Health and Care Working Together in South Yorkshire and Bassetlaw Review of hospital services Public event 6 December 2017 1
Welcome and introductions Helen Stevens Associate director of communications, Health and Care Working Together in South Yorkshire and Bassetlaw 10.00 – 10.10 2
Agenda Des Breen 10.10 Introduction to the Accountable Care System 10.25 The Hospital Services Review Alexandra Norrish 10.45 Questions All 11.00 Comfort break 11.15 Urgent and emergency care Dr Nick Mallaband Dr Andy Hilton 11.30 Primary Care and the ACS 11.40 Mental Health and the ACS Dr Graeme Tosh 11.50 Questions All 12.10 Lunch 13.00 Stroke Dr Peter Anderton Dr Mo Thoufeeq 13.15 Gastroenterology and endoscopy 13.30 Questions All 14.00 Maternity Sharon Dickinson 14.15 Care of the acutely ill child Dr Nicola Jay 14.30 Questions All 10.00 – 10.10 Alexandra Norrish 14.50 Summary and close 3
Introduction to the Accountable Care System Des Breen Medical Director, Health and Care Working Together in South Yorkshire and Bassetlaw 10.10 – 10.25 4
Who are we/what is an Accountable Care System? We are Health and Care Working Together in South Yorkshire and • Bassetlaw. We are a partnership of 25 NHS, local authority, voluntary and • independent organisations responsible for looking after the health and care of the 1.5 million people living in Barnsley, Bassetlaw, Doncaster, Rotherham and Sheffield. Through working together, we have been chosen by NHS England • as one of the first areas of the country to become an accountable care system – giving us more freedom to have a local system for local people. Working together in this way means that we will be able to • better join up GPs and hospitals, physical and mental healthcare, social care and the NHS and give our patients seamless care. 10.00 – 10.10 5
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The Hospital Services Review Alexandra Norrish Programme director 10.25 – 10.45 9
Why are we reviewing hospital services? • South Yorkshire and Bassetlaw has some excellent hospitals and some great care • But healthcare has changed since the NHS was set up, and the NHS has to change with it • At the same time we are facing challenges we have never faced before, and we are struggling to provide good care for everyone • We need to look at how we provide care in order to safeguard the future of the NHS. 10.00 – 10.10 10
We need to change, just as healthcare has changed. The way that the NHS is organised now was designed in 1962. So when the NHS took its current form much of the healthcare of today did not exist 10.00 – 10.10 11
At the same time we are facing challenges we’ve never had before; In 1901 baby boys were expected to live for 45 years and girls for 49 years. In 2012, boys could expect to live for 79 years and girls for 83 years. By 2032, this is expected to increase to 83 years and 87 years respectively*. This is good news – but it means that the number of very elderly and frail people with multiple health needs is growing 10.00 – 10.10 12 King's Fund analysis of Office for National Statistics 2010-based National Population Projections
Demand for care is both growing and changing The number of older people needing care is predicted to • increase by 25% by 2025. The greatest increase is predicted to come from an increase in • cases of dementia*. At the same time, lifestyle-related conditions such as obesity are • increasing. For patients with dementia, staying in a hospital is often not the best place to be. 10.00 – 10.10 13 Guzman-Castillo et al: Forecasted trends in disability and life expectancy in England and Wales up to 2025: a modelling study
There are shortages of staff across the country in many services Last year, for example, there was a big • drop in the number of people across the country applying to train as nurses* . At the moment, we have 180 posts • unfilled just in the 5 services we are including in the Hospital Services Review. In some services, more than half the posts are vacant. Even when we recruit temporary staff, • there are often just not enough trained people to fill the posts. We need to find ways to keep our workforce and use their skills in the best way. 10.00 – 10.10 14 *https://www.ucas.com/file/92646/download?token=FFC9R2rP
We’re struggling to meet national targets, which then impacts on care: Only 2 out of the 7 hospitals covered by the review have • met the target for 62 day waiting times for cancer in the first part of 2016-17. Only 1 of our 7 hospitals met targets for A&E waiting times • in the first part of 2016-17. Only 4 of our 7 hospitals met targets for 18 weeks’ wait for • elective (planned) care in the first part of 2016-17. This means that patients in different parts of the region are receiving different standards of care. 10.00 – 10.10 15
The review of hospital services has been set up to look at ways to make healthcare in South Yorkshire and Bassetlaw sustainable. The review is independent and has been commissioned by all the partner organisations. It will develop recommendations, with engagement from the public and patients, about how healthcare might be improved – for now and the future. 10.00 – 10.10 16
Questions? 10.45 – 11.00 17
Break 11.00 – 11.15 18
Urgent and Emergency Care Dr Nick Mallaband 11.15-11.30 19
Urgent and emergency services help people get to the best place for their care All of our hospitals accept patients all day. Urgent and Emergency Care • But not all our sites accept all patients. • Dr Nick Mallaband At the moment, in South Yorkshire and Bassetlaw, if you have a • heart attack, or if your child is badly burned, the ambulance may well drive past your nearest hospital – to get to the hospital where you will get the most specialised care. As healthcare can do more and more, we need ways of making sure patients can get to the best place for their care. 11.15-11.30 20
Current struggles in Urgent and Emergency Care: Urgent and Emergency Care We do not have enough staff to provide full cover at 7 A&Es, • around the clock. Dr Nick Mallaband Sometimes, our specially trained staff are not used in the • best way, particularly for minor injuries or illnesses that could be treated elsewhere. We staff all of our emergency departments overnight, but • some A&Es have hardly any patients overnight. We need to find ways to better work with the staff we have to provide care. 11.15-11.30 21
We’ve been looking at what other places are doing: For example, In Cambridge and Peterborough, a new community-based mental health crisis first response service was introduced for people to access urgent mental health support 24 hours a day, seven days a week. The service is open 24/7 for people of all ages throughout Cambridgeshire and Peterborough. There was a 34% average weekly reduction in trips to A&E across the four hospitals and a 20% reduction in admissions because people were getting the care they needed, faster, in a different way. 11.15-11.30 22
Please add any ideas to the flipcharts on the wall at the end of the session We want to hear your ideas on how we might solve some of the issues we have talked about today. 13.15-13.30 23
Primary Care services Dr Andy Hilton 11.30 – 11.40 24
The Accountable Care Transformation Agenda Supporting “population health” through prevention and • promotion of community wellbeing. Developing sustainable patient centred services for the future. • Greater integration of services - physical and mental health, • primary and secondary care, health and social care and statutory and voluntary sector. Tackling inequality. • Improving primary and community care can reduce the need for treatments in hospitals. 11.30 – 11.40 25
As GPs we are asking how we, Are just as involved as other colleagues when influencing • changes Ensure General Practice and primary care; • • Are well resourced • Has an appropriately skilled workforce • Are well led • Are consistent in the offer to patients across the city/region • Are integrated with wider system • Are responsive to our patients? We want our patient groups to help shape ACS developments – how do we do this? 11.30 – 11.40 26
Primary Care and the ACS Developing General Practice within wider • primary care Engaging primary care in each ACS • workstream Developing ‘Primary Care Networks’ as • integrated, multi-organisational teams with on the ground clinical leadership 11.30 – 11.40 27
The General Practice and Primary Care strategy: National policy: the General Practice Forward View • General practice both regionally and locally available • Improved consistency, reduced variation and available locally • Workforce development and diversity • Developing access to services over 7 days • Protecting core values • General practice should be at the heart of the primary care • team to manage care differently, closer to home How we work better together with other services and our communities is central to our work. 11.30 – 11.40 28
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