Developing care closer to home Carolyn Morrice Chief Nurse
Aim of today s event Tell you about how we are bringing care closer to home across Buckinghamshire Update you on progress with the community hub pilots at Marlow and Thame Get your views on how the learning from the pilots affects your vision for a community hub where you are
Helping people to stay well Through prevention and early-intervention we want to: help patients to take greater control over their care and treatment ensure we meet patients long-term needs to help them to stay independent make it easier to access the right services 3
What has been achieved so far Over 75s community nursing reducing admissions Some GP home visits undertaken by paramedics Airedale support to care homes to prevent A&E attendances New ways of working in care homes to improve outcomes Practices have clustered to start roll out of new integrated teams
In development In the last year, we have invested over 1m to expand community services including: Locality teams Rapid response intermediate care Community care coordination team Community hubs - pilots in Thame and Marlow
Your community hub vision Rapid access to testing Enhancing self-management, providing education Easier signposting to health and care Base for skilled staff working in the community Sociable space with a café More local outpatient clinics Full range of therapy services Joined up teams Information shared between organisations to improve care Virtual information networks 6
Community hubs a pilot At Marlow and Thame hospitals Providing: A new community assessment and treatment service More outpatient clinics More diagnostic testing Working with the voluntary sector 7
New services on offer Marlow Outpatient clinics Orthopaedics Urology General surgery Plastic surgery Chemotherapy & Macmillan Continence Psychological therapies Parkinson s disease Falls assessment Care of the elderly Tissue viability Continence Voluntary sector services Carers Bucks staff offering support and linking with NHS staff Healthy Minds Prevention matters Assessment and diagnostics Community assessment and treatment service (CATS) Additional day of plain film x-ray (3 days a week) Blood testing, immediate results to support decision making
New services on offer Thame Outpatient clinics Voluntary sector services Assessment and diagnostics General surgery Carers Oxford staff Community Orthopaedics offering support and assessment and Care of the elderly linking with NHS staff treatment service (Day hospital) Prevention Matters (CATS) IAPT (psychological Health Blood testing, therapies) Minds/Prevention immediate results Plastic surgery Matters to support Falls assessment Victim Support decision making clinic & care of the Age Concern elderly Alzheimer's society Continence
Developing the pilot Operational group: clinical and operational staff managing the day-to-day running Stakeholder engagement group: local representatives from GP patient participation groups, League of Friends, local councils, Healthwatch being a critical friend, holding us to account and giving advice and support Governance group: senior clinical staff, chaired by the medical director, providing strategic oversight and monitoring safety and effectiveness Together these groups have ensured that the community hub programme has been responsive and has adapted to the needs of patients
Marlow community hub April-Dec 2016: 180 patients admitted into Marlow Community Hospital April-Dec 2017: 353 patients seen by Community Assessment and Treatment Service 96% increase in patients seen Inpatients April-Dec 2016: 9% Marlow postcode Community Assessment and Treatment Service April-Dec 2017: 24% Marlow postcode April-Dec 2016: 332 outpatient appointments April-Dec 2017: 542 outpatient appointments 63% increase in outpatient appointments 11
Thame Community Hub April-Dec 2016: 141 patients admitted into Thame Community Hospital April-Dec 2017: 288 patients seen by Community Assessment and Treatment service 104% increase in patients seen Inpatients April-Dec 2016: 5% Thame postcode Community Assessment and Treatment Service April-Dec 2017: 15% Thame postcode April-Dec 2016: 421 outpatient appointments April-Dec 2017: 660 outpatient appointments 56% increase in outpatient appointments 12
How else are patients benefitting 92 people seen in their own homes Only 6.6% of patients seen in clinics went on to be admitted to hospital 25% increase since pilots began in the multidisciplinary assessment service at Wycombe 13
What have patients most valued? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% April/May June July August Sept Oct Listening to my concerns and wishes Thorough assessment Suggesting improvements in my care Providing support for my family/carer Response from 213 out of 313 patients (80% response rate)
What patients have said... Felt cared for, and the services received have had a positive impact on their health and wellbeing Very positive about outpatient appointments closer to home Improved quality of life as a result of being visited at home We need to raise awareness of hub
What patients have said 16
Jean s story 17
What s working well Staff are motivated and committed to bringing care closer to home Patients have reported a positive experience Increasing levels of activity and increasing number of referrals to the community assessment and treatment service We are able to provide more complex treatments locally such as chemotherapy Stakeholder engagement has been instrumental in shaping local services and providing an important independent voice
What could be improved Working with voluntary sector We need to continue to raise awareness of the hub, not just the community assessment and treatment service, amongst GPs and public to increase referrals It has taken more time to mobilise than we anticipated Broader patient feedback from other parts of the hubs service
Have we delivered your vision? Rapid access to testing Easier signposting to health & care Base for skilled staff working in the community Health & wellbeing - self-management, providing education Full range of therapy services Joined up teams Sociable space with café Information shared between organisations to improve care More local outpatient clinics Virtual information networks 20
Questions for clarification? 21
Group activity 1 What do you like about what you have heard? What are you concerned about? 22
Group activity 2: Taking into account what you have heard about the pilot hubs, and looking at your vision for a community hub from 2016: What is your vision for a community hub in in 2018? 23