Southern Health may lose community services as CCGs prepare to procure

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Commissioners seeking to procure “integrated model of care” to replace Southern Health’s community services
Trust says divestment of its community services is a “possible solution”
Community services account for more than a third of Southern’s income

Southern Health Foundation Trust has confirmed it is considering divesting itself of its community services provision – which accounts for a third of its turnover – ahead of a procurement for a new integrated model of care.

The trust has told HSJ that ceasing community provision is “a possible option” as system leaders look to shift its physical community health services to new models of care based around three “local delivery systems”.

Board papers from neighbouring Hampshire Hospitals FT suggest a “community services disinvestment process” at Southern Health.

In her monthly report to the board, Hampshire Hospitals chief Alex Whitfield said in July that “Southern Health will remain responsible for delivering community services until April 2019”, but “commissioners will procure a new provider” between now and then. The procurement will be for “an integrated model of care”, she added.

In response, a spokesman for Southern Health said: “Divestment is a possible option, but no decision has been made at this point.

“We are currently working with commissioners to understand future models of care for the system, considering the emerging local delivery systems in Hampshire.”

Southern Health has been working with GPs in Hampshire since 2015 on a new care model vanguard project to trial a multispecialty community provider.

The FT is one of the largest mental health and community providers in England, with a 2016-17 turnover of £320m, of which £120m came from community services.

The trust’s reputation has been badly damaged in the last few years over failures that led to the death of inpatient Connor Sparrowhawk, a Care Quality Commission prosecution, and the controversial departure of former chief executive Katrina Percy.

HSJ has also learned that the trust is now in the process of relinquishing its leading role in the Better Local Care vanguard.

This follows a report from Deloitte in late May into the vanguard, which examined the progress of work to create an MCP.

Better Local Care aims to create “extended primary care teams”, which work from GP practices to provide patients with specialist advice and support, and primary care hubs to improve patient access. The vanguard began in Gosport, East Hampshire and the South West New Forest, but has since been extended to 12 areas of the county.

Reflecting on how the vanguard could further develop the new care models, the Deloitte report concluded that Southern Health’s “sphere of influence regarding the leadership of the work…is limited…and arguably has been taken as far as it can”.

The report, which was published by the trust earlier this year, recommended that if local commissioners took the leadership role Southern Health would be “repositioned” to focus on “elements that are within its gift to progress” such as its mental health services and extending its directly provided primary care teams.

According to its July board papers, Southern Health is working with commissioners and Hampshire County Council to agree upon the process and timelines for the transformation of its physical health services.

Maggie MacIsaac, the accountable officer for four CCGs in Hampshire, said: “We are not yet at the point at which a procurement process would begin – commissioners and our partners are currently engaged in a collective effort to fully understand all the complexities involved in delivering integrated services across a wide area, before being ready to move forwards.”