Healthcare in Bedfordshire
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Healthcare in Bedfordshire is the responsibility of Bedfordshire and Luton Integrated Care Systems.


History

From 1947 to 1965 NHS services in Bedfordshire were managed by the North-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 ...
. In 1974 the Boards were abolished and replaced by regional health authorities. Bedfordshire came under the North West Thames RHA. Regions were reorganised in 1996 and Bedfordshire came under the Anglia and Oxford Regional Health Authority. Bedfordshire had an Area Health Authority from 1974 until 1982 when it was divided into two district health authorities: North and South. in 1993 these were reunited. Regional health authorities were reorganised and renamed strategic health authorities in 2002. Bedfordshire and Hertfordshire was under Bedfordshire and Hertfordshire SHA. In 2006 regions were again reorganised and Bedfordshire came under NHS East of England until that was abolished in 2013. There were two
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 ...
s for the area: Luton and Bedfordshire. In July 2022, a further reorganisation resulted in Befordshire coming under the current Integrated Care System.


Sustainability and transformation plan

Milton Keynes, Bedfordshire and Luton 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 with Pauline Philip, the Chief Executive of
Luton and Dunstable University Hospital NHS Foundation Trust Luton and Dunstable University Hospital NHS Foundation Trust was an NHS foundation trust which ran Luton and Dunstable University Hospital. The trust acquired Bedford Hospital NHS Trust on 1 April 2020, forming Bedfordshire Hospitals NHS Founda ...
, as its leader The three CCGs shared a single clinical commissioning group chief officer and planned to set up a “fully operational”
integrated care system 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 ...
but it was to continue in shadow form until 2019. In June 2018 the leaders of
Milton Keynes Milton Keynes ( ) is a city and the largest settlement in Buckinghamshire, England, about north-west of London. At the 2021 Census, the population of its urban area was over . The River Great Ouse forms its northern boundary; a tributary ...
,
Luton Luton () is a town and unitary authority with borough status, in Bedfordshire, England. At the 2011 census, the Luton built-up area subdivision had a population of 211,228 and its built-up area, including the adjacent towns of Dunstable an ...
and Bedford councils threatened to quit the partnership, saying it could not legitimately claim to be working towards an integrated system. The partnership was then led by Richard Carr who was also chief executive of
Central Bedfordshire Council Central Bedfordshire Council is the local authority for the Central Bedfordshire unitary authority area in the ceremonial county of Bedfordshire, England. It was created from the merger of Mid Bedfordshire and South Bedfordshire District Councils ...
, also in the STP, which did not sign the letter. In January 2019 Luton Borough Council pulled out of what is now called an integrated care system, although it said it had close working relationships with Luton
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 Integ ...
and that this would continue.


Commissioning

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 ...
appointed Nick Robinson, an accountant, as interim accountable officer for Bedfordshire CCG, in March, breaching its own guidance about clinical leadership, although there were two interim assistant clinical deputy chairs. In June 2017 Milton Keynes CCG was reported to be considering rationing the supply of hearing aids to one per person, and none for people with mild hearing loss.
Central and North West London NHS Foundation Trust Central and North West London NHS Foundation Trust is an NHS Foundation Trust in England. It provides healthcare in London, Milton Keynes, Surrey and elsewhere. It was created in 2002 by a merger between Brent, Kensington & Chelsea and Westminst ...
, which runs community services in the area, complained that these proposals were “incredibly damaging”, contrary to national policy, robust evidence, and professional opinion..." In October 2017 plans were announced to deny surgery to smokers and obese people indefinitely unless the patients stopped smoking or lost substantial amounts of weight. Ian Eardley of the
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations ...
said, "This goes against clinical guidance and leaves patients waiting long periods of time in pain and discomfort. It can even lead to worse outcomes following surgery in some cases." Luton Borough Council agreed to establish a health commissioning budget jointly with its CCG starting in 2018. Bedfordshire Integrated Care Systems was said to be in the most difficult financial position of any in England in 2014. It was supposed to produce a £4.6m surplus at the end of 2014/15 but now expects to run up a ‘very serious and disturbing’ £25m deficit. Accountable Officer Dr Paul Hassan said “Much of our overspend has been on caring for patients at our local acute hospitals, but we have also seen a large rise in costs for providing mental healthcare and continuing healthcare for people in the community." By March 2015 the deficit for the year was predicted to be “up to £40m”. Contributing factors were said to be a difficult winter, increased hospital activity and a high number of expensive out of area placements for mental health service users. It restated its accounts in June 2015 to record a £12.7m deficit for 2013-14 and £30.5m for 2014-15, resulting in a £43.2m cumulative deficit. It has had an increase in funding of £30 million per year.


Primary and community care

There are 55 GP practices in Bedfordshire CCG and 31 in Luton CCG.
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 b
Bedford On Call
Palliative care is provided by Keech Cottage, the
Sue Ryder Margaret Susan Cheshire, Baroness Ryder of Warsaw, Lady Cheshire, (''née'' Ryder; 3 July 1924 – 2 November 2000), best known as Sue Ryder, was a British volunteer with Special Operations Executive in the Second World War, and a membe ...
St John’s Hospice in Moggerhanger, Bedford Daycare Hospice and Willen Hospice in
Milton Keynes Milton Keynes ( ) is a city and the largest settlement in Buckinghamshire, England, about north-west of London. At the 2021 Census, the population of its urban area was over . The River Great Ouse forms its northern boundary; a tributary ...
. In November 2017
East London NHS Foundation Trust East London NHS Foundation Trust is an NHS foundation trust which provides health services in East London and specialist services to a wider region. History The trust was established as the East London and The City Mental Health NHS Trust on 3 ...
won a £195 million five year contract to provide community health services in the county.


Acute care

The main provider of NHS acute hospital care in the county is Bedfordshire Hospitals NHS Foundation Trust, which runs
Bedford Hospital Bedford Hospital is a 400-bed district general hospital located in the English town of Bedford, serving north and mid Bedfordshire run by Bedfordshire Hospitals NHS Foundation Trust. History The hospital was founded by Samuel Whitbread, the ...
and Luton and Dunstable University Hospital.
Circle Health Ltd Circle Health Group is a private healthcare provider in the United Kingdom, co-founded in 2004 by former investment banker Ali Parsa and consultant ophthalmologist Massoud Fouladi. The company is currently led by former lastminute.com Financ ...
have a contract in the county for management of musculoskeletal care, which started in 2014. They have reduced the proportion of patients going on to secondary care by 24%. Bedford Hospital staff complain that patients are diverted to the nearby private hospital, that there are delays in referrals and that the trauma service which they provide is financially unsustainable without the flow of elective work. Some of these problems, they say, would be alleviated if there was an integrated information system.


Mental health

NHS mental health services are provided by
East London NHS Foundation Trust East London NHS Foundation Trust is an NHS foundation trust which provides health services in East London and specialist services to a wider region. History The trust was established as the East London and The City Mental Health NHS Trust on 3 ...
.
South Essex Partnership University NHS Foundation Trust South Essex Partnership University NHS Foundation Trust was an NHS foundation trust providing mental health, learning disability, social care and community services across Bedfordshire, Essex, Luton and Suffolk, England. It was involved in runni ...
provided mental health services in the county until 1 April 2015.


HealthWatch

Healthwatch HealthWatch is a UK charity which promotes evidence-based medicine. Its formal aims are: # The assessment and testing of treatments, whether “orthodox” or “alternative”; # Consumer protection of all forms of health care, both by thorou ...
is an organisation set up under the
Health and Social Care Act 2012 The Health and Social Care Act 2012c 7 is an act of the Parliament of the United Kingdom. It provided for the most extensive reorganisation of the structure of the National Health Service in England to date.'' BMJ'', 2011; 342:d408Dr Lansley's M ...
to act as a voice for patients. There are three separate local Healthwatch groups in the county covering Bedford Borough, Central Bedfordshire, and Luton.


See also

* :Health in Bedfordshire *
Healthcare in the United Kingdom Healthcare in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together wi ...


References

{{reflist


External links


Bedfordshire CCGLuton CCGHealthwatch Bedford BoroughHealthwatch Central BedfordshireHealthwatch Luton
Bedfordshire Bedfordshire (; abbreviated Beds) is a ceremonial county in the East of England. The county has been administered by three unitary authorities, Borough of Bedford, Central Bedfordshire and Borough of Luton, since Bedfordshire County Council ...