Out of Hospital (OOH) Strategy and Draft Commissioning Intentions - - PowerPoint PPT Presentation

Out of Hospital (OOH) Strategy and Draft Commissioning Intentions Draft Commissioning Intentions 2014/15

4

4

Hounslow serves 288,000 patients

Other clinics CCG boundary Locality boundary Hubs >7,500 3,000-7,500 <3,000 GP practices:

Brentford & Isleworth 56,300 patients 10 practices Great West Road Hounslow 288,000 patients 54 practices § Hounslow fully authorised as a CCG since July 2013, three remaining conditions on since April 13 have been removed by NHS England § Hounslow has two key objectives in its operating plan; delivery of the Out of Hospital Strategy and Improving the Quality of Primary Medical Services (GP) § Hounslow CCG plan to spend £31m (11%) of their 2013/14 budget on community health services providing easy access to high quality; responsive primary care; high quality elective (planned) care and well understood planned care

Hounslow is planning significant improvements to its OOH care

2 6

1 2 3 4 5 6

Feltham 65,263 patients 14 practices Heart of Hounslow 63,046 patients 11 practices Chiswick 41,132 patients 8 practices 52,264 patients 10 practices elective (planned) care and well understood planned care pathways; rapid response to urgent needs; health and social care working together, and appropriate time in hospital. § Hounslow’s out of hospital plans are focused on delivering these objectives from 2013/14, including new community and primary care services, ambulatory emergency care services and the integration of care. § Joint working is central to this. For example Hounslow CCG are working with the local and neighbouring authorities as well as the Hounslow and Richmond Community Healthcare NHS Trust and Richmond CCG to develop an Integrated Care Organisation (ICO) programme. Source: CCG Prospectus

2 4 6

1 4 6

Hounslow will progress its OOH strategy

Other clinics CCG boundary Locality boundary Hubs Hospitals >7,500 3,000-7,500 <3,000 Local Hospitals

LH

GP practices:

Hounslow plans, and is currently implementing, several major programmes to deliver its OOH strategy

Planned initiatives 2013/14 and 14/15 § Primary care mental health services will be enhanced to enable more people with a severe mental illness to be effectively supported by their GP and reduce the need for secondary care – Shifting Settings of Care (650 patients)

Hounslow is developing its estate to deliver this, including enhancing three hubs

Easy access to high quality, responsive care A Simplified planned care pathways B

§ Review of a number of pathways, diagnostics and procedures to improve community provision and potentially re- commission services § Heart Failure § Community Respiratory § Sleep Apnoea

1 4 6 7

2

2 3 5

Integrated care for LTC and elderly Rapid response to urgent needs D C

§ 111 and UCC improvements have been delivered as part of NW London-wide developments. § LAS and Heart Failure link to UCC § Expanded the Integrated Community Response Service § Implementation of ‘Co-ordinate My Care’ (CMC) for end of life patients § Whole systems integrated care – ICO § Stroke Association advisors § A new role of care navigators to ensure patients find the right service and are linked into the local voluntary sector and can build networks and social support § Dementia services will be improved through improved advice and information for patients and their carers, training for carers of patients with dementia, and integration with local authority services

Source: DMBC

2 3 5

No. Heston Health Centre Potential OOH Hub Heart of Hounslow Centre for Health 2 1 Meadows Centre for Health 3 Brentford Health Centre 4 Feltham Centre for Health 5 West Middlesex Hospital 6 Chiswick Health Centre 7

We agreed quality standards for primary and community services

Individual empowerment and self-care Access, convenience and responsiveness

1 2

Care planning and multi-disciplinary care delivery Information and communication

2 3 4

• GP Access – Local Priority
• Appointments audit being carried out in practices
• Procurement for GP Out of Hours
• Working with NHS England to agree standards about opening hours, the

number of appointments, supporting people to manage their long term condition

Improving the quality of Primary medical services

condition

• Locality networks
• Reduction in unscheduled admissions
• Improvements in the quality of referrals
• Improvements in the quality of care
• Delivery of cost effective and evidence based medicines
• GP Assurance Framework

We have worked to understand peoples’ priorities from general practice, and developed a programme in response

Improved quality & reduced variation

We surveyed over 1,000 service users, representative of the NWL population, about their priorities for General Practice. The top three priorities were:

• 1. I can quickly get an emergency appointment when I

need one

• 2. I have enough time in my appointment to cover

Understanding peoples’ priorities from General Practice Better integrated services Flexible access

Timely, appropriate care

• 2. I have enough time in my appointment to cover

everything I want to discuss

• 3. I can rely on getting consistently good service at my

GP surgery We learned that access is a complex issue because what patients want depends on overall health needs and the immediacy of their presenting condition, rather than demographic or other determinants. We are clear that delivering these three priorities will require new ways of delivering primary care, it cannot be a case of more of the same. In response, we developed a programme to improve primary care across NWL.

Easy access to high quality responsive care

• Diagnostics, radiology and pathology
• Reduce medicines related harm
• Transport
• High quality nursing home care

Draft Commissioning Intentions 2014/15

• High quality nursing home care

Simplified planned care pathways

• Musculoskeletal – Trauma and Orthopaedics
• Mental health programme
• Reduction of alcohol related admissions
• Management of Tuberculosis
• CAHMS Tier 2 (Children and Adolescent Mental Health Services)

Rapid response to urgent needs

• Night nursing
• Fast track continuing care
• Ambulatory Care

Integrated care for LTC and elderly

Commissioning Intentions 2014/15 contd.

• Remodel the care pathway for patients with diabetes
• End of Life Care
• Dementia
• Stroke Advisors, stroke pathway after hospital discharge
• Additional children’s disability health provision

Joint Commissioning and the Social Care Integrated Fund

• Integrated model including mental health (Integrated Care Org)

Health and Wellbeing Board Comments and Additions to Commissioning Intentions Commissioning Intentions