Stakeholder Engagement Workshop Wednesday 28 th February 2018
Dr Jessica Sokolov, CCG Clinical Lead ◦ Welcome & Workshop Context Mr George Rook, Workshop Facilitator Out of Hospital Programme Team ◦ Lisa Wicks, Head of Out of Hospital ◦ Pete Downer, Commissioning & Redesign Lead ◦ Barrie Reis-Seymour, Commissioning Manager
Report back Description Journey and next steps
Ice breaker & Introductions Workshop ground rules ‘Park It’ sheet for comments ‘Unknown Word’ sheet for needed definitions End of day feedback form Name for the programme of work Toilets Fire escape route Lunch 12.50pm – 1.20pm Aim to close at 3.00pm
Current services not sustainable and unprecedented demand on the acute hospital Commissioned services which have grown organically and failed to take into account key factors such as demographic changes Redesign necessary for services provided outside of the hospital, with a focus on sustainable communities
“We are going to be collaborative and will involve all our partners throughout the process. We shall communicate what we are doing, why we are doing it, when it will be done and how people can get involved as we go. We shall be transparent and open throughout the process and explain the rationale for our decisions at all times”.
Initial scoping workshops held: ◦ Patient Involvement Group December 2017 ◦ Shrewsbury GP Locality December 2017 ◦ South GP Locality January 2018 ◦ North GP Locality January 2018 What does ‘Out of Hospital’ mean to localities and patients?
Equity of access to services throughout the county Consistency in services Ease of access – clear simple signposting to the right service first time All patient information in one shared system Collaborative design of patient-centred care More services in the community, closer to home Locally developed, meeting local needs One contact co-ordinating all healthcare needs
What does Out of Hospital care mean to GP localities: ◦ There are some common themes surrounding issues across all three localities. ◦ A “one-size fits all” solution will not resolve these, solutions must be locally developed locally owned and locally driven. ◦ This means at least 3 solutions are likely to emerge to address these issues.
Step up/down hubs or spaces for middle cohort of patients between primary & secondary care Additional community services in GP practice (diagnostics, bloods, physio etc.) More services available locally in the community (wounds, physio, outpatient follow up, microsuction etc.) Optimised workforce (upskilling of staff, new or changed roles, sharing of pooled staff, i.e. practice and district nurses becoming advanced nurse practitioners) Improved redistribution of services across the county (overcoming access and rurality issues)
Want more services within the community closer to home, enabling earlier intervention and prevention of escalating care needs Need for robust IT infrastructure where systems ‘talk’ to each other – integrity of data that can be tracked More services available locally in the community (wounds, physio, outpatient follow up, microsuction etc.) Optimised workforce (upskilling of staff, new or changed roles, sharing of pooled staff, i.e. practice and district nurses becoming advanced nurse practitioners) Improved redistribution of services across the county (overcoming access and rurality issues) Requirement for community beds
Step up/down hubs or spaces for middle cohort of patients between primary & secondary care, and mobile healthcare hubs reaching rural locations Additional community services in GP practice (diagnostics, bloods, physio etc.) Need for robust IT infrastructure where systems ‘talk’ to each other – integrity of data that can be tracked Improved access – simple and clearly signposted pathways (1 phone or 1 door, single point of access, right place the first time) Optimised workforce (upskilling of staff, new or changed roles, sharing of pooled staff, i.e. practice and district nurses becoming advanced nurse practitioners) Service to support Women & Children in GP practice
Feedback gathered from patient involvement group and GP Locality workshops and consolidated where the same point was being made SHREWSBURY GP LOCALITY 1st More services within community allowing care closer to home for patient, and earlier intervention preventing escalation to acute Unique 2nd Robust IT infrastructure - systems that 'talk' to each other, linked and sharing same information, integrity of data Shared 3rd More services available to patients in their local community (Outpatient follow-ups, minor wounds, rehab, physio, diagnostics, microsuction etc) Shared 4th Optimised workforce (upskilling/changed or new roles/sharing pooled staff), i.e. practice and district nurses become ANP's Shared 5th Improved redistribution of services and resources Shared SOUTH GP LOCALITY 1st Development of hubs/spaces (step up/step down) to refer the middle cohort of patients to, who are not unwell enough for acute hospital Shared 2nd Additional Community Services in GP Practice (bloods, physio, diagnostics, pharmacy, community matrons etc) Shared 3rd Robust IT infrastructure - systems that 'talk' to each other, linked and sharing same information, integrity of data Shared 4th Access - simple and clearly signposted pathways (1 phone or 1 door - single point of access, right place 1st time) Unique 5th Optimised workforce (upskilling/changed or new roles/sharing pooled staff), i.e. practice and district nurses become ANP's Shared NORTH GP LOCALITY 1st Development of hubs/spaces (step up/step down) to refer the middle cohort of patients to, who are not unwell enough for acute hospital Shared 2nd Additional Community Services in GP Practice (bloods, physio, diagnostics, pharmacy, community matrons etc) Shared 3rd More services available to patients in their local community (Outpatient follow-ups, minor wounds, rehab, physio, diagnostics, microsuction etc) Shared 4th Optimised workforce (upskilling/changed or new roles/sharing pooled staff), i.e. practice and district nurses become ANP's Shared 5th Improved redistribution of services and resources Shared PATIENT REPRESENTATIVE GROUP 1st More services within community allowing care closer to home for patient, and earlier intervention preventing escalation to acute Shared 2nd Access - simple and clearly signposted pathways (1 phone or 1 door - single point of access, right place 1st time) Shared 3rd Robust IT infrastructure - systems that 'talk' to each other, linked and sharing same information, integrity of data Shared 4th Model developed locally to reflect needs of local community Shared 5th More services available to patients in their local community (Outpatient follow-ups, minor wounds, rehab, physio, diagnostics, microsuction etc) Shared Programme Plan developed spanning 4 key phases: 1. Frailty (in place) 2. Primary Care development including local enhanced services and case management 3. Hospital at Home and crisis intervention, rapid response, DAART and step-up community beds 4. Children and young adults
30 minutes for everyone to reflect and discuss - Is there anything missing? - What would be the constraints? - What is particular about my area or locality that needs to be take into consideration?
Top 3 points from each table
Outputs and themes from all workshops were collated to develop an overarching vision and strategy: “Using all available resources to commission integrated health and care services that are clinically effective and cost-efficient and as close as possible to where people with the greatest need live”.
Dr Finola Lynch ◦ Frailty Dr Jessica Sokolov ◦ Importance of the transformation of Shropshire
Lunch in main foyer Reconvene to start again at 1.20pm
Agreeing the understanding & definitions of: ◦ Engagement ◦ Communication ◦ Involvement ◦ Consultation
25 minutes to explore in groups, who to engage with in the journey as the programme moves forward, and how
Each table group to feedback their thoughts on engagement Captured to develop a collaboratively agreed engagement plan
Write learnings from the day into an engagement strategy Agreed engagement plan and ongoing updates and communication: ◦ Email ◦ Website ◦ Media GP Locality Task & Finish Groups Programme Board and Working Group Consultation of options: ◦ Phase 2- September 2018 ◦ Phase 3 – December 2018
Any questions?
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