Healthcare in Somerset is now the responsibility of three Clinical Commissioning Groups covering Somerset, North Somerset and Bath and North East Somerset.
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History
From 1947 to 1965, National Health Service services in Somerset were managed by the South-Western Regional Hospital Board. In 1965 a new Board was formed for Wessex which also covered Somerset. In 1974 the Boards were abolished and replaced by Regional Health Authorities; the whole of Somerset came under the South West RHA. Regions were reorganised in 1996 and Somerset came under the South and West (Wessex and South Western) Regional Health Authority. Somerset had its own Area Health Authority from 1974 until 1992. Regional Health Authorities were reorganised and renamed Strategic Health Authorities in 2002, with Somerset part of Dorset and Somerset SHA. In 2006 regions were again reorganised and Somerset came under NHS South West until that was abolished in 2013. There were three Primary Care Trusts for the area: Bath & North East Somerset PCT, North Somerset PCT, and Somerset PCT.
Somerset formed a sustainability and transformation plan area in March 2016 with Dr Matthew Dolman, the Chair of Somerset Clinical Commissioning Group, as its leader. Bristol, North Somerset and South Gloucestershire formed a separate sustainability and transformation plan area with Robert Woolley, Chief Executive of University Hospitals Bristol NHS Foundation Trust, as its leader
Commissioning
The Clinical Commissioning Group for Bath and North East Somerset proposed to set up a pooled budget with Bath and North East Somerset Council in August 2015.
Primary care
There are 15 GP practices in Bath and North East Somerset CCG and 25 in North Somerset CCG. Somerset CCG has 63 practices divided into nine GP Federations. Out-of-hours services are provided by South Western Ambulance Service NHS Foundation Trust.
Yeovil District Hospital NHS Foundation Trust set up a subsidiary company called Symphony Healthcare Services in 2016. It took over the running of three small practices, with a combined registered list of 12,500 in March 2016. Symphony is also forming a partnership with South Somerset Primary Healthcare which will become an accountable care organisation managing an outcomes based budget for the 120,000 population of South Somerset.
Acute care
The main providers of NHS acute hospital care in the county are Yeovil District Hospital NHS Foundation Trust, Taunton and Somerset NHS Foundation Trust, Royal United Hospitals Bath NHS Foundation Trust and Weston General Hospital.
Mental health and community services
NHS Mental Health services are provided by Somerset Partnership NHS Foundation Trust, Avon and Wiltshire Mental Health Partnership NHS Trust and Oxford Health NHS Foundation Trust.
Somerset CCG is planning a significant reduction in community hospital beds provided by the Partnership trust. There are 312 at present and the CCG considers only 210 are needed. They are also planning to procure an integrated service for patients with long term conditions. It is also planning a health campus in Shepton Mallet which will have surgical and diagnostic services and medical assessment beds. The service provider will also be expected to collaborate closely with local charities and voluntary groups.
Virgin Care won a seven year contract to act as prime provider of community services in Bath and North East Somerset for an annual cost of £69.2 million in December 2016. This includes adult social work services, public health nursing, integrated re-ablement, speech and language therapy, continuing healthcare and children’s community health. Most were previously run by Sirona Care & Health. Some will be provided directly by Virgin and some contracted out. It is intended that the services will be more joined up and focussed on preventative care because locality hubs aligned with GP practices will be set up.
Palliative care is provided by St. Margaret's Hospice, which operates from Taunton and Yeovil.
HealthWatch
Healthwatch is an organisation set up under the Health and Social Care Act 2012 to act as a voice for patients. There are three separate local Healthwatches in the county covering Somerset, North Somerset and Bath and North East Somerset.