Calderdale and Greater Huddersfield Health and Social Care Strategic Review February 2014

8/12/2019 Calderdale and Greater Huddersfield Health and Social Care Strategic Review February 2014

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Calderdale and Greater Huddersfield

Health and Social Care Strategic

Review

February 2014


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Agenda

This presentation sets out the current position on theprogress of the Calderdale and Greater HuddersfieldHealth and Social Care Strategic Review.

Work to date and current status of the overallprogramme.

How this fits with the strategic intentions and workprogrammes of the seven partner organisations.

A summary of the proposed future service model setout in the Strategic Outline Case.

The next steps.


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Background and Context


Health and Social Care StrategicReview


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Seven partner organisations have been working togetheron the Strategic Review over the past two years and havedeveloped a shared vision and approach to encourageinnovation and transform services.

Transformation is needed to address the significantchallenges facing the health and social care system nowand in the years ahead.

These include an ageing population with increasing needs,greater prevalence of long-term and lifestyle related health

and social care problems, the need to respond to the needsand aspirations expressed by patients, service users andlocal people and increased pressure on limited anddiminishing resources.


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Initially, work focused on four care streamschildren, long-term care, planned care andunplanned care.

This highlighted five cross-cutting themes whichimpact on all areas of health and social care:- Making the most of capacity and capability

Digitisation

Integration of services in the community

Integrated commissioning and personalisation

Taking forward work on the childrens servicesworkstream


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The seven partner agencies share common strategic intentions/directionwhich is reflected in the Strategic Review and its work to date.

The Strategic Review and Strategic Outline Case also reflect the strategicpriorities identified by the Joint Strategic Needs Assessments (JSNAs) forboth Calderdale and Greater Huddersfield.

Overall, all partners share some key overarching aims and these includechanging the way health and social care is provided so that:- There is easy access to the right information and guidance for people to make

informed choices for themselves and their families

People only have to tell their story once and are supported to make positivechoices

As much care as possible is provided close to home to keep people safe, well

and as healthy as possible for as long as possible Every child has a healthy start with opportunities to achieve their full potential

High quality, safe and effective specialist care is available when needed

Different agencies make best use of shared resources


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Strategic Outline Case




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Informed by the Calderdale and Huddersfield StrategicReview, discussion with partners and feedback frommembers of the public and staff.

Jointly developed by Calderdale and Huddersfield NHS

Foundation Trust, Locala Community Partnerships andSouth West Yorkshire Partnership NHS FoundationTrust and supported by Greater Huddersfield CCG andCalderdale CCG.

Changes proposed will improve the safety and qualityof services for people and respond to the challenge ofincreased demand and reducing resources.

The changes proposed will require public consultation.


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Increasing needs and demand for services from an ageingpopulation and reducing resources.

Conversations with the public and service users have made clearthey want care as close to home as possible and for all the differentparts of the system to work well together.

The National Clinical Advisory Team (NCAT) has recommended thedevelopment of more integrated care in the community and twospecialist hospitals: one being designated the planned site and onethe unplanned site.

Need to respond to national health and social care policy,particularly: the Francis Report, the Keogh Urgent and EmergencyCare Review, 7 Day Working, the Better Care Fund, Future Hospital:Caring for Medical Patients, and; Parity of Esteem for MentalHealth.


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Summary Case for Change


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Future Care System


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Overview of the Service Proposal

People will be able to take more responsibility for their health andstay in control of the support they need.

People will be supported to self-manage and self-care. Support willfocus on assisting people to live well in their community , includingthe development of community hubs at Todmorden Health Centre

and Holme Valley Hospital. When people need complex care it will be available 7 days a week

and extended working hours. Every effort will be made to meetpeoples needs in their home including some specialist services thatare currently hospital based.

Hospital care will be more patient centred so that people do notexperience delays and to minimise ward moves. Senior decisionmaking support will be available 7 days a week.


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Overview of the Service Proposal

For people with a serious or life threatening emergencythey will receive treatment in a specialist acute andemergency hospital. This will improve their chances ofsurvival and a good recovery. Senior decision making staffwill be available 7 days a week over extended hours.

Planned treatments and operations will be provided in aspecialist hospital. People will be confident that theirtreatment date will not be cancelled.

There will be a 24 hour 7 day psychiatric liaison service inboth specialist hospitals. The changes will also offeropportunity to consider the optimal alignment and servicemodel for acute inpatient and rehabilitation psychiatricservices for Calderdale and Kirklees.


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Integrated Locality Teams

T S i li A & E d


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Two Specialist Acute & Emergency and

Planned Care Hospitals

C it H b t


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Community Hubs at

Todmorden and Holme Valley


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Key Enablers

Putting people in control oftheir own health andwellbeing needs: people areengaged and supported tomake decisions that willimprove their health.

Leadership: whole systemstrategy for qualityimprovement and workforcedevelopment that invests instaff and General Practice

capabilities and skills. Large Scale Use of Information

Technology: to provideservices, enable self-care andsupport new ways of working.


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Benefits for Patients and Service Users

More control over managing ownhealth and accessing range ofsupport in local communities toprevent or limit illness or to liveas well as possible with a longterm health condition.

More options of care andtreatment available close tohome 7 days a week reducing theneed to go to hospital.

More convenient and efficientcare using technology.

Better experience and saferhospital care improving survivaland recovery chances and gettinghome quickly.


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Wider Social Benefits

The principles of co-production, self care and localcommunity engagement are atthe centre of the proposals.

This will support building

wider social capital. The proposals can enable the

redirection of resources tonon-statutory serviceprovision and widerdeterminants of health and

wellbeing in localcommunities.

Keeping Health & Social Carejobs in our local areas.


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Economic Case

Assumptions based on:- reduction in planned and unplanned care hospital beds to

ensure the right number of beds to meet population needsin the proposed service model.

improved efficiency of community services by havingintegrated locality teams

reduced reliance on public services through the promotionand reinvestment in alternate capacity and models of self-care.

Identified potential net efficiency saving of 50m. More detailed work at next stage of business planning

to model capital options and affordability.


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Clinical Engagement and Support for

ProposalsThis makes servicesmore sustainable, it will

allow very senior care to

be on site for longer, 7

days a week. Dr John

Naylor, Consultant in

Geriatric Medicine.Calderdale and

Huddersfield NHS

Foundation Trust

The emphasis on the model of

care and integrated teams with

GPs in the centre is excellent.

The opportunity to work with

consultant colleagues in the

community can only be a good

thing. I fully support this

development. Dr Steven Warner

GP & Medical Advisor, Locala

The on-going discussions

we have re service

transformation will not come

to the right model without

this type of collaboration

/integration as well as

working with the primary

care. Nisreen Booya,

Medical Director, SWYPFT

This shared model with community and

hospital services allows better

understanding and more person centred

care planning Barbara Schofield, Nurse

Consultant, Older People Calderdale

and Huddersfield NHS Foundation Trust


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Alignment with

Wider Stakeholder Plans The strategic outline case

describes and confirms thealignment of the proposalswith:- The Calderdale and Greater

Huddersfield Health andSocial Care Strategic Reviewand importantly the views oflocal people about what theywant from services.

Calderdale and Kirklees

Health and Wellbeing BoardStrategies

Calderdale CCG andHuddersfield CCGCommissioning Intentions


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Four Key TestsRelevant Information Provided in this Strategic Outline Case

ClinicalCommissioner

Support

The proposals are consistent with the direction identified by the Greater Huddersfield and Calderdale Strategic Review.The proposals are also aligned with the commissioning intentions of Greater Huddersfield and Calderdale CCGs. During

preparation of the Strategic Outline Case there have been several discussions with the Chairs and Chief Officers of both

CCGs and this has informed the proposals that are presented. During the past two months an engagement meeting and

a workshop with GPs has taken place and the feedback and discussion at these confirm support for the general

direction of the proposals described in the Strategic Outline Case.

Public and Patient

Engagement

The proposals have taken account of views expressed by members of the public about current services and what

matters to them that were provided as part of the Greater Huddersfield and Calderdale Strategic Review and through

engagement events held by SWYPFT. The proposals strongly align with the priorities identified in Calderdale and

Kirklees Joint Health and Wellbeing Strategies (and with the Joint Strategic Needs Assessment for each Council) which

are based on extensive public consultation and engagement.

Clinical Evidence

Base

The Case for Change section of the Strategic Outline Case details the clinical evidence related to the changes proposed.

The proposals are consistent with the national strategic direction for emergency services described by NHS England

Medical Director and draws on the substantial evidence base associated with Sir Bruce Keoghsreport.

The changes proposed for the way community services are provided draws on a range of evidence sources such as the

KingsFund, the Royal College of Physicians and the Institute for Healthcare Improvement. Senior doctors and nursesthat currently deliver the services on which these proposed changes will impact over-whelming support the strategic

direction of the Strategic Outline Case recognising the need for change to improve safety and quality.

Patient Choice The proposed changes in the way community services will be provided will significantly improve choice and control for

people. At the heart of these proposals is that services will be truly personalised and tailored to help support and meet

peoples needs. The proposed changes in the configuration of emergency and hospital services has taken careful

account of the need to balance access and the significant clinical evidence that patient safety and improved outcomes

can be achieved through the concentration of planned and unplanned services on two separate sites. According to the

evidence this should result in better treatment and reduced mortality from serious illnesses and injuries.


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Next Steps




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Next Steps

Subject to confirmation of support for the proposals and strategicdirection described in this Strategic Outline Case, next steps are:

To further define the potential models for engagement.

To develop an Engagement Strategy and Action Plan.

To engage and use the feedback from the activity to inform the nextstage of Business Case development.

To further refine the Business Case to test the quality of benefits,affordability and value for money of each of the service models.

The final Business Case will be subject to formal public consultation ifthere are changes to way services are currently provided or delivered.


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Topics for discussion with staff, key stakeholders,

public, patients, carers and their representatives

Topics Description

1. Continue with the existing hospital and community service model and configuration.

2. Implement the community and hospital service model proposed in this presentation

with Huddersfield Royal Infirmary as the site for acute and emergency care andCalderdale Royal Hospital as the site for planned hospital care.

3. Implement the community and hospital service model proposed in this presentationwith Calderdale Royal Hospital as the site for acute and emergency care andHuddersfield Royal Infirmary as the site for planned hospital care.

4. Continue with the existing community service model and change emergency

hospital care provided locally so that those people needing specialist treatments are

transferred to a major emergency centre outside the local area. Huddersfield Royal

Infirmary and Calderdale Royal Hospital would offer see and initiate treatment

services with people needing specialist treatments transferred to specialist centres.

This would reduce demand at the local emergency centres in Halifax and

Huddersfield.

5. Other topics which may emerge from the planned engagement activity with staff,

public, patients, carers and their representatives.


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Conclusion

The proposals will improve the safety and qualityof services in Huddersfield and Calderdale in acontext of increasing demand and reducingresources.

It is likely the proposals will require formal publicconsultation.

The proposals must demonstrate that the fourDepartment of Health tests for major service

reconfiguration have been met. The Strategic Outline Case demonstrates how the

four tests are addressed at this stage.


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CCG Support

Calderdale Clinical Commissioning Group and

Greater Huddersfield Clinical Commissioning

Group are recommending that the proposals

progress to next stage of Business Casedevelopment.

Calderdale and Greater Huddersfield Health and Social Care Strategic Review February 2014

Documents

Transcript of Calderdale and Greater Huddersfield Health and Social Care Strategic Review February 2014