Annual General Meeting 2019 Peter Cruttenden, Chair of the Hampshire and Isle of Wight Partnership Board Dr David Chilvers, Clinical Chair Maggie MacIsaac , Chief Executive Sara Tiller , Managing Director Working together for our local communities
About the Partnership We develop, plan and pay for health services for more than 1 million local people across Hampshire and Isle of Wight. We work with patients, public, voluntary, statutory and private sector partners. Total annual budget of £1.4 billion Partnership of five clinical commissioning groups: • Fareham and Gosport/ • South Eastern Hampshire • Isle of Wight • North Hampshire • North East Hampshire and Farnham Working together for our local communities
Our priorities and objectives Quality, People, Implementing Performance Systems and models of care & Money Partnership We will ensure that We will achieve this by We will succeed by local people have fully implementing supporting the consistent access to models of care in all development of our timely high quality localities, working workforce and member care , in line with the with patients and practices . We will reform NHS constitution. partners in order to the way we and the We will improve improve outcomes and commissioning system efficiency and value for experience, and to work, planning and money so that we make services delivering care with our manage within the sustainable. partners - locally , in available budget. integrated health and care systems , and at scale across the Partnership.
How are we performing? We have continued to experience sustained pressure across the Partnership – particularly in acute care and mental health services (for both children and adults). However there are improvements and signs of recovering including: • Increased investment in mental health (adults and children) and care in the community. • We are reducing the number of delays in discharge across the whole area.
South Eastern Hampshire budget 2018/2019 Acute Primary care £42m £155m Community Services Mental £33m Health £25m * All figures shown in millions
Partnership budget 2018/2019 Prescribing Acute Continuing care £93m £598m Community Services Mental £108m Health £102m * All figures shown in millions
Cost of treatments 999 Call 111 Call Minor Injury £252 £8.10 £69 Non-Elective Knee Cataract inpatient Replacement Procedure £2,543 £6,586 £740 Elective Critical Care Pathology Test Outpatient £1,466 £1.70 £182
Tackling the big issues 1. Develop a robust workforce 2. Sustainable health and care 3. Enhanced Primary Care We are working together with our partners to address these issues so that we can deliver real change which will improve the health and wellbeing of our local communities.
In the news… “The doctor will see you now” column in The Basingstoke Gazette BBC South Today interviews the Complex Care Team
Changing the model of care Ensuring people only go to hospital when it’s Supporting Improving essential, and people to stay access to leave as soon as well specialist care they are medically fit, with the right support Joined up care Integrating for those with urgent and the most emergency care complex needs 24/7 Benefits: right care in the right place at the right time More joined up care More care in Avoiding the need for delivered around community and hospital stays patient’s needs primary care settings
Care models in action Working differently to care for children Benefits: right care in the right place at the right time Enhanced care for Reduction in Reduction in GP and children outpatient referrals ED attendances
Care models in action Helping GP practices remain resilient across the Isle of Wight Supporting GPs • Providing coaching, mentoring and buddying training • Creating opportunities for GPs in the last five years of their careers • Developing support networks • Helping GPs understand career opportunities • Developing a website and marketing approach to recruit more GPs Making an impact • Over 100 GPs have been supported through initiatives such as portfolio careers, peer networks, mentoring/coaching and buddying • 6 trainee GPs have elected to stay on the Island • ‘Dream Medical’ has resulted in 7 GPs currently in the process of being recruited • The Legacy-5 support project has been highlighted by NHS England in its soon to be published GP Retention toolkit • Work nominated for a parliamentary award by Bob Seely MP Benefits: right care in the right place at the right time Over 100 GPs 6 GP trainees staying 7 GPs currently being supported on the Island recruited
Care models in action Improving the quality of life, healthcare and planning for people living in care homes across North and Mid-Hampshire The North Hampshire pilot: 7 Care Homes, 5 GP Practices • Proactive care planning, greater self-care, reducing chances of health deterioration • Greater engagement with residents and families • Improve quality of life, reducing inappropriate moves to hospital or other care facility • Support improved quality of care at end of life • Provide essential skills for care home staff (e.g. RESPECT forms) Multi Disciplinary Teams include: • GP and Advanced Nurse Practitioner • Pharmacist: Links with hospital/community pharmacy • Dietician: provides Food First training • Care Home Nurse Educator Benefits: right care in the right place at the right time Ambulance Emergency ED attendances are conveyances 26% admissions are 27% 3% below last year below last year below last year
Care models in action Supporting those with the most complex needs across Gosport, Fareham and south east Hampshire The Gosport Complex Care Team pilot • Brings together health (GPs and Southern Health), social care and housing • Works with patients with the most complex health and social care needs • They support these individuals with their health and wellbeing • They help them access many forms of support and not just rely on GP contact • This has reduced demand on urgent care services Patient impact Mr J, 85, has multiple illness, poor mobility, lives alone and recent bereavement. Before: “Four wall syndrome ”, Isolated , lonely, poor understanding of illness, unsure how to help himself After: Attending monthly social group, weekly befriender visits, going to Memory Café, more independent, more involved in own care Benefits: right care in the right place at the right time Urgent hospital NHS111 calls / Minor Extending the service admissions reduced Injuries Units visits into other areas by 75% reduced by 63%
Working with the voluntary sector Playing a key role in the development of care models What difference can the voluntary sector make? • Work with some of the most marginalised and disadvantaged people • Provide highly effective early intervention and prevention services • Engage with people that mainstream services can struggle to reach • Reduce health inequalities • Support people and communities with some of the most complex health issues How are we already working together? • Surgery Signposters – linking people with local support • Home from hospital service – supporting people after a hospital stay • No Limits – offering free and confidential support for young people • Hampshire and Isle of Wight Social Prescribing Network – working together Benefits: right care in the right place at the right time Helping people to Reducing the need to Linking people with self-manage their see a healthcare support in their local health and wellbeing professional community
Primary Care is changing GP practices are working together with community services, social care and the voluntary sector, as Primary Care Networks, to offer more personalised, coordinated health and social care What will Primary Care Networks do? • Develop over the next five years with funding • Deliver extended hours services and NHS Long Term Plan commitments such as structured medication reviews and optimisation and enhanced health in care homes • Introduce new roles – Clinical Pharmacists, Social Prescribers, First Contact Physiotherapists, Physician’s Associates and Community Paramedics • Work together to deliver better outcomes for patients closer to home • Improve the resilience of primary care • Build on work we’ve done so far Benefits: right care in the right place at the right time Delivering better Developing a Working with a range patient outcomes changing workforce of partners
Thank you for coming. Please stay to meet our Partnership Board.
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