increase, the planned cases and outpatient appointments suffer delays and cancellations.
We need to develop a different way of working that is affordable and improves patient experiences.
At present, mothers in labour are routinely transferred from one hospital site to another if there are too many births taking place in one of the units, or not enough staff are available on a unit to provide adequate care. Care provided for babies born prematurly or ill is currently split across two sites. St Mary’s birthing unit in Melton Mowbray is under-used despite efforts to promote services. The number of births has decreased every year since 2012-13, with only 141 births in 2018-19, with less than three births per week on average. By building a new £88 million state-of-the-art maternity hospital we will improve the safety, efficiency and effectiveness of the service and provide better care for mothers and their babies.
Some of the hospital buildings are old, tired and beyond their useful life. Over the last two decades there has been no significant investment into Leicester’s hospitals apart from the recent development of the new emergency department. There are only a few facilities we can call state-of-the art and there is a backlog in repairs to the buildings, resulting in poorer conditions and buildings being no longer fit-for-purpose.
We want local facilities to enable us to deliver safe, high quality services to our patients and provide staff with a good working environment.
In 2020-21 the NHS in Leicester, Leicestershire and Rutland is forecast to spend around £2.2 billion on running local health services. The impact of Covid-19 could make this figure even higher. This includes paying staff, running our buildings, providing equipment and information technology, and funding treatments and drugs. The greatest proportion of this will be spent on acute hospital services. This is clearly a significant sum of public money and it increases year-on-year. However, in recent years the rate of growth in local health funding has been exceeded by the increase in the need for services, which puts pressure on the cost of providing them.
We are working hard to save money by cutting waste and finding better ways of doing things more efficiently. But we need to do more and prepare for the future. We believe changing how we use our buildings will help us to use our money in a much better way to support local people.
These proposals were put together before the Covid-19 pandemic of 2020 but its impact has only strengthened the view of clinicians as to the need for change. Covid-19 put a huge strain on health and care services. Locally and nationally, patients who had been previously listed for operations and procedures were cancelled in very large numbers as hospitals made preparations for the pandemic. This affected all services and all types of patients, even some with cancer.
In our plans we are going to build a standalone treatment centre at the Glenfield Hospital. This will help us separate emergency and planned procedures. This means that when we are busy with high numbers of emergencies, our patients due to receive planned care still receive their care. Had this been in place by the time of the pandemic we would have been able to maintain significant amount of our non-emergency care and potentially create a ‘Covid-19 clean’ site.
Even before the pandemic we regularly struggled to effectively staff our services. The fact that we have three separate hospitals with the duplication and triplication of services that entails means that we often have to spread our staff too thinly in order to cover clinical rotas. Once reconfigured we would no longer have to run triplicate rotas for staff. For example, with two super intensive care units rather than the current three smaller ones we would have been able to consolidate our staffing making it easier to cover absences and give staff the time to ‘decompress’ after repeat days of long and harrowing shifts.
The experience of managing health and care services during Covid-19 has only strengthened the case for these proposals.