better health and care: developing a plan for north east...
TRANSCRIPT
Easy Read
Better health and care: developing a plan for north east London A summary of what we’ve done so far
This is a draft document which means it could change
Autumn 2016
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In this easy read document when a tricky word is first used it will be in bold blue text. Where it isn’t explained in the text there will be a blue box giving the meaning. For example, “Sustainability and Transformation Plan (STP)” is mentioned on page 2 and here is the meaning:
Sustainability and Transformation Plan (STP): A document that looks at how services can improve and how they can carry on in the future
Contents
Our vision....................................................................................... Working together for change.......................................................... Why do we need a new plan for health and care?......................... Benefits to patients......................................................................... Solving our problems...................................................................... Vanguards...................................................................................... Our approach.................................................................................
1 Make sure we have the right services in the right place.... Spotlight on... Maternity............................................... 2 Change the way care is provided........................................
3 Secure the future................................................................. Spotlight on... Cancer.................................................. How things could work.... Virtual kidney clinics........... 4 Improve specialised care..................................................... Spotlight on... Primary Care........................................ 5 Working together................................................................. 6 Our buildings....................................................................... King George Hospital A&E.................................................... Spotlight on... Mental health.................................................. Money.................................................................................... Spotlight on... Workforce........................................................ How our plans will make a difference to you..........................
Tell us what you think..................................................................... Word List........................................................................................
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Introduction
Everyone living in north east London should live independent and healthier lives, and for this to happen, the National Health Service (NHS) needs to improve and change.
The NHS and councils are working together to make this happen.
One way we’re doing this is by developing a Sustainability and Transformation Plan (STP) for north east London.
The STP plan will turn aims of the NHS Five Year Forward View into reality.
NHS Five Year Forward View: A document that talks about gaps, problems and solutions for NHS services
It’s still being developed, and we need local people’s ideas before it’s finished.
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Our vision:
Improve health and wellbeing for local people, and make sure care services are built around their needs.
Develop new ways of working that’s better for everybody, focuses on preventing ill health and giving out of hospital care.
Work in partnership to plan, commission (buy), contract and deliver services well and safely.
Working together for change
Everyone is working together to make changes and they are putting the patient and their experience at the heart of everything they do.
This includes plans for the future and involves over 20 organisations including GPs (doctors), NHS England, NHS Improvement, Health Education England, University College London (UCL) Partners and local councils.
It will only be possible to improve health and care in north east London with support and comments from local people.
This document is about our early thinking, but we will be doing lots of work to make sure there is an opportunity to discuss these plans with you. No plans will happen without talking to local people.
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Why do we need a new plan for health and care?
Our population is growing at the fastest rate in London. Many people are being taken into hospital with conditions that could be cared for in the community. Accident and Emergency (A&E) use is increasing in most boroughs.
There are some very poor areas, where people face poor physical and mental health. This is linked to not having very much money, bad housing conditions and high smoking rates.
Generally, adults in these areas are not physically active, which can lead to diabetes, dementia and being overweight. These are all more common in poor areas.
With people living longer, more care and support is needed later in life, and conditions like dementia are becoming more common.
We have lots of children who are overweight and there are low immunisation (vaccine) rates.
Many of our hospitals are in special measures. This means there are worries about the quality of care provided.
More people find it hard to get a GP appointment. There is a shortage of GPs everywhere, and many local GPs are getting close to retirement age.
Money we spend on health and care will go up over the next few years but the money available to us will not.
Working together will give us the best chance of making sure local health and care services can continue.
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Benefits to patients
You will:
Be empowered to be independent and take responsibility for your health and wellbeing
Live longer and healthier lives
Find it easier to use urgent and emergency care
Have your care provided in modern buildings that are welcoming for patients and staff
Find it easier to use primary care, with some services opening from 8am - 8pm, seven days a week
Primary Care: Health care provided in the community such as GP practices
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Solving our problems
Our top three aims are:
1 Prevention and self-care - to reduce the strain on health services, we want to encourage more people to look after themselves and their health so that they stay well.
2 Primary care - to meet growing demand we will work together and use community, social care and healthcare professionals.
3 Hospital services - most of our hospital care does not meet the required standards. We will change this by changing hospital care, redesigning patient pathways and working together more closely.
The STP is a plan for working together across north east London where it makes sense to do so. There are also a number of local plans that help achieve our plans:
Hackney devolution pilot www.cityandhackneyccg.nhs.uk
Barking and Dagenham, Havering and Redbridge (BHR): as a devolution pilot BHR www.bhrpartnership.org.uk
Newham, Tower Hamlets and Waltham Forest partnership between the CCGs and Barts Health NHS Trust www.transformingservices.org.uk
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Vanguards
In north east London there are also two 'vanguard' programmes, aimed at helping services get better and work together.
Each vanguard site has special freedoms and flexibilities which they would not have if they weren’t a vanguard site. These are:
Urgent and emergency care vanguard
Local GPs, hospitals, community services and councils are working across Barking and Dagenham, Havering and Redbridge to better urgent and emergency care services.
This is happening by changing the way people use urgent care locally, creating a simpler urgent care system.
For more information: www.bhrpartnership.org.uk
New models of care vanguard
In Tower Hamlets local health and care partners are developing new ways of working to provide joined and person-centred care.
It focuses on the whole person (physical, emotional, social), prevention, high quality services, and improving life-long health and wellbeing.
For more information: www.towerhamletsccg.nhs.uk
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Our approach
We have six priorities to focus on across north east London:
1 Make sure we have the right services in the right place
Our growing population is putting pressure on our health and social care services. We need to focus on preventing illness, improving GP services and making sure there are beds in our hospitals for those who need them.
We can make this happen by:
Focusing on prevention and self-care, giving everybody the tools they need to help themselves where possible,
Directing people to the right place first time through our urgent and emergency care system,
Offering good outpatient care, so hospital beds are only for those who really need them,
Making sure our hospitals work together,
Getting our hospitals working with community and social care services, and
Ensuring the staff and hospitals can support local people from birth and throughout their life.
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Spotlight on... Maternity
There is more demand for maternity services, and more pregnant women require specialist support.
We want services that are focused on women and families that are caring and offer the best experiences of safe care, with kindness and choice.
We will:
Improve women’s experiences of our maternity services.
Create more opportunities to give birth in midwife-led settings.
Develop care that works for all mothers and make maternity services better and able to offer more choice by supporting staff.
Make sure there is access to the right mental health services for women before and after they give birth.
Support self-care / personal health budgets for women.
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2 Change the way care is provided
We will empower people to manage their own health and wellbeing where possible, and make sure the care they receive is of a high quality by:
Offering care from 8am to 8pm, seven days a week.
Making sure that people receive high quality care in the right place, ideally close to their home.
Providing care to people with complex needs by working in partnership with the teams needed.
Making sure that hospitals provide strong, safe and high quality services.
Giving better urgent and emergency care, planned care/surgery, offering more birthing options and getting hospitals to work together.
Changing the way and order people are treated in urgent and emergency care so that only patients who need more intensive care are admitted to hospital. This will reduce the demand for costly hospital beds.
Developing outpatient care so it’s provided in the community and where possible reducing the need for people to have to go into hospital.
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3 Secure the future
Many of our health and care providers are going to struggle with money in the future. Although they have made big progress to save money, more savings are needed.
We need to work together to find a way to support organisations providing local services. This will involve:
Changing the way services are provided so fewer people go to hospital and less are admitted when they don’t need to be. We also want to make sure that those who are admitted are treated and sent home quickly.
Making our organisations work better from office support to surgery.
Looking at ways to work together more formally.
Exploring ways for the NHS to work more closely with councils through local devolution pilots.
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Spotlight on... Cancer
In north east London (NEL), cancer screening is below the England average and emergency presentation is 5% higher than the national average.
This needs to change so that cancers are diagnosed quicker and earlier.
We want fewer people in NEL to get cancer and those who do need to be diagnosed more quickly so they have a better chance of survival.
We want those diagnosed with cancer to have quick access to high quality modern treatments and have a better care experience.
We will do this by:
Reducing late diagnosis by making sure more people with cancer see a doctor sooner
Reducing the risks of getting cancers and ensuring people who have had cancer have better support to prevent further illness
Improving one-year survival rates
Making sure all people with cancer are cared for by high quality patient centred services, during and after their treatment
Supporting people living with cancer as a long term condition, making sure 95% of patients have an agreed after treatment plan
Achieving world-class cancer outcomes, as set out in the National Cancer Taskforce Report by 2020
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How things could work.... Virtual kidney clinics
GP thinks patient needs more specialist care and refers them to a face-to-face clinic at a hospital
People can sometimes wait two months or more for an appointment
Patient has tests, is assessed by a consultant to diagnose their condition and work out treatment plan
This year a new service in east London was started
where patients at risk of kidney problems are referred to a virtual clinic. This involves a specialist reviewing a patient's GP notes online and any tests results, often within five days of a referral.
The specialist then tells the GP and patient what should happen next.
This means more specialist advice, earlier and faster. Patients are more able to look after themselves and help stop their condition getting worse. It also reduces waiting times for face-to-face appointments as fewer people need them.
We want to roll out these pilots out across NEL and share our learning.
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4 Improve specialised care
Demand for specialised services like some treatment for rare cancer is growing. We need to work with other NHS organisations in London to become the best in the world at providing these services.
Spotlight on... Primary care
Our population is growing and people are living longer, and in poor health with complex care needs. This means there is more demand for services. We want to provide high quality, local primary care, making it easier to use GP services. This will make us more proactive, with GPs being in charge of patients care. It will also give GPs more time to spend with the patients who need it, by:
Letting patients book their GP appointments online using the new service
Better GP opening hours and allowing different appointment lengths to meet people’s needs
Starting social prescribing pilots; where patients are referred to other local voluntary and community organisations to support their health and care needs
Practices and medical staff being easier to contact and speak to on the same day
A better service for patients with complex conditions who need care from more than one health professional
Patients getting more involved and also being more able to look after themselves and stay healthy
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Benefits
Shorter waiting times
Health and care services will be more efficient and easier to use
You will be supported to be independent in your own home for as long as possible
Better access to specialist services locally and within London, saving some patients long journeys to other locations elsewhere in England
Better outcomes by faster access to help and earlier diagnosis
More opportunities for innovation/new ideas
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5 Working together
We need to change the way we work if we want to improve care and create care that is truly people-centred and sustainable. This will involve: Pulling health and social care budgets together (known at pooling) Joining services up where we can Close working between local authorities, the NHS and other voluntary and community organisations.
6 Our buildings
We want care to be in modern buildings suitable for healthcare. We are looking at our buildings, what services are based in them and where there are opportunities to use them better, or sell them.
We need to look at how we can better manage buildings we fund through private money, something we call private finance initiative (PFI).
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Benefits
Focus on the whole person: mental health, physical health, social and spiritual circumstances
Better physical health for people with mental health issues and vice versa (the other way round).
More choice of where care is provided
More services together in one place
Better access to 24/7 emergency care
King George Hospital A&E
The decision to make changes to A&E services at King George Hospital in Goodmayes has already been made and supported by the Secretary of State for Health.
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Spotlight on... Mental health
Locally, mental ill health is common, and NEL has the highest levels of new cases of psychosis in England. Deprivation adds to this and puts our health services under pressure. We expect demand for these services to go up.
We want to improve people's mental health and wellbeing, and give person- centred services that can continue in the future, by;
Psychosis: A mental illness that affects someone’s ability to connect to reality
Deprivation: Lack of money to be able to live to a good standard
• Better self-care and prevention, including digital support
• Better before and after birth services, psychological therapies, early help, crisis and dementia care, meeting national requirements
• Making sure we will be able to meet future demand
• Putting mental health at the heart of all of our services and as close to home as possible
• Better support for people with long term conditions
• Better physical health of people with severe mental illness
• Better access to psychological treatment for people with common mental disorders, including additional mental health support service
• Improve psychosis support - pathways, crisis and accommodation
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Money
We know that things need to change.
If we carry on as we are in north east London, we will need to find £578m by 2021 of extra money.
We have found ways to help close this gap and find savings through:
Individual organisations working together and running better
Bringing back office functions like HR, finance and IT together so that work is only done once
Joining services up where we can and sharing good practice
Using our buildings and spaces better
Use our buying power for example buy medicines in bulk
Working with local people to design new services, find opportunities and make changes
Get funding from the national Sustainability and Transformation Fund, but to do this we need a good STP
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Spotlight on... Workforce
We cannot do any of this without our staff - they are crucial to the success of the STP. We will transform our workforce by:
• Keeping staff - by making our organisations great places to work, offering career development, education and training so our staff have the skills they need, and keeping our staff happy and healthy.
• Promoting north east London as a great place to live and work - in order to recruit staff, we need people to see this part of London is a great place to live and work. We must create career and education opportunities for people so they want to be here.
How our plans will make a difference to you
• People will live longer and healthier lives
• There will be new ways of delivering care that focus on keeping people well and out of hospital
• Our hospitals will provide are that is safe, understanding, effective and efficient, every time.
• All care will be to a high standard
• Care will be planned and provided by joined up services
• We will work with voluntary and community organisation to give better support to patients and unpaid carers.
• We will make sure we can afford to run safe services that can continue in the future.
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Tell us what you think
This document is still a draft so a lot can change.
We’d like to hear what as many people as possible think of our ideas so we can develop them further.
It’s only possible to improve health and care in north east London with the support of local people.
We won’t make any changes without talking to local people first.
Please send us an email and tell us what you think:
To find out more about the STP or sign up to our newsletter visit our website: www.nelstp.org.uk
You can also share your views with us by completing a short survey by visiting:
www.surveymonkey.co.uk/r/HWCommunityViews
We will be holding a number of local events across north east London, if you would like to find out more or attend an event please contact Sarah on:
020 8553 1236 or email [email protected]
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Word List
A&E Accident and Emergency
Commission Buy
Deprivation Lack of money to be able to live to a good standard
GP Doctor
Immunisation Vaccine
Innovation New ideas
NEL North East London
NHS National Health Service
NHS Five Year Forward View
A document that talks about gaps, problems and solutions for NHS services
Pooling Pulling health and social care budgets together
Primary Care Health care provided in the community
Includes GP practices and clinics
Private Finance Initiative (PFI)
Buildings we fund through private money
Psychosis A mental illness that affects someone’s ability to connect to reality
Social Prescribing Refers patients to other local voluntary and community organisations
Sustainability and Transformation Plan (STP)
A document that looks at how services can improve and how they can carry on in the future
UCL University College London
Vanguard Programmes aimed at helping services get better and work together. Each vanguard site has special freedoms and flexibilities which they would not have if they weren’t a vanguard site.
Vice versa The other way round
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