July 2013 What is better care, together? Better care, together is a - - PowerPoint PPT Presentation

A NEW CLINICAL STRATEGY FOR HEALTH SERVICES IN MORECAMBE BAY Update Report July 2013

What is better care, together?

Better care, together is a review of local health services which is being carried

• ut by local NHS organisations, led by:

– Lancashire North Clinical Commissioning Group – Cumbria Clinical Commissioning Group – University Hospitals of Morecambe Bay NHS Foundation Trust, which runs the hospitals in Lancaster, Barrow and Kendal – Lancashire Area Team and Cumbria Area Team – The review is an opportunity to make sure the best possible health services are provided across North Lancashire and South Cumbria, which meet the needs of residents, now and well into the future. Health professionals in the area, including GPs and hospital doctors, are considering how the different parts of the health service can work together more effectively to ensure individual patients get the most appropriate care.

Background and context

• Quality and Safety issues in UHMB

– Monitor intervention

• Maternity & Paediatrics; ED; Outpatients; Safeguarding

– CQC

• Financial issues in UHMB

– Monitor intervention – Formal Recovery Plan

• Expensive / non sustainable remedies
• Health economy financial challenge
• Demographics / Austerity / Geography
• Desire for integration, moving care closer to where people live
• Recognition that certain treatments require travel to specialist centres
• National context – David Nicholson’s £20 billion

Vision

• The provision of safe, high quality care which will be patient-centred, safe and effective,

affordable and sustainable.

• Future NHS services in Morecambe Bay to be increasingly joined-up as part of an

integrated health and social care system

• Safe, appropriate, accessible services delivered by the appropriate clinicians as near to

people’s homes as possible.

• Some care is best provided in a hospital. We want to ensure that residents requiring

hospital care receive safe care of the highest quality possible, based on clinical evidence and best practice to ensure the best health outcomes for them.

• Where possible this hospital care would be provided by local hospitals with more

specialist care being provided by specialist centres, as is the case now.

• We want to empower residents to manage their own health and care with the support
• f the appropriate clinicians where necessary.
• We want to engage local residents and communities in the decision making process to

improve healthcare as part of a developing clinical strategy for the population of Morecambe Bay.

Who is involved from the local health community?

Steering Group Membership:

– Cumbria CCG – Lancashire North CCG – University Hospitals of Morecambe Bay FT – Cumbria Partnership FT – Lancashire Care FT – Blackpool Teaching Hospitals FT – Lancashire County Council – Cumbria County Council – North West Ambulance Service – Lancashire Area Team, NHS England – Cumbria, Northumberland and Tyne & Wear Area Team, NHS England

Sponsor Programme Workstream

Trust Boards

Membership Council / Governing bodies Steering Group Public Reference Group CS Clinical Reference Group Finance & Activity Unscheduled care Planned Care Children & Young People Maternity

Communications & Engagement

HR & Workforce

Estates

Programme Governance Structure

Membership Council / Governing bodies Programme Support Organisation

Transport Informatics Primary & Community care Task & Finish group

The four clinical workstreams

Clinical work streams looking at four key areas: – Unplanned care e.g. emergency care – Planned care e.g. elective surgery, long term conditions – Maternity – Children and Young People They report to a Clinical Reference Group comprising of GPs, Hospital Consultants, Medical Director and CCG Clinical Chairs. They are also supported by cross cutting work streams e.g. Workforce including union representation; Finance & Activity; Transport; Estates; Communications & Engagement.

Milestones

• The programme plan and key milestones for the option appraisals

were revised to allow more time to ensure engagement /robustness.

• A recent informal visit by the National Clinical Advisory Team in

June will be followed by a formal review later in the year

• A Health Gateway 0 (strategic assurance review) took place 15 – 18

July.

• The results of this will inform the next steps of the Programme

along with our pre-engagement work

• Partners will be kept up to date with developments and timescales

via our stakeholder briefings and our on-going engagement programme.

The Route to Viable Options

Workstream Clinical Models Combined Clinical Models Generate Options Appraise Options Short Listed Options

Public Engagement

Pre-consultation engagement to date has reached

• ver 5000 people via representative groups or

individual contact

Includes:

• TNS BMRB independent research company: four phases including a survey

for staff, stakeholders and the public

• St Johns Hospice focus group
• Age UK South Lakeland event
• Road show bus visits
• Cumbria Youth Alliance focus groups and questionnaires
• Manna House Centre for the homeless
• Field events in town centres
• Vox pop film bites
• Clinical engagement

In addition we have on-going engagement with OSCs, MPs, local Councils , staff and clinicians

Pre-consultation communication to date

Includes:

• Launch letters
• Advertorials
• Press releases
• Radio interviews
• Newsletters
• Presentations
• MP briefings
• Stakeholder briefings
• Website

Key themes to date include:

• Travel e.g. people are used to travelling for highly

specialised care

• Proximity to facilities e.g. culture of services being local
• Patient experience e.g. positive and negative
• Perceived risk e.g. of transfer while ill
• Communication e.g. listening skills and remote contact
• Relationships e.g. with medical staff
• Access e.g. weekend access
• Staffing e.g. levels of staffing in secondary and primary care
• Level of acceptance of change e.g. sustainability and

timescales

Comments to date include:

Strengths:

• “I experienced a fast track system

at RIL – I went through 4 different departments to get a range of tests and results in the same day. I was glad to get an answer at the end of the day – I was nervous but I walked away a free man”

• Nearly 2/3 of general public and

staff said they would recommend services to a friend or family member

• “Nurses get a hard time in the

media but on the whole provide an excellent service”

Areas for improvement:

• “Felt like I was going from

pillar to post”

• “Older people need good

care today not at some point in the future”

• “Not meant to be ill at

weekend”

Initial consultation plans

Engagement

• Full consultation document
• Summary consultation

document

• On-line and paper

questionnaire

• Launch event
• Drop in events
• Exhibitions
• Staff engagement
• Events with partners

Communication

• Webinars
• Media relations
• Hospital radio interviews
• Website
• Social media
• Advertorials
• Meetings with key

stakeholders

Next steps

• This exercise and feedback from the public and stakeholders has been

passed on to health professionals to inform their views when shaping

• ptions for providing services in future.
• Further engagement with hard to reach groups and protected groups

(including the well majority)

• Further develop the staff engagement programme
• Consider clarity of communications e.g. clear explanations of any changes

to patient pathways

• Continued work with key stakeholders such as Health and Wellbeing

boards, elected members and OSCs

• On-going meetings of the Public Reference Group (1st held on 17th July)

to help review communication and engagement processes

• External Assurance – NCAT, Health Gateway, Legal advice and Consultation

Institute “compliance” package.

• Primary and Community Care Task & Finish group to start project work

shortly

Thank you for your time today

Your questions?