Seeking your views on transforming health and care in Bedfordshire, Luton and Milton Keynes. March 2017

Transcription

1 Seeking your views on transforming health and care in Bedfordshire, Luton and Milton Keynes March 2017

2 Agenda 1. STP update October submission, feedback so far, about the March 2017 Discussion Paper 2. Current thinking 3. Priority focus areas for transforming hospital-based care 4. Next steps and gathering your views 2

3 What are STPs all about? A national initiative, enabling local NHS organisations and councils to work together to transform local health and care services, to meet the NHS triple aim 44 STPs in England regional footprints Our footprint is Bedfordshire, Luton and Milton Keynes (BLMK) Covers publicly-funded health and care services including community and social care, GP services, hospital and specialist care, ambulance services, urgent and emergency care NHS triple aim 3

4 16 So BLMK far who STP has been partners involved in developing our ideas and in defining our priorities East of England Ambulance Service NHS Trust South Central Ambulance Service NHS Trust Bedford Borough Council Central Bedfordshire Council Luton Borough Council Milton Keynes Council 4 Local Councils NHS Bedfordshire CCG NHS Luton CCG NHS Milton Keynes CCG Cambridgeshire Community Services NHS Trust Central and North West London NHS Foundation Trust East London NHS Foundation Trust South Essex Partnership NHS Foundation Trust 2 Ambulance Trusts 4 Community /Mental Health Trusts BLMK STP Steering Group 3 Acute Trusts 3 CCGs Bedford Hospital NHS Trust Luton & Dunstable University Hospital NHS Foundation Trust Milton Keynes University Hospital NHS Foundation Trust 4

5 October submission Our October 2016 submission to NHS England set out: What the STP is all about The challenges faced by our local health economy BLMK STP partners vision for the future Five priorities and initial ideas for transforming health and care in BLMK How we are involving you 5

6 Five priorities have been identified Three front line priorities Two behind the scenes priorities Technology Prevention Encourage healthy living and self care, supporting people to stay well and take more control of their own health and wellbeing. Transform our ability to communicate with each other, e.g by having shared digital records that can be easily accessed, using mobile technology for better co-ordinated care. Primary, community and social care Build high quality, resilient, integrated primary, community and social care services across BLMK. Sustainable secondary care Make our hospital services clinically and financially sustainable by working collaboratively across the three hospital sites, building on the best from each and removing unnecessary duplication. System redesign Improving the way we plan, buy and manage health and social care services across BLMK to achieve a joined up approach that puts people s health and wellbeing at the heart of what we do. Taken together, these five priorities signal an ambitious and far-reaching overhaul of the health and social care landscape in BLMK 6

7 Initial engagement Introduction to STP 144 people gave feedback at four introduction to the STP events, organised by Healthwatch across BLMK 189 questionnaires completed / ed responses (including 37 responses from NHS staff / clinicians) 7 View feedback report online at

8 Feedback key themes Plans generally supported but lacking detail Are the timescales realistic? How will the proposals be funded, especially given council cuts to social care funding? OK in theory, but implementation and communication will be key More focus needed on mental health issues, family carers and integration of health and social care 8 View feedback report online at

9 Feedback on the 5 priorities P1 Prevention: Generally supported, education from 9 school level and voluntary sector support needed P2 Primary, community and social care: Overall support, changes need to be in place before hospital changes, need more GPs, involve pharmacists more, mixed views on GP mergers and Single Point of Access P3 Sustainable secondary care: Closer working between hospitals supported but major concerns about potential removal of services, especially relating to transport and travel; key services (consultant-led A&E, maternity and paediatrics) need to be at all three sites P4 Technology: Long overdue and a good idea if it can be achieved, some concern over security of patient records P5 System redesign: Sounds promising, needs cultural change, less use of contractors / locums

10 Discussion Paper, 1 March Some more detail on the challenges we face Main areas we re considering for primary, community and social care (Priority 2), to support and align with any changes to hospital services Six key focus areas for transforming hospital services (Priority 3) 10

11 Public engagement 11

12 Public engagement Dr Vicky Alner Milton Keynes Hospital Dr Ian Reckless Milton Keynes Hospital Beryl Adler L&D Hospital Paul Tisi Bedford Hospital Cathy Jones STP Programme Director, Secondary Care Jane Meggitt STP Engagement Lead David Kirby L&D Hospital Jim Gray L&D Hospital Dr Rory Harvey Bedford Hospital Ed Neale Bedford Hospital Presentations and involvement from 8 local clinicians, supported by the STP programme team 12

13 The challenges we face a quick recap Imbalanced healthcare system Growing, changing, ethnically diverse population Health inequalities Rising demand and more pressure on services Financial challenges Workforce ageing / difficulty recruiting 13

14 Current thinking Services are under significant pressure and, with demand increasing all the time, we must think differently about how those services are delivered Our 16 STP partners are all agreed that no change is not an option This is not about downgrading hospitals or stopping services it s about delivering them differently and having our three hospitals working closely together to provide an integrated service across the three existing sites No decisions have been made as yet We will consult formally on any major service changes or decisions that impact on patients or staff 14

15 Primary, community and social care what we are considering Improving access to urgent care services outside of hospital Strengthening GP services with a new model of care Integrating community and mental health services with primary and social care Integrated working to deliver more joined up care, closer to home Harnessing contribution of voluntary sector Local area co-ordinators Enhanced care for people with complex needs Improved prescribing Improved hospital admission / discharge 15

16 We ve all seen the headlines The NHS is under pressure A national problem Change is needed Local clinicians are working together in BLMK to see how we can do things differently We want to know what you think 16

17 Transforming hospital care six focus areas Emergency care Care closer to home Planned care Maternity care Centres of excellence Paediatric services 17

18 Emergency care With our population growing, and hospital A&E services under considerable pressure, how do we make sure local people continue to have access to safe, high quality emergency services, especially at night when our clinical staff can be most stretched? Are there are safety benefits in enabling teams to work together to run some services from fewer sites, especially overnight? Improving urgent care outside of hospitals Telephone-based Clinical Hub 24/7 single point of access (SPoA) through NHS 111 Further developing rapid access care, delivered close to home 18

19 Planned care High levels of demand for emergency services are having an impact on the planned care provided by hospitals, leading to cancellations and longer waits. We need to design services in such a way that we are able to protect planned care, which may mean separating it from emergency care. How would people feel about this? 19

20 Centres of excellence We are currently not achieving national standards for planned care consistently and, in some areas, do not have enough specialists to be able to further improve. Could we split particular specialisms into separate functions, which could then be delivered in centres of excellence on different hospital sites? 20

21 Care closer to home Part of our overall vision for the future of local healthcare is for more services to be delivered closer to people s homes. Are there any specific services, or aspects of them, that could be delivered more effectively in community settings, rather than in hospital? 21

22 Maternity care How do we make sure we can offer all mothers high quality maternity care while accommodating an increasing number of births? Could we concentrate services associated with high risk births on fewer sites? 22

23 Paediatric services With children s services at our hospitals facing staffing and capacity pressures, can we change the way we deliver paediatric care at each of our hospitals? Could we separate out different aspects of paediatric care? 23

24 Timetable for engagement Oct 16 Feb 17 BLMK STP submission to NHS England Events and questionnaire to gather your views on BLMK STP plans March 17 Discussion Paper Events and questionnaire to gather your views on transforming health and care April 17 What we ve heard so far paper Incorporating public views gathered in previous two phases May 17 Formal Case for Change Followed by further engagement and opportunities to input 24

25 Your feedback We want your feedback on the thoughts and ideas contained in the Discussion Paper What do you think? Anything else we should be considering? Online through Call By post write to us or print off a feedback form at and post it to us Deadline: 31 March