NHS Lincolnshire's 'Healthy Conversation' will 'deliver co-ordinated, joined-up care at a local level', district leaders are told
Health services closer to home, with more "joined-up" working between GP surgeries, is the way forward for the NHS in Lincolnshire.
This was the main message from John Turner, the man in charge of modernising medical care across the county, during a meeting of South Holland District Council on Wednesday.
Mr Turner was invited to give an update on Healthy Conversation 2019, a year-long review of NHS services in Lincolnshire involving all four of its Clinical Commissioning Groups (CCGs).
Each body, including South Lincolnshire Clinical Commissioning Group which covers South Holland, the Deepings and Bourne, is responsible for planning and then "buying in" NHS services for patients at the same times as district and county councils promote public health throughout their communities.
But Mr Turner warned of "three key problems" facing the county's NHS services, quality of care for patients, staffing levels and overspending.
He said: "The NHS in Lincolnshire has a great number of things happening in it, with some of the services that we have for people in the county ranking amongst the very best in the country.
"We have though quite a number of problems that we need to work our way through.
"Some of the quality of care that we provide is falling short of what we want it to be, most obviously in our accident and emergency services, as well as elements of cancer and dementia care.
"We're also struggling to recruit and retain the numbers of people we need to staff our health services and the further east you go in Lincolnshire, the more difficult the staffing problems become.
"The third issue that we have is around money as, essentially, the budget for the NHS in Lincolnshire is about £1.2billion, but we have considerably overspent that and this year, we're in the £60million-£70million overspend area."
Mr Turner went on to suggest three solutions to remodelling the NHS in Lincolnshire after the describing the current structure as "not sustainable going forward".
"We're looking to revamp the amount of care that people can get locally so that our larger hospitals are kept for people who need its care," Mr Turner said.
"The NHS has become quite fragmented in terms of the way we work with our partners so we're also on a mission to join up the service more, including GP practices, community hospitals and nurses, social care, visiting consultants, physiotherapists, speech and language therapists.
"Finally, our services are very reactive so that when people are sick, they come to our services where we try to fix them up.
"But we don't work proactively so that people can manage their health and prevent themselves from slipping into ill health, with our services having to react to that."
Specific plans Mr Turner said were under consideration for the NHS in Lincolnshire include the provision of specialist care, including hip and knee operations, from a new "centre of excellence" based at Grantham Hospital.
There are also plans to provide health care digitally in order to overcome problems with public transport to and from hospitals, more shared access to patient records across GP practices and hospitals and the development of a new medical school in Lincoln.
But most significant were plans to raise the profile of community nurse-led Neighbourhood Teams and Primary Care Networks which sees individual GP practices working together in providing patient care.
Mr Turner said: "There is some really promising and exciting stuff happening, but it can only do so when GPs, community nurses and people in the community can identify how to work in a more integrated way because whilst the NHS is pretty good at care, it needs to be better at prevention."