Ambition, Action, Achievement Leading your local NHS
Dec 18, 2015
Our Vision:
Havering will be a healthy place to live for all
To commission best in class services that give people personal choice and control of their healthcare needs in the most appropriate settings
Working with our partners we will radically redesign our Primary Care Provision, align the targeted and open access services with the Borough and operate jointly 7 days a week
Delivering best in class services will mean that we will make informed evidence based investment decisions, delivering clearly defined outcomes
We will empower our residents to access health and wellbeing, education and training opportunities
Ambition, Action, Achievement
Key points from JSNA• Oldest population in London and numbers are growing
expected 29% increase people aged 65 or over • 57% increase aged 85 or over with long term limiting
illness by 2025• Diabetes levels predicted to rise 48% by 2025 and stroke
levels predicted to rise 31% over the same period. • 2nd highest in London % of obese adults (22%)• Cancer mortality higher than expected for bowel/breast
at 1 year• 2nd highest rate in London of overweight children at age 5
(ticking timebomb)• Havering deprivation (IMD) 200th out of 354 PCTs
Actions are needed to deliver the outcomes for our population
• Increase– Improved identification/diagnosis of dementia– % of deaths that occur at home – Breastfeeding at 6-8 weeks– Uptake of DTP at age 5 (proxy for MMR) – Self reported experience of patients/users
Our eight local outcomes:• REDUCE
– COPD mortality– Stroke deaths within 30 days– Premature cancer mortality
Key Actions speak louder than words – must be
realistic
• Polysystem model implement during 2010/11
• LTC care transformed with 50+ strategy actions & modernised community services
• Health4NEL shifts linked to CSP initiatives
• Organisational including Board development
• Clinical & Public engagement strategies delivered
What’s a Polyclinic/Community Hospital
Post acute stroke beds Step down and palliative care
beds Advanced physiotherapy services Day Hospital Plus services available in the Hub
DDA Compliant Induction Loop fitted to reception Treatment room At least one consulting room Minimum of 1 disabled parking
space per clinical room Baby Changing Facilities Breast-feeding friendly Secure pram/pushchair/cycle
storage Satisfactory Infection control
report IT compatible with hub to allow
reciprocal appointment booking and records access
Confidential reception facilities Energy efficiency audit action plan
completed On-line booking facilities for
patients
Ambition, Action, Achievement
Features for all new facilities
Polyclinic Hub
• Min 12hr x 7 days a week, Urgent Care Centre, with direct links to A/E
• X-ray, ultrasound, possibly mobile MRI and mobile breast screening
• Full range of near patient testing• Dedicated disability facilities • Access to health information
available in leaflet or electronic form
• Range of Borough service• Voluntary sector services• Community based services e.g.
physiotherapy, audiology, sexual health, pharmacy
• Consultant led outpatients• Direct links with Out of Hours
services• All GPs offering full range of
enhanced services• Range of services for children and
young people with direct links to the Children’s Centre
• Mental health including dementia support
• Long Term Conditions working through multi-disciplinary groups
• End-of-life support network• Maternity with close links to BHRT
and children’s centres • Diabetes – up to level three
services
Ambition, Action, Achievement
Spoke GP Practice Tier 1
Min 12hr x 7 days Blood tests & ECG Access to health information
available in leaflet or electronic form
Full range of Enhanced GP services
Walk in GP services
Consultant led outpatients Minimum of 8 wte GPs Premises that can be
expanded Long Term Conditions Diabetes – up to level two
services
Ambition, Action, Achievement
GP Practice Tier 2
Min 12hr x 6 days Blood tests & ECG Access to health information
available in leaflet or electronic form
Full range of Enhanced GP services
Minimum of 4 wte GPs Long Term Conditions Diabetes – up to level one
services
Ambition, Action, Achievement
GP Practice Tier 3
Core Primary Care Services Range of agreed additional
services
Long Term Conditions where appropriate
Single handed practices up to 4 wte GPs
Ambition, Action, Achievement
Community/Home
• Tailored education to support patients and carers in managing long term conditions and end of life care supported from the Hub/Spoke
• Rehabilitation services for stroke patients• Mental health assessments e.g. dementia• Children and young people with complex
health needs• Ability to single point of access for information
and advice to self manage - e.g. telephone, web, tele health, NHS Direct
• Home births
Ambition, Action, Achievement
Urgent Care Centres
Our plan for Urgent Care Centres is: • North-west System
Urgent Care Centre will be based at Queen’s Hospital• North-east System
Urgent Care Centre will be based at Harold Wood Polyclinic• South System
Urgent Care Centre will initially be provided at South Hornchurch operating from 6am to midnight, but the services will be moved to St. George’s
Hospital site when appropriate
Urgent Care Centre will be provided at Cranham operating from 6am to 9pm.
All 3 Polysystems will have one Urgent Care Facility fully operational by December 2010. Future Urgent Care Centres will be considered at Collier Row, Maylands and Harold Hill.
Ambition, Action, Achievement
Joint Priorities with Council
• Advice Services (including dementia)• Keeping people out of hospital (includes
intermediate care, integrated case management, DTOC and falls prevention)
• Polysystems (to ensure maximum reach and success of moving services into the community)
• Speech and language therapy (for children)
Partnership working - the key to a healthy Havering
• What’s in it for the voluntary sector?• How can the NHS and Borough ensure the
voluntary sector is bidding on a level playing field
• What are the timescales – this year?