Agenda Time Subject Lead 18:30 Welcome and Introduction Jackie - - PowerPoint PPT Presentation

Improving health services…

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Time Subject Lead 18:30 Welcome and Introduction Jackie Powell 18:35

• St. Marys Health campus and St. James Hospital

update Dr Jim Hogan 18:45 Q&A All 18:55 Urgent care survey and follow up actions from previous sessions David Barker 19:10 Integrated Care Katie Hovenden 19:20 What will be different in Primary Care? Paul Cox 19:30 Questions and discussion All 20:00 Close Jackie Powell

Agenda

Improving health services… Improving health services…

ST MARYS & ST JAMES UPDATE

Dr Jim Hogan

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Portsmouth Community Care Estate Review

March 2014

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Context

• Two community hospitals only 1.2 miles apart.
• Acute PFI opened in 2009 with spare capacity
• Over 6,000m2 of void space across St Mary’s and St James’ –

and significant under-utilisation

• Money spent on surplus and inefficient buildings is not being

spent on patients.

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Current Position – St Mary’s

• Currently owned by NHSPS
• Floors 1 and 2 of St Mary’s

Block B have been vacant since 2009 (2,200m²) – The services moved to QAH

• 600m² void on the ground

floor of Block A

• 200m2 void in DSU Med

Block (site plan next page)

• Portsmouth CCG has

confirmed St Mary’s as its prime strategic site (in preference to St James).

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Current Position – St Mary’s

Overall site accommodation* = 16,498 sq.m Of which 3,183 sq.m overall is empty = 19.3%

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Current Position – St James’

• Currently owned by

Solent NHS (with DH conditions)

• Victorian Asylum Site with

mix of modern and old mental health satellite buildings in the grounds.

• Main block Over

16,000m2. Less than 5% used for clinical activity – mainly administrative and clinical support.

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Phase 1 – 2014/15

5 = CDC = 1391 sq.m (851 CDC + 540 HS)

Child Physiotherapy / Occupational Therapy / Speech & Language / Consultant Paediatricians / Podiatry / Autism Clinics

6 = Fair Oak = 897 sq.m

Voids (Empty)

7 = Yew House = 411 sq.m

Voids (Storage only)

8 = The Beeches = 763 sq.m

Pain Clinic (PP/CP), Community Development Workers, Criminal Justice Team, Control of Infection, Safeguarding Children

Suite136 = 53 sq.m

Crisis management – secure admissions

Project to be delivered in two phases. Phase 1 by June 2015

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Phase 2- by December 2016

To Be Retained 1. Limes, & Orchards plus Kite Unit/New Build 2. Oakdene 3. Baytrees 4. Falcon Phase 1 (By June 2015) 5. CDC Centre/ Harbour School 6. Fair Oak 7. Yew House 8. The Beeches Phase 2 (By Dec 2016) 9. Main Block

• 10. West and Forest

Lodges

Sold St James Health Campus 1 3 4 5 6 7 8 9

PCC

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Kite Unit and location of potential new build

SOLD TO BE SOLD 1

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NHS Benefits

Outline Business Case demonstrates significant systems wide benefits.

• Creation of a modern Children’s Services centre of excellence, including

integration with services from Battenburg Clinic and possibly Portsmouth City Council

• Refurbishment and re-use of 3,000m2 of void space at St Mary’s, which is

Portsmouth CCG’s core strategic asset – and has better patient

• accessibility. St Mary’s fully utilised.
• Mental health services retained at St James’ on smaller fit for purpose

campus

• Efficiency savings of £3.25m per annum (NPV approx £52m) which will

primarily benefit Portsmouth CCG and Solent NHS budgets – allowing more funds to be directly allocated to patient care

• Re-use of surplus estate – probably for delivery of local housing.

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Timetable

OBC Approval Process

• Feb 2014: OBC completed
• 13 March: NHSPS Board
• 24 March: Solent NHS Trust Board
• 26 March: Portsmouth CCG Board
• 27-31 March: Freehold assets transfer

Phase 1 Delivery

• Full Business case by mid June
• Refurbishment works commence September
• Refurbishment works complete February 2015
• All moves complete and Phase1 land disposed – by June 2015

Phase 2 Delivery

• Revised OBC mid-June
• FBC end 2014
• Vacant possession of surplus estate by Dec 2016

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Questions?

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Under Pressure

Findings and actions from our urgent care campaign week supported by The News

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What we did

Back in January…

• Three local CCGs worked with The News on a week-long

campaign promoting alternatives to Emergency Department

• Led by CCGs, supported by all local NHS providers
• To relieve pressure on ED/A&E
• To promote alternatives available and highlight how people

can access them

• To seek people’s views, through a survey, on what they felt

about the services they had used.

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The coverage we got

Day 1 Six hour stint at QAH Emergency Dept Day 2 Behind the scenes at St Mary’s NHS TC Day 3 Focus on how the money gets spent Day 4 A day in the life of a GP Day 5 A look at out of hours services Day 6 Support available from community

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About the survey

Online and in The News’ local offices…

• 414 people took part; 60% aged between 18 and 64, and

36% aged between 65 and 84

• Over half (57%) had a long term health condition

We asked:

• what services people had used
• how they rated them
• specific questions eg access
• for suggestions or comments

20 40 60 80 100 120 Under 18 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 Over 85

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What we learned

In headline terms…

• Patients value minor injuries services highly.
• Emergency Dept at QAH and NHS 111 also scored well.
• Most respondents were also satisfied by the service they

received from their GP surgery when wanting a same day appointment.

• Out of hours results disappointing for this survey and very

different when compared to another recent patient survey.

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In more detail…

GPs

• 308 people

had used for urgent appt

• 78% rated

service either satisfactory, good or excellent

20 40 60 80 100 120 Same day/urgent appointment at your GP surgery Excellent Good Satisfactory Poor Very Poor

• More flexible appointment booking (online)
• Ability to see same GP each time
• 56% would consider ‘virtual’ appointment
• 80% would favour more appointments to be

available, including before 8.30am, after 6pm and at weekends

comments

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In more detail…

QAH/111

• 239 had

used A&E

• 78%

satisfied or +

• 171 had

called 111

• Two thirds

‘satisfied’,

• ne third

‘poor’

• Alternative services: signposting and info
• Patients under influence of alcohol should

have separate unit and be charged

• Shorter waiting times with children
• More information about waiting times
• 111: more relevant questions/call back times

comments

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In more detail…

• More out of hours doctors and nurses
• GP from own practice on out of hours calls
• Service’s own survey run at same time (350 people)

saw 83% highly satisfied; over half rated service 10/10

Out of hours

• 122 people used service
• 61% rated ‘satisfactory’,

39% ‘poor’

• 46% rated home visits

poor, too

• QAH based service: 71%

satisfaction

comments

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In more detail…

• More privacy/access to talk to pharmacist in private
• Confidence in advice
• Better trained counter staff
• More information about what they can do
• Ability to directly prescribe day to day medicines.

Pharmacies

• 267 responded
• Two thirds said they did

use local pharmacist as source of treatment and advice.

comments

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In more detail…

Minor injuries

• 182 respondents had

used service

• 83% rated service either

satisfactory, good or excellent.

comments

• Clear information

about how to access services and what each can offer

• Combined working

between services and better communication

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What happens now?

• Report on survey has been

produced and shared with lead GPs, + response to The News

• More publicity on alternative

services to A&E

• Next phase will be to look at

some digital media information tools with specific groups.

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Better Care Fund A very brief overview

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Better Care Fund What is it? A single pooled budget for health and social care services to work more closely together in local areas, based on a plan agreed between the NHS and local authorities

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How will it be delivered?

Scheme 1: Establishing fully Integrated locality based health and social care community teams Scheme 2: Review of current bed based provision Scheme 3: Increased delivery of Reablement services

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Better Care Fund

Improving health services…

How will things be different for patients?

• People will have a care plan they own and will know

what to do when things go wrong

• More people dying in preferred place of death
• Reduced readmissions to hospital
• Reduced delays in transfers of care and improved quality
• f discharge planning
• Integrated locality teams involving voluntary sector

social care, primary care, community and acute care

• Services tailored to individual need

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Better Care Fund

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Sam’s story…..

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Portsmouth PPG Meeting 30th April 2014

• Surgeries will enhance it services for highly

vulnerable patients

• Identify patients with a high risk of hospital

admission and add to a new case management register

• Develop personalised care plans
• Improved same day telephone access
• Improve telephone communication with hospitals,

A&E and care homes

• Named GP for over 75’s
• NHS contract changes

 Unplanned hospital admissions are very

distressing, disruptive and challenging for patients, carers and families

 Elderly, infirm or those with complex physical or

mental health needs are most likely to require urgent attention

 Package of improvements are now being

introduced to improve and better coordinate health services for our most vulnerable patients

• Consequently helping to avoid unnecessary

hospital admissions where appropriate

 GP’s will be identifying the most vulnerable

registered patients

• Target is to identify 2% of our registered patients

 Approximately 3,360 patients across Portsmouth  Plus any children with complex healthcare needs

• Patients informed/advised of named accountable

GP, and where applicable their appointed care coordinator

• Jointly owned by GP/patient/carer
• Includes:
• Patient contact information
• Details of a named accountable GP and care coordinator
• Details of any patient consents given for information

sharing

• Next of kin/carer/responsible adult contact information
• Patients condition and significant medical history
• Ongoing medication
• Allergies
• Individual special requirements or preferences
• Actions/plans
• e.g for crisis management

 Surgeries will assign special telephone

numbers for direct contact from ambulance teams and A&E

 Care and nursing homes will also be given

special numbers to call the surgery.

 Practices must provide quicker telephone

access to GP’s for specialist care providers

• E.g. Mental health and social care teams

 Patients who are on the case management

register will also have access to same day telephone consultations

 Named accountable GP

• Work with all health and social care professionals to

deliver appropriate care

• Ensure access to health checks

 Practice will contact patients advising

allocated GP

• By 30th June (letter, consultation or prescription

info)

• Requests to offer alternative GP

will be considered but cannot be guaranteed

 Surgeries must offer online appointment booking  Surgeries must offer repeat prescription requests

• nline

 Patient access to GP records

• View/print summary information

 Medication  Allergies  Adverse reactions  Other items agreed between GP and patient

 Vaccination programme extended

• e.g Flu for children aged 2-4 years (previously 2-3

years)

 Appointment duration – Surgeries can offer

shorter/longer appointments

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Questions?

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