Trusts set to merge after ICS review

Papers from Hampshire and Isle of Wight Integrated Care Board revealed that a review the system had commissioned of its services had recommended “a new trust should be created for all community and mental health services across Hampshire and Isle of Wight, with local divisions to focus on our communities”.

Speaking at Southampton City Council’s health overview and scrutiny panel’s September meeting, the ICB’s chief medical officer Derek Sandeman said the ICB had accepted this recommendation. It is expected to ratify this at its next board meeting, due to take place in early October. 

The main providers of these services in the patch are Southern Health Foundation Trust and Solent Trust. However, the transaction will also involve Isle of Wight Trust, which is an integrated trust providing mental health, community, acute and ambulance services on the island. It is unclear what the proposal means for IoW Trust’s acute and ambulance services.

One local source raised concerns with HSJ  that, because it is the only FT in the area, Southern Health would lead the transaction and could dominate the new organisation, despite its care quality and cultural problems in recent years.

Ron Shields, chief executive of Southern Health FT – one of the region’s main mental health providers – told the meeting the new trust was “supported by all of the partners” and had a target date to be created of 1 April 2024. He added a full business case needed to be produced and formally approved by all of the relevant boards, which was expected to happen in “the final part of this year”.

Solent Trust is rated “good” overall by the Care Quality Commission. Southern Health FT is rated “requires improvement” and has been the subject of a major care failings scandal in recent years.

The papers continued: “The review [by Carnall Farrar] found a compelling case for change in the way community and mental health services are resourced and delivered across Hampshire and Isle of Wight so that they can be of the highest standard…

“Previous commissioning arrangements mean some services are provided by different NHS providers and there is a need for greater consistency… The complexity of multiple providers can make it unclear who is accountable for individual patients and creates an imbalance of clinical risk where patients are escalated to high acuity settings rather than treated in the most appropriate care setting for their needs.

“It also creates wider confusion around leadership and ownership for improving system-wide provision of community and mental health services. This acts as a barrier to integrating across health and care services and we are committed to collectively breaking through this barrier.”

The review also proposed evaluating the system’s community physical health beds, developing a system-wide clinical strategy for community and mental health, with a particular focus on “prevention, early intervention and patient-centred care”, establishing a system-wide strategy for place and local leadership, and taking a more strategic approach to community and mental health funding to address inequalities.

The ICB and trusts issued a joint statement to HSJ, saying: ”Ensuring people in our communities across Hampshire and Isle of Wight have equal access to health and care services is a key priority, and we will consider closely the five recommendations made in this review – working alongside our communities, patients, service users and colleagues to help shape the future of our community and mental health services.”