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Healthcare in Cheshire was the responsibility of Eastern Cheshire, South Cheshire, Vale Royal and West Cheshire clinical commissioning groups until July 2022.
The Cheshire Care Record, an electronic health record, 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. [1]
From 1947 to 1974 most NHS services in Cheshire were managed by the Manchester Regional Hospital Board, 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, 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. They were managed by the Cheshire and Merseyside Strategic Health Authority until 2006 and then by the North West SHA from 2002 until 2013.
The clinical commissioning groups 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. [2] In November 2018 they appointed a single accountable officer and planned to merge completely by April 2020. [3]
Cheshire is part of the Merseyside and Cheshire sustainability and transformation plan area, which is facing £909m cuts by 2020. [4] 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. [5]
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. [6]
Out-of-hours services are provided by East Cheshire NHS Trust and the Western Cheshire GP Out of Hours Service. [7] Community care is provided by Bridgewater Community Healthcare NHS Foundation Trust and Cheshire and Wirral Partnership NHS Foundation Trust.
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 [8] and that patients in the area are on average older and more in need of healthcare. [9]
Cheshire and Wirral Partnership NHS Foundation Trust and Mersey Care NHS Foundation Trust are the main NHS providers. A document seen by The Guardian 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. [10]
Clatterbridge Cancer Centre NHS Foundation Trust, East Cheshire NHS Trust, Countess of Chester Hospital NHS Foundation Trust, Mid Cheshire Hospitals NHS Foundation Trust and Warrington and Halton Teaching Hospitals NHS Foundation Trust are all located in the county. Specialised hospital services are provided by NHS trusts in Stoke-on-Trent, Liverpool and Manchester. According to a document seen by Guardian reporters in 2017, endoscopies 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. [10]
West Midlands Ambulance Service had a five-year patient transport 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. [11]
The Countess of Chester Hospital is the main NHS hospital for the English city of Chester and the surrounding area. It currently has 625 beds, general medical departments and a 24-hour accident and emergency unit. It is managed by the Countess of Chester Hospital NHS Foundation Trust, one of the first Foundation Trusts in the UK, formed in 2004. Cardiac rehabilitation services at the hospital are provided by Cheshire and Wirral Partnership NHS Foundation Trust.
The North West Ambulance Service NHS Trust (NWAS) is the ambulance service for North West England. It is one of ten ambulance trusts providing England with Emergency medical services, and is part of the National Health Service, receiving direct government funding for its role.
NHS North West was a strategic health authority (SHA) of the National Health Service in England. It operated in the North West region, which is coterminous with the local government office region.
Wirral University Teaching Hospital NHS Foundation Trust (WUTH) is an NHS Foundation Trust. It provides healthcare for people of the Wirral Peninsula and the surrounding areas of North West England and North Wales.
Healthcare in the city of Bristol, England and the surrounding area is largely provided by the National Health Service (NHS). Until July 2022, this was provided through the Bristol, North Somerset and South Gloucestershire clinical commissioning group. Facilities include a large teaching hospital – Bristol Royal Infirmary – which offers nationally commissioned specialist cardiac, cancer and children's services from its city-centre campus to patients in the southwest of England and beyond.
Clatterbridge Health Park is a campus of otherwise independent, health care-related organisations, including three separate NHS trusts.
The Clatterbridge Cancer Centre is an NHS Foundation Trust, which specialises in the treatment of cancer. The centre is one of several specialist hospitals located within Merseyside; alongside Liverpool Heart and Chest Hospital, Alder Hey Children's Hospital, Liverpool Women's Hospital, and the Walton Centre.
Healthcare in London, which consumes about a fifth of the NHS budget in England, is in many respects distinct from that in the rest of the United Kingdom, or England.
Healthcare in Liverpool reflects the unique historical legacy of the port. The city had five of the most deprived areas in the country in 2012 according to a Church Urban Fund report. According to Mayor 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".
The Five Year Forward View was produced by NHS England in October 2014 under the leadership of Simon Stevens as a planning document.
Healthcare in Dorset was primarily the responsibility of Dorset Clinical Commissioning Group until July 2022. Dorset County Council is leading in the development of an electronic health record, to be called the Dorset Care Record, provided by Orion Health. It is intended to enable all health and social care providers to share records.
Healthcare in Devon was the responsibility of two clinical commissioning groups until July 2022, one covering Northern, Eastern and Western Devon, and one covering South Devon and Torbay. It was announced in November 2018 that the two were to merge.
Healthcare in Somerset, England was the responsibility of three clinical commissioning groups (CCGs) until July 2022. These covered the ceremonial county of Somerset, which comprises the areas governed by the three unitary authorities of Somerset, North Somerset and Bath and North East Somerset.
Healthcare in Staffordshire was the responsibility of six clinical commissioning groups until July 2022, covering Stafford & Surrounds, North Staffordshire, South East Staffordshire and Seisdon Peninsula, East Staffordshire, Cannock Chase, and Stoke-on-Trent.
Healthcare in the West Midlands was, until July 2022, the responsibility of five integrated care groups: Birmingham and Solihull, Sandwell and West Birmingham, Dudley, Wolverhampton, and Walsall.
Healthcare in Essex is now the responsibility of six clinical commissioning groups: Basildon and Brentwood, Mid Essex, North East Essex, Southend, Thurrock and West Essex.
Healthcare in Gloucestershire was the responsibility of two clinical commissioning groups, covering Gloucestershire and South Gloucestershire, until July 2022. The health economy of Gloucestershire has always been linked with that of Bristol.
Healthcare in Norfolk was the responsibility of five clinical commissioning groups: Great Yarmouth and Waveney CCG, Norwich CCG, North Norfolk CCG, West Norfolk CCG and South Norfolk CCG, they merged in April 2020 becoming the Norfolk and Waveney CCG until they were replaced by an integrated care system in July 2022. Social Care is the responsibility of Norfolk County Council.
Healthcare in Yorkshire from 2016 was the responsibility of 19 clinical commissioning groups, which were replaced by integrated care systems in July 2022.
The ceremonial county of Cheshire, which comprises the unitary authorities of Cheshire East, Cheshire West and Chester, Halton and Warrington, has returned 11 MPs to the UK Parliament since 1997.