What will the NHS be like in 5 years, 20 years time? NHS Castle Point and Rochford Clinical Commissioning Group (CCG) and NHS Southend CCG are groups of local doctors and other health professionals who organise the delivery of local NHS services. Commissioning involves understanding what health and care needs the local population has, planning what care will be needed, and buying that care from hospitals, care organisations and other providers. Inside: The needs of patients today are very different from back in the 1940s when the NHS healthcare system was set up. Then, the life expectancy was lower and the types of conditions that people suffered from were less complex. Now, the number of people aged over 65 is expected to increase by 65% in the next 25 years and half of those over the age of 60 have chronic illness. We are therefore looking at possible changes to the way health and care services are currently delivered. To be able to look after everyone s health and care needs in the future we need to transform services and think differently. Find out more about our plans for local health care services www.successregimeessex.co.uk NHS Castle Point and Rochford CCG NHS Southend CCG March 2017
STP and the Success Regime: What s it all about? A new and important piece of work in health and care is being developed in mid and south Essex called a Sustainability and Transformation Plan (STP). Each area in the country has its own STP. The STP is an opportunity for all of the services that work across health and care in mid and south Essex to agree a shared plan for the next five years. NHS England will use the STP to inform funding decisions about mid and south Essex. It s about the way we re going to: change what we do across health and care achieve our ambitions meet rising demand and achieve financial sustainability As part of a national initiative, mid and south Essex was identified as one of the most challenged health and care systems across the country and was selected as one of three areas to benefit from extra support to help achieve our local STP. This initiative was called the Success Regime. For more information visit: www.successregimeessex.co.uk Update on our plans for health and care services in south east Essex Last year we asked you what was important to you in health and care. It s time to share the latest plans for health and care services in south east Essex, plans that will shape the way you access the NHS in both 5 and 20 years time. The NHS needs to change in order to stay fit for the future, this document will explain how you can help and get involved. We believe that it is vitally important for people to be able to manage their physical and mental health at home, wherever it is possible and safe to do so. However, we do recognise that people need to be given the right opportunities and information to enable them to understand how best to manage their individual needs. For some health conditions, people will need the type of care and treatment that can only be safely provided in a hospital setting. However, we believe there are some services that are currently provided in hospitals that could be provided in other locations including certain GP practices, health centres and in some cases, e.g. follow-up appointments, via telephone. To achieve this, we need to ensure health and care services in the community become more responsive to people s needs both in and out-of-hours to prevent people falling into crisis and having to go to A&E. At the moment, a large proportion of the money we spend on healthcare is focussed on hospital services. We want to shift that focus to more preventative community care to better support people in their health and care journey before they reach a point of crisis. 2
Over the next five years: You could see a different range of professionals at your local surgery, and your GP could have longer consultation time available when you need it. A wider range of qualified health professionals will be able to provide patients, especially those with long-term conditions, the continuity of care they need The range of professionals linked to your local surgery, such as mental health specialists and social care workers, would create a service that supports you as a whole person rather than looking at each single problem separately Through investment and collaboration, some specialists and facilities that were previously only available in hospital could be available at your local surgery e.g. skin problems, stroke recovery, pain control and various scans and tests If you live with long-term conditions, such as diabetes, heart disease and other health risks, experts would help you to plan and manage your care. This means understanding mental and physical issues, as well as health and social needs. Your local team would know you and be ready to act quickly to prevent problems Early action, such as to prevent falls or to manage dementia, would help you to improve your quality of life and stay independent for as long as possible You would have a greater say in your own health and care plans. You and everyone involved in your care would have access to shared confidential records and other information to monitor and plan your care For people at the end of life, services would work as one to support you and your family at home or in a local place such as a hospice, if you preferred Getting help would be easier than it is now and you would be less likely to be admitted to hospital or residential care You would have more services locally, including online and telephone help, 111 linked to more services and specialist teams that can act quickly, without the need for an ambulance journey to hospital 3
Care in your community Combine hospital and social care. 81 year old Benfleet woman What you told us One point of contact instead of what seems five separate areas. 45-64 year old Rochford man Communication links between services - so that things flow and reduce unnecessary delays. 75-80 year old Rayleigh woman Did you know? Of 1,400 GP consultations studied in Brentwood, the Dengie and Southend last year, 25% of these appointments could have been handled differently. Some (around 11%) could have been better dealt with by another professional such as a dietician, a midwife, a physiotherapist, a pharmacist, a health care assistant or a mental health practitioner. Other appointments could have been avoided with better self-care and social care. Some appointments were simply administrative and could have been handled by an office process. 4
Care in your community There are a number of ways we could deliver more care in the community. This could mean increasing the number of services delivered in GP practices, health centres or other public settings as well as developing new ones. Regardless of the location, one thing we know we need to focus on is making sure all services work in a more joined up way. We want to make sure all residents have access to high quality care in the community when they need it, making a trip to hospital only necessary when specialist help is needed. Examples of the kinds of services we think could be delivered in the community are: Minor surgery this is already delivered in some GP practices and we are looking at offering a wider range of procedures where it is safe and appropriate to do so. Outpatient appointments many appointments do not require specialist equipment or tests and just require a physical examination and discussion with the patient. There is no reason why this can t be offered in the community. Children s services many children s services are already provided in the community and again we want to broaden the range of services e.g. follow-ups, outpatient appointments and mental health services to reduce the need for children to have to visit a hospital. Mental health support services - We want to increase the level of support delivered in the community to reduce the amount of people that find their condition worsening and in crisis. End of life care - We will be working with local hospices to avoid patients spending the end of their lives in a hospital bed, which we know many patients do not want. In Essex as a whole, we face significant workforce challenges. We are working with colleagues to help us to understand local needs and how we can meet them through both recruitment and additional training. Our vision is to create a network of health and care that can reach out to its patients. We want to see better collaboration between GP practices to create practice groups who can work more efficiently at scale and reduce duplication. Whether the network has a single health centre or several, its services and professionals can work together to achieve more than if they continued separately. We envisage a future where all organisations providing health and social care, including our voluntary sector, will work together to provide joined up services. 5
Care in your community Self care The below is an illustration of how and where local health and care networks might operate. More co-ordination with sports & leisure groups i.e. dance classes, weight watchers etc. 45-64 year old Rochford woman Education is important - responsibility and accountability. 45-64 year old Benfleet man Southend CCG Last year we asked what could be made available to allow people to take more responsibility for their health and wellbeing. What you told us Keep fit and [look at] their diet. 45-64 year old Canvey woman There needs to be more concentration on prevention. 70 year old Southend man It is everyone s responsibility to look after themselves and make their own choices. We want to make sure local residents have everything they need to improve their general health and where necessary recovery. There are areas that we believe will help to reduce reliance on health and care services. Information and advice: There are already many resources available to support people to keep well, part of our role is to put people in touch with them. The local services below are available now can help point you in the right direction for FREE: CAVS Ways to Wellness can help you find services and opportunities to improve your health and wellbeing in Castle Point and Rochford. Contact 01268 638405 or wellness@castlepointavs.org.uk For activities in Southend, visit the SHIP website at www.southendinfopoint.org. We envisage these types of services to be more accessible and widely available through our local health and care networks. 6
Self care Screening and preventative services: Surprisingly, many people do not take up the screening services that are provided for FREE by the NHS. Screening is a vital, life-saving service, which can highlight health concerns at a very early stage, often before any symptoms present themselves. This allows much quicker treatment and vastly increases the chance of recovery. We want to encourage people to take full advantage of the FREE screening service, for example: Diabetic Retinopathy (eye screening) in early stages retinopathy doesn t have noticeable symptoms, but if it is not treated can lead to blindness. NHS Cancer screening programmes, such as breast mammograms, cervical smears and bowel screening. NHS Health Check including health checks specifically for those with a learning disability and for people aged 40-74. These FREE checks can spot early signs and help prevent these happening to you, which means you'll be more likely to enjoy life for longer. Support for carers We are also aware that many people rely on family or friends to support them when they are unwell. In some cases the level of care needed can put a strain on the care-giver, and many carers put the needs of others above the needs of their own and become ill themselves. We want to work with our partners to better support carers, helping to put them in touch with services and groups that can support them. Supporting Carers in Essex is a single source of help and advice for unpaid carers of all ages in Essex. For information call 0300 770 80 90 or visit: www.carersinessex.org.uk Lifestyle choices: We want to work with our partners in local authorities to encourage people to make better lifestyle choices that will keep them healthy and reduce the likelihood of becoming ill e.g. stop smoking, reduce alcohol intake, eating healthily and getting more exercise. Even simple things like keeping warm can help reduce the chance of illness. There are a wide range of FREE support services that can already help but we can t force people to use them. It s important that, as a community, we take responsibility for our health and our children s health. Stop Smoking Services: Southend - 01702 212000, Castle Point and Rochford - 0300 303 9988 Local information and support on being more active and losing weight: Southend - www.activesouthend.com Castle Point and Rochford - www.acelifestyle.org www.essexlifestyle.org.uk For information and advice on healthy living: www.nhs.uk/livewell www.nhs.uk/change4life (Children) 7
We want to get better at managing demand for local health and care services Better support and a focus on prevention Our vision is for each health and care network to be able to access information about their local population. This would help the local teams to identify what people need to stay well along the following lines: Joined up services to help people at the earliest opportunity One team, one contact for both health and social care Health and social care staff using the same records and information to support older people and vulnerable people at home, including people at the end of life Support to residents and staff in care homes Support for people to manage their long term condition Standardised procedures for admission to and discharge from hospital, with facilities in the local community to ensure that people spend the shortest possible time in hospital. Improvements in services to respond to urgent needs and emergencies Investing in a new and better 111 helpline that is linked to the network of local services, including at night and at weekends Investment and increase in support for people in a mental health crisis More specialists in children s care available in the community, avoiding the need to go to hospital Skills development for paramedics and greater use of technology to contact specialists who can supervise treatments NHS Castle Point and Rochford CCG www.castlepointandrochfordccg.nhs.uk 01268 464508 cpr.ccg@nhs.net NHS Southend CCG www.southendccg.nhs.uk 01702 314299 southend.ccg@nhs.net Keep in touch We want to hear from you if you are interested in being more involved in helping to shape future health and care services. By providing your details, we will invite you to events to talk through ideas with us, and to keep you up to date with how our plans are developing. If you live or work in south east Essex and are interested in keeping in touch, please include your details below. If you are on Twitter, please follow us @CPRCCG @SouthendCCG Name E-mail address Address (or postcode if you d rather be contacted via email) Please return to: Communications, FREEPOST NHS CASTLE POINT AND ROCHFORD CCG 8