July 2013 What is better care, together? Better care, together is a - PowerPoint PPT Presentation

A NEW CLINICAL STRATEGY FOR HEALTH SERVICES IN MORECAMBE BAY Update Report July 2013

What is better care, together? Better care, together is a review of local health services which is being carried out by local NHS organisations, led by: – Lancashire North Clinical Commissioning Group – Cumbria Clinical Commissioning Group – University Hospitals of Morecambe Bay NHS Foundation Trust, which runs the hospitals in Lancaster, Barrow and Kendal – Lancashire Area Team and Cumbria Area Team – The review is an opportunity to make sure the best possible health services are provided across North Lancashire and South Cumbria, which meet the needs of residents, now and well into the future. Health professionals in the area, including GPs and hospital doctors, are considering how the different parts of the health service can work together more effectively to ensure individual patients get the most appropriate care.

Background and context • Quality and Safety issues in UHMB – Monitor intervention • Maternity & Paediatrics; ED; Outpatients; Safeguarding – CQC • Financial issues in UHMB – Monitor intervention – Formal Recovery Plan • Expensive / non sustainable remedies • Health economy financial challenge • Demographics / Austerity / Geography • Desire for integration, moving care closer to where people live • Recognition that certain treatments require travel to specialist centres • National context – David Nicholson’s £20 billion

Vision • The provision of safe, high quality care which will be patient-centred, safe and effective, affordable and sustainable. • Future NHS services in Morecambe Bay to be increasingly joined-up as part of an integrated health and social care system • Safe, appropriate, accessible services delivered by the appropriate clinicians as near to people’s homes as possible. • Some care is best provided in a hospital. We want to ensure that residents requiring hospital care receive safe care of the highest quality possible, based on clinical evidence and best practice to ensure the best health outcomes for them. • Where possible this hospital care would be provided by local hospitals with more specialist care being provided by specialist centres, as is the case now. • We want to empower residents to manage their own health and care with the support of the appropriate clinicians where necessary. • We want to engage local residents and communities in the decision making process to improve healthcare as part of a developing clinical strategy for the population of Morecambe Bay.

Who is involved from the local health community? Steering Group Membership: – Cumbria CCG – Lancashire North CCG – University Hospitals of Morecambe Bay FT – Cumbria Partnership FT – Lancashire Care FT – Blackpool Teaching Hospitals FT – Lancashire County Council – Cumbria County Council – North West Ambulance Service – Lancashire Area Team, NHS England – Cumbria, Northumberland and Tyne & Wear Area Team, NHS England

Programme Governance Structure Sponsor Trust Membership Council / Membership Council / Governing bodies Governing bodies Boards Public Reference Steering Group Programme Group Programme Support Organisation HR & CS Clinical Reference Estates Workforce Group Finance & Transport Activity Children & Young Workstream Planned Communications People Informatics & Engagement Care Maternity Unscheduled Primary & care Community care Task & Finish group

The four clinical workstreams Clinical work streams looking at four key areas: – Unplanned care e.g. emergency care – Planned care e.g. elective surgery, long term conditions – Maternity – Children and Young People They report to a Clinical Reference Group comprising of GPs, Hospital Consultants, Medical Director and CCG Clinical Chairs. They are also supported by cross cutting work streams e.g. Workforce including union representation; Finance & Activity; Transport; Estates; Communications & Engagement.

Milestones • The programme plan and key milestones for the option appraisals were revised to allow more time to ensure engagement /robustness. • A recent informal visit by the National Clinical Advisory Team in June will be followed by a formal review later in the year • A Health Gateway 0 (strategic assurance review) took place 15 – 18 July. • The results of this will inform the next steps of the Programme along with our pre-engagement work • Partners will be kept up to date with developments and timescales via our stakeholder briefings and our on-going engagement programme.

The Route to Viable Options Workstream Combined Generate Appraise Short Listed Clinical Clinical Options Options Options Models Models Public Engagement

Pre-consultation engagement to date has reached over 5000 people via representative groups or individual contact Includes: • TNS BMRB independent research company: four phases including a survey for staff, stakeholders and the public • St Johns Hospice focus group • Age UK South Lakeland event • Road show bus visits • Cumbria Youth Alliance focus groups and questionnaires • Manna House Centre for the homeless • Field events in town centres • Vox pop film bites • Clinical engagement In addition we have on-going engagement with OSCs, MPs, local Councils , staff and clinicians

Pre-consultation communication to date Includes: • Launch letters • Advertorials • Press releases • Radio interviews • Newsletters • Presentations • MP briefings • Stakeholder briefings • Website

Key themes to date include: • Travel e.g. people are used to travelling for highly specialised care • Proximity to facilities e.g. culture of services being local • Patient experience e.g. positive and negative • Perceived risk e.g. of transfer while ill • Communication e.g. listening skills and remote contact • Relationships e.g. with medical staff • Access e.g. weekend access • Staffing e.g. levels of staffing in secondary and primary care • Level of acceptance of change e.g. sustainability and timescales

Comments to date include: Strengths: Areas for improvement: • “I experienced a fast track system • “Felt like I was going from at RIL – I went through 4 different pillar to post” departments to get a range of tests and results in the same day. • “Older people need good I was glad to get an answer at the end of the day – I was nervous care today not at some but I walked away a free man” point in the future” • Nearly 2/3 of general public and • “Not meant to be ill at staff said they would recommend services to a friend or family weekend” member • “Nurses get a hard time in the media but on the whole provide an excellent service”

Initial consultation plans Engagement Communication • Full consultation document • Webinars • Summary consultation • Media relations document • Hospital radio interviews • On-line and paper • Website questionnaire • Social media • Launch event • Advertorials • Drop in events • Meetings with key • Exhibitions stakeholders • Staff engagement • Events with partners

Next steps • This exercise and feedback from the public and stakeholders has been passed on to health professionals to inform their views when shaping options for providing services in future. • Further engagement with hard to reach groups and protected groups (including the well majority) • Further develop the staff engagement programme • Consider clarity of communications e.g. clear explanations of any changes to patient pathways • Continued work with key stakeholders such as Health and Wellbeing boards, elected members and OSCs • On-going meetings of the Public Reference Group (1 st held on 17th July) to help review communication and engagement processes • External Assurance – NCAT, Health Gateway, Legal advice and Consultation Institute “compliance” package. • Primary and Community Care Task & Finish group to start project work shortly

Thank you for your time today Your questions?