
HOSC responds to consultation on configuration of Primary Care Trusts; Strategic Health Authority configuration; and the configuration of NHS Ambulance Trusts in England:
21 March 2006
East Sussex HOSC does not express a preference for either one or two PCTs for East Sussex but notes the strengths and weaknesses of each option .
HOSC would additionally like to make the following comments and observations regardless of which configuration is chosen:
- Further thought needs to be given to the locality structure and arrangements to ensure that local needs are properly reflected and addressed as well as simultaneously realising the benefits of a much larger organisation such as for commissioning and being coterminous with adult social care and children's services boundaries.
- The ability to engage with GPs has been a strength of the current configuration and will be more difficult to manage in a larger PCT; an effective locality structure will be needed to ensure continuing success in a merged organisation.
- HOSC would be concerned if there was any disruption to services in the transition, especially given the early target date of 1 October 2006 .
- HOSC supports a locality structure for PPIFs because of its dependence on local information and reliance on local volunteers to be effective.
East Sussex HOSC supports option 2: A Strategic Health Authority for Kent, Medway, Surrey and Sussex and one for Thames Valley and Hampshire and the Isle of Wight .
HOSC is concerned at the lack of a financial assessment of the options linked to the SHA reconfiguration making the choice a difficult one. It reached its view based on an assumption that a very large SHA is likely to find local engagement more difficult.
In general, HOSC is far more concerned about the role of the SHA rather than how big an area it covers.
HOSC will continue to strive to understand the SHA's complex relationship with the health trusts as well as that with the standards monitoring and audit type bodies. It will also carefully consider the SHA's role in resolving the debt faced by trusts locally as well as some key local challenges such as delayed transfers of care.
East Sussex HOSC endorses the proposal for an ambulance trust for Kent, Surrey and Sussex .
HOSC would additionally like to make the following comments and observations:
- Outstanding strategic and operational issues with the relationship with Kent Air Ambulance service need to be resolved and HOSC would like to see a consistent approach to the use of the air ambulance used in Sussex , Kent and Surrey .
- The new techniques for dealing with cardiac patients currently being piloted locally are welcomed and should be rolled out further under the new configuration.
- HOSC is concerned about how different organisational cultures are to be successfully assimilated into one organisation; failure in this area would jeopardise all the other benefits of merging.
- HOSC would expect that all opportunities to share facilities with fire and police services are pursued where possible.
- Whilst accepting the need to appropriately locate ambulances to ensure fast response times, HOSC would require further evidence to be satisfied that the state of the road infrastructure in East Sussex would not contribute unduly towards difficulties in meeting response time targets.
- Responsiveness to local knowledge is considered critical to success and HOSC would expect the ambulance service to demonstrate high responsiveness to PCT and acute trust feedback.
- HOSC supports a local structure for PPIFs regardless of the size of the ambulance trust.
- HOSC is seeking an assessment and reassurance concerning the impact of potential job losses if the new administration or control headquarters is moved from Lewes.