Transcript NHS Newcastle & Gateshead Alliance

NHS Newcastle & Gateshead
Alliance
Wednesday 8th October 2014
Key Issues
• Strategic Plans
• Five Year
• BCF
• Primary Care
The role of Commissioning
• Ensure we have safe health care services
• Ensure that we have health care services
that meet the needs of the population:
– ‘Stay well’
– ‘Get better’
– ‘Cope with long term conditions’
• Efficiently – finite resources
• Effectively – best outcomes
Increasing demands – reducing
resources
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Newcastle Gateshead - £655m budget
Expected to reduce by c£25m
£155m local authority savings
Call to Action – national £30bn shortfall
c£280m on Newcastle Gateshead
Continued austerity measures to 2020
The NHS five year strategic plan
Newcastle’s health and social care
economy vision:
‘People who live, work or learn in
Newcastle equally enjoy positive
wellbeing and good health’
In line with 2013-16 Newcastle Wellbeing for
Life Strategy
• Getting a good start in life… laying the foundation for wellbeing
and health throughout life
• Learning and employability across the life course… all people
maximising their capabilities and potential
• Promoting wellbeing and health across the life course… making
wellbeing and health promotion a key dimension of all we do
• Protecting across the life course… reducing the potential harm
from environmental hazards
• Safeguarding across the life course… reducing potential harm
from the action (or inaction) of others
• Maximising the wellbeing of people who have long term
conditions… preventing further progression of an illness and
ensuring quality of life
2020 – key principles
• People have the skills & knowledge to make the best
decisions for their needs
• We are working together, with an evidence led
approach, to keep as many people ‘well’ as we can
• We deliver care and support in the community wherever
we can
• Where people require a minor intervention this happens
in or near people’s homes as much as possible
• Where people need to go into hospital they receive high
quality, safe services that are promptly delivered
• When people are coming out of hospital they arrive
home with the appropriate support already in place
Our new system vision
• High quality out of hospital care with the GP
responsible and accountable for patient care
• The patient / citizen at the heart of the system,
supported to be “Confident and connected”
• High quality, sustainable services for patients
when they need to have care in hospital
• Primary care acting as co-ordinator of all parts of
the system, that are integrated and aligned
• Social care integral to care across the system,
supporting transformation
Engagement reports
Social media
My NHS
Partnership Forum
General public
Practice Engagement
GP bulletin
Local media
supplements
Intranet
Events
Involvement Forum
Community Forum
Focus groups
mailbox
website
Practice participation
groups
Newcastle West
Patient
Forum/ACORN
Surveys
Stakeholder
bulletin
Education events
Interviews
Our proposal for Better Care
High quality out of hospital care with the GP responsible
and accountable for patient care
The patient / citizen at the heart of the system, Supported to
manage and adapt, “Confident and connected”
High quality, sustainable services for patients when they need to
have care in hospital
Primary care acting as co-ordinator of all parts of the system, that
are integrated and aligned
Social care integral to care across the system, supporting
transformation
Delivering Out of Hospital Care
Delivering better care out of hospital is based on
three clusters of schemes which will be
implemented over five years:
• Cluster 1 - Integrated turn around and intensive
case management system
• Cluster 2 - GP led Person centred community
integrated care and support system
• Cluster 3 - Integrated prevention, early intervention
and management system
Out of Hospital
• Integrated working across tertiary, secondary, primary,
community and social care
• New models of care - ‘Healthcare without walls’
• Changing the culture
• Satellite facilities enabling community outreach
• Strengthening partnerships with primary care providers
• Enhancing partnerships with the voluntary sector
• Care closer to / and in people’s homes
• Bespoke offer, parochial to each neighbourhood
• Testing new technologies
In hospital care
To ensure we continue to make our Vision a reality, our Strategic Plan is
underpinned by 3 key strategies:
 Quality Strategy – patient safety; clinical effectiveness; patient
experience
 Clinical Strategy – safe, high quality care; listening and learning; right
place and right time; seamless care pathways; convenient and flexible
 Business Strategy – targeted growth; building capacity; improving
efficiency; comprehensive community outreach; care closer to home;
partnership working
 Research and Innovation – improving clinical outcomes; maintaining
high levels of clinical trial recruitment; academic partnerships; attracting
opportunities to the North East
The Hospital Role
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World class 7 day services
National providers of specialist services
Consultant led emergency care 24/7
Continuing our approach to increase efficiency
Ensuring high quality facilities and environments
Enhanced clinical leadership – supporting development
of capacity and skills across the system
• Specialists deployed in community settings
• Further improving access and responding to choice
across Greater Tyneside
Key Issues
• Mental Health Transformation
• Urgent Care
• Children & Young People Early
Intervention
Mental Health Transformation
From Parity to Priority
• Mental Health Programme Board
– CCGs committed to co-production
– Meets monthly
– Membership includes
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CCGs
LAs/Public Health/
Service User and Carers
VCS
NTW
• MHPB Principles
– Be Bold, Brave and Creative
– Right Person, Right Time, Right Place
– Improving quality and experience, safety and
effectiveness
– Carer and user focussed outcomes
– Engagement / Involvement
– Equality and Diversity
– Hope, meaningful choice and control, and
recovery orientated
• Quality Agenda
– Commissioning for Quality and Innovation
(CQUIN)
– Three thematic CQUINs
• Physical health
• Carers
• Diversity
• Workstreams for the CCGs and the MHPB
– Primary care and access
– Urgent care
– Physical health and complex needs
– Public Health
– Dementia
– Learning disabilities including Winterbourne
– Children’s emotional wellbeing
• Northumberland Tyne and Wear (NTW)
Foundation Trust
– Review of pathways and bed configuration
– How can we develop models of care that
improve quality?
– How do our principles help?
NEWCASTLE URGENT
CARE
Work streams & Committees
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Resilience & Operational Group
1 – Admission Avoidance
2 – 1st Contact
3 – Going Home
“Winter surge”
GP OOH
1- Admission Avoidance
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intermediate care model
older person’s resource centres
discharge pathways
emergency social beds
Ambulatory Care pathways
unscheduled care system is fragmented
1 – 1st Contact
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Directory of services is fully populated, brought up-to-date
Mental Health Emergency Access
clinical capacity with general practice
Encouraging patients to contact 111
Alternatives to A&E for less serious conditions
Inconsistent model across Newcastle
Primary care - review home visiting –reduce batching of patients
pathways of care and service models for specific patient groups;
2 – 1st Contact
• appropriate pathways of care - Frequent attenders Deliberate self-harmers - Mental health conditions Substance misuse
• ambulance staff to treat minor injuries and illness at the scene
• improve LTC management
• Public Health Campaigns
• Care Planning
• Improve active case management and care planning of
patients with complex needs
3 – Going Home
• Agreement is needed about when
discharge is appropriate, timely, and safe
• Transport discharge system is fragmented
• Formalise discharge protocol
• Review reablement model
• Develop the role of the voluntary and
community sectors
Winter
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Short term resource to address surge
Annual - 2014 new system
NUTH
L.A.
Primary Care
NTW
(VCS – other route)
GP OOH
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Redesign starts soon
Multiagency approach with GP at core
7 day working
Pilots
Possible developments
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Prevention processes
Mental health support
Health champions
Peer support
Social prescribing
Systems lessening the need for urgent
care
Children & Young People
Early Intervention
• Joining up for Newcastle Children
– Better Start bid
– Rising from the ashes
• PUP and PIP
• Working with schools
• Children’s communities
• The challenge
– Moving to prevention
– Inequalities and the Marmot review
– Financial catastrophe
• Our approach to emotional wellbeing
– A single process for the city
– A single plan
• Significant opportunity to transform
– Models of care
– Tiered levels of activity and investment
– Family approach
Organisational Change – NHS Newcastle
Gateshead CCG 1st April 2015
Key questions that have been asked
about the merger :
• What will this mean for the public and patients of Newcastle?
• How will it be different from the existing ways of working with the
three CCGs?
• Will the public and patients of Newcastle be disadvantaged by the
merger, particularly in respect of resources and finance?
Benefits of the merger
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Plan in a more “joined up” manner especially in relation to Newcastle as a whole and with
respect to the flows of patients between Newcastle and Gateshead
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Standardise, as far as possible, pathways and approaches to care to improve outcomes for
everybody
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Improve the spread and adoption of best practice and approaches that would be beneficial for
everybody
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Strengthened clinical input and decision making and capacity to make the very best of new
partnership working practices with local authorities, the voluntary and community sector and
service providers
A greater ability to influence
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Speed of change required
Health Inequalities
Fragmented services
Merger delivers for patients
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More positive change
More effective change
Faster delivery
Greater and faster improvements to outcomes