Transcript Document

Urgent Care Winter Plan 2013-2014
Ensure services are available to manage surges in demand system-wide.
Winter Plan Timeline
20/07/2013
Winter initiatives
finalised and
summarised
02/10/2013
All provdiers to complete final documentation and sign
04/11/2013
Initial Winter
Initiatives commence
03/12/2013
22/10/2013
Remainder of
Integrated Care
Winter Initiatives
Network meets
Commence
09/07/2013
Integrated care Network refreshed plans
and re-assess risk, revising metrics
for all initiatives and
25/08/2013
17/10/2013
consider success
2nd Integrated
Evaluation process 18/11/2013
Care Plan
communicated to Weekly
18/06/2013
Submission to
evaluations
all providers
1st Winter Summit
Area Team
continue
19/09/2013
Workshop
Initiative
costs confirmed
01/07/2013
01/08/2013
01/09/2013
18/06/2013
12/07/2013
Network members
submitted
winter initiative
updates
1
01/11/2013
01/12/2013
01/01/2014
27/11/2013
Update of
previous 7
days
performance
to CCG
27/06/2013
1st Integrated
Care Plan
Submission to
Area Team
02/07/2013
2nd Winter
Summit
Workshop
01/10/2013
30/04/2014
Final Evaluations
reviewed
31/03/2014
Winter initiatives
close down
13/08/2013
Winter initiatives
ranked by Network high ranked initiatives
agreed
01/10/2013
Integrated Care
Network meets
Primary Care
Winter
Plan to Network 01/11/2013
Urgent Care
Escalation Plan
ratified by
Board
11/11/2013
1st evaluation
submission
16/10/2013
Formal documentation received
from all providers initiatives
Continual Annual Cycle
01/02/2014 01/03/2014
01/04/2014
01/05/2014
26/05/2014
16/04/2014
Final evaluations submitted
Preparation for Winter 2013
•
•
•
•
•
Two Winter Summits were held in the summer, involving all providers
what worked well? what could be done better?
Urgent Care Winter Plan 2012 revised, lessons learnt
Statutory providers developed their own internal Escalation Plans
Education and Training Events for Primary Care
Statutory providers asked to submit bids for key initiatives to support Winter
Plan
21 submitted bids broken down as:
14 from IHT
4 from ACS
1 from EEAST
1 from Harmoni
1 from SCH
•
•
•
2
Integrated Care Network decision making body
6 winter projects commissioned
Winter contract for primary care
Total commitment investment £1.6 m
Winter Project Initiatives 2013-14
21 Escalation beds in Ipswich
Hospital
ICN agreed to fund 21 Escalation
beds in Ipswich Hospital from
November 2013
Cost : £529,758
Up to 25 community based beds
for helping patients to step down/step
up/step across from Ipswich Hospital
Block Purchased
5 beds at Baylham
5 beds at Barham
5 beds at Monmouth Court
5 Beds at Home ( virtual model)
* Potential to Spot purchase up to 5
beds in addition to the above
Extension of Flexible Dementia
Service
The provider will be able to deliver a
same day and on-going flexible
support service, provided by suitably
skilled and qualified staff
Cost:£100k 0.5 WTE social worker
for 16/52 @ £650 per week (agency
rates) Spot purchasing of FDS
Increase therapy service at
weekends to Woodbridge Ward
(IHT)
Cost:£53k
Urgent Care Escalation
Plan
Escalation Coordinators
(WSCCG &IESCCG)
Responsible for overseeing
delivery of the system-wide
Escalation Policy to secure
an integrated response from
the urgent care system in
maintaining quality care
standards throughout the
winter
Winter Contract for Primary Care
There are two elements to the Winter
Contract 2013/14 for Primary Care
which are as follows:
1.COPD ‘Traffic Light’ initiative
Cost:£350,000
2.Streaming of appropriate A&E
patients back to their GP practice for
treatment
GP presence in the Accident and
Emergency Department at Ipswich
Hospital to help patients who do not require
acute care - IHT/Harmoni to work together
to ensure the service is integrated
Cost:£195,000
3
Social Care Crisis Response Service to
be extended to out of hours (7 days per
week, 09:00 – 21:30 Monday – Saturday,
and 10:00 – 18:00 Sunday) resources
include social workers and others
Cost:£90k
Total cost: £90k
Impact Evaluation
Provider
Scheme
KPI (INTEGRATED CARE NETWORK TO FINALISE
METRICS 12 NOVEMBER 2013)
Adult Social care
Social Care Crisis Response
Avoids inappropriate hospital admission – daytime and out of hours.
Service established to determine demand and level of unmet need. Will be
closely monitored to measure level of demand and response will be in
accordance with the funding
To provide a Social Care Crisis Response Service that can deliver a coordinated response to deal with the immediate crisis and provide shortterm support, until mainstream services are able to take over.
Timely response to care need - 100% of people will be contacted within 2
hours
95% of those requiring care will receive a response within 4 hours
ACS3 Flexible Dementia Service
To extend the capacity of the Flexible Dementia Service (FDS) to take
referrals at point of discharge from hospital.
Reduce levels of DToC for those delays for people with dementia waiting
for either home care or residential placements. It is anticipated that over
the period November to February, the service will facilitate the discharge
of an average of 3 people per week for whom there would otherwise be
such delay.
Reduced admissions to residential care Of those people receiving a
service from FDS 23% will avoid an admission to residential or nursing
care.
Reduced levels of hospital re-admissions within 30 days of discharge. Of
those people receiving a service from FDS no more than 20% will have
been re-admitted
Ipswich and East CCG
Community Beds
This proposal seeks to commission 20 block and up to 5 spot purchased
beds from December to March in order to step up community patients or
step down acute patients, to be treated in the most appropriate place
Daily utilisation of beds
Monthly evaluation of qualitive information (MDT) and patient experience
Monthly evaluation of quantitative information (length of stay (less than
9.6 days and in excess of 35 patients monthly) and categories of
admissions)
Evaluation report with contributions from all stakeholders
Ipswich Hospital Trust
Escalation Beds
Actual number of additional escalation beds used on a daily basis - IHT /
CCG TO AGREE BASELINE FOR MONITORING
This proposal seeks to re-establish 21 beds on x1 closed ward from
November as a minimum, with the potential to reconfigure the medical
bed base to enable the right patient to get to the right place, first time.
Actual number of medical outliers on all wards on a daily basis
Number of delayed transfers of care (DToC)– on all wards on a daily basis
% of patients to have access to the correct speciality medical bed the first
time (all wards) - IHT / CCG TO AGREE TARGET
The number (%) of patients transferred internally and the number (%) of
occasions
All (100%) of patients within 24 hours of admission to have an expected
discharge date (EDD)
EAU Therapy Woodbridge Ward
To further improve patient flow by increasing the therapy resource
available in EAU and Woodbridge short stay ward at weekends.
Harmoni
4
% of patient discharges to meet the EDD - IHT / CCG TO AGREE TARGET
Increase in number of patients assessed, signposted, treated at the
earliest stage following arrival in to EAU, and discharge planned /
facilitated by therapy service 15% increase
Number and % of patients admitted over weekend that received therapy
input
GP Streaming in ED
Reduction in A&E attendance - HARMONI / IHT TO PROPOSE METRIC
PRIOR TO ICN ON 12/11/13
Supporting A&E at Ipswich Hospital with a GP referral point for patients
who don’t require A&E services but do require primary care.
Reduction in waiting times for patients attending A&E - HARMONI / IHT
TO PROPOSE METRIC PRIOR TO ICN ON 12/11/13
Improved patient experience, Reduction in patient complaints, Increase in
compliments, Reduction in wait times, Improved patient journey i.e.
streamed to appropriate service = less patient contact - HARMONI / IHT
TO PROPOSE METRIC PRIOR TO ICN ON 12/11/13