The ideas and changes being proposed for the local Health Service which were announced in the new Sustainability and Transformation Plan (STP) have caused anxiety for many residents. Members of the Alton Street Surgery have described them as a great challenge.

A spokesperson said: “Many of the ideas in the STP are to be applauded. Investment in primary care is very welcome - GP surgeries provide 90% of the contacts within the NHS, but receive only 7% of the funding. Specialist numbers have increased dramatically in recent years, while most surgeries are struggling to recruit GPs. The current funding structures reward expensive, hospital based care, but we need to focus much more on prevention than cure - this is both cheaper and better for patients. The STP recognises this, but the plans are still very aspirational, and implementing them remains a huge challenge.”

The practice agrees with the aims of the STP that reducing spending on hospital care will free up money which can be used for prevention. Encouraging self care for minor illness is important, as GP time is better spent seeing complex and chronic diseases rather than coughs and colds.

The spokesperson added: “There are currently multiple ways of seeking help, which is confusing for patients, and a single point of access would make the system much easier to navigate. Pharmacists and the NHS 111 service will give advice, and increasingly nurse practitioners will see more urgent cases. There is no doubt surgeries will have to adapt to survive, and sadly this may mean the end of the ‘family doctor’.

Instead patients will see the most appropriate clinician for that condition.” The spokesman said: “This is a huge blow, as continuity is a cornerstone of general practice, but without enough doctors to provide care, it is hard to see an alternative.”

GPs already try very hard to keep patients at home rather than admitting them to hospital, but in practice the cuts to social care have made this harder to achieve. Unfortunately there does sometimes come a point at which staying at home becomes unfeasible, and Ross-on-Wye is very lucky to have an excellent local hospital.

GPs in Ross are very supportive of the community hospital, and struggle with the idea of closing local, relatively cheap beds, while the County Hospital is in almost permanent bed crisis.

One thing that will help social care and the NHS is by linking in to local non-medical sources of support. Ross-on-Wye is already leading the way on this ‘social prescribing’ model, and the Ross mental health group are exploring the idea of a drop in cafe, as well as local support for people living with dementia and their carers.

There are many, very active volunteer and faith groups already filling some of the gaps in provision, and ensuring people are aware of community resources is an important way of using the rich resources around us.

Walking groups and other activities encourage contact and exercise, while community ventures such as Enviroability and the Tudorville & District Community Centre are great examples of what dedicated people can achieve.

The team at Alton Street believe that what is needed is more honest conversations about the sort of NHS we want.

Paul Deneen, the Chair of Herefordshire Healthwatch hopes that those charged with putting the STP forward take into account the impact and effects of budget reductions at Herefordshire Council, as well as the age profile of residents. He is also concerned that if there is an expectation that the voluntary sector can assist in the future regarding any transformation, then resources need to be made available to the respective organisations.

He said: “The final agreed budget will need to fund the particular challenges involved within the rural County of Herefordshire regarding the delivery of its Plan for overall future health and social care provision.”

Anyone who values the NHS, should make sure the government and your local MP know this, to ensure that our health is given the priority it deserves. The STP is available at www.hacw.nhs.uk/yourconversation/ where you will also find an online survey. This a great opportunity to have your say on how healthcare should look, so follow the link and complete the survey.