nhs newcastle & gateshead alliance
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NHS Newcastle & Gateshead Alliance. Wednesday 8 th October 2014. Key Issues. Strategic Plans Five Year BCF Primary Care. The role of Commissioning. Ensure we have safe health care services Ensure that we have health care services that meet the needs of the population: ‘Stay well’ - PowerPoint PPT PresentationTRANSCRIPT
NHS Newcastle & Gateshead Alliance
Wednesday 8th October 2014
Key Issues
• Strategic Plans
• Five Year
• BCF
• Primary Care
The role of Commissioning• Ensure we have safe health care services• Ensure that we have health care services
that meet the needs of the population:– ‘Stay well’– ‘Get better’– ‘Cope with long term conditions’
• Efficiently – finite resources• Effectively – best outcomes
Increasing demands – reducing resources• Newcastle Gateshead - £655m budget• Expected to reduce by c£25m• £155m local authority savings• Call to Action – national £30bn shortfall• c£280m on Newcastle Gateshead• Continued austerity measures to 2020
The NHS five year strategic plan
Newcastle’s health and social care economy vision:
‘People who live, work or learn in Newcastle equally enjoy positive wellbeing and good health’
In line with 2013-16 Newcastle Wellbeing for Life Strategy
• Getting a good start in life… laying the foundation for wellbeing and health throughout life
• Learning and employability across the life course… all people maximising their capabilities and potential
• Promoting wellbeing and health across the life course… making wellbeing and health promotion a key dimension of all we do
• Protecting across the life course… reducing the potential harm from environmental hazards
• Safeguarding across the life course… reducing potential harm from the action (or inaction) of others
• Maximising the wellbeing of people who have long term conditions… preventing further progression of an illness and ensuring quality of life
2020 – key principles
• People have the skills & knowledge to make the best decisions for their needs
• We are working together, with an evidence led approach, to keep as many people ‘well’ as we can
• We deliver care and support in the community wherever we can
• Where people require a minor intervention this happens in or near people’s homes as much as possible
• Where people need to go into hospital they receive high quality, safe services that are promptly delivered
• When people are coming out of hospital they arrive home with the appropriate support already in place
Our new system vision• High quality out of hospital care with the GP
responsible and accountable for patient care
• The patient / citizen at the heart of the system, supported to be “Confident and connected”
• High quality, sustainable services for patients when they need to have care in hospital
• Primary care acting as co-ordinator of all parts of the system, that are integrated and aligned
• Social care integral to care across the system, supporting transformation
Events
Surveys
Focus groups
Interviews
Stakeholder bulletin
Local media supplements
Social media
Engagement reports
website
My NHS
mailbox
Intranet
GP bulletin
Education events
Community Forum
Practice participation groups Newcastle West
Patient Forum/ACORN
Involvement Forum
General public Practice Engagement
Partnership Forum
Our proposal for Better CareHigh quality out of hospital care with the GP responsible
and accountable for patient care
The patient / citizen at the heart of the system, Supported to
manage and adapt, “Confident and connected”
High quality, sustainable services for patients when they need to
have care in hospital
Primary care acting as co-ordinator of all parts of the system, that
are integrated and aligned
Social care integral to care across the system, supporting
transformation
Delivering Out of Hospital Care
Delivering better care out of hospital is based on three clusters of schemes which will be implemented over five years:
• Cluster 1 - Integrated turn around and intensive case management system
• Cluster 2 - GP led Person centred community integrated care and support system
• Cluster 3 - Integrated prevention, early intervention and management system
Out of Hospital• Integrated working across tertiary, secondary, primary,
community and social care• New models of care - ‘Healthcare without walls’• Changing the culture • Satellite facilities enabling community outreach • Strengthening partnerships with primary care providers• Enhancing partnerships with the voluntary sector• Care closer to / and in people’s homes• Bespoke offer, parochial to each neighbourhood • Testing new technologies
In hospital care
To ensure we continue to make our Vision a reality, our Strategic Plan is underpinned by 3 key strategies:
Quality Strategy – patient safety; clinical effectiveness; patient experience
Clinical Strategy – safe, high quality care; listening and learning; right place and right time; seamless care pathways; convenient and flexible
Business Strategy – targeted growth; building capacity; improving efficiency; comprehensive community outreach; care closer to home; partnership working
Research and Innovation – improving clinical outcomes; maintaining high levels of clinical trial recruitment; academic partnerships; attracting opportunities to the North East
The Hospital Role
• World class 7 day services• National providers of specialist services• Consultant led emergency care 24/7• Continuing our approach to increase efficiency • Ensuring high quality facilities and environments• Enhanced clinical leadership – supporting development
of capacity and skills across the system• Specialists deployed in community settings• Further improving access and responding to choice
across Greater Tyneside
Key Issues
• Mental Health Transformation
• Urgent Care
• Children & Young People Early Intervention
Mental Health Transformation
From Parity to Priority
• Mental Health Programme Board– CCGs committed to co-production– Meets monthly– Membership includes
• CCGs• LAs/Public Health/• Service User and Carers• VCS• NTW
• MHPB Principles– Be Bold, Brave and Creative– Right Person, Right Time, Right Place– Improving quality and experience, safety and
effectiveness– Carer and user focussed outcomes– Engagement / Involvement– Equality and Diversity– Hope, meaningful choice and control, and
recovery orientated
• Quality Agenda– Commissioning for Quality and Innovation
(CQUIN)– Three thematic CQUINs
• Physical health• Carers• Diversity
• Workstreams for the CCGs and the MHPB– Primary care and access– Urgent care– Physical health and complex needs– Public Health– Dementia– Learning disabilities including Winterbourne– Children’s emotional wellbeing
• Northumberland Tyne and Wear (NTW) Foundation Trust– Review of pathways and bed configuration– How can we develop models of care that
improve quality?– How do our principles help?
NEWCASTLE URGENT CARE
Work streams & Committees
• Resilience & Operational Group• 1 – Admission Avoidance• 2 – 1st Contact• 3 – Going Home• “Winter surge”• GP OOH
1- Admission Avoidance
• intermediate care model• older person’s resource centres• discharge pathways • emergency social beds • Ambulatory Care pathways• unscheduled care system is fragmented
1 – 1st Contact
• Directory of services is fully populated, brought up-to-date • Mental Health Emergency Access • clinical capacity with general practice • Encouraging patients to contact 111• Alternatives to A&E for less serious conditions• Inconsistent model across Newcastle• Primary care - review home visiting –reduce batching of patients • pathways of care and service models for specific patient groups;
2 – 1st Contact• appropriate pathways of care - Frequent attenders -
Deliberate self-harmers - Mental health conditions - Substance misuse
• ambulance staff to treat minor injuries and illness at the scene • improve LTC management • Public Health Campaigns• Care Planning • Improve active case management and care planning of
patients with complex needs
3 – Going Home
• Agreement is needed about when discharge is appropriate, timely, and safe
• Transport discharge system is fragmented • Formalise discharge protocol • Review reablement model • Develop the role of the voluntary and
community sectors
Winter
• Short term resource to address surge• Annual - 2014 new system• NUTH• L.A.• Primary Care• NTW• (VCS – other route)
GP OOH
• Redesign starts soon• Multiagency approach with GP at core• 7 day working• Pilots
Possible developments
• Prevention processes• Mental health support• Health champions• Peer support• Social prescribing• Systems lessening the need for urgent
care
Children & Young People Early Intervention
• Joining up for Newcastle Children– Better Start bid– Rising from the ashes
• PUP and PIP• Working with schools
• Children’s communities
• The challenge– Moving to prevention– Inequalities and the Marmot review– Financial catastrophe
• Our approach to emotional wellbeing– A single process for the city– A single plan
• Significant opportunity to transform– Models of care– Tiered levels of activity and investment– Family approach
Organisational Change – NHS Newcastle Gateshead CCG 1st April 2015
Key questions that have been asked about the merger :
• What will this mean for the public and patients of Newcastle?
• How will it be different from the existing ways of working with the three CCGs?
• Will the public and patients of Newcastle be disadvantaged by the merger, particularly in respect of resources and finance?
Benefits of the merger• Plan in a more “joined up” manner especially in relation to Newcastle as a whole and with
respect to the flows of patients between Newcastle and Gateshead
• Standardise, as far as possible, pathways and approaches to care to improve outcomes for everybody
• Improve the spread and adoption of best practice and approaches that would be beneficial for everybody
• Strengthened clinical input and decision making and capacity to make the very best of new partnership working practices with local authorities, the voluntary and community sector and service providers
A greater ability to influence
• Speed of change required• Health Inequalities• Fragmented services
Merger delivers for patients• More positive change• More effective change• Faster delivery• Greater and faster improvements to outcomes