Transcript Slide 1

CARDIFF 3rd SECTOR COUNCIL HEALTH AND SOCIAL
CARE NETWORK
26 MARCH 2014
Shaping our Future Wellbeing
Siân Harrop-Griffiths, Assistant Director of Planning, Cardiff
and Vale UHB
Objectives
1.
Increase awareness of the UHB’s organisational strategy
2.
Develop an understanding of the population health needs and how
Shaping our Future Wellbeing Plan will need to respond to these.
3.
Seek and gain views on the issues which the Health and Social Care
Network feels are important as the Plan is developed.
3.
Seek views on how the Network would like to be involved.
4.
Discuss ideas for how we can engage with others to support
development of the Plan.
Vision What will the
UHB be like 10 years
from now?
We are starting this conversation today – your views matter to us
6 strategic steps
towards greater
integration
Establish integrated care
teams (ICT)
Measure cost together with
outcomes that matter to
patients at every level
Develop ‘year of care’ and care
budgets
Integrate care delivery system
to ensure what we offer is
consistent
Develop care delivery networks
Build an enabling IT
infrastructure
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To become the UK’s
leading integrated
health care
organisation
In 10 years time…..
To become the UK’s leading integrated health care
organisation
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Our system will be tilted towards
care at home
Much more support for people to
keep well by helping themselves
Tightly defined tertiary services at
the top of their game
Rebalanced hospitals – more
critical care, fewer beds
Social care and health joined up
Inequalities of health narrowing
Technology will support what we
need to do and keep people at
home
Clinical information platform
available anywhere
Help patients take care of
themselves
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Smaller secondary care estate,
fewer big sites
Research and innovation fuel our
progress
Reputation for teaching, research
and clinical excellence attract and
retain great people
We will deploy evidence relentlessly
so we ensure unwarranted variation
is eliminated
Patients express a strong belief in
the quality of care we provide
The public regard the UHB as a
trusted, safe and accomplished
integrated health care organisation
that has their best interests at heart
Population health profile for
Cardiff and Vale
More people, older people
Need and demand will increase
2014
2017
2019
2024
%
10 years increase
Age
Now
3 years
5 years
0-4
30,836
31,724
32,124
32,723
6.1%
5-16
63,599
66,067
68,816
74,896
17.8%
17-64
317,264
324,112 327,595
336,731
6.1%
65-84
63,598
67,144
69,803
76,873
20.9%
>85
10,738
11,565
12,156
14,182
32.1%
All
486,035
500,612 510,494
535,405
10.2%
C&V. Source: StatsWales
The disease profile is changing
The disease profile is changing
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For example
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Diabetes
• 1 in 5 inpatients
Dementia
• 1 in 4 inpatients
Patients such as these are our core population
Our services need to continue to evolve to meet the
evolving needs of our population
Chronic conditions
Chronic condition %
Area
Asthma
CHD
COPD
Diabetes
Epilepsy
Heart
failure
Cardiff South East
5.7
2.6
1.7
4.3
0.6
0.6
Cardiff West
6.6
2.2
1.0
3.2
0.5
0.5
City & Cardiff South
6.0
2.6
1.5
5.8
0.6
0.6
Cardiff and Vale UHB
6.4
2.4
1.2
3.8
0.6
0.5
Wales
6.4
2.6
1.4
3.9
0.7
0.6
Adults, QOF registers
Diabetes
Dementia
Ask: what could we have done to prevent
people getting to this stage?
We = the NHS, partner organisations,
the patient, their carer
What could we have done to prevent
someone getting to this stage?
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For many conditions pathway can be ‘shifted left’
Slowing progression
• Reducing complications
• Preventing complications
• Earlier diagnosis
• Improved self management
• Preventing condition
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Why bother?
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Benefits may include (depends on particular
evidence / experience):
Reduced morbidity
• Improved patient experience
• Reduced cost to NHS as a system
• Free up / release capacity
• Greater job satisfaction
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Unhealthy behaviours are endemic
Lifestyle characteristics
Lifestyle characteristic %
Smoker
Non-smoking adults regularly exposed to
passive smoke indoors
Consumption of alcohol: above guidelines
Consumption of alcohol: binge drinking
Consumption of fruit and vegetables:
meets guidelines
Exercise or physical activity done: meets
guidelines
Overweight or obese
Obese
C&V, adults
Area
Cardiff
Vale
21
Wales
21
23
19
17
21
45
28
46
28
44
27
35
32
34
25
53
20
29
56
22
30
57
22
Lifestyle characteristics
Lifestyle characteristic %
Area
Cardiff & Vale
Wales
C&V, 0-15 year olds
Physically
active on 5 Physically
or more
active on 7 Overweight
days
days
or obese Obese
50
34
31
18
52
36
35
19
Stark inequalities exist
Health varies hugely within C&V
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22 years
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The number of additional years of healthy life a man in one of our
least deprived areas can expect to live, compared with a man in one of
our most deprived areas
Where, when and how people access health services
varies significantly
Improving access to services for people who need them
most is key
expectancy, healthy life expectancy and disability-free life expectancy
63.0
2001-05 and 2005-09 He althylife
22.5
63.7
e xpe
c tancy
alth Wales Observatory, using
ADDE/MYE
(ONS), WIMD/WHS(WG)
WIMD 2008 (WAG)
Inequality gap
Dis ability-fre e life
e xpe c tancy
59.2
59.8
2001-05
22.7
17.2
17.1
2005-09
Females
Comparison of life expectancy, healthy life expectancy and disability-free life
80.6
Life at birth, Cardiff and
expectancy
Vale UHB 2001-05 and 2005-09
77.3
81.7
e
xpe
c
tancy
Produced by Public Health Wales Observatory, using ADDE/MYE (ONS), WIMD/WHS (WG)
75.9
fe expectancy
63.9
fe expectancy
2001-05
He althylife
60.8
Males e xpe c tancy
64.7
fe expectancy
61.5
79.9
fe expectancy
81.0
Life expectancy with 95%
confidence interval
2005-09
65.4
65.9
63.4
Disability-free life
expectancy
59.6
Inequality gap
21.0
(SII in years)
22.0
11.6
76.1
Life expectancy
Dis ability-fre e life 77.362.1
62.5
e xpe c tancy
Healthy life
expectancy
8.8
10.0
12.3
12.9
11.8
22.5
64.2
22.7
65.5
fe expectancy
66.1
62.0
fe expectancy
16.7
16.7
60.1
62.5
Females
0
10
20
30
Life expectancy
40
80.7
50
60
70
80
90
8.5
9.9
81.8
Healthy life
expectancy
65.7
Disability-free life
expectancy
62.1
20.2
21.3
66.3
62.5
C&V. Source: Public Health Wales Observatory (2011)
12.3
12.9
Deprivation
C&V
Equity of access
C&V
Immunisation uptake
C&V, MMR 2 by age 5
Culture and ethnicity
Main language spoken
C&V
English or Welsh
424,755
Arabic
3,644
Polish
2,849
Chinese
2,534
Bengali (with Sylheti and Chatgaya)
2,477
Urdu
1,243
French
859
Portuguese
714
Panjabi
680
Spanish
679
Gujurati
649
Tamil
345
C&V figures
% of total
population
93.5%
0.8%
0.6%
0.6%
0.5%
0.3%
0.2%
0.2%
0.1%
0.1%
0.1%
0.1%
Technology may help (or hinder)
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94% of population have a mobile phone
Over half of mobiles are smartphones
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Proportion rising very fast and tablet use growing rapidly too
Cardiff has highest % internet access by adults of all
major UK cities (joint with Leeds)
A third (36%) of internet users look for health
information
Inequalities
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BME groups using and embracing technology more than non-BME
But lower socioeconomic groups and older people use internet less
Source: Ofcom (2013)
Summary
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Many more people
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Especially older people
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Next 10 years : 10% (C&V)
Extra 50,000 people – or a second Barry
Next 10 years >85s:  32%
An extra 3,500 people – historically some of highest users of NHS
Modifiable risk factors are endemic
Stark inequalities in illness and treatment
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Technologies may play a part in increasing access and efficiency
Developing our Clinical Services Plan
What is the Problem We are Trying to Fix?
We need a long term plan to make sure that we have
sustainable services for our citizens that take account of:-
• Demographic changes
• Epidemiology
• Financial climate
• Workforce
• Changes in clinical practices and innovation
• Technological
• Environmental impact
We need to think radically differently
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How do we engage with people and
communities
Prudent healthcare
New ways of working
What Could the End Product Look Like?
A clear picture of the future shape
of care that reflects the health
needs of our population
From now until 2024
So what is shaping our thinking
Prevention and Well Being
Out of Hospital
Hospital
We know the
words aren’t
quite
right.........wha
t do you think
of the idea
though?
Hyper Acute
and Tertiary
What is the thinking at the moment?
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Clinically owned with high collaboration amongst
ourselves and with partners
Organised piece of work broadly structured on:
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People not sites
Priority pathways
Levels of care (acuity)
Use what we already have – previous work, local for a
and plans that already exist
What do you think?
What would a good Plan look like to you as
Stakeholders?
• Are we going in the right direction?
• How would you like to be involved?
• Who else/how else should we engage with
stakeholders?
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