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Prof Mike Holmes, Chair of Nimbuscare, says he's worried about the transition, as Health and Care get set to undergo yet another major reorganisation - the third he has worked through in his 20 years as a GP in the City.

The clocks have gone forward and, despite the snow, we are welcoming springtime but we are also entering a new business year for the NHS. This allows us to reflect on the last couple of years and the current challenges the world is facing. The Covid 19 pandemic has claimed over 6 million lives globally, but we have made progress, albeit different countries at different rates. Here we are beginning to learn to live with Covid 19, but there are clear reminders it is not over.

Despite the relaxation of restrictions, changes in the law and the closing of testing centres we are embarking on the spring vaccine booster campaign, seeing rising rates of infection, large numbers of hospital inpatients with covid and more sickness in health and social care than ever before during the pandemic. I’ll say it again…this is not over.

If we turn our attention away from Covid, we see war in Europe. There are terrible accounts of human suffering being reported on all forms of media. As both a human being and a health care professional, I struggle to comprehend a mindset that allows this to happen, but of course feel powerless to stop it. We ready ourselves to care for those displaced by the war and hope that their passage to the UK is not slowed by bureaucracy.

The knock-on effect on the lives of citizens in the UK is being felt – the rise in the cost of living is a major concern, as are increasing waiting times for care in the NHS and both will have consequences for all of us and our families.

I mention all of this because it is real, but also because it puts greater context around the challenges we are facing in York as the NHS undergoes yet another major reorganisation.

As I personally reach the milestone of 20 years as a GP in this city I think this is the third major restructure I have worked through – to be clear that is not a complaint, I realise changes like this are needed, although I do question the timing of this one – at least form the perspective of a clinician working in a system under huge pressure.

We face a wholesale change, despite the rhetoric, with Integrated Care Systems over large areas becoming responsible for commissioning and coordinating care. Our area means North Yorkshire, East Riding, Hull and North and North East Lincolnshire. However, within that there will be areas known as ‘Places’ that oversee some elements of care locally. City of York will be one of those ‘places’.

The Act of Parliament that provides the legislation for this is likely to be approved in the next few weeks and we expect the new structures to take effect from July. So much work is going on in the background and of course there will be a transitional period.

I am worried about this transition and what it might mean for us and the services we deliver in the city particularly as we are under the greatest amount of pressure that I have witnessed in my 20 years in practice.

I certainly don’t have all the answers, but I am willing and ready to contribute to them. There is however one thing that gives me some confidence…..the people involved in this locally and their commitment to delivering care.

It has been a privilege to work hand in glove with all health, social and voluntary care providers during the pandemic – those on the front line in all sectors, the administrative and management teams and those in leadership roles.

The pandemic has demonstrated that we are all here to do the same thing – provide care and support when needed for our population.

If we can remember that ethos, value working together and put the needs of the population first then we can get through this; we can deal with changing structures, limited resources and a workforce that is tired and depleted.

I’ve said it repeatedly that we must work together – the NHS, Health and Social Care providers, the Voluntary Sector and the Public. Please be kind, support each other and look for ways to collaborate….the recovery from this will not be quick, but I am convinced that together it will be quicker.

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