Suffolk Community Healthcare. Pamela Chappell Dawn Godbold

Transcription

1 Suffolk Community Healthcare Pamela Chappell Dawn Godbold

2 Service Provision Provide a range of NHS clinical services to a population of approximately 650,000 across the county (excluding Waveney). Service are delivered in a variety of settings including: Patients own homes Clinics/Health Centres GP Practices Community Hospitals Schools Covering both adults and children, working in an integrated model, utilising individual professional skills whilst complementing one another around the patient and their family.

3 Services Overview Adults: Community Health Teams Delivered by a range of professionals which include District Nurses, Community Matrons, Physiotherapists, Occupational Therapists, Leg Ulcer teams, Generic Workers, and Health Care Assistants. They work in an integrated model around a cluster of GP Practices working in a co-terminous way with social care. There are 15 teams working in four localities across the county. The teams service offer is for all adults aged 18 years and above primarily supporting older people with both short term and long term physical health needs and those at the end of their life..we value the services provided by the Community Matrons. It is often difficult for the GP to really understand the bigger picture of what is going on for a patient and the Community Matrons are often able to fill the gaps. Face-Face contacts: (Jan-Dec 2015) 405,998

4 Adults: Services Overview Admission Prevention Service: The Admission Prevention Service provides a 24 hour service responding to referrals for patients who have an acute health need, are clinically stable but are at risk of admission to hospital. Face-Face contacts (Jan-Dec 2015) 19,749 Community Hospitals: The community hospitals offer bed based rehabilitation, intermediate care, end of life care, planned post operative care and admission avoidance services. There are a variety of outpatient clinics at each location. Nursing, therapy, interface geriatrician support, social work is available at all sites. Referrals can be made by GP s, community teams, acute hospitals. East Aldeburgh 20 beds ( currently 16 open), Felixstowe 16 beds, Bluebird Lodge 28 beds West Newmarket 16 beds We also commission from private providers a further 16 beds in the east and 12 beds in the west.

5 Services Overview Podiatry: To provide regular and responsive clinical care to patients with foot ailments and advice on self-care. The service received referrals predominantly for elderly patients who may receive on-going treatment for long periods of time. The service also includes a biomechanical assessment and diagnosis of gait problems, orthotic service and nail surgery. Face- Face contacts (Jan-Dec 2015) 52,321 Foot and Ankle Service: Provides treatment for foot conditions requiring surgical intervention. Allied Health professional Consultant led day surgery service. Run as a dedicated unit within the Walker Close facility. Accepts referrals from GPs and consultants Face- face contacts (Jan-Dec 2015) 6316

6 Adults: Services Overview Continence Service: The Community Continence Service covers both urinary and faecal incontinence supporting patients in their own homes or clinic setting. The aim of the service is to promote continence and enable self- management with a focus on health promotion/prevention. Where this is not possible the service are key in assessment of patients for the Home Delivery service of products. Face-face contacts: (Jan-Dec 2015) 11,567 Specialist Services: (Falls/Fracture Fragility, Stoma, Neurology, Cardiac Rehabilitation & Heart Failure, COPD & Pulmonary Rehabilitation): A range of services providing specialist support for patients with specific conditions allowing patients to manage their care more effectively along their care pathway. Face-Face contacts: (Jan-Dec2015): 19,642

7 Services Overview Care Co-ordination centre: A single point of access (SPA) providing a 24/7 dedicated telephone contact for patients, carers and professionals. All referrals for community health services to be co-ordinated via the CCC (approx. 5-6 services using this process currently). Future plan is for all services to be routed through this process. In December 23,978 contacts with patients, carers, professionals (telephone, fax, s).

8 Integrated Community Paediatric Services Who We Are: We consist of eight core services which operate as part of an integrated model of delivery MEDICAL SERVICES AUDIOLOGY CHILDREN S NURSING PHYSIOTHERAPY OCCUPATIONAL THERAPY SPEECH AND LANGUAGE THERAPY CHILD AND FAMILY PSYCHOLOGY SCARC We primarily support children and young people (0 to 18/19 years) with medical, developmental, neuro-disabling and cognitive disabilities and longer term health conditions

9 Care For Growing Needs! Many of the children on our caseloads remain with us throughout their life until transition to adulthood Referral numbers have gradually increased over time Complexity of the caseloads is a more significant challenge

10 Working in Partnership ICPS work in partnership with children, young people & families in meeting needs and developing care plans ICPS work in partnership with all colleagues from Health, Education, Social Care and voluntary agencies, including: Universal Services Early Years settings Schools Acute Trusts Mental Health Tertiary/Specialist Centres

11 Equipment Medequip: Community Equipment loan service to enable people to remain at home/discharge from hospital. Provision of hospital beds/hoists/bathing equipment/ mobility aids. Delivered from 3 bases in Suffolk, Bury, Ipswich and Beccles. Provides services to both acute hospitals and Suffolk county council. Staff headcount 38 6,834 requests for individual items of equipment in December 4,052 items of equipment collected in December Bartrams: Provision of both manual and electrical wheelchair assessment, supply and maintenance for both adults and children. Ranges from issue of wheelchair voucher for patients to source their own chair to highly complex chairs/bespoke specialised seating Assistive technology including environmental controls, communication aids for adults and children who are severely disabled

12 Service Structure JOINT VENTURE BOARD (IHT & WSFT) Provider Management Board (WSFT, IHT & NCHC) Medequip Community Equipment services Norfolk Community Services West Suffolk FT Ipswich Hospital Trust Staff Headcount: 38 Bartrams Wheelchair Services Staff Headcount: 7 Local Area Health Teams Admission Prevention Podiatry Staff Headcount: 598 Newmarket Community Hospital Paediatrics Adult Speech & Language Therapy Estates & FM services Informatics Central Governance Neurology Staff Headcount: 428 Aldeburgh Community Hospital Bluebird Lodge Felixstowe Community Hospital Stoma Continence Foot & Ankle Heart Failure/Cardiac Rehab COPD Pulmonary Rehab Falls/Fragility Care Coordination Centre Information Technology Workforce Staff Headcount: 239

13 Trust Board West Suffolk Foundation Trust JOINT VENTURE BOARD (IHT & WSFT) Provider Management Board (WSFT, IHT & NCHC) WEST SUFFOLK HOSPITAL Workforce Director Chief Operating Officer Chief Executive Financial Director Medical Director Chief Nurse General Manager Clinical Support Services (CSS & W&C) Bernadine Bramble General Manager Medical Division Annie Campbell NCH Clinical Lead Informatics Nicola Yates Estates & Facilities Riva Knight Clinical Governance WSFT Clinical Governance Central Team Integrated Therapies Manager Gylda Nunn Deputy General Manager Lesley Standring Deputy General Manager Karen McKinnon Karen Eaton Team Lead Jon Haworth Sam Girling Paediatric Community Services Associate Director of Integrated Community Paediatric Services Nic Smith- Howell Adult Speech & Language Therapy (SALT) Operational Manager Julia Dinley Newmarket OPD Operational Manager CSS Kirsty Rawlings Newmarket (NCH) In-patients & Community Beds Neurologica l Parkinson s & Epilepsy Newmarket Felixstowe Bluebird Lodge Aldeburgh

14 Integrated Quality & Governance Structure Key Controls Monthly SLA meetings with CCG Monthly Contractual meeting with Providers Risk Register Incident Reporting Performance/Quality reporting Quality Assessment Visits Patient Experience feedback Complaints/Compliments Joint Venture Board Provider Management Board Key. Governance Groups chaired by External Agencies. CCG Quality Sub Group Suffolk Community Services Integrated Quality & Governance Committee Patient Experience Group Resuscitation Information Governance Medicines Management Safeguarding Infection Control Workforce Clinical Audit Host Organisation Quality & Governance structures: Ipswich Hospital, WSFT, Norfolk Health and Community Care, Medequip, Bartrums.