• Birmingham and Solihull STP published despite NHS England request to delay publication
  • Single ‘lead provider’ for maternity care is mooted
  • STP leads say there is ‘no expectation’ that the acute bed base in the system will reduce
  • Four acute trusts will have a shared back office function and centralised laboratory for routine pathology
  • STP will support phased implementation of the multispecialty community provider model across the system

Birmingham and Solihull’s sustainability and transformation plan, which has been published today despite NHS England asking for the release of STPs to be delayed, has proposed a single “lead provider” for maternity care.

STP leaders have been told to hold off on publishing their “full” submissions, which were made on Friday, while they are checked by national officials, HSJ understands. This has come amid rising anxiety about the potentially-controversial proposals and how they will be communicated.

However Birmingham City Council has ignored this, and published the full 80-page submission today ahead of a council meeting later this week.

The Birmingham and Solihull STP, which is chaired by the council’s chief executive, said it will:

  • Establish a single “lead provider” for maternity care across Birmingham and Solihull;
  • Look to “immediately” implement a shared service for back office functions across its four main acute providers and create a centralised laboratory for routine pathology work;
  • Support a phased implementation of a multispecialty community provider model across the patch over the next five years.
  • A “universal offer for enhanced general medical practice” will also be made available to GPs.

There are currently two main providers of maternity care across the Birmingham and Solihull STP patch: Birmingham Women’s Foundation Trust and Heart of England FT.

The STP document, published by Birmingham City Council today, states that a “lead provider” will be established for maternity care. Under the lead provider model, a single organisation becomes responsible for all services within scope of the contract, but is able to subcontract to other providers.

The STP also outlines plans for a new a Birmingham and Solihull maternity pathway – known as “BUMP” – which aims to create a single point of access to maternity services for all women by 2018. Both trusts providing maternity services will to “commit to delivering the [BUMP] programme at pace through a lead provider contracting model”, it says.

Birmingham Women’s Hospital FT’s chief executive, Sarah-Jane Marsh, is also chair of NHS England’s maternity transformation programme board.

Plans also state the intention to move to a “prime provider” model for specialist services across the patch, by 2017-18, in order to address NHS England plans for specialised commissioning.

Although the introduction of lead and prime provider models will change how services are commissioned, the document says “there is currently no expectation that the current acute bed base in the system will reduce”.

In June, NHSI chief executive Jim Mackey and chair Ed Smith wrote to every trust chief executive requiring them to draw up plans for consolidating pathology, back office and “unsustainable” elective services.

Birmingham and Solihull STP plans outline the intention for University Hospitals of Birmingham and Heart of England FT to provide back office functions to Birmingham Children’s Hospitals and Birmingham Women’s. This will include finance, HR, IT, procurement and payroll services.

Plans to merge Birmingham Women’s and Birmingham Children’s Hospitals by next year have already been announced, while University Hospitals of Birmingham and Heart of England FT announced in September the intention to create a “single organisation”. Both mergers will be subject to approval by national bodies.

The STP document outlines a key intention is to “provide stabilisation to Heart of England Foundation Trust in terms of clinical quality and financial controls”.

In line with national guidelines the Birmingham STP hopes to roll out extended GP access fund pilots and support a phased implementation of an MCP model across the next five years.

It also reveals that in July system leaders sought to use local CCGs’ 1 per cent contingency funds to address financial gaps left by underfunded social care. However, it said, even if the contingency fund were used solely to address pressures in adult social care the local system would still be left with a £15m gap. The STP now states that under “current NHS priorities” it would not be possible to use the funds in this way.

And, the STP says, if Birmingham City Council reduced social care services, the risk of the health and care system being destabilised could not be mitigated within the system.

Second 'full' STP published as council hits out at process