STRUCTURE: : A Monitor-backed review of health services across Bedfordshire and Milton Keynes has pinpointed three key areas to be revamped across the two regions.

General practice, community care and hospital services are “unlikely” to survive in their current form, according to the initial findings of a report into the services’ stretched financial state by Bedfordshire and Milton Keynes clinical commissioning groups.

The review, the first of its kind to be funded by Monitor, is part of the health regulator’s new approach to dealing with trusts facing financially unsustainable futures.

Monitor launched the review at the request of Bedfordshire and Milton Keynes CCGs, commissioners of the financially troubled Milton Keynes Hospital Foundation Trust and Bedford Hospital Trust.

The report, jointly written by the CCGs, found that “overall, our healthcare systems are not providing consistently joined up and effective care”.

It noted: “People can find it difficult to make appointments with their GP when they want to (especially in Milton Keynes), and may either not seek help – missing an opportunity for healthcare to intervene early – or choose to use hospital-based emergency care instead”.

It identified delays diagnosing long-term conditions and inadequate support for patients with long-term conditions. This meant opportunities for early intervention- when healthcare can be most effective- were sometimes missed.

“The often unpredictable peaks in emergency activity overstretch hospital resources, with knock-on impacts on planned care, and create unnecessary patient safety risks at times of extreme pressure, times which are becoming increasingly common.

Hospital discharges could be “poorly co-ordinated” between the hospital, general practice and community services. This ran the risk of “deterioration in the patient’s health and readmission to hospital”.

The report adds: “It is becoming increasingly difficult to assure the public that existing services are consistently safe and that they can continue to provide the best care possible, the report said.

The review is expected to publish full recommendations in July. These will then be put out to public consultation.

Milton Keynes CCG chair Nicola Smith said: “Our healthcare services are not sufficiently joined up – too often co-ordinating treatment between GPs, community care, hospitals and social care is difficult.”  

Paul Hassan, Bedfordshire CCG’s accountable officer, said the report “shows just how essential it is that we do something now.  

He described the review as a “unique opportunity for us to develop a sustainable health system that delivers the healthcare local people tell us they want”.

Jane Halpin, NHS England area team director for Hertfordshire and South Midlands said the report “gives us a real understanding of the needs of our local community for their future health services”.