Healthcare in Wiltshire, England, is the responsibility of the integrated care board (ICB) for Bath and North East Somerset, Swindon and Wiltshire.
Victoria Hospital in Swindon was established in 1887, [1] at first with 12 beds, increasing to 22 by 1904; it finally closed in 2007. [2]
From 1947 to 1974, NHS services in Wiltshire were managed by the South-West Metropolitan Regional Hospital Board (covering New Sarum, Wilton, and the rural districts of Amesbury, Mere and Tisbury, and Salisbury and Wilton), by the South-Western Board (responsible for the Lyme Regis area) and by Oxford Regional Hospital Board (Marlborough and Swindon). In 1965 a new board was formed for Wessex which covered the boroughs of New Sarum and Wilton and the rural districts of Amesbury, Mere and Tisbury, and Salisbury and Wilton.
In 1974 the boards were abolished and replaced by regional health authorities, with the whole of Wiltshire coming under the Wessex RHA. Regions were reorganised in 1996 and Dorset came under the South and West Regional Health Authority. Wiltshire had three area health authorities: Wiltshire, Salisbury and Swindon, from 1974 until 1994 when it was united into one authority for Bath and Wiltshire. Regional health authorities were reorganised and renamed strategic health authorities in 2002; Wiltshire was part of Avon, Gloucestershire and Wiltshire SHA. In 2006 regions were again reorganised and Wiltshire came under NHS South West until that was abolished in 2013. There was one primary care trust for the county.
Bath, Swindon and Wiltshire formed a sustainability and transformation plan area in March 2016, [3] chaired from December 2019 by Stephanie Elsy, a former leader of Southwark Council. [4]
Bath and North East Somerset, Swindon and Wiltshire clinical commissioning group (CCG) was formed in April 2020 by merging three CCGs which covered Bath and North East Somerset, Swindon and Wiltshire. [5] At that time the combined CCG had an annual budget of £1.3 billion and served a population of 934,000 across an area of 1,511 square miles (3,910 km2). [6] The CCG's headquarters were in Chippenham and it had offices in Bath, Devizes and Swindon. [6] Its chief executive was Tracey Cox, [7] formerly a manager at Bath and North East Somerset Primary Care Trust and then the corresponding CCG. [8]
Swindon CCG agreed in June 2015 to fund a community therapy team at the Prospect Hospice, providing occupational and physiotherapy at home, in order to reduce pressure on hospital beds. [9] Wiltshire CCG expected a £23 million funding gap in 2016/17 and to miss its financial target by £4.8m in 2015/6. Consequently it capped the amount of planned care delivered in hospitals, limited the number of funded procedures, and recovered money from drug companies. [10]
In July 2022, integrated care boards (ICBs) were established throughout NHS England to plan and deliver health and care services, replacing CCGs. Wiltshire is covered by the board for Bath and North East Somerset, Swindon and Wiltshire, which is branded as BSW Together. [11] Stephanie Elsy continued in the new role of ICB chair, and Sue Harriman – formerly a nurse and chief executive of Solent NHS Trust – was appointed as the first chief executive of the ICB. [11]
The ICB is required to work with local authorities to create an integrated care partnership (ICP) committee, to include local organisations such as the voluntary sector and social enterprises. [12] [13] The ICP works on prevention, wider social and economic factors affecting health, and reducing health inequalities. [12] The first ICP chair is Richard Clewer, leader of Wiltshire Council. [14]
As of April 2020 [update] , there were 22 GP practices in Swindon [15] and 49 in Wiltshire; [16] the CCG's 94 practices are grouped into 23 primary care networks. [6] Out-of-hours services are provided by Medvivo.
Community child health services, including children’s specialist community nursing, health visiting and speech and language therapy, have been run by Virgin Care since April 2016. [17] They were formerly run by five separate NHS organisations. [18]
Swindon Council and Swindon Clinical Commissioning Group set up a contract with SEQOL, a newly formed community interest company, to provide a variety of adult social care services in 2011. The council paid £9.4 million and the CCG £17 million a year. In March 2016, they decided not to renew the contract because of performance problems: in 2014-15 the average daily rate, per 100,000 population, of delayed hospital discharges from hospital attributable to social care was 6.9 in Swindon, compared to a national average of 3.7. [19] SEQOL requested to end their involvement without completing the 12 months' notice provided in the contract, and from October 2016, Great Western Hospitals NHS Foundation Trust were responsible for these services. SEQOL's staff returned to employment by the hospital or the council, and the company intended to cease trading. [20]
From April 2022, [21] community cardiology services in Wiltshire are provided by Wiltshire Health and Care LLP, who already ran community hospitals in the county. These services include diagnostics, assessment and advice, and rehabilitation of heart failure patients. [22]
Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) provides adult mental health and related services in Wiltshire and the former county of Avon, an area centered on Bristol.
From April 2010, Oxford Health NHS Foundation Trust has provided tiers 3 and 4 of Child and Adolescent Mental Health Services (CAMHS) in Wiltshire and Bath and North East Somerset following a competitive tender. Previously this service had been operated by three providers, though primarily AWP. The service is jointly funded by the NHS and local authorities. [23]
Great Western Hospitals NHS Foundation Trust and Salisbury NHS Foundation Trust are the main acute providers in the county. In June 2018 they agreed to form an alliance with Royal United Hospitals Bath NHS Foundation Trust, as they provide most of the hospital services in the Bath, North East Somerset, Swindon and Wiltshire sustainability and transformation plan area. [24]
Community hospitals at Chippenham, Devizes, Melksham, Marlborough (Savernake), Trowbridge and Warminster are run since 2016 by Wiltshire Health and Care LLP. [25] The Chippenham and Trowbridge hospitals have minor injuries units. [25]
Wiltshire is a historic and ceremonial county in South West England with an area of 3,485 km2. It is landlocked and borders the counties of Dorset to the southwest, Somerset to the west, Hampshire to the southeast, Gloucestershire to the north, Oxfordshire to the northeast and Berkshire to the east. The county town was originally Wilton, after which the county is named, but Wiltshire Council is now based in the county town of Trowbridge. Within the county's boundary are two unitary authority areas, Wiltshire and Swindon, governed respectively by Wiltshire Council and Swindon Borough Council.
The Royal United Hospital (RUH) is a major acute-care hospital in the Weston suburb of Bath, England, which lies approximately 1.5 miles (2.4 km) west of the city centre. The hospital has 565 beds and occupies a 52 acres (21 ha) site. It is the area's major accident and emergency hospital, with a helicopter landing point on the adjacent Lansdown Cricket Club field. The hospital is operated by the Royal United Hospitals Bath NHS Foundation Trust.
The South Western Ambulance Service NHS Foundation Trust (SWASFT) is the organisation responsible for providing ambulance services for the National Health Service (NHS) across South West England. It serves the council areas of Bath and North East Somerset, Bournemouth, Christchurch and Poole Council, Bristol, Cornwall, Devon, Dorset, Gloucestershire, North Somerset, Plymouth, Isles of Scilly, Somerset, South Gloucestershire, Swindon, Torbay and Wiltshire.
Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) is an NHS mental health trust providing adult mental health and related services in Wiltshire and the former county of Avon, an area centred on Bristol.
Healthcare in the city of Bristol, England and the surrounding area is largely provided by the National Health Service (NHS), 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.
Virgin Care was a British private provider of community health and social services, commissioned by the National Health Service and local authorities in England. From 2010 the company was known as Virgin Care and was part of Virgin Group. In December 2021, it was acquired by Twenty20 Capital and rebranded as HCRG Care Group.
Oxford Health NHS Foundation Trust is an NHS foundation trust that provides physical, mental health and social care for people of all ages across Oxfordshire, Buckinghamshire, Swindon, Wiltshire, Bath and North East Somerset. Its services are delivered at community bases, hospitals, clinics and people's homes.
Solent NHS Trust runs mental health and community services and community hospitals in Southampton and Portsmouth, England. Its sites include Western Community Hospital, Royal South Hants Hospital, St James Hospital, St Mary’s Hospital.
Healthcare in Cumbria is now the responsibility of Cumbria Clinical Commissioning Group. From 1 April 2017 32 GP practices will leave the CCG and merge with Lancashire North CCG to form Morecambe Bay CCG.
Healthcare in Kent is now mainly the responsibility from 1 April 2020 of the Kent & Medway Clinical Commissioning Group. Certain specialised services are directly commissioned by NHS England, coordinated through the South East integrated regional team. Some NHS England structures are aligned on a Kent & Medway basis, others on a South East basis and there is liaison with London that provides many tertiary healthcare services to the residents of Kent.
Healthcare in Bedfordshire is now the responsibility of Bedfordshire and Luton Integrated Care Systems.
Sirona Care & Health is a Community Interest Company based in Bath, Somerset which provides publicly funded health and social care services.
Healthcare in Somerset, England is the responsibility of three clinical commissioning groups (CCGs) covering the ceremonial county of Somerset, which comprises the areas governed by Somerset County Council and the unitary authorities of North Somerset and Bath and North East Somerset.
Healthcare in Sussex was the responsibility of seven Clinical Commissioning Groups covering: Brighton and Hove; Coastal West Sussex; Horsham and Mid Sussex; Crawley; Eastbourne Hailsham and Seaford; Hastings and Rother; High Weald; and Lewes-Havens from 2013 to 2020. From April 2020 they will be merged into three covering East Sussex, West Sussex, and Brighton and Hove.
Healthcare in Staffordshire is now the responsibility of six clinical commissioning groups, covering: Stafford & Surrounds; North Staffordshire; South East Staffordshire and Seisdon Peninsula; East Staffordshire; Cannock Chase; Stoke-on-Trent.
Healthcare in the West Midlands is now the responsibility of five clinical commissioning groups (CCG): Birmingham and Solihull; Sandwell and West Birmingham; Dudley; Wolverhampton; and Walsall.
Healthcare in Surrey was the responsibility of 5 Clinical Commissioning Groups: East Surrey, North West Surrey, Surrey Downs, Guildford and Waverley, and Surrey Heath from 2013 to 2020 when East Surrey, North West Surrey, Surrey Downs, Guildford and Waverley merged to form Surrey Heartlands CCG. the new organisation started with a £62 million deficit.
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 is the responsibility of two clinical commissioning groups covering Gloucestershire and South Gloucestershire. The health economy of Gloucestershire has always been linked with that of Bristol.
In England, an integrated care system (ICS) is a statutory partnership of organisations who plan, buy, and provide health and care services in their geographical area. The organisations involved include the NHS, local authorities, voluntary and charity groups, and independent care providers. The NHS Long Term Plan of January 2019 called for the whole of England to be covered by ICSs by April 2021. On 1 July 2022, ICSs replaced clinical commissioning groups in England.
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