21st Century Health and Care Making difficult decisions to ensure the future of quality health care for you
Challenges to Public Services All over the world public services are having to find ways to continue to deliver high quality services while experiencing many, many challenges Doing nothing is not an option as, as we hope to show, we cannot go on as we are without making changes The following slides show what is happening nationally and locally that mean we have to work together to find solutions
The effect of an ageing population Currently there are 61,475 people over the age of 65 in North Derbyshire By 2030 this number will reach 86,680 (an increase of 42%) 7,817 are over 85 and this will rise to 12,273 (an increase of 57%) Increases in Long Term Conditions Those who are living longer live with a chronic condition/s or disability In 4 years time 3 million people nationally will have a long term condition By 2030 there will be a 100% rise in arthritis cases
As well as not having enough money to pay for services now...... future budgets are going to be cut. Something different has to be done.
What s the financial challenge? 000s Deficit of 37m in 4 years
Nationally finding staff that can meet these challenges is difficult We are not getting enough people trained to meet the demand. GPs Nurses Other staff
Outdated or inappropriate service models Although we have moved on from when the NHS was first set up, we now need to be thinking about how we manage these challenges and meet the demands for the future. The NHS was designed at a very different time, for a very different population. We need to consider now how we can do things differently.
1914 2014 43 million UK population 63.2 million 52 (male) 55 (female) Average life expectancy (if born in this year) 90.7 (male) 94 (female) 0.3% (male) 1.2% (female) Chance of living to 100 (at birth) 32.9% (male) 39.9% (female) 63% Chance of dying before 60 12% 130 Infant mortality per 1,000 4 Infectious, perinatal and respiratory diseases Most likely cause of death Cancer and heart disease 39,000 Deaths from TB 261 Owbridge s Lung Tonic Curic Wafers Pistoia Gout Powder Common medicines Simvastatin (lowers cholesterol) Ramapril (lowers BP) Aspirin
Engagement with the public In 2012 public meetings were held around the county to share the challenges that are creating the need for change We listened to your views You gave us feedback on the principles that should be used to make the decisions about future service changes
Guiding Principles
What else did you tell us? I want to be able to get an appointment to see a GP when I need to see one I want to be treated as close to my home as possible or in my own home I don t want to go into hospital unless it s absolutely necessary I want to come out of hospital as soon as I m fit enough
But, good news! There are opportunities to do things differently
How? Developments in technology eg. prescription monitors, use of telephone landlines and apps on mobile phones to measure things like glucose levels Reduction in the size of medical devices mean they can be used outside hospital Developments in research to improve patient care
You don t want to be in hospital if you don t need to be and we don t want patients to be in beds unnecessarily, because this leads to: Loss of Confidence Reduced quality of life Loss of independence Likelihood of getting an infection Loss of mobility Not dying where you want to Inappropriate use of scarce money
Improve the support for prevention and self management Look after people in their own home or as near to home as possible Look after people better so that they do not keep going into hospital Reduce the number of people in hospital who shouldn t be there Get people out as soon as they are clinically ready to be transferred Take advantage of the opportunities Use the freed up money where it is needed the most
What are we working on? Developing Integrated Working Teams Providing beds at Ashgate Hospice Improving Discharge Planning Specialist Falls Ambulance Linking GPs to Care Homes Prompt access in A&E to specialists for MH patients Developing integrated behaviour pathways for children and young people Early Supported Discharge for Stroke Patients Re-directing patients at A&E to a GP Single Point of Access for Clinicians and Voluntary Sector Telehealth Initiatives Improve Service Capacity Over Winter Specialist Hospital Unit for Older people Just-in-Case boxes in people s homes Hospice at Home/Night sitting services Improving Care Plans Re-ordering items that are not needed to reduce waste on repeat prescribing Increasing Pulmonary Rehabilitation Programmes
Sam s story
We need to be thinking about what you need as a patient and design the service around those needs Community Support Team Acute Local beds to meet your needs Voluntary Sector Support Patient Specialist nurses Community Services Physiotherapy Community Networks
What are we working on? Providing beds at Ashgate Hospice Improving Discharge Planning Specialist Falls Ambulance Linking GPs to Care Homes Prompt access in A&E to specialists for MH patients Developing integrated behaviour pathways for children and young people Early Supported Discharge for Stroke Patients Re-directing patients at A&E to a GP Single Point of Access for Clinicians and Voluntary Sector Telehealth Initiatives Improve Service Capacity Over Winter Specialist Hospital Unit for Older people Just-in-Case boxes in people s homes Hospice at Home/Night sitting services Improving Care Plans Re-ordering items that are not needed to reduce waste on repeat prescribing Increasing Pulmonary Rehabilitation Programmes
As a result We are successfully reducing the need for hospital beds both in Chesterfield Royal Hospital and in our five Community Hospitals and therefore need to consider how many beds we keep. Acute Acute Acute Acute Acute Acute Acute Community Bed Community Bed Community Bed
What do we want the result of all of this work to be? Enough hospital beds for patients who need them, with access to specialist care The right services in your community to meet your needs Work with others to try to meet the needs of carers
What else will be part of the consultation? Prevention and self management programmes Increasing opportunities to see a GP when you need one What community services will be available and where they will be located Improving services for people with Mental Health needs, especially dementia The future of services available when your GP surgery is not open (the possibility of using Minor Injury Units, A&E Units, Walk-in Centres, Primary Care Centres)
One of the things we want to discuss with you is the future of the buildings where community based services are currently provided Pre-consultation meetings are happening now including public meetings being held throughout June Formal consultation will happen later in the year
So what do we need you to do? Talk to your friends and neighbours about what you have heard and get people interested and wanting to know more Respond to the invitation to attend the formal consultation public events (and tell your neighbours and friends to do so) to give your views on the final options