Welcome to Big Chat 8 Bootle Cricket Club 11 July 2017
Welcome Dr Andy Mimnagh Chair NHS South Sefton CCG #CCGBigChat
What we will cover • Shaping Sefton – strategic update • How we have used views from earlier Big Chats: – Community services - our new provider, Mersey Care – Medicines and prescribing - schemes to save and improve quality • Primary care - update on Hightown Surgery • Commissioning policy review • Balancing the books – the ongoing challenge • Fingers on the buttons • Q & A surgery
Q&A surgery As we have a packed agenda, please save your questions for the Q&A surgery at the end or complete a question form and we will get back to you after the event Thank you for your support
Further information Take a look at the various displays around the room and the information to take away and included in your packs about: • Continuing health care (CHC) • Personal health budgets (PHBs) • Special educational needs and disabilities (SEND) • Voluntary, community and faith sector update report • Orthopaedic/ear nose and throat public consultation • Other health care schemes and initiatives • Other CCG information
Q. How did you hear about today’s Big Chat? 1. Letter/email invite 26 2. Newspaper article 3. Word of mouth 4. CCG website 5. Other website 5 6. Social media 3 1 7. Poster 0 0 0 Newspaper article CCG website Social media Letter/email invite Word of mouth Other website Poster
Shaping Sefton – strategic update Fiona Taylor Chief officer NHS South Sefton #CCGBigChat
What is Shaping Sefton? • Our vision – community centred health and care • Services working better together, provided closer to home, more flexible and responsive to people’s needs • Vision informed by views from earlier Big Chats and other conversations with residents and partners • Our focus - transforming services so they are more effective, efficient and sustainable into the future
Our partners in Shaping Sefton • Working collectively across health and social care in North Mersey on system wide change, when it offers benefits for our patients – for example, the proposals to reconfigure and improve regional orthopaedic services • As a CCG we are able to remain locally focused on the health needs of south Sefton residents
Our challenges • NHS finances – rising costs, rising demand for services, additional duties, no real terms increase in budgets • Changing and transforming services to ensure sustainability of our local NHS into the future • Difficult choices ahead – your views remain important as ever as we work to understand what this means for local NHS services
Your views count • You will hear examples of where we’ve used your feedback to shape our schemes and services – like our community services and prescribing initiatives • We will update you on forthcoming programmes that have been, or will be informed by your views • And, we will ask for your thoughts about some of the difficult choices being considered in other CCG areas, and your ideas of what else we could do
Community services • We begin our update on how your views are informing our work with a look at community services • We look back at our recent re-procurement of these services, and • We welcome our new provider from 1 June 2017 – Mersey Care NHS Foundation Trust
What are community services? • Includes blood testing, community matrons, district nurses, therapies, leg and foot care • With GP practices, central to achieving Shaping Sefton vision – community centred health and care • Regularly reviewed to ensure ongoing quality and ahead of re-procuring these services
Community services review • Review included public engagement exercise – discussions at earlier Big Chat, survey, attending events • Mersey Care NHS Foundation Trust named new provider in our re-procurement process, which was informed by the review • You’ll hear next how Mersey Care is responding to our Shaping Sefton vision for community centred health and care
South Sefton Community Services Trish Bennett, Director of Integration
Sou South th Seft Sefton on Commu Community nity Ser Service vices Mersey Care delivery: • • Adult Occupational Therapy Palliative Care • • Adult Physiotherapy Podiatry • • Community Matrons Heart Failure • • District Nursing Respiratory • • Total Wound Purchasing X-Ray • • Virtual Ward Treatment Rooms • • Adult Dietetics Adult Safeguarding • • Adults Speech and Language Discharge Planning • Therapy Integrated Care Seft o n Direct • • Adults Diabetes Intermediate Care (bed-based and • Community Respiratory community) • • IV Therapy Vaccination and Immunisation
Ot Othe her r Co Cont ntrac actu tual al Ar Arran ange geme ment nts • Subcontracted to Phlebotomy North West Boroughs • Community Equipment Healthcare NHS Foundation • Walk-in Centre Trust: • Child Safeguarding • Specialist Children's Services • Hosted by Liverpool Single Point of Access Community Health: • Child Health Information • Health Records
The fir he first st 4 w 4 weeks eeks • The South Sefton Community Services ‘landed’ safely and successfully in Mersey Care NHS Foundation Trust on 1 st June 2017. • The South Sefton Community Services Division has been established with the interim leadership and governance arrangements in place. • The first meeting of the Senior Leadership Team has taken place with key strategic priorities agreed for the next 3 months. • The governance structure for the division has been agreed along with a corporate timetable, reporting to the Trust Board and its Committees • There is a CQC Action Plan in place that has transferred with the services and which has open actions being addressed as part of the usual operational activities of the Division and the wider Trust.
Ho How w w we e will will do this do this • Case management determined by risk • Care co-ordination with MDT wrapped around the patient “Team You” • Service development and delivery informed and supported by a strong data set • Shared approach to community assets use • Urgent response to reduce bed pressure and speed up discharge • Target intervention, know our population • Free up resource for prevention and early intervention • Develop our workforce
Ser Service R vice Reviews views • All services to be reviewed over the next 12 months. • Priorities for the next 3 months include: • Urgent Care • Respiratory Services • Skin • Out of Hours
Perf erfect Car ect Care e Priorit Priorities ies We are entering the fourth year of transformation in our services as well as: • Delivery against our priorities in 2016 • The ‘must do’s’ from national guidance • The regional STP footprint • Our emerging priorities for 2017/18: - Reduction of pressure sores - Co-ordinated end of life care - Prevention and early intervention - Team You • The concept of a Just and Learning Culture
We have reached the limits to ’biological’/medical approaches Mental health has always been framed around a bio psychosocial model, with biological and medical aspects of the condition being treated alongside the psychological and social aspects. Physical healthcare, which has traditionally focused on understanding biological causes, must enhance the psychological and social aspects of treatment and condition management to make care more effective. This is particularly true when you consider the impact of social factors such as deprivation and loneliness in Sefton.
Lots of assessment and signposting, but who is actually getting to know Mary? District Social nurse worker Hospital consultant Mental health practitioner Pharmacist Practice nurse
If health is 70% driven by social factors then does an integrated team need to look different? Debt adviser Social worker Neighbourhood watch Behaviourist ’ New friend Local faith group
Mary’s story: A medical paradigm She has phoned her GP Mary’s diagnosis surgery on several COPD occasions requesting a home visit and over the Heart failure last year has frequently Diabetes been taken to the local A&E department after Leads to Le o sep separate pro providers for or: she has dialled 999. primary care, social care, heart specialist, Mary is a 70 year old widow She has been admitted to diabetes specialist, with COPD, heart failure and hospital on 7 occasions in COPD specialist, diabetes. She lives alone. the last year and now She is very anxious, is often keeps a small packed pharmacist, very breathless and feels suitcase by her armchair. community matron unable to manage.
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