george campbell maddy ruff - king's fund

GEORGE CAMPBELL

MADDY RUFF

Together as one community:

Integrating primary, community and

social services

142000 patients with 22 practices Budget £168 m

Hawes to Runswick Bay

Over 80 miles and more than

a two hour drive

Challenges

• Inherited deficit of

£1.8 million

• Ageing population

• Rural & sparsely

populated

• Suspicious public

• Suspicious County

Council

Wanted to do things differently

Partners

Communication with partners

There are no big bang solutions

Small sequential steps

Continually look back & reassess

our progress

Success

• Paid off our debt

• Made a £752K surplus

• Reduced non elective admissions

• Keeping elective admissions virtually static

• Had a good 360 degree stakeholder survey

• Well regarded General Practice

» Nominated for HSJ awards 2014 x 3, including

Health & Social Care Integration

Collaboration

with Yorkshire Ambulance Service

1. GP Triage

2.Paramedics working

with GPs and A&E/OOHs

3. GP urgent-hospital transport

365Response

4. Public Involvement

Removing barriers between health

& social care

Functionally integrated health & social

care teams

GP basket of out of hospital

services

Cooperation between

primary, secondary &

community services

DVT

Ambulance Triage

Ring Pessaries

Community Mx of male

acute urinary retention

Follow up of stable Ca

Prostate

Level 4 anticoagulant

monitoring

Initiation of insulin

Complex wound care

Minor Injury

Re-tendering of services in

Whitby & District

Redevelopment of Whitby Hospital

only 25% of present site utilised

Development of Site

(Preferred Option)Hospital integrated with NYCC Services

PMCF – Together as one community

Impetus to share the

vision - reinvigoration

Primary care no longer a

bystander

Formation and

development of a fully

constituted GP federation

-21 practices

Together as one community

Highly organised enterprise

within 3 months – CSU

partnership.

Face & manage the conflicts

of interest challenge

8-8 access in Whitby from

October

8-8 access in Hambleton &

Richmondshire from

January

Innovative Business Plan

• Preparing to bid for £42m

community services

contract

• Plans for 0ver 75’s

• Telemedicine to address

our geography

• Working together to

further develop high

quality community care

In Conclusion• Clear shared vision

& destination –

owned by all

• Flexibility of

approach

• Route has evolved

• Communication &

listening

• Developing trust