Wessex CF Service Meeting Friday 16 December 2016 www.england.nhs.uk
Agenda • Welcome / Introductions Sian Summers, NHS England • Dorset CF Service – immediate plan Mark Major, Poole Hospital Why things need to change • National Guidance Sian Summers • CF Trust Peer Review Lynne O Grady/Dominic Kavanagh Questions to the panel • The future for CF patients Thom Daniels, UHS • What happens next? Vicky White, UHS Questions to the panel • Next steps Sian Summers www.england.nhs.uk
Sian Summers NHS England www.england.nhs.uk
The Panel • Sian Summers – Service Specialist, NHS England Specialist Commissioning • Lynne O’ Grady – Head of Clinical Programmes, Cystic Fibrosis Trust • Dominic Kavanagh – Clinical Care Advisor , Cystic Fibrosis Trust • Dr Thomas Daniels – Lead CF consultant, University Hospital Southampton • Mark Major, Care Group Manager - Poole Hospital • Victoria White, Care Group Manager – University Hospital Southampton www.england.nhs.uk
How the WebEx will work • Everyone will have a chance to ask questions • We will aim to gather questions during the course of the presentation • During the presentation you can type a message to the moderator who will ensure we have captured all requests • During the question and answer session you can also raise a hand on the screen to show you want to ask a question • To ensure good sound quality for everyone listening all lines will be muted except for the person who is speaking. You can raise your hand on screen to ask a question and type a message. When you are invited by the Chair to ask your question your line will be opened so that everyone can hear you. www.england.nhs.uk
CF services in Dorset • CF service is commissioned (planned and bought) by NHS England. We are also responsible for monitoring how the service is delivered • University Hospital Southampton (UHS) has the contract for Adult CF services across Hampshire, Isle of Wight, Wiltshire and West Sussex as well as for Dorset • UHS subcontracts with Poole Hospital to provide the service in Dorset www.england.nhs.uk
Mark Major Poole Hospital www.england.nhs.uk
Short term changes to CF services in Dorset • Outpatient services will remain at Poole until at least the end of April • Inpatient services will move UHS in February www.england.nhs.uk
Why is this necessary? • Dr Mark Allenby leaves Poole at the end of January • Two specialist nurses and a physiotherapist are also leaving • This means the service will no longer have enough staff or the right mix of specialist staff to provide the CF service safely • When Dr Allenby moves to Southampton there will be enough doctors to offer 24/7 specialist advice including at the weekend and in the evenings. www.england.nhs.uk
Why can’t new staff be recruited? • CF is a very specialist condition provided to a small number of patients across the country • This means doctors with the right skills are in short supply • Even though Dr Allenby has made himself available out of hours, there are still times when a specialist consultant is not available at Poole • Until the future of the service is agreed it is not possible to recruit staff into the other vacant posts www.england.nhs.uk
Sian Summers NHS England www.england.nhs.uk
National Guidance • The complex needs of CF patients means the whole team needs to develop expertise so specialist services must have a minimum of 100 patients • Southampton has the contract because it is a specialist centre – it has 220 patients • Shared arrangements between a specialist centre and a district hospital are not allowed. www.england.nhs.uk
Mark Major Poole Hospital www.england.nhs.uk
Why Dorset service has operated differently to the national guidance • Poole was fortunate to have a respiratory consultant with specialist CF expertise in Poole. This doctor spent part of their time with CF patients and also worked for the general respiratory service. • The Dorset CF service was also supported by UHS CF consultants holding clinics in Poole. • However, a peer review raised concerns about whether this service was sustainable www.england.nhs.uk
Lynne O’Grady and Dominic Kavanagh Cystic Fibrosis Trust www.england.nhs.uk
CF Trust Peer Review • The Cystic Fibrosis Trust, NHS England, British Thoracic Society and British Paediatric Respiratory Society conduct peer reviews of both adult and children’s CF services • Aim to support improvements and share best practice • Specialists from all aspects of care conduct the review • Findings are shared and published on the CF Trust Website www.england.nhs.uk
Southampton and Poole Peer Review – March 2014 • Overall there is good care • Strive to provide excellent care – but staff often work far beyond their hours to achieve this • Good transition for patients moving into adult service • Active research programme www.england.nhs.uk
Southampton and Poole Peer Review – March 2014 • Review the number of network clinics, particularly those with small patient numbers where there may be difficulty in achieving adequate seven-day Multi Disciplinary Team levels • Need for patients to attend regional centre should not be seen as exceptional www.england.nhs.uk
Southampton and Poole Peer Review – March 2014 • Few IV home courses provided • Involve patients, parents and Cystic Fibrosis Trust in any changes • Nationally, it is unlikely that small clinics will be sufficient to provide the level and experience of staffing required to meet the Cystic Fibrosis Trust’s Standards of Care www.england.nhs.uk
Questions? www.england.nhs.uk
Thomas Daniels Southampton Hospital www.england.nhs.uk
Future for adults with CF Life expectancy for people living with CF has improved and continues to do so • Life expectancy for people living with CF has improved and continues to do so www.england.nhs.uk
Setting up a service for the future • The numbers of CF patients across the country living to be adults will increase by 25% - rising from 6037 in 2016 to 7575 in 2025 • We need to adapt services to ensure you have a better quality of life as well as a longer life www.england.nhs.uk
Vicky White Southampton Hospital www.england.nhs.uk
Setting up a service for the future • Keeping the service the same is not an option • Three options for the future: 1. Move all care to Southampton 2. Move inpatient care to Southampton but keep outpatients in Dorset 3. Patients can choose an alternative service. Bristol or Exeter, for example www.england.nhs.uk
Option 1 Move all care to Southampton Well established centre – treats patients from Isle of Wight, across Hampshire including Portsmouth and Basingstoke, Channel Islands, West Sussex, Salisbury Some hospital services will be provided in the community/at home: • Port flushes • Lung function • Blood tests • IV antibiotic service Less time in hospital Meets national specification for care www.england.nhs.uk
Option 1 Move all care to Southampton x Greater distance to travel www.england.nhs.uk
Option 2 Move hospital care to Southampton Keep outpatients in Dorset Southampton will provide 24/7 care Outpatient appointments in Dorset New community service IV antibiotics at home Less time in hospital Meets national specification for care www.england.nhs.uk
Option 2 Move hospital care to Southampton Keep outpatients in Dorset x Greater distance to travel for inpatient care www.england.nhs.uk
Option 3 Patients can choose an alternative service Dependent on where you live the service may be nearer than Southampton Patient choice www.england.nhs.uk
Option 3 Patients can choose an alternative service x Greater distance to travel than Poole x Dependent on where you live. Greater distance to travel for hospital care than Southampton X You will not know your team and they will not know you (But we will work to ensure your transfer is as smooth as possible) www.england.nhs.uk
Questions ? www.england.nhs.uk
Sian Summers NHS England www.england.nhs.uk
Next Steps • We want to hear your views. This is how you can hear from us, ask questions and talk to us further • Another WebEx 4 January 6.00-7.30pm • Book a meeting to discuss this directly. PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 PHFT Health Information Centre - 01202 448003 • Talk to us on the phone or email us PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 PHFT Health Information Centre - 01202 448003 PALS.Mailbox@poole.nhs.uk Health.Information@poole.nhs.uk www.england.nhs.uk
Next Steps • Book a meeting to discuss this directly. PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 Poole Health Information Centre - 01202 448003 • Talk to us on the phone or email us PHFT Patient Advice & Liaison Service (PALS) - 01202 448499 PHFT Health Information Centre - 01202 448003 PALS.Mailbox@poole.nhs.uk Health.Information@poole.nhs.uk • You can also speak to the Southampton CF service as follows: Phone patient support services on 023 8120 6325. or Email patientsupportservices@uhs.nhs.uk. www.england.nhs.uk
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