urgent and emergency care vanguard - king's fund dowse pres... · urgent and emergency care...
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Urgent and
Emergency Care
VanguardChris Dowse, Chief Officer
North Kirklees CCG
Chair – West Yorkshire Urgent and Emergency Care Network
Dr Philip Foster, Associate Medical Director
Yorkshire Ambulance Service
Healthy Futures: WY UEC
Network
Implementing Keogh recommendations: Building on work done so far
• Phase 2 stocktake underway
• Specialist emergency services: 6 acutes
• Enhanced general practice developments: impact on OOH contract
• Regional support for network
Healthy Futures: WY UEC
Network Ambition
• Health and social care in the right place, first time, every time
• Further and faster through the vanguard
West Yorkshire & Harrogate CCGs
Airedale, Wharfedale & Craven CCGBradford City CCG
Bradford Districts CCGCalderdale CCG
Harrogate & Rural Districts CCGGreater Huddersfield CCG
Leeds North CCGLeeds West CCG
Leeds South & East CCGNorth Kirklees CCG
Wakefield CCG
KEY
Total population of the areas covered: Approximately 3 Million
Local Themes
Systems Leadership Hear, See and Treat
Mental Health
Acute Reconfiguration
Health Care Record
Engagement and Consultation
Academic Health Science Network
Enablers Workstreams
New Payment Models
New Payment Models
Primary Care Workforce
System Leadership (1)• Build on and strengthen system wide leadership
already in place to enable us to bring about change at pace and scale. We need to develop ways of making decisions together quickly. We will design governance and accountability arrangements around the Network and SRGs.
• Join up the separate elements of the urgent and emergency care system. We will be supported to use a ‘systems thinking approach’ by Yorkshire and Humber Academic Health Science Network.
Enablers
System Leadership (2)• Accelerate change by learning from our Prime
Minister’s Challenge Fund and Vanguard sites, particularly in primary care and care homes, as well as scaling up local innovation.
• Test out how we can use our existing workforce in a more creative and agile way across organisations and services within our system, recognising workforce and skills shift as one of the biggest challenges.
Enablers
Engagement & Consultation
With HealthWatch - Programme of work to understand the self-
care behaviours and choices made by people in the differing populations across West Yorkshire, recognising the potential system wide impact of developing new ways to offer urgent care closer to home. E.g. using pharmacists differently; engaging specifically with young people to understand their view and use of urgent and emergency care services.
Enablers
Academic Health Science
Network• Managing our information and intelligence
• Creating real time, regional dashboard
• Providing support and advice on health economics and modelling
• Securing and overseeing local evaluation
• Support to SRGs
Enablers
Workforce
• Workstreams to consider workforce challenges and develop sustainable workforce solutions for urgent and emergency care services.
• Network to consider options and agree approaches across system.
Enablers
Workstream: Hear, See &
TreatLead - Yorkshire Ambulance Service
Accelerate the pace at which Yorkshire Ambulance Service - as the single provider of 999 and NHS 111 services in West Yorkshire – is recognised by patients as a mobile treatment service rather than conveyance to hospital. Yorkshire Ambulance Service has a vital role to play in leading the delivery of a number of the high impact actions that will transform the way urgent and emergency care is delivered.
Workstream
Workstream: Mental Health
Lead - Bradford District Care NHS FTBuild on an existing programme of work through the Mental Health Crisis Concordat to understand in detail the flow of patients with urgent / emergency mental health need recognising this cohort of patients touch all points of our urgent and emergency care system including social services and police.
Develop a comprehensive approach to managing mental health crisis responses in a way that reduces demand on Police, ambulance and acute sector and provides timely and local interventions that reduce serious incidents and harm
Workstream
Workstream: Acute Service
Reconfiguration Hospital Chains: Improve quality of specialised emergency services across West Yorkshire adopting a networked/ hospital chains approach.
SRGs: Emergency Departments – prompt, senior decision making; 7 day working for interdependent services; service reconfigurations to adopt Royal Colleges’ guidelines and make best use of scarce, specialist workforce. Maximise potential of the role of Paramedics and Allied Health Professionals.
Workstream
Workstream: Intelligence &
Technology
Lead – Leeds North CCGBring together patient information / clinical systems and our data collection systems so we have real intelligence about what is happening to individual patients and at a service level across the whole system. We want patients to know that vital information about their medical history and health needs can be shared easily to support their care. We will develop and implement a real time dashboard and the West Yorkshire Care Record.
Workstream
Workstream: New Payment
Models
The Vanguard will be examining a three-part payment approach for urgent and emergency care – taking in fixed core, outcome and performance linked and volume-based payments.
Workstream
Challenges
• Relationships
• Maintaining momentum
• Early successes
• Regional v local ambitions
• Network: today/ ‘winter’ v tomorrow/ Vanguard