Healthcare In Wiltshire
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Healthcare in Wiltshire, England, is the responsibility of the
integrated care board In England, an integrated care system (ICS) is a statutory partnership of organisations who plan, buy, and provide health and care services in their geographical area. The organisations involved include the NHS, local authorities, voluntary and cha ...
(ICB) for Bath and North East Somerset, Swindon and Wiltshire.


History


Prior to 2022

Victoria Hospital in Swindon was established in 1887, at first with 12 beds, increasing to 22 by 1904; it finally closed in 2007. From 1947 to 1974, NHS services in Wiltshire were managed by the South-West Metropolitan
Regional Hospital Board In geography, regions, otherwise referred to as zones, lands or territories, are areas that are broadly divided by physical characteristics (physical geography), human impact characteristics (human geography), and the interaction of humanity and t ...
(covering New Sarum, Wilton, and the rural districts of Amesbury, Mere and Tisbury, and Salisbury and Wilton), by the South-Western Board (responsible for the
Lyme Regis Lyme Regis is a town in west Dorset, England, west of Dorchester and east of Exeter. Sometimes dubbed the "Pearl of Dorset", it lies by the English Channel at the Dorset–Devon border. It has noted fossils in cliffs and beaches on the Herita ...
area) and by Oxford Regional Hospital Board (Marlborough and Swindon). In 1965 a new board was formed for Wessex which covered the boroughs of New Sarum and Wilton and the rural districts of Amesbury, Mere and Tisbury, and Salisbury and Wilton. In 1974 the boards were abolished and replaced by regional health authorities, with the whole of Wiltshire coming under the Wessex RHA. Regions were reorganised in 1996 and Dorset came under the South and West Regional Health Authority. Wiltshire had three area health authorities: Wiltshire, Salisbury and Swindon, from 1974 until 1994 when it was united into one authority for Bath and Wiltshire. Regional health authorities were reorganised and renamed
strategic health authorities Strategic health authorities (SHA) were part of the structure of the National Health Service (England), National Health Service in England between 2002 and 2013. Each SHA was responsible for managing performance, enacting directives and implementin ...
in 2002; Wiltshire was part of Avon, Gloucestershire and Wiltshire SHA. In 2006 regions were again reorganised and Wiltshire came under NHS South West until that was abolished in 2013. There was one
primary care trust Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May ...
for the county. Bath, Swindon and Wiltshire formed a
sustainability and transformation plan In England, a sustainability and transformation plan (STP) is a non-statutory requirement which promotes integrated provision of healthcare, including purchasing and commissioning, within each geographical area of the National Health Service. The ...
area in March 2016, chaired from December 2019 by Stephanie Elsy, a former leader of
Southwark Southwark ( ) is a district of Central London situated on the south bank of the River Thames, forming the north-western part of the wider modern London Borough of Southwark. The district, which is the oldest part of South London, developed ...
Council.


Commissioning prior to 2022

Bath and North East Somerset, Swindon and Wiltshire
clinical commissioning group Clinical commissioning groups (CCGs) were NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in each of their local areas in England. On 1 July 2022 they were abolished and replaced by Integra ...
(CCG) was formed in April 2020 by merging three CCGs which covered
Bath and North East Somerset Bath and North East Somerset (B&NES) is a unitary authority district in England. Bath and North East Somerset Council was created on 1 April 1996 following the abolition of the county of Avon. It is part of the ceremonial county of Somerset. Th ...
,
Swindon Swindon () is a town and unitary authority with Borough status in the United Kingdom, borough status in Wiltshire, England. As of the 2021 Census, the population of Swindon was 201,669, making it the largest town in the county. The Swindon un ...
and
Wiltshire Wiltshire (; abbreviated Wilts) is a historic and ceremonial county in South West England with an area of . It is landlocked and borders the counties of Dorset to the southwest, Somerset to the west, Hampshire to the southeast, Gloucestershire ...
. At that time the combined CCG had an annual budget of £1.3 billion and served a population of 934,000 across an area of . The CCG's headquarters were in
Chippenham Chippenham is a market town A market town is a settlement most common in Europe that obtained by custom or royal charter, in the Middle Ages, a market right, which allowed it to host a regular market; this distinguished it from a village ...
and it had offices in
Bath Bath may refer to: * Bathing, immersion in a fluid ** Bathtub, a large open container for water, in which a person may wash their body ** Public bathing, a public place where people bathe * Thermae, ancient Roman public bathing facilities Plac ...
,
Devizes Devizes is a market town and civil parish in Wiltshire, England. It developed around Devizes Castle, an 11th-century Norman architecture, Norman castle, and received a charter in 1141. The castle was besieged during the Anarchy, a 12th-century ...
and
Swindon Swindon () is a town and unitary authority with Borough status in the United Kingdom, borough status in Wiltshire, England. As of the 2021 Census, the population of Swindon was 201,669, making it the largest town in the county. The Swindon un ...
. Its chief executive was Tracey Cox, formerly a manager at Bath and North East Somerset Primary Care Trust and then the corresponding CCG. Swindon CCG agreed in June 2015 to fund a community therapy team at the Prospect Hospice, providing occupational and physiotherapy at home, in order to reduce pressure on hospital beds. Wiltshire CCG expected a £23 million funding gap in 2016/17 and to miss its financial target by £4.8m in 2015/6. Consequently it capped the amount of planned care delivered in hospitals, limited the number of funded procedures, and recovered money from drug companies.


Since 2022

In July 2022, integrated care boards (ICBs) were established throughout
NHS England NHS England, officially the NHS Commissioning Board, is an executive non-departmental public body of the Department of Health and Social Care. It oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the ...
to plan and deliver health and care services, replacing CCGs. Wiltshire is covered by the board for Bath and North East Somerset, Swindon and Wiltshire, which is branded as BSW Together. Stephanie Elsy continued in the new role of ICB chair, and Sue Harriman – formerly a nurse and chief executive of
Solent NHS Trust Solent NHS Trust runs mental health and community services and community hospitals in Southampton and Portsmouth, England. Its sites include Western Community Hospital, Royal South Hants Hospital, St James' Hospital, Portsmouth, St James Hospital ...
– was appointed as the first chief executive of the ICB. The ICB is required to work with local authorities to create an integrated care partnership (ICP) committee, to include local organisations such as the voluntary sector and
social enterprises A social enterprise is an organization that applies commercial strategies to maximize improvements in financial, social and environmental well-being. This may include maximizing social impact alongside profits for co-owners. Social enterprises ca ...
. The ICP works on prevention, wider social and economic factors affecting health, and reducing health inequalities. The first ICP chair is
Richard Clewer Richard Clewer ( fl. 1385–1390) of Bath, Somerset, was an English burgess who briefly sat in two 14th century parliaments of the Kingdom of England. He was a Member (MP) of the Parliament of England The Parliament of England was th ...
, leader of
Wiltshire Council Wiltshire Council is a council for the unitary authority of Wiltshire (excluding the separate unitary authority of Swindon) in South West England, created in 2009. It is the successor authority to Wiltshire County Council (1889–2009) and the ...
.


Primary care

, there were 22 GP practices in Swindon and 49 in Wiltshire; the CCG's 94 practices are grouped into 23 primary care networks.
Out-of-hours service Out-of-hours services are the arrangements to provide access to healthcare at times when General Practitioner surgeries are closed; in the United Kingdom this is normally between 6.30pm and 8am, at weekends, at Bank Holidays and sometimes if the ...
s are provided by
Medvivo Medvivo is a provider of telehealth and related services based in Chippenham, Wiltshire, England and owned by the Eight Roads venture capital fund. The company was founded in 2004 as Wiltshire Medical Services, in response to a change to the cont ...
.


Community care

Community child health services, including children’s specialist community nursing, health visiting and speech and language therapy, have been run by
Virgin Care Virgin Care was a British private provider of community health and social services, commissioned by the National Health Service and local authorities in England. From 2010 the company was known as Virgin Care and was part of Virgin Group. In Dec ...
since April 2016. They were formerly run by five separate NHS organisations. Swindon Council and Swindon Clinical Commissioning Group set up a contract with SEQOL, a newly formed
community interest company A community interest company (CIC, colloquially pronounced "kick") is a type of company introduced by the United Kingdom government in 2005 under the Companies (Audit, Investigations and Community Enterprise) Act 2004, designed for social ente ...
, to provide a variety of adult social care services in 2011. The council paid £9.4 million and the CCG £17 million a year. In March 2016, they decided not to renew the contract because of performance problems: in 2014-15 the average daily rate, per 100,000 population, of delayed hospital discharges from hospital attributable to social care was 6.9 in Swindon, compared to a national average of 3.7. SEQOL requested to end their involvement without completing the 12 months' notice provided in the contract, and from October 2016,
Great Western Hospitals NHS Foundation Trust Great Western Hospitals NHS Foundation Trust runs the Great Western Hospital, a large hospital situated in Swindon, Wiltshire, England, next to junction 15 of the M4 motorway. Performance In the ratings produced by the Healthcare Commissio ...
were responsible for these services. SEQOL's staff returned to employment by the hospital or the council, and the company intended to cease trading. From April 2022, community cardiology services in Wiltshire are provided by Wiltshire Health and Care LLP, who already ran community hospitals in the county. These services include diagnostics, assessment and advice, and rehabilitation of heart failure patients.


Mental health

Avon and Wiltshire Mental Health Partnership NHS Trust Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) is an NHS mental health trust providing adult mental health and related services in Wiltshire and the former county of Avon, an area centred on Bristol. Trust services The trust is he ...
(AWP) provides adult mental health and related services in Wiltshire and the former county of Avon, an area centered on
Bristol Bristol () is a city, ceremonial county and unitary authority in England. Situated on the River Avon, it is bordered by the ceremonial counties of Gloucestershire to the north and Somerset to the south. Bristol is the most populous city in ...
. From April 2010,
Oxford Health NHS Foundation Trust Oxford Health NHS Foundation Trust is an NHS foundation trust that provides physical, mental health and social care for people of all ages across Oxfordshire, Buckinghamshire, Swindon, Wiltshire, Bath and North East Somerset. Its services are de ...
has provided tiers 3 and 4 of
Child and Adolescent Mental Health Services Child and Adolescent Mental Health Services (CAMHS) is the name for NHS-provided services in the United Kingdom for children, generally until school-leaving age, who are having difficulties with their emotional well-being or are deemed to have pe ...
(CAMHS) in Wiltshire and
Bath and North East Somerset Bath and North East Somerset (B&NES) is a unitary authority district in England. Bath and North East Somerset Council was created on 1 April 1996 following the abolition of the county of Avon. It is part of the ceremonial county of Somerset. Th ...
following a competitive tender. Previously this service had been operated by three providers, though primarily AWP. The service is jointly funded by the
NHS The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
and local authorities.


Hospital provision

Great Western Hospitals NHS Foundation Trust Great Western Hospitals NHS Foundation Trust runs the Great Western Hospital, a large hospital situated in Swindon, Wiltshire, England, next to junction 15 of the M4 motorway. Performance In the ratings produced by the Healthcare Commissio ...
and
Salisbury NHS Foundation Trust Salisbury NHS Foundation Trust is an NHS foundation trust based in Salisbury that covers South Wiltshire, North and East Dorset and South West Hampshire. It gained foundation trust status in 2006. Its main site is Salisbury District Hospital, ...
are the main acute providers in the county. In June 2018 they agreed to form an alliance with
Royal United Hospitals Bath NHS Foundation Trust The Royal United Hospitals Bath NHS Foundation Trust runs the Royal United Hospital (RUH), a major acute-care hospital in Bath, England. The trust also runs the Royal National Hospital for Rheumatic Diseases (since 2015) and Sulis Hospital at ...
, as they provide most of the hospital services in the Bath, North East Somerset, Swindon and Wiltshire
sustainability and transformation plan In England, a sustainability and transformation plan (STP) is a non-statutory requirement which promotes integrated provision of healthcare, including purchasing and commissioning, within each geographical area of the National Health Service. The ...
area. Community hospitals at Chippenham, Devizes, Melksham, Marlborough (Savernake), Trowbridge and Warminster are run since 2016 by Wiltshire Health and Care LLP. The Chippenham and Trowbridge hospitals have minor injuries units.


References

{{Reflist, 30em


External links


BSW Together
– the integrated care system
Wiltshire Wiltshire (; abbreviated Wilts) is a historic and ceremonial county in South West England with an area of . It is landlocked and borders the counties of Dorset to the southwest, Somerset to the west, Hampshire to the southeast, Gloucestershire ...