• Northamptonshire STP says there is potential to move to a “single commissioning organisation” across regional boundaries
  • “Fundamental review” of estates proposed as part of aim to create “single model” of acute care
  • STP aiming for £116m of savings from decommissioning services, CIP and QIPP schemes

Service redesign under the Northamptonshire sustainability and transformation plan may go so far that it will “make little sense to continue with separate organisational processes”.

The plan said the “ambitions” of the STP “extend well beyond” the national 2020-21 timetable and a “review of organisational form” for providers and commissioners may be needed.

Kettering general hospital

Kettering general hospital

Kettering is currently operating its A&E out of a ‘temporary build’

In the “immediate” future, the STP wants to develop a single contracting and strategic commissioning framework across both clinical commissioning groups in the footprint – Nene and Corby – which will include “full delegation” of primary care commissioning. From 2018-19 the area may move to “fewer commissioning organisations” across Northamptonshire to ensure “sustainability” of the CCGs.

It added that there was “potential” for a “single commissioning organisation” to develop that would work across Northamptonshire with the potential to include social care, or even across a “wider geographical area” but with a “locality focus” on Northamptonshire.

The STP did not mention mergers involving Kettering General Hospital Foundation Trust and Northampton General Hospital Trust, however it said it wanted to conduct a “fundamental review of its estates over a three to 15 year period”.

It warned that both acute hospitals have “significant levels” of backlog maintenance and the STP process presented an “opportunity” to develop “sustainable estate solutions”. It is working with a consultancy to develop a model of urgent and emergency care that “aligns” with the STP, as Kettering is operating its A&E out of a “temporary build” that is “time limited”.

Financially the STP said it will make £116m of savings from decommissioning services as well as cost improvement plans and QIPP schemes. But it admitted that 75 per cent of its plans to achieve these savings were still not developed. It added that “timing of schemes will require significant acceleration” to meet the control totals in the “early years of the plan”.

The STP also confirmed it intends to create a “single model of acute care across Northamptonshire”, with 10 specialities already chosen for collaboration between Kettering and Northampton. It intends to review the rest of the acute specialities on offer, however implementation of the initial 10 is still dependent on “resources becoming available”.

The STP will also continue with the “development of GP federations/super practice” which would “support the development of multispecialty community providers”. The plan said out of hospital services will “evolve into four community based MCP models”, which will integrate primary care services.

All organisations involved in the footprint signed a “binding” memorandum of understanding in October and will be governed by a STP programme board, which will have “overall responsibility and accountability of the STP”. Northamptonshire county council’s health and wellbeing board will provide “democratic overview” of the board’s processes.