The ‘Compton Review’ – a year on

The Compton Review (formerly known as Transforming Your Care) started in June 2011, headed by then Chair of the Health and Social Care Board, John Compton, assisted by an independent panel. It is essentially Northern Ireland’s equivalent to reforms started by Andrew Lansley in England. It was completed in November.

The approach was:

  • a review of context and good practice;
  • assessment of existing arrangements;
  • assessment of alternative options/models;
  • analysis and reporting; and
  • engagement.

Unsurprisingly, this found three major problems with the current system, each feeding from the previous:

  • growing/ageing population;
  • poorer health and growth in chronic conditions; and
  • instability of the system.

None of these is particular to Northern Ireland (although they are if anything worse than elsewhere in the UK, as the population is both growing and ageing faster).

The consequences of this were noted as:

  • unplanned/haphazard change;
  • poorer care and treatment;
  • poorer health outcomes;
  • difficulties meeting future health needs; and
  • failing the health workforce.

Key reasons for change include more patient-centred care, managing increasing demands, and delivering an evidence-based and sustainable service.

The report emphasises a divide between emergency, planned and specialist care and suggests that:

  • people will make decisions about their own care (the Service will provide the tools);
  • most services will be provided locally (and care, ideally, at home); and
  • very specialist provision will be provided in cooperation with Great Britain and Ireland.

The review is also specific about its desire to close at least three hospitals (talking of 5-7 “hospital networks), and to set up 17 integrated care partnerships.

It is stated that the intention in Northern Ireland is not to reduce Health and Social Care spending, but rather to use what spending currently exists more efficiently. Nevertheless, given the strains on the Service, this will seem like a reduction in spending in some areas.

A year on, the ‘Compton Review’ still receives strikingly little coverage. It has, in fact, received broad support for its thrusts towards localism and individual choice. What this all means ultimately depends on your own priorities.

Nevertheless, it is a massive political undertaking and, in a democracy where local interests predominate (as is the case more in Northern Ireland than elsewhere), issues such as ‘hospital closures’ will be resisted – after all, in 2003, an Independent candidate topped the poll in West Tyrone on that issue alone!

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