Bolton split into 6 districts to improve health and social care

The plans, which have been lodged by Bolton Health and Care Partnership, propose to divide the borough into six 'neighbourhoods' which will be served by  health and care teams.

Splitting the area into neighbourhoods, each made up of 30-55k people, would aid the service to "help people stay well for longer" and "provide proactive, personalised care".

As well as the neighbourhoods, a greater emphasis on 'short term care' is proposed, which is where services and support are provided primarily to older adults after leaving hospital, or when at risk of hospital admission, aiming to avoid hospital admissions and residential care.

Called 'Living Well at Home', the programme would focus on keeping residents healthy and well in the community.

The partnership says that the programme is needed due to life expectancy in the borough being lower than the average for England, health inequalities having risen and the need and demand for services rising, with people often presenting in crisis.

Councillors and officers met to discuss the proposals at the Health Overview and Adult Social Care Scrutiny Committee on Wednesday, October 25.

Speaking at the meeting, one officer said: "Over the Covid period we moved into three districts, the North, the South and the West, so that we were resilient and we could provide robust services in that difficult period. 

"The plan was that we were going to nine neighbourhoods before Covid, but what we found in the Covid period is actually that would have spread us too thinly over the borough. 

"A piece of work was started in January of this year with health and care partners and we considered the residents, the registered population of GPs across the borough, age, the profiles with support of public health colleagues. 

The proposed new health and social care map (Image: Bolton Health and Care Partnership)

"Over the three districts, we had a population of 75,000 in each of those, but actually we should be serving populations of around 55,000 in neighbourhoods, that is what the benchmark is and national guidance." 

Cllr John Walsh of Astley Bridge said: "I welcome the report, only because I have had some fairly detailed involvement with... someone being released from hospital, I was granted power of attorney. What I have identified are a number of gaps in the way that we process it. 

"My experience has caused for some alarm. He was actually admitted to Chorley, and there was an obvious gap between Chorley discharge and picking up services locally. 

"There had been duplication, people turning up unannounced, apparently. And although I've got power of attorney, I have not been told about these things. 

"I do think that the need for the sort of process you're putting forward here is huge and I welcome the fact you're bringing it forward."

Cllr Karen Hon of Great Lever said: "I think it is massively beneficial, what you are doing. I think it's going to be a great asset to the people of Bolton.

"But with something that is going to become a good asset, it has obviously already got a demand before it started.

"Is there going to be a way of making sure we can maintain this, staff it and meet the costs?"

Rachel Tanner, who works in social care and integration at the council, said: "The financial envelope is unlikely to grow, and some of what we need to look at is innovation and ways of moving the money around the system to where we think we can use it to prevent care further upstream.

"I think it is going to be a real challenge for us, we know we have waiting lists in terms of accessing care, and part of our role is how we target that to best use.

"Hopefully it will free some capacity up, it is not necessarily going to solve the massive demand we have, but we are targeting it where we can."