Agenda Time Subject Lead 18:30 Welcome and Introduction Jackie Powell 18:35 St. Marys Health campus and St. James Hospital Dr Jim Hogan update 18:45 Q&A All 18:55 Urgent care survey and follow up actions from David Barker previous sessions 19:10 Integrated Care Katie Hovenden 19:20 What will be different in Primary Care? Paul Cox 19:30 Questions and discussion All 20:00 Close Jackie Powell Improving health services… 1
ST MARYS & ST JAMES UPDATE Dr Jim Hogan Improving health services… Improving health services… 2
Portsmouth Community Care Estate Review March 2014 Page 3
Context Two community hospitals only 1.2 miles apart. Acute PFI opened in 2009 with spare capacity Over 6,000m 2 of void space across St Mary’s and St James’ – and significant under-utilisation Money spent on surplus and inefficient buildings is not being spent on patients. Page 4
Current Position – St Mary’s Currently owned by NHSPS Floors 1 and 2 of St Mary’s Block B have been vacant since 2009 (2,200m²) – The services moved to QAH 600m² void on the ground floor of Block A 200m 2 void in DSU Med Block (site plan next page) Portsmouth CCG has confirmed St Mary’s as its prime strategic site (in preference to St James). Page 5
Current Position – St Mary’s Overall site accommodation* = 16,498 sq.m Of which 3,183 sq.m overall is empty = 19.3% Page 6
Current Position – St James’ Currently owned by Solent NHS (with DH conditions) Victorian Asylum Site with mix of modern and old mental health satellite buildings in the grounds. Main block Over 16,000m 2 . Less than 5% used for clinical activity – mainly administrative and clinical support. Page 7
Phase 1 – 2014/15 Project to be delivered in two phases. Phase 1 by June 2015 5 = CDC = 1391 sq.m (851 CDC + 540 HS) Child Physiotherapy / Occupational Therapy / Speech & Language / Consultant Paediatricians / Podiatry / Autism Clinics 6 = Fair Oak = 897 sq.m Voids (Empty) 7 = Yew House = 411 sq.m Voids (Storage only) 8 = The Beeches = 763 sq.m Pain Clinic (PP/CP), Community Development Workers, Criminal Justice Team, Control of Infection, Safeguarding Children Suite136 = 53 sq.m Crisis management – secure admissions Page 8
Phase 2- by December 2016 St James Health Campus To Be Retained 1. Limes, & Orchards plus Kite Unit/New Build Sold TO BE SOLD 2. Oakdene 3 4 SOLD 3. Baytrees 4. Falcon Kite Unit and location of 1 potential new Phase 1 (By June 2015) build 1 5. CDC Centre/ Harbour School 9 6. Fair Oak 8 7 7. Yew House 6 8. The Beeches 5 Phase 2 (By Dec 2016) 9. Main Block 10. West and Forest 10 PCC 2 Lodges Page 9
NHS Benefits Outline Business Case demonstrates significant systems wide benefits. Creation of a modern Children’s Services centre of excellence, including integration with services from Battenburg Clinic and possibly Portsmouth City Council Refurbishment and re-use of 3,000m 2 of void space at St Mary’s, which is Portsmouth CCG’s core strategic asset – and has better patient accessibility. St Mary’s fully utilised. Mental health services retained at St James’ on smaller fit for purpose campus Efficiency savings of £3.25m per annum (NPV approx £52m) which will primarily benefit Portsmouth CCG and Solent NHS budgets – allowing more funds to be directly allocated to patient care Re-use of surplus estate – probably for delivery of local housing. Page 10 10
Timetable OBC Approval Process Feb 2014: OBC completed 13 March: NHSPS Board 24 March: Solent NHS Trust Board 26 March: Portsmouth CCG Board 27-31 March: Freehold assets transfer Phase 1 Delivery Full Business case by mid June Refurbishment works commence September Refurbishment works complete February 2015 All moves complete and Phase1 land disposed – by June 2015 Phase 2 Delivery Revised OBC mid-June FBC end 2014 Vacant possession of surplus estate by Dec 2016 Page 11 11
Questions? Improving health services… Improving health services… 12
Under Pressure Findings and actions from our urgent care campaign week supported by The News Improving health services… Improving health services…
What we did Back in January… • Three local CCGs worked with The News on a week-long campaign promoting alternatives to Emergency Department • Led by CCGs, supported by all local NHS providers • To relieve pressure on ED/A&E • To promote alternatives available and highlight how people can access them • To seek people’s views, through a survey, on what they felt about the services they had used. Improving health services…
The coverage we got Day Six hour stint at QAH 1 Emergency Dept Day Behind the scenes at 2 St Mary’s NHS TC Day Focus on how the 3 money gets spent Day A day in the life of a 4 GP Day A look at out of hours 5 services Day Support available 6 from community Improving health services…
About the survey Online and in The News’ local offices… • 414 people took part; 60% aged between 18 and 64, and 36% aged between 65 and 84 • Over half (57%) had a long term health condition We asked: 120 • what services people had used 100 80 • how they rated them 60 • specific questions eg access 40 • for suggestions or comments 20 0 Under 18 - 25 - 35 - 45 - 55 - 65 - 75 - Over 18 24 34 44 54 64 74 84 85 Improving health services…
What we learned In headline terms… • Patients value minor injuries services highly. • Emergency Dept at QAH and NHS 111 also scored well. • Most respondents were also satisfied by the service they received from their GP surgery when wanting a same day appointment. • Out of hours results disappointing for this survey and very different when compared to another recent patient survey. Improving health services…
In more detail… 120 GPs 100 • 308 people 80 had used for Excellent Good urgent appt 60 Satisfactory Poor • 78% rated 40 Very Poor service 20 either 0 satisfactory, Same day/urgent appointment at your GP surgery good or comments - More flexible appointment booking (online) excellent - Ability to see same GP each time - 56% would consider ‘virtual’ appointment - 80% would favour more appointments to be available, including before 8.30am, after 6pm and at weekends Improving health services…
In more detail… QAH/111 • 239 had used A&E • 78% satisfied or + • 171 had called 111 • Two thirds ‘satisfied’, one third comments - Alternative services: signposting and info ‘poor’ - Patients under influence of alcohol should have separate unit and be charged - Shorter waiting times with children - More information about waiting times - 111: more relevant questions/call back times Improving health services…
In more detail… Out of hours • 122 people used service • 61% rated ‘satisfactory’, 39% ‘poor’ • 46% rated home visits poor, too • QAH based service: 71% satisfaction comments - More out of hours doctors and nurses - GP from own practice on out of hours calls - Service’s own survey run at same time (350 people) saw 83% highly satisfied; over half rated service 10/10 Improving health services…
In more detail… Pharmacies • 267 responded • Two thirds said they did use local pharmacist as source of treatment and advice. - More privacy/access to talk to pharmacist in private comments - Confidence in advice - Better trained counter staff - More information about what they can do - Ability to directly prescribe day to day medicines. Improving health services…
In more detail… Minor injuries • 182 respondents had used service • 83% rated service either satisfactory, good or excellent. comments - Clear information about how to access services and what each can offer - Combined working between services and better communication Improving health services…
What happens now? • Report on survey has been produced and shared with lead GPs, + response to The News • More publicity on alternative services to A&E • Next phase will be to look at some digital media information tools with specific groups. Improving health services…
Better Care Fund A very brief overview Improving health services… Improving health services…
Better Care Fund What is it? A single pooled budget for health and social care services to work more closely together in local areas, based on a plan agreed between the NHS and local authorities Improving health services… 25
Better Care Fund How will it be delivered? Scheme 1 : Establishing fully Integrated locality based health and social care community teams Scheme 2 : Review of current bed based provision Scheme 3 : Increased delivery of Reablement services Improving health services… 26
Better Care Fund How will things be different for patients? • People will have a care plan they own and will know what to do when things go wrong • More people dying in preferred place of death • Reduced readmissions to hospital • Reduced delays in transfers of care and improved quality of discharge planning • Integrated locality teams involving voluntary sector social care, primary care, community and acute care • Services tailored to individual need Improving health services… 27
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