Healthcare in Cheshire
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Healthcare in Cheshire was the responsibility of Eastern Cheshire, South Cheshire, Vale Royal and West Cheshire
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 ...
s until July 2022. The Cheshire Care Record, an
electronic health record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
, was implemented in 2016, across acute, primary, council, community, mental health and cancer data with a total 44 million clinical records, but needed further finance for its development.


History

From 1947 to 1974 most NHS services in Cheshire were managed by the Manchester
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 ...
, apart from those in part of Chester (borough of Bebington); the urban districts of Ellesmere Port, Hoylake, Hoole, Lymm, Neston, Runcorn, and Wirral; and the rural districts of Chester, Runcorn and Tarvin which were managed from Liverpool. In 1974 the boards were abolished and replaced by regional health authorities. The whole of Cheshire came under the Mersey RHA. Regions were reorganised in 1996 and Cheshire came under the North West Regional Health Authority. Cheshire from 1974 had an
area health authority Area health authorities were 90 bodies responsible for administering the National Health Service, established in England by the National Health Service Reorganisation Act 1973 in 1974. Each covered a geographical population which matched a Local Go ...
, divided into six districts: Chester, Crewe, Halton, Macclesfield, Warrington and Wirral. The area health authorities took over responsibility for many of the health services previously managed by local authorities including vaccination, health centres, family planning, school health, health visiting and home nursing. In 1993 four new district health authorities were established covering Central and Eastern Cheshire, Warrington, Western Cheshire, Birkenhead and Wallasey, and Bebington and West Wirral. In 2006 the last two were merged into Wirral
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 ...
. They were managed by the Cheshire and Merseyside
Strategic Health Authority Strategic health authorities (SHA) were part of the structure of the National Health Service in England between 2002 and 2013. Each SHA was responsible for managing performance, enacting directives and implementing health policy as required by the ...
until 2006 and then by the North West SHA from 2002 until 2013.


Commissioning

The
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 ...
s for West Cheshire, South Cheshire, Vale Royal and Eastern Cheshire agreed to establish a unified health commissioner in April 2017. This may lead to a merger of the organisations. In November 2018 they appointed a single accountable officer and planned to merge completely by April 2020.


Sustainability and transformation plans

Cheshire is part of the Merseyside and Cheshire
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, which is facing £909m cuts by 2020. Four accountable care organisations are proposed for Cheshire and the Wirral, and some services would be moved from Macclesfield to Stockport. The plans envisage a total of £755 million in capital funding, but it is not clear where this might come from.


Primary and community care

There are 22 general practices in Eastern Cheshire, 39 in West Cheshire, 18 in South Cheshire and 12 in Vale Royal. According to the WhatClinic website, there are 229 Private General Practices in Cheshire, but the vast majority of those which are not NHS GP services offer only chiropody, physiotherapy or sports injury services.
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
East Cheshire NHS Trust East Cheshire NHS Trust runs Congleton War Memorial Hospital, Knutsford and District Community Hospital and Macclesfield District General Hospital, in Cheshire, England. It provides both acute hospital services and community services has been ra ...
and the Western Cheshire GP Out of Hours Service. Community care is provided by
Bridgewater Community Healthcare NHS Foundation Trust Bridgewater Community Healthcare NHS Foundation Trust (Bridgewater) is a leading provider of community health services in the northwest of England. In 2013/14 Bridgewater was responsible for providing community and specialised health services ...
and
Cheshire and Wirral Partnership NHS Foundation Trust Cheshire and Wirral Partnership NHS Foundation Trust (CWP) provides mental health services, learning disability services and substance misuse services across Cheshire and Metropolitan Borough of Wirral, Wirral, England. Additionally it provides ...
. The practices in east Cheshire started a campaign for fairer funding in 2017, asking all residents to write to their prospective parliamentary candidates. They claim that NHS funding does not take age into account and that patients in the area are on average older and more in need of healthcare.


Mental health

Cheshire and Wirral Partnership NHS Foundation Trust Cheshire and Wirral Partnership NHS Foundation Trust (CWP) provides mental health services, learning disability services and substance misuse services across Cheshire and Metropolitan Borough of Wirral, Wirral, England. Additionally it provides ...
and
Mersey Care NHS Foundation Trust Mersey Care NHS Foundation Trust runs a specialist mental health trust and provides learning disabilities, addiction management, acquired brain injury services and the provision of community nursing and therapies services in The City of Liver ...
are the main NHS providers. A document seen by ''
The Guardian ''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...
'' in 2017 maintained that there are plans to cut costs over mental health care which could harm patients. If these plans were acted on there was concern psychiatric patients would get expensive but inappropriate care in A&E instead of more suitable care in specialist mental health facilities.Cheshire cancer patients 'could die sooner' if NHS cuts are forced through
''
The Guardian ''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...
''


Hospital and acute care

Clatterbridge Cancer Centre NHS Foundation Trust The Clatterbridge Cancer Centre (colloquially known as The Royal Cancer Hospital) is an NHS Foundation Trust, which specialises in the treatment of oncology, cancer. The centre is one of several specialist hospitals located within Merseyside; al ...
,
East Cheshire NHS Trust East Cheshire NHS Trust runs Congleton War Memorial Hospital, Knutsford and District Community Hospital and Macclesfield District General Hospital, in Cheshire, England. It provides both acute hospital services and community services has been ra ...
,
Countess of Chester Hospital NHS Foundation Trust Count (feminine: countess) is a historical title of nobility in certain European countries, varying in relative status, generally of middling rank in the hierarchy of nobility. Pine, L. G. ''Titles: How the King Became His Majesty''. New York: ...
and Mid Cheshire Hospitals NHS Foundation Trust are all located in the county. Specialised hospital services are provided by NHS trusts in
Stoke-on-Trent Stoke-on-Trent (often abbreviated to Stoke) is a city and Unitary authorities of England, unitary authority area in Staffordshire, England, with an area of . In 2019, the city had an estimated population of 256,375. It is the largest settlement ...
,
Liverpool Liverpool is a city and metropolitan borough in Merseyside, England. With a population of in 2019, it is the 10th largest English district by population and its metropolitan area is the fifth largest in the United Kingdom, with a popul ...
and
Manchester Manchester () is a city in Greater Manchester, England. It had a population of 552,000 in 2021. It is bordered by the Cheshire Plain to the south, the Pennines to the north and east, and the neighbouring city of Salford to the west. The t ...
. According to a document seen by ''
Guardian Guardian usually refers to: * Legal guardian, a person with the authority and duty to care for the interests of another * ''The Guardian'', a British daily newspaper (The) Guardian(s) may also refer to: Places * Guardian, West Virginia, Unite ...
'' reporters in 2017,
endoscopies An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inser ...
were to be reduced by 25% among other cost-cutting measures. Cost-cutting proposals in Cheshire could delay the start of treatment for cancer patients and lead to them dying sooner.
West Midlands Ambulance Service The West Midlands Ambulance Service University NHS Foundation Trust (WMAS) is responsible for providing NHS ambulance services within the West Midlands region of England. It is one of ten ambulance trusts providing England with emergency medic ...
had a five-year
patient transport Patient transport is a service that transfers patients to and from medical facilities in non-emergency situations. In emergency situations, patients are transported by the emergency medical services. Non-emergency patient transport is sometimes ...
contract for Cheshire, Wirral and Warrington, at a cost of £25 million from 2016 but decided to hand it back in May 2018 because centralisation of secondary care services meant that it was not sustainable due to longer journeys.


See also


References

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Cheshire Cheshire ( ) is a ceremonial and historic county in North West England, bordered by Wales to the west, Merseyside and Greater Manchester to the north, Derbyshire to the east, and Staffordshire and Shropshire to the south. Cheshire's county t ...