Moor to Sea Locality Development

Moor to Sea Locality Development

Moor to Sea Locality Ashburton Community Hospital Bovey Tracey Community Hospital Dartmouth Community Hospital Totnes Community Hospital

Moor to Sea Locality The Surgery Ashburton Riverside Surgery Bovey Tracey Buckfastleigh Medical Practice Tower House Surgery Chudleigh

Moor to Sea Locality Dartmouth Medical Practice Leatside Surgery Totnes Catherine House Surgery Totnes

Complex Care Team Point of Access Moor to Sea Practice Population: 53,729 Population Over 65: 13,916 Population over 80: 3,739 TSDHCT & DCC Employed Workforce 45.67 wte Total Non Registered 22.42 wte Total = 68.09 wte Leatside Surgery TOTNES AND DARTMOUTH GPS Dartmout h Medical Practice Totnes & Dartmouth Catherine House Surgery Care Direct Moor to Sea Public Buckfastleig h Medical Centre MOORLAND GPS The Bovey Tracey & Chudleigh Practice Moorland Ashburton Surgery KEY Torbay and Southern Devon Health and Care Trust Employed staffing as at 08.07.15 Devon County Council Employed Section 256 Monies Funded but employed by TSDHCT Totnes & Dartmouth Moorland Community Nursing Intermediate Care Therapies Therapy Manager 1.0 wte x Band 8 Social Services Community Nursing Therapies Social Services Complex Care Team Zone Manager 1.0 wte x Band 8b Cluster Co-ordinator 2.0 wte x Band 4 Non-registered = 3.0wte Community Nursing Team Leader 1.0 wte x Band 7 Community Matron 1.0 wte x Band 7 Community Nurses 1.85 wte x Band 6 6.24 wte x Band 5 0.8 wte x Band 5 vacancy Assistant Practitioners 2.0 wte x Band 4 Healthcare Assistant 1.0 wte x Band 3 Phlebotomist 0.67 wte x Band 2 10.89 wte Total Non Registered 3.67 wte Grand Total = 14.56 wte Discharge Liaison Sister 0.8 wte x Band 6 0.8wte INTERMEDIATE CARE Occupational Therapist 1.0 wte x Band 6 Physiotherapist 1.0 wte x Band 6 Support Worker 1.0 wte x Band 3 2.0 wte Total Non Registered 1.0 wte Grand Total = 3.0 wte TOTNES Physiotherapy Team Leader 0.8 wte x Band 7 Occupational Therapist 0.61 wte x Band 6 Physiotherapist 1.0 wte x Band 6 1.0 wte x Band 5 Multi-link Support Worker 0.53 wte x Band 3 0.8 wte x Band 3 Admin 0.6 wte x Band 3 3.41 wte Total Non Registered 1.93 wte Grand Total 5.34 wte DARTMOUTH Physiotherapist 1.0 wte x Band 6 1.0 wte x Band 5 Occupational Therapists 1.0 wte Band 6 1.0 wte Band 5 Physiotherapy Technician 0.63 wte x Band 4 Therapy Assistant 0.4 wte x Band 4 0.56 wte x Band 3 4.0 wte Total Non - Registered 1.59 wte Grand Total 5.59 wte Practice Manager 1.0 wte x Grade H Community Care Workers 2.0 wte x Grade E Social Workers 1.0 wte x Grade G Social Worker vacancy 1.0 wte x Grade G Occupational Therapist 1.0 wte x Band 6 4.0 wte Total Non Registered 2.0 wte Grand Total = 6.0 wte Community Nursing Team Leader 1.0 wte x Band 7 Community Matron 0.91 wte x Band 7 Team Leaders 2.0 wte x Band 6 Community Nurses 6.3 x Band 5 Healthcare Assistant 2.25 wte x Band 3 1.7 wte x Band 2 Admin 1.1 x Band 2 10.21 wte Total Non Registered 5.05 wte Grand Total = 15.26 wte Therapy Manager 0.48 wte x Band 7* Physiotherapist 0.92 wte Band 7 2.0 wte x Band 6 Occupational Therapist 1.58 x Band 6 1.28 wte x Band 5 Support Worker Intermediate Care 1.0 wte x Band 3 Rehab Assistant 0.43 x Band 3 Physiotherapy Assistant 0.75 x Band 3 6.26 wte Total Non Registered 2.18 wte Grand Total = 8.44 wte Intermediate Care Practice Manager 0.6 wte x Grade H Community Care Worker 2.0 wte x Grade E Social Worker 2.0 wte x Grade G Occupational Therapist 0.5 wte x Band 6 3.1 wte Total Non Registered 2.00 wte Grand Total = 5.1 wte Totnes Community Hospital Torbay Acute Hospital N.B// This includes only Permanent and Fixed Term Temporary Posts therefore Bank and Agency staff are excluded *Indicates where a role is divided across multiple teams (i.e. Management & Team Leaders that are responsible across more than one area or where support may be required in line with demand not necessarily divided equally). Dartmouth Community Hospital Bovey Tracey Hospital Torbay Acute Hospital Ashburton & Buckfastleigh Hospital Draft in development

Activity Summary Directly Age Standardised Rate (DSR) per 100,000 registered population 2013/14-2014/15 (annual average) Activity Moor to Sea Locality Count of registered patients South Devon and Torbay DSR per 100,000 DSR per 100,000 A&E 8,775 15,845 24,032 MIU 10,384 19,424 12,883 Elective 11,412 9,318 11,101 Non-Elective 8,869 7,827 10,300 Outpatient - all activity Outpatient - single patients 49,533 83,236 107,547 28,609 24,808 29,403

Outpatient Activity Heat Maps

Outpatient Activity Heat Maps

Totality of Health Service Use: Totnes & Dartmouth GP Consultations: 175,584 Community Therapy and Nursing Services: 39,321 Secondary Care Outpatient Appointments: 32,896 A&E and MIU Attendances: 10,747 Radiology events: 8,634 Elective Acute Care: 3,762 Non Elective Acute Care: 2,083 Intermediate Care: 1,932 Figures relate to activity not people and is based on available NHS data Community Hospital Admissions: 739

Totality of Health Service Use: Ashburton, Buckfastleigh, Bovey Tracey and Chudleigh GP Consultations: 178,665 Community Therapy and Nursing Services: 36,490 Secondary Care Outpatient Appointments: 33,709 A&E and MIU Attendances: 7,802 Radiology events: 7,460 Elective Acute Care: 3091 Intermediate Care: 2,964 Non Elective Acute Care: 1862 Figures relate to activity not people and is based on available NHS data Community Hospital Admissions: 402

Totality of Health Service Use: Moor to Sea Locality GP Consultations: 354,249 Community Therapy and Nursing Services: 76,841 Secondary Care Outpatient Appointments: 66,605 A&E and MIU Attendances: 18,549 Radiology events: 16,094 Elective Acute Care: 6,853 Intermediate Care: 4,896 Non Elective Acute Care: 3,945 Figures relate to activity not people and is based on available NHS data Community Hospital Admissions: 1141

Dartmouth Community Hospital Utilisation Admissions (Patients registered within ) Admissions (Patients registered outside ) 43% 57% Total Admissions 375 Of which, patients registered within the Of which, patients registered outside 213 162 Average LoS (days) 12 Total bed days 4,514 Beds 16 Totnes Community Hospital Utilisation Admissions (Patients registered within ) Admissions (Patients registered outside ) 51% 49% Total Admissions 364 Of which, patients registered within the Of which, patients registered outside 184 180 Average LoS (days) 17 Total bed days 6,107 Beds 18

Ashburton Community Hospital Utilisation Admissions (Patients registered within ) Admissions (Patients registered outside ) 43% 57% Total Admissions 177 Of which, patients registered within the Of which, patients registered outside 101 76 Average LoS (days) 19 Total bed days 3,354 Beds 10 Bovey Tracey Community Hospital Utilisation Admissions (Patients registered within ) Admissions (Patients registered outside ) 44% 56% Total Admissions 225 Of which, patients registered within the Of which, patients registered outside 126 99 Average LoS (days) 13 Total bed days 63,021 Beds 9

Moor to Sea Locality Community Hospital Utilisation Admissions (Patients registered within ) Admissions (Patients registered outside ) Total Admissions 1,154 Of which, patients registered within the Of which, patients registered outside 667 517 Average LoS (days) 15.3 44% 56% Total bed days 13,996 Beds 53

Overall Financial Position As a CCG above our target resource allocation by 28m (c8%) We need to reduce our spending to move closer to what the DH says we should be spending on our population Timescale and by how much is unclear Can expect a reduced or nil level of growth Will have to deliver efficiencies across the system to remain within the funding available & still treat the health needs of an ageing population. Shortfall in budget against contract 5million this year and 15 million 20126/17 Target ( 000) Allocation ( 000) DFT ( 000) DFT (%) 2015/16 351,130 379,182 28,052 7.99

Community Hospital Costs Hospital No of beds Bed Days No of Bed day Cost Admissions Avg. cost per Admission ASHBURTON HOSPITAL 10 3388 306.56 176 5,901 BOVEY TRACEY HOSPITAL 9 3088 326.22 235 4,287 BRIXHAM HOSPITAL 20 6253 261.81 431 3,798 DARTMOUTH HOSPITAL 16 4391 331.58 387 3,762 DAWLISH HOSPITAL 18 5278 362.28 440 4,346 NEWTON ABBOT HOSPITAL 20 7768 342.61 595 4,473 PAIGNTON HOSPITAL 28 9462 263.70 719 3,470 TEIGNMOUTH HOSPITAL 12 4476 267.80 261 4,593 TOTNES HOSPITAL 18 6016 285.04 364 4,711 178 59,041 4064 Avg Bed Avg cost per Day Cost 297.90admission 4,328

MIU Costs Cost Per Hospital Attendances Attendance Ashburton MIU 268 541.99 Brixham MIU 3081 93.56 Dartmouth MIU 3340 64.73 Dawlish MIU 3851 71.94 Newton Abbot MIU 16453 51.22 Paignton MIU 3274 71.45 Teignmouth MIU 3492 57.74 Totnes MIU 5665 85.78 50,244 69.77Avg. MIU Attendance Cost

Community Nursing Costs Locality Activity Avg Cost Coastal 32,322 32 Moor to Sea 32,632 38 Newton Abbot 34,813 34 Paignton/Brixham 49,283 34 Torquay 43,228 32 Average cost 35