Hampshire County Council

Health Review Committee Item 5

8 April 2003

HealthFit - Configuring Health Services in Hampshire and the Isle of Wight

Report of the Chief Executive, Hampshire & Isle of Wight Health Authority

Contact at H&IoWHA: Richard Samuel

1. Summary

1.1. This report provides background to the development of HealthFit, a major process underway across Hampshire and the Isle of Wight to make sure that health services are "fit for the future".

2. Introduction

2.1. Any public authority has a duty to use public money wisely. Part of this duty includes making sure that the services it provides are "fit for the future" rather than ignoring the challenges ahead and letting services drift into decline.

2.2. This is a challenge facing the NHS across the country. In Hampshire and the Isle of Wight the NHS has started a process called HealthFit, which aims to agree the way in which health services should be configured in the future. Only by doing this can the NHS ensure that health services meet the future health needs of all the 1.8 million people living in Hampshire and the Isle of Wight. And, only through the increasing involvement of patients, the public, NHS staff, colleagues in local authorities and partners in other sectors does the NHS have the best chance of reaching the best possible outcome.

2.3. A HealthFit document was produced by the Hampshire and Isle of Wight Strategic Health Authority and distributed to key stakeholders in December 2002. It is important to note that the document was neither a policy statement, nor a set of proposals. Rather it was a discussion document that sought to highlight the impending challenges and to stimulate debate about how we can respond to those challenges. Amongst the challenges and factors that will shaping the future of healthcare in Hampshire and the Isle of Wight highlighted were:

· the needs and expectations of local people;

· the changing profile of the population;

· the special needs and circumstances of each part of Hampshire and the Isle of Wight;

· the increased investment in health services, and the duty of the NHS to live within its means (we cannot spend any more on local health services than we receive from central government);

· new ways of working that bring groups of health and social care professionals together around their patients;

· new evidence about what works, and what is less effective;

· legislation that influences employment practice (for example the European Working Time Directive affects the number of hours that doctors can work);

· new technologies that mean we can bring many diagnosis and treatment services closer to people's homes.

3. The Principles Underpinning HealthFit

3.1. The HealthFit process will be underpinned by the following key principles:

· the public should be involved throughout the process of change;

· drivers for change (social, clinical and financial) should be explored in an open and honest way with the public and with NHS staff;

· change should be driven by the health service needs of human populations, rather than the needs of institutions or organisations;

· processes should be modernised to provide high quality care and make the best use of resources;

· services should be effective and safe, but calculated and agreed risks need to be taken and managed to achieve change;

· service configurations should be sustainable;

· the three E's of Equity, Efficiency and Effectiveness should drive the process.

4. The HealthFit Process

4.1. There are four phases to HealthFit, that will take place during 2003:

· Phase 1 - Forces and Drivers

The first phase of the process looked at the factors or `drivers' for change in health services. This was an opportunity for the NHS and its partners to decide whether these "drivers" for change might lead to any real changes in health services. This early phase concluded that the NHS did need to look at some aspects of health services if they are going to be fit for the future, and that people and organisations across Hampshire and the Isle of Wight need to be involved in that process. This phase led to the discussion document produced in December 2002.

· Phase 2 - Clinical Options:

The second phase of HealthFit, which has now concluded, sought to identify the range of clinically viable options for health services, drawing heavily on public comment and public views.

· Phase 3 - Testing Themes:

The third phase of HealthFit will take place between April and September 2003 and will involve working with service users, the public and other stakeholders to consider and develop the options for health services. This phase will include taking the clinical options from Phase Two out to local people and communities and finding out their views about them. This should mean that the possible service models are enhanced and improved to better reflect patient's experiences.

· Phase 4 - Formal Consultation:

The final phase of the HealthFit process will take place between October 2003 and January 2004 and will involve the NHS undertaking formal consultation with the public on any proposed substantial changes to health services.

5 Recommendation

That the Committee considers how it can assist and will, at the appropriate time, respond to consultation.