Cash-strapped SHA scraps emergency care network

The cash-strapped strategic health authority has recommended primary care trusts withdraw funding for the Norfolk, Suffolk and Cambridge emergency care network. In late January the SHA
e-mailed network members saying it would be wound up at the end of March.

The SHA also recommended PCTs stop funding a computerised capacity and activity monitoring system that allows co-ordination between hospital trusts and ambulances. Talks were under way this week between acute and ambulance trusts to try to save the service.

The Department of Heath recommends all areas should have an emergency care network to oversee urgent care transformation.

At an HSJ conference last week, network members and staff were angry at the decision. Operational lead for the monitoring system Christine Ames said: 'It's crazy. We have lobbied the SHA, but they are not listening.'

Network director Judi Davis told HSJ: 'This decision is down to lack of funding. Unfortunately we are one of the things to fall by the wayside. Most members under- stand this.'

The SHA forecasts an overspend of£175m this year.

SHA head of service development Kate Gill said the network's strategic role would be taken on by the SHA while local PCT networks would continue to spread good practice. She said the network 'did a wonderful job but there are other ways of delivering the same service'.

The capacity and activity monitoring system is used across neighbouring areas and is about to roll out across Kent and Sussex. It had been running in Norfolk, Suffolk and Cambridge since 2004.

Ms Ames said: 'If money is not found then on 31 March the screens will go blank and we will be back to pen and paper. We will see crazy things happen along the borders [of neighbouring ambulance trusts].'

An East Anglian Ambulance trust spokesman said talks were under way this week about the future of the system, which tells ambulances which hospitals have most capacity. 'It's a valuable service and we would be very disappointed to see it go.'

Ms Gill said the decision to pull PCT funding from the system was because it would have been costly to roll out across the whole SHA area. She said the full potential of the system 'had yet to be demonstrated'.

She added: 'PCTs felt they were funding something that benefited the acute side and we had some sympathy with that.'

The move came as national emergency care director Professor Sir George Alberti lobbied the DoH to increase networks' influence by renaming them urgent care boards and giving them decision-making powers.

He told the HSJ conference last week: 'They need to be empowered. I would like to see PCTs and practice-based commissioners commissioning the network rather than lots of individual bits. You would then have your urgent care board plan services for your patch. That would immediately get everybody involved.'

Warning over commissioning support

Lack of support for practice-based commissioning is threatening to undermine the difference the system could make to unscheduled care, Primary Care Foundation director David Carson told an HSJ conference.

Dr Carson, a well-known authority on out-of-hours and unscheduled care, said: 'I do not really see a system to support PBC. People are paying lip service but the bureaucracy is tending to protect itself.'

He warned primary care trusts that PBC was their only hope of delivering on the unscheduled care agenda.