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Healthcare in Merseyside

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Healthcare in Liverpool reflects the unique historical legacy of the port. Liverpool has been recognised as an unhealthy place to live since the nineteenth century. The city had five of the most deprived areas in the country in 2012 according to a Church Urban Fund report.[1] According to Joe Anderson "The people in Calderstones, Woolton and Childwall outlive the people in other areas of Liverpool, like parts of north Liverpool, by 10 to 12 years or so." [2]

History

Liverpool's Health of the Town Committee appointed Thomas Fresh as 'Inspector of Nuisances' on 4 September 1844 The city appointed its first Medical Officer of Health, William Henry Duncan, in 1847.[3][4] In 1851, a boy born in inner Liverpool had a life expectancy of only 26 years[5]

Management structures

Liverpool has had unstable administrative arrangements with the North West region, and in particular with Manchester since the establishment of the NHS. In 1946 drawing the boundary between the Liverpool and Manchester Regional Hospital Boards proved to be particularly difficult because of "the jealousy felt by Liverpool for Manchester and the reluctance of Preston to consider any scheme centred on Liverpool or Manchester." [6]

NHS North West was established as a strategic health authority in 2006. It had oversight of 24 Primary Care Trusts, 23 acute NHS trusts, 8 mental health trusts, 7 specialist trusts, as well as the North West Ambulance Service. In October 2011 NHS North West, alongside NHS Yorkshire and Humberside and NHS North East became a part of the NHS North of England SHA cluster - a temporary administrative merger to manage the North of England health economy until the planned dissolution of SHAs in March 2013. The authority closed on 31 March 2013 as part of the Health and Social Care Act 2012.

The Liverpool City Region is submitting proposals for greater local control of the NHS and social care following developments in Manchester.[7]

Cheshire and Mersyside formed a sustainability and transformation plan area in March 2016 with Louise Shepherd, the Chief Executive of Alder Hey Children's NHS Foundation Trust as its leader[8]

Acute Services

Liverpool is unusual in having a large number of small specialist NHS trusts. In October 2014 plans were unveiled in the Healthy Liverpool programme, approved by Liverpool Clinical Commissioning Group and supported by the City Council which would concentrate services, especially for cancer patients and major trauma at the Royal Liverpool University Hospital.[9] The proposals, which will be subject to public consultation, include:

  • improvements in primary care;
  • greater access to GPs;
  • more support for people to manage their own care;
  • better illness prevention;
  • some services moving from hospitals into the community;
  • changes to some hospital services to improve outcomes and quality.

Dr Fazlani, Chair of the CCG said “If we reduced emergency admissions to hospitals by just 11% we would be able to afford an extra one and a half GPs in every practice in the city. This is the virtuous circle we are aiming to create".[10]

There will be fewer hospitals in Liverpool under the Healthy Liverpool plans to shake-up the city’s NHS by providing more care in the community. Cardiology services are offered at four or five sites in Liverpool in 2015 but it is proposed that they will be delivered by a single team at one or two sites.[11]

Between 2010 and 2015 hospitals in Merseyside lost a large number of beds, mostly in general hospitals, though there was some increase in specialist hospitals.[12]

Beds available 2015 2010
Arrowe Park & Clatterbridge 760 813
St Helens & Whiston 693 716
Liverpool Heart and Chest 153 148
Alder Hey Children's 206 218
Aintree 672 788
Clatterbridge Cancer Centre 69 84
Liverpool Women's 140 182
Walton Centre 160 134
Royal Liverpool & Broadgreen 802 892
5 Boroughs Partnership 314 339
Southport & Ormskirk 491 502
Mersey Care 632 411
Warrington & Halton 599 643

Community Services

Liverpool Community Health NHS Trust is the main NHS provider.

A Government-funded initiative, More Independent, is being piloted across four UK regions, of which Liverpool is one. It offers gadgets – Life Enhancing Technologies – designed to help people who use NHS or social services live more independently, monitor their health, make everyday life simpler, and help them stay in touch with their family or carers.[13]

Primary Care

Out-of-hours services are provided by Urgent Care 24 Limited.

Dharmana’s Family and General Practice, in Walton was put in Special measures by the Care Quality Commission in January 2015 after being rated “inadequate”. In October 2015 it was closed.[14]

See also

References

  1. ^ "Liverpool has five of the most deprived areas in the country as report claims England is one of most unequal countries in Western world". Daily Mail. 22 May 2012. Retrieved 16 November 2014.
  2. ^ "Your Q&A with Mayor of Liverpool Joe Anderson on the future of the city's green spaces: Part II". Liverpool Echo. 14 November 2014. Retrieved 16 November 2014.
  3. ^ Halliday, S. (2003). "Duncan of Liverpool: Britain's first Medical Officer". Journal of Medical Biography. 11 (3): 142–149. PMID 12870037.
  4. ^ Ashton, John R. (2004). "Aphorism of the Month: "The following is my entire establishment… your servant, William Henry Duncan"". Journal of Epidemiology and Community Health. 35 (16): 5625–5633. PMC 1732861.
  5. ^ Daunton, Martin (11 April 2004). "London's 'Great Stink' and Victorian Urban Planning". BBC History. Retrieved 16 November 2014.
  6. ^ Webster, Charles (1988). The Health Services Since the War. London: HMSO. p. 268. ISBN 0116309423. {{cite book}}: |access-date= requires |url= (help)
  7. ^ Hudson, Bob (7 October 2015). "What do the government's devolution plans mean for a national health service?". Retrieved 18 October 2015.
  8. ^ "The leaders chosen for 41 of England's STPs". Health Service Journal. 30 March 2016. Retrieved 18 April 2016.
  9. ^ "Liverpool reconfiguration plans unveiled". Health Service Journal. 17 October 2014. Retrieved 16 November 2014.
  10. ^ "New Healthcare Vision for Liverpool is unveiled". BayTV Liverpool. 4 November 2014. Retrieved 16 November 2014.
  11. ^ "Massive shake-up of Liverpool's NHS to see less hospitals and more care in the community". Liverpool Echo. 13 July 2015. Retrieved 13 July 2015.
  12. ^ "How many beds has your hospital lost since David Cameron came to power?". Liverpool Echo. 19 October 2015. Retrieved 19 October 2015.
  13. ^ "I do it Mi Way". More Independent. Retrieved 11 July 2015.
  14. ^ "First special measures GP practice to close". Health Service Journal. 7 October 2015. Retrieved 7 November 2015.