CF Service Meeting Friday 16 December 2016 www.england.nhs.uk - - PowerPoint PPT Presentation

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Wessex CF Service Meeting

Friday 16 December 2016

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• Welcome / Introductions

Sian Summers, NHS England

• Dorset CF Service – immediate plan Mark Major, Poole Hospital

Why things need to change

• National Guidance

Sian Summers

• CF Trust Peer Review

Lynne O Grady/Dominic Kavanagh Questions to the panel

• The future for CF patients

Thom Daniels, UHS

• What happens next?

Vicky White, UHS Questions to the panel

• Next steps

Sian Summers

Agenda

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Sian Summers

NHS England

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• Sian Summers – Service Specialist, NHS England Specialist Commissioning
• Lynne O’ Grady – Head of Clinical Programmes, Cystic Fibrosis Trust
• Dominic Kavanagh – Clinical Care Advisor , Cystic Fibrosis Trust
• Dr Thomas Daniels – Lead CF consultant, University Hospital Southampton
• Mark Major, Care Group Manager - Poole Hospital
• Victoria White, Care Group Manager – University Hospital Southampton

The Panel

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• Everyone will have a chance to ask questions
• We will aim to gather questions during the course of the

presentation

• During the presentation you can type a message to the

moderator who will ensure we have captured all requests

• During the question and answer session you can also raise

a hand on the screen to show you want to ask a question

• To ensure good sound quality for everyone listening all

lines will be muted except for the person who is speaking. You can raise your hand on screen to ask a question and type a message. When you are invited by the Chair to ask your question your line will be opened so that everyone can hear you.

How the WebEx will work

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• CF service is commissioned (planned and bought) by

NHS England. We are also responsible for monitoring how the service is delivered

• University Hospital Southampton (UHS) has the

contract for Adult CF services across Hampshire, Isle

• f Wight, Wiltshire and West Sussex as well as for

Dorset

• UHS subcontracts with Poole Hospital to provide the

service in Dorset

CF services in Dorset

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Mark Major

Poole Hospital

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• Outpatient services will remain at Poole until at least

the end of April

• Inpatient services will move UHS in February

Short term changes to CF services in Dorset

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• Dr Mark Allenby leaves Poole at the end of January
• Two specialist nurses and a physiotherapist are also

leaving

• This means the service will no longer have enough

staff or the right mix of specialist staff to provide the CF service safely

• When Dr Allenby moves to Southampton there will be

enough doctors to offer 24/7 specialist advice including at the weekend and in the evenings.

Why is this necessary?

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• CF is a very specialist condition provided to a small

number of patients across the country

• This means doctors with the right skills are in short

supply

• Even though Dr Allenby has made himself available
• ut of hours, there are still times when a specialist

consultant is not available at Poole

• Until the future of the service is agreed it is not

possible to recruit staff into the other vacant posts

Why can’t new staff be recruited?

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Sian Summers

NHS England

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• The complex needs of CF patients means the whole

team needs to develop expertise so specialist services must have a minimum of 100 patients

• Southampton has the contract because it is a

specialist centre – it has 220 patients

• Shared arrangements between a specialist centre and

a district hospital are not allowed.

National Guidance

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Mark Major

Poole Hospital

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• Poole was fortunate to have a respiratory consultant

with specialist CF expertise in Poole. This doctor spent part of their time with CF patients and also worked for the general respiratory service.

• The Dorset CF service was also supported by UHS

CF consultants holding clinics in Poole.

• However, a peer review raised concerns about

whether this service was sustainable

Why Dorset service has operated differently to the national guidance

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Lynne O’Grady and Dominic Kavanagh

Cystic Fibrosis Trust

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• The Cystic Fibrosis Trust, NHS England, British

Thoracic Society and British Paediatric Respiratory Society conduct peer reviews of both adult and children’s CF services

• Aim to support improvements and share best practice
• Specialists from all aspects of care conduct the

review

• Findings are shared and published on the CF Trust

Website

CF Trust Peer Review

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Southampton and Poole Peer Review – March 2014

• Overall there is good care
• Strive to provide excellent care – but staff often work

far beyond their hours to achieve this

• Good transition for patients moving into adult service
• Active research programme

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Southampton and Poole Peer Review – March 2014

• Review the number of network clinics, particularly

those with small patient numbers where there may be difficulty in achieving adequate seven-day Multi Disciplinary Team levels

• Need for patients to attend regional centre should not

be seen as exceptional

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Southampton and Poole Peer Review – March 2014

• Few IV home courses provided
• Involve patients, parents and Cystic Fibrosis Trust in

any changes

• Nationally, it is unlikely that small clinics will be

sufficient to provide the level and experience of staffing required to meet the Cystic Fibrosis Trust’s Standards of Care

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Questions?

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Thomas Daniels

Southampton Hospital

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• Life expectancy for people living with CF has

improved and continues to do so

Future for adults with CF

Life expectancy for people living with CF has improved and continues to do so

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• The numbers of CF patients across the country living

to be adults will increase by 25% - rising from 6037 in 2016 to 7575 in 2025

• We need to adapt services to ensure you have a

better quality of life as well as a longer life

Setting up a service for the future

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Vicky White

Southampton Hospital

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• Keeping the service the same is not an option
• Three options for the future:
• 1. Move all care to Southampton
• 2. Move inpatient care to Southampton but

keep outpatients in Dorset

• 3. Patients can choose an alternative
• service. Bristol or Exeter, for example

Setting up a service for the future

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 Well established centre – treats patients from Isle of Wight, across Hampshire including Portsmouth and Basingstoke, Channel Islands, West Sussex, Salisbury  Some hospital services will be provided in the community/at home:

• Port flushes
• Lung function
• Blood tests
• IV antibiotic service

 Less time in hospital  Meets national specification for care

Option 1 Move all care to Southampton

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x Greater distance to travel

Option 1 Move all care to Southampton

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 Southampton will provide 24/7 care  Outpatient appointments in Dorset  New community service  IV antibiotics at home  Less time in hospital  Meets national specification for care

Option 2

Move hospital care to Southampton Keep outpatients in Dorset

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x Greater distance to travel for inpatient care

Option 2

Move hospital care to Southampton Keep outpatients in Dorset

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 Dependent on where you live the service may be nearer than Southampton  Patient choice

Option 3

Patients can choose an alternative service

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x Greater distance to travel than Poole x Dependent on where you live. Greater distance to

travel for hospital care than Southampton X You will not know your team and they will not know you (But we will work to ensure your transfer is as smooth as possible)

Option 3 Patients can choose an alternative service

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Questions ?

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Sian Summers

NHS England

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• We want to hear your views. This is how you can hear from us, ask

questions and talk to us further

• Another WebEx 4 January 6.00-7.30pm
• Book a meeting to discuss this directly.

PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 PHFT Health Information Centre - 01202 448003

• Talk to us on the phone or email us

PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 PHFT Health Information Centre - 01202 448003 PALS.Mailbox@poole.nhs.uk Health.Information@poole.nhs.uk

Next Steps

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• Book a meeting to discuss this directly.

PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 Poole Health Information Centre - 01202 448003

• Talk to us on the phone or email us

PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 PHFT Health Information Centre - 01202 448003 PALS.Mailbox@poole.nhs.uk Health.Information@poole.nhs.uk

• You can also speak to the Southampton CF service as follows:

Phone patient support services on 023 8120 6325.

• r Email patientsupportservices@uhs.nhs.uk.

Next Steps

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• We will also be considering how we can improve the

service across the wider Wessex area

• This will include how we make services equitable

(fair) for all patients

• We will be conducting an online survey and using

meetings like this to hear people’s views

Wessex wide

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• We will take into account everything that we have heard

from: Patients Our staff The views of doctors

• Our final decision will be based on what is in the best

interest of patients taking into account all that we have heard

• We will provide a full explanation of what we have heard

and how we have come to our decision

How will a final decision be made?

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Thank you