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Your spotlight on local services

Major change in the NHS – what your services will look like


To find out how you can have your voice heard, click here

To read the panel's Questions & Answers click here

Large plans are being worked on in the local NHS, an audience of local residents has heard. These changes are aimed at delivering care in south-west London at substantially lower costs, and at resolving a separate deficit in Richmond's NHS.

The raft of changes includes providing more care locally, a step aimed at reducing the demand on acute hospitals in south west London. It also includes establishing stricter criteria for certain common treatments.

At a public event last week, held by Healthwatch Richmond, NHS commissioners answered pressing questions from around 120 local residents – patients, carers, NHS, local council voluntary sector staff, across a broad range of ages. It was the first public meeting in Richmond about the newly published changes in the NHS.

The event began with an exhibition in which residents directly spoke with Healthwatch Richmond, local healthcare trusts and commissioners. Following this, in the main auditorium Healthwatch Richmond presented a detailed review of its own work for health and social care and the commissioners explained their plans for local health services.

Key plans

Richmond faces two major sets of changes to its healthcare. The first is the Sustainability and Transformation Plan (STP), which aims to eliminate £900 million from right across south west London NHS’ annual running costs within five years.

These plans are set out in the Five Year Forward View and in the presentation provided at the event. This will involve reducing the demand on, and therefore the amount of care provided, in acute hospitals by moving more health into the community.

The second change is Richmond-specific: the Financial Recovery Plan - set out from slide 23 of the event's presentation. Richmond is expected to have a £20 million deficit, and plans to tackle this by:

  • moving care out of hospitals, into the community
  • working with providers to reduce duplication and costs
  • establishing stricter criteria for procedures including knee surgery, cataracts, bunion surgery and IVF
  • encouraging people to care for and manage their conditions.

Tough questions

The audience passionately shared viewpoints around the planned changes. Read the Questions and Answers here. Many expressed strong support for the NHS and asked for reassurance around the future of those services they use. Some people expressed concern over the impact of cost cutting at this scale. Others had questions about the details of the plans and their achievability.

Commissioners were asked about the changes to specific treatment and audience members expressed concerns over the impact of some of these such as sleep apnoea, arthroscopic knee surgery and bunion surgery. Richmond CCG committed to providing details of the policy changes. We are disappointed that this has not yet been forthcoming; however, a one page summary of the changes has been produced and is available here, and the changes will also be discussed at the governing body meeting held in public on 17 January. 

Some concern was expressed by people about changes to the range of medications available on prescription. Richmond CCG has clarified that only medications available over the counter without the need for prescription would be considered.

Commissioners also spoke on localisation of some services, which would contribute in the long run to the cost savings. Asked whether the expenditure required to make the changes is affordable, given the immense financial pressure on the NHS, Ms Magson said: “There is funding for these changes. In the period to 2021, there’s £54 million available for making the locality changes. But we have to start the changes to access that money.”

To read an edited writeup of commissioners' answers, click here.