Bedfordshire & Milton Keynes Healthcare Review

Transcription

1 Bedfordshire & Milton Keynes Healthcare Review Stakeholder Forum Wednesday 26 November 2014

2 Agenda Agenda Welcome, introductions and purpose of this morning s forum Presentation: Key findings from the Bedfordshire & Milton Keynes Healthcare Review Round table activity: Views on key findings Presentation: Beneath the findings Round table activity: What do the findings mean to you? Break and refreshments Presentation: Next steps; continuing the strong patient voice Round table activity: How can you help? Open questions and close Presenter Johnathan Bradley Participate Dr Paul Hassan Chief Clinical Officer & Accountable Officer Participate Dr Paul Hassan Chief Clinical Officer & Accountable Officer Dr Peter Parry-Okeden Vice Chair & Bedford GP Participate Katharine Parker Public Engagement Officer Participate Participate and all speakers

3 The purpose of this morning s forum Jonathan Bradley Participate

4 Who are Participate? Here to help Independent from the NHS Helping you to take part and get involved

5 What happens this morning? This morning is an opportunity to have your say on the Bedfordshire & Milton Keynes Healthcare Review Progress Report Presentations and table discussions relating to: Key findings from the healthcare review What happens next Your thoughts on public engagement in the future Your thoughts - captured and considered Time for questions, answers and listening

6 We re here to deliberate Open discussion Look at the issues Discuss the facts and dispel the rumours Understand different people s points of view Listen to other people without bias Give time for people to have their say

7 Comfort and access Natural break whenever you like Refreshments Ask if you need anything else Many ways to feed back This presentation is available in paper format

8 Opinions board write down your thoughts Feedback form let us know what you think about the event Interest form tell us if you want to continue to be involved

9 Key findings from the review Dr Paul Hassan

10 10 Progress Report Bedfordshire & Milton Keynes Healthcare Review Progress Report Published 29 October 2014 Outlines the evidence gathering and analysis that has taken place so far, and how this has helped develop options for further detailed consideration Sets out the actions that commissioners must take to develop coherent plans for developing local health services that can form the basis for local consultation

11 11 What the review is telling us A. Things cannot stay the way they are B. Better access to more services, closer to home C. Greater integration across all health and social care services D. Improved efficiency and quality to meet needs of growing population E. We need a modern district general hospital at Bedford with inpatient beds delivering core services including inpatient A&E, maternity and paediatrics F. Hospital care has become more complex hospitals need to work in networks to provide the sharing of scarce expertise, specialist services and treat more patients G. We need to simplify and consolidate urgent care H. There is more work to make options financially viable I. We need to maintain good levels of engagement with local people and other key stakeholders

12 12 The national context The NHS England Five year forward view Published 23 October 2014 It sets out a vision of a better NHS, the steps we should now take to get us there, and the actions we need from others

13 The national context Bedfordshire & Milton Keynes Healthcare Review Progress Report Things cannot stay the way they are Better access to more services, closer to home Greater integration across all health and social care services Improved efficiency and quality to meet needs of growing population We need a modern district general hospital at Bedford with inpatient beds delivering core services including inpatient A&E, maternity and paediatrics Hospital care has become more complex hospitals need to work in networks to provide the sharing of scarce expertise, specialist services and treat more patients We need to simplify and consolidate urgent care NHS England Five Year Forward View A radical upgrade in prevention and public health. One new option will permit groups of GPs to combine with nurses, other community health services, hospital specialists and perhaps mental health and social care to create integrated out-of-hospital care. The NHS will take decisive steps to break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, between health and social care. So to sustain a comprehensive high-quality NHS, action will be needed on all three fronts demand, efficiency and funding. Less impact on any one of them will require compensating action on the other two. Smaller hospitals will have new options to help them remain viable, including forming partnerships with other hospitals further afield, and partnering with specialist hospitals to provide more local services. Integrated urgent and emergency care services will be redesigned to integrate between A&E departments, GP out-ofhours services, urgent care centres, NHS 111, and ambulance services. 13

14 14 Exercise 1: your views on our key findings What are your first impressions? What do you agree / disagree with? Is there anything missing?

15 Beneath the findings Dr Paul Hassan Dr Peter Parry-Okeden

16 Next steps health systems Bedford Borough: Programme development: close working with Bedford Borough Council, Bedford Hospital and emerging GP Federation Central Beds: Close working with Central Bedfordshire Council, Luton & Dunstable & Lister hospitals and emerging GP Federations, closely aligned to the Better Care Fund. What we are doing now: Detailed clinical and financial modelling of future capacity needs across hospital, community and primary care Simplified, consolidated urgent care systems accessed through 111 Investigating opportunities for efficiency and productivity improvements across the health economy hospital, community and primary care Clarity on the options and detailed underpinning evidence for acute and networked specialist services Developing a vertically integrated system involving Bedford Hospital, GPs, community services and, if possible, social care Financially credible five year plans for the CCG and Bedford Hospital that are drawn from the changes in services

17 17 We are exploring a federated network of GP practices in each locality Included in hub Bedford Borough Ivel Valley West Mid Beds Leighton Buzzard Chiltern Vale Bedford Borough has 26 GP practices covering ~176,000 people Creating an integrated care centre on the Bedford Hospital site with GP practices could support an integrated care centre on site Supporting GP spokes could remain in Cranfield and Sharnbrook Ivel Valley has 9 GP practices covering ~87,000 people GP spokes in the southern part of Ivel Valley can remain as networked GP practices West Mid Bedfordshire has 6 GP practices covering a largely rural area with two main towns, Ampthill and Flitwick and a number of smaller towns and villages. Total population in the area is ~58,000 There is an opportunity to consolidate 2-3 GP practices into a large GP practice and retain the rural practice spokes Consolidation of GP practices Leighton Buzzard Locality is the smallest within Bedfordshire Clinical Commissioning Group and serves a registered population of ~ 44,000 patients with 4 GP practices There is a potential to consolidate 4 practices into a single healthcare hub in Leighton Buzzard Networked spoke 10 GP practices serve Chiltern Vale population of ~79,000 people There is a potential to consolidate 5 GP practices into a large GP practice in Dunstable with 5 supporting GP spokes Source: Bedfordshire CCG, Central Bedfordshire Council position statement, Care Closer to Home Modeling

18 18 Bedford locality: our vision We need to bring General Practice up to date and work to scale. If we are going to build a truly integrated health care system locally, we need to construct an organisation of practices that can respond and be an integral part of the solution. Areas that we are exploring: Seven day working Home visiting service Care home support for the frail elderly Complex care to support patients with multiple long term conditions Urgent care centre Practice nurse development Repeat prescribing Back office functions Training and development

19 Hospital services A range of potential models will now be further explored for Bedford Hospital Models have been honed following extensive clinical input and patient / public feedback We need a modern district general hospital (DGH) in Bedford offering core services including inpatient beds, A&E, maternity and paediatrics Integration vertical (between care pathways spanning secondary, community & primary) and horizontal (with networked specialist providers) Joint programme with Bedford Hospital has been established 19

20 Integration Self care Primary Care Secondary Care Community Care Mental healthcare Generalist Specialist Informal care from family and voluntary help

21 21 Summary of key actions Finding fully financially sustainable solutions Care closer to home including simplified urgent care services Community services vertically integrated with hospitals and GP federations. Core hospital services Networks of specialist services Establish Your Health in Bedfordshire programme Ensure effective link ups with Milton Keynes and neighbouring CCGs where required Continued engagement on report, prior to formal consultation

22 22 Exercise 2: what do the findings mean to you? Take a look at the key findings Discuss them in order of priority Write down your views in the speech bubbles What do you think that this means in practice? What would this mean to you and / or the people you care for?

23 Continuing the strong patient voice Katharine Parker Public Engagement Officer

24 24 Your Health in Bedfordshire Programme New name now that the review has completed Gaining further feedback on the progress report Targeted engagement activity with key stakeholders NHS staff Seeking the views of statutory bodies e.g. Healthwatch, HWB, JHOSC Broader public engagement Online survey Report on feedback gathered to Governing Body in January 2015 Social media activity

25 25 Next steps our approach to consultation and engagement Bedford Borough Bedford Central Bedfordshire Ivel Valley West Mid Beds Leighton Buzzard Chiltern Vale Bedford Borough: Programme development: close working with Bedford Borough Council, Bedford Hospital and emerging GP Federation Central Beds: Close working with Central Bedfordshire Council, Luton & Dunstable & Lister Hospitals and emerging GP Federations closely aligned to the Better Care Fund.

26 Next steps our approach to consultation and engagement January 2015 January March 2015 March 2015 June 2015 onwards Formal response from Governing Body Further engagement activity Pre-consultation business case presented to Governing Body Consultation and engagement Ongoing engagement activity

27 Next steps our approach to consultation and engagement No Big Bang approach

28 28 Next steps our approach to consultation and engagement Areas we are focusing on now: Emerging GP federations to support more care closer to home Clarity on options for hospital services (general hospital and specialist hospital services) Simplified and consolidated urgent care system Out of hospital care (opportunities for efficiency and productivity improvements across the health economy hospital, community and primary care) Areas we may not need to formally consult upon e.g. Phlebotomy Patient and public voice

29 29 Exercise 3: How can you help How can you support the Your Health in Bedfordshire programme? How can you help? How can you make other people aware? How would you encourage other people to participate? What sort of methods would you use to involve them? What would you need from us?

30 Thank you for your time and feedback If you have any further thoughts you can get contact the Your Health in Bedfordshire team by Web: Survey: If you want to continue to be involved please complete the Expression of Interest form Feedback forms on your table

31 Any questions? 31