The South Yorkshire and Bassetlaw (SYB) Acute Federation is undertaking a Clinical Services Sustainability Programme to secure the long-term viability and quality of key clinical services across the region. The programme aims to address workforce challenges, standardise services across the region, and address rising demand, ensuring equitable access to high-quality care for all residents of South Yorkshire and Bassetlaw.

The Clinical Services Sustainability Programme focuses on six priority services, which were identified due to shared challenges: Audiology, Community Paediatrics, Dermatology, Oral and Maxillofacial Surgery (OMFS) and Oral Surgery, Ophthalmology and Urology.

 

All five acute Trusts in SYB highlighted audiology as a speciality with significant challenges in terms of patient access, workforce, and service variation.

We want to ensure patients receive high-quality, consistent audiology care regardless of provider, and to reduce unnecessary hospital attendances through smarter, more integrated pathways.

The programme is focusing on four areas:

  • Governance and Workforce Development: Mapping workforce gaps and developing strategies to support recruitment and retention, including a system-wide survey to identify priority issues.
  • Estates and Commissioning: Exploring joint procurement opportunities, such as hearing aids, and piloting digital tools like tinnitus pre-questionnaires to streamline patient intake.
  • Standardised Pathways and Capacity Management: Aligning reassessment intervals and harmonising paediatric and adult pathways, with tools in development to benchmark current practices.
  • Digital Transformation: Conducting a digital stocktake to unify referral systems and improve coding, with discussions around standardising reporting and dashboard interpretation.

In addition to local efforts, the programme is actively engaging with other regions across the UK — including London and Wales — to learn from their successful approaches to transforming audiology services. 
 

Dermatology was identified as an area experiencing consultant workforce shortages, challenges with estates in some places, growing demand and variation in commissioning and adoption of digital tools.

Opportunities were identified for further development of nursing teams, community provision, digital advancements and system-wide service models.

To build on these opportunities, a Clinical Improvement Group has been established to identify the key features of a sustainable, patient-centred, and technology-enabled dermatology service that successfully attracts and retains a skilled workforce across SYB and Chesterfield.

We have assessed nurse-led interventions, identifying opportunities to share learning, reduce unwarranted variation, work in partnership and further develop nursing roles. Development of a training academy for dermatology nursing is being explored and peer visits to explore how services are being delivered at neighbouring hospitals are being scheduled.

Great work is already taking place in SYB; such as a community dermatology hub in Doncaster, imaging hubs in Sheffield, and nurse-led service delivery in Rotherham. Opportunities are being explored to scale these services across SYB, where appropriate.

As part of the Clinical Services Sustainability Programme, the Acute Federation has been mapping community paediatric services to identify where improvements could be made. This report identifies significant variation in service models, access, workforce and funding across South Yorkshire and Bassetlaw. 

In order to standardise services and reduce inequality in access and outcomes, we will: 

  • Align our service models for consistency and equity 
  • Clarify and strengthen our work models 
  • Promote multi-disciplinary and integrated neighbourhood approaches 
  • Improve data capture, standardisation and use 
  • Strengthen joint strategic planning across sectors

The Urology Area Network (UAN) is launching a series of peer review site visits across South Yorkshire, Bassetlaw, and Chesterfield to drive service improvement and collaboration.

These visits, involving adult and paediatric services, will assess each Trust’s strengths and challenges in urology care, focusing on leadership, clinical pathways, workforce, and staff / patient experience. Clinical, nursing and operational urology leads will be involved in the visits alongside staff and patient engagement.

This programme will focus on: 

  • Delivering a sustainable out-of-hours service which meets patients needs and pools expertise across Trusts 
  • High Volume Low Complexity pathways to improve access, reduce wait times and create capacity for urology cancer care 
  • Equal access to latest treatments regardless of where in South Yorkshire, Bassetlaw and Chesterfield patients live. 

Across South Yorkshire and Bassetlaw, Ophthalmology has varying wait times, variation in commissioning of community optometry services, consultant ophthalmologist workforce shortages and risks to the sustainability of on-call rotas.

However, there is huge potential to provide some eyecare services in community optometry, closer to people’s homes, rather than in hospital. There is also opportunity to work collectively on a system-wide on-call rota, which should improve recruitment rates to consultant vacancies. There is also opportunity to work system-wide on sub-specialty service delivery, which should reduce the variation in waiting times for the people in SYB.

Pathways that could be moved out of hospitals and into the community have now been agreed by both hospital and community providers. Activity numbers are being collected and pathways are being designed. Other opportunities include a shared on-call rota amongst clinical leads.

A sub-specialty risk review has taken place, which takes into consideration the current and planned secondary care workforce. This has identified opportunities for inter-trust support, as well as focussing attention to the areas with greatest opportunity to benefit from support from community providers.