Health Services Fit for the Future - NHS Grampian - Caring · 2018-05-19 · NHS Grampian’s vision is ‘proudly working together to deliver the best possible services for a healthier

Health Services Fit for the Future

Public Forum – 20th November 2010

Dr Lesley WilkieDirector of Public Health & Planning

Our Vision:

Proudly working together to deliver the best possible services

for a healthier Grampian

Grampian Health Plan

Care delivered at the right time, by the right person and in the right place which is high quality, effective,

efficient, sustainable and affordable.

• Helping people to maintain good health, and protect against and prevent against ill-health

• Care closer to people’s homes and away from specialist hospitals

• Care delivered using trained and experienced staff across a range of professions

• Radical changes and difficult choices will need to be made

Challenges • Changing population

• Fewer people of working age

• Lower funding increases - we are currently at risk of spending more than we can afford

• Rising public, staff and partner expectations

• Advances in technology and treatments

• Required to deliver national policy and targets

• Managing these challenges means we need to do things differently and make difficult choices

How Do We Meet The Challenges?

• The Health and Care Framework (H&CF) will provide the detail to deliver the Grampian Health Plan.

• The H&CF will:– describe how health and care in the future (the model) will

be safe, effective and sustainable, which meets future population needs and is delivered within available resources

– set out detailed plans to deliver the agreed model

– guide services and the organisation in allocating resources and making decisions based on the model of care.

You The Individual

Your Carers And Families

Your Local Community

Local Authorities and Voluntary Sector In Your Area

Your Local Health Services

(GP & Community Teams)

Care which is Delivered in a Number of Localities

Specialist Care In Hospitals In Grampian

Specialist Care Out

with Grampian

Draft – 12/11/10/LMS

What Will This Mean?• services will collectively focus on the key priorities

for health and care

• help us be clearer where we need to use our resources such as workforce, property, equipment etc.

• set clear improvement areas (outcomes) which will focus on the health and healthcare needs, evidence of effectiveness, and the available resources

• help manage current and future challenges

• care being more appropriately delivered at the right time, by the right person and in the right place

Proposed Plans & Timescales

Develop and agree the future model for health and care

(By early April 2011)

Develop, test and agree a process to guide resource allocation and decision making in NHS Grampian

(By early February 2011)

Develop and agree an action plan for the next 5-10 years to implement the agreed model for health and care

(By early October 2011)

NHS Grampian service plans and strategies reflect and implement the agreed future model for health and care

(By early December 2011)

Achieved through joint working with

patients, the public, carers, staff

and partners

Some of the Active Working Groups

• Forres Pathfinder Project • Inverurie Pathfinder Project• Elderly Care in Aberdeen City• Maternity Review• Aberdeen City CHP Redesign• Long Term Conditions Programme• Mental Health Collaborative• Palliative Care Group• Keep Well/Well North• Managed Clinical/Care Networks (e.g. Respiratory,

Diabetes, Oral Health & Dentistry, Stroke etc)

Getting Involved

• To get involved in the development of the H&CF:– E-mail NHS Grampian Corporate Communications

Department on [email protected]– Telephone the NHS Grampian Corporate Communications

Department on 01224 554400

• To receive regular updates on the development of the H&CF:– NHS Grampian Website - www.nhsgrampian.org/healthfit– Contact the Corporate Communications Department (details

above)

Resource Allocation & Decision Making

Public Forum20th November 2010

Alan GallDirector of Finance/Deputy Chief Executive

Why?

• Moving into challenging times with less available resource

• Need to ensure that the allocation of resources gains maximum impact for the Grampian population

• More consistent approach to resource allocation

• More difficult decisions about what we do, what we change and what we may not do – this will mean more scrutiny

What Will This Mean?

• Services will focus collectively on the key priorities for maximising health and care in Grampian

• Better use of our resources such as workforce, equipment, property etc.

• Better results and impact for Grampian population

• Care being more appropriately delivered at the right time, by the right person and in the right place

• A more consistent approach to allocating resources

Who & How?

Who?• Services, Managed Clinical/Care Networks and the

Board

How?• Consistent approach using a template and guidance

• A group of clinicians, managers, other key individuals with the input from patients/public, staff and partners

• Refreshing the approach which will be tested before the Board agrees it in February 2011

Proposed Criteria

• Improved Health Outcomes for the Patient

• Improved Health of the Population

• Best Value for Resources

• Improved Patient Experience

• Equity – Care in the Right Place and the Right Person

• Involving Others

• Risk and Impact Within and Out With NHS Grampian

Group Work ~ 30 mins• Individually rank criteria (10 mins)

– from 1 to 7 (1 is the most important to you and 7 is the least important)

– you must rank each number differently e.g. only 1 criteria can be ‘1’ etc.

• Facilitator in each group will:– pull together the results and advise the group of what the

ranking looks like– Feedback to the Forum on the most important 3 criteria

identified by the group

NHS Grampian Public Forum Meeting Report

NHS Grampian Health and Care Framework Saturday 20 November 2010

Introduction The final meeting of the NHS Grampian Public Forum of 2010 was held on Saturday 20 November, in the Recreation Hall, Woodend Hospital, Aberdeen. Laura Gray, Director of Corporate Communications, chaired the meeting. The topic on the day was NHS Grampian’s Health and Care Framework. The speakers were: Dr Lesley Wilkie – Director of Public Health and Planning Alan Gall – Finance Director / Deputy Chief Executive Dr Roelf Dijkhuizen – Medical Director

Health and Care Framework Dr Lesley Wilkie started the meeting with a presentation on the Health and Care Framework, which will be the ‘meat on the bones’ of the NHS Grampian Health Plan 2010-2013 (published in April 2010). The Grampian Health Plan (GHP) emphasises the importance of care being delivered at the right time, in the right place, by the right person. While no one disagreed with this principle, throughout the consultation for the GHP it was clear that people wanted more information and more detail about what this would mean in practice. The Health and Care Framework will provide this detail, which will include information on how NHS Grampian will make decisions about ‘spreading’ resources. Alan Gall then went on to describe how important is it to consider the criteria that is used when allocating resources and described some of the factors that need to be taken into account. With less available resource, a more consistent approach for allocation is required for the (approximate) £950 million that NHS Grampian spends each year. Questions Following the presentations, Forum members were given the opportunity to ask questions before moving on to group discussions. A summary of the questions and answers is given below: Q. What is meant by ‘local community’ in the pyramid shown on one of the slides in the presentation? A. We (NHS Grampian) recognise the power within local communities that can help people to help themselves, and others. There is a great deal of support for people in their local areas – these places tend to have an identity and know what they want as well as being aware of all of the other groups e.g. churches, local councils, voluntary organisations.

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Q. Communities need funding to have power - is there extra funding for groups in the local communities? A. There are funded organisations within the community but there is also power within the communities through the people. There is no specific funding. Q. With money tight the best way to save money is to prevent costs from occurring, one example of this is a befriending service for older people – will there be funding for services like these? A. Services like these are extremely important and anything that shifts care to the lower end of the pyramid i.e. people helping themselves, local community support, and we will support them as much as we can. Currently, the Scottish Government allocates small pots of money targeted to specific things. This can actually make things more difficult and for this reason, work is being done to move to a ‘Single Outcome Agreement’ where there are no targeted pots but just an amount of money to cover agreed outcomes. This means that it can be decided locally how to spend the money appropriately. Q. The ‘risk and impact within and out with NHS Grampian’ criteria – what does this mean? A. This is about not working with partners but working in isolation. An example to illustrate this would be elderly patients – NHS Grampian could say that we can’t afford to keep patients in hospital once they are well enough to leave (e.g. close Woodend Hospital) – this would mean that the Local Authority would then have to take responsibility for them but then the Local Authority has to deal with this when they may not be in a position to do so. Another example is the impact on the local Universities – what NHS Grampian does impacts on them and vice versa. Q. With an increase in the number of people with long term conditions, which will continue to grow with people living longer, at what point and what do you do to minimise expense? There has recently been a lot of work done on self management and information that is provided at diagnosis but patients really need education. How far ahead are you looking for payback in investment? Are you willing to take a risk to spend now to gain in the future? A. This is a problem area for society. We would like to have more money available for Public Health to work on prevention but we need to spend money on treatment. This is also a good question to raise at this meeting as we can keep this in mind while we are working through the group exercise – how much do you spend on prevention if need to spend money on treatment? The work that is being done around the Health and Care Framework will help us to try and answer this question. Group Discussion For the second part of the meeting, Forum members split into groups to discuss the proposed criteria. Groups were asked to individually rank the seven criteria, discuss each and then try to reach a group consensus for the top three.

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Each of the four groups reported that, while there was some consensus around the tables about some of the criteria, it was difficult to firmly agree on a top three. Some of the key points from the discussions were: Recognition that all of the criteria are important. The way that individuals will rank the criteria will depend on their own experiences

and circumstances. It will also depend on the understanding of the criteria – not sure that everyone was

clear about what each of the criteria meant. Some of the criteria are difficult to influence – much of it is out with NHS Grampian’s

control. People should be working together more to make the best of all the resources we

have and to come up with solutions. Everyone has a responsibility to try and help themselves, and should try to help

others. The table below shows the total for each individual ranking (out of 25) Ranking (1=most important, 7=least important) Criteria 1 2 3 4 5 6 7 A. Improved health outcomes for the patient

14 6 2 0 2 1 0

B. Improved health for the population

6 6 4 6 2 1 0

C. Improved patient experience

1 7 5 7 1 2 2

D. Best value for resources such as workforce, funding, equipment, buildings

0 2 7 3 6 3 4

E. Equity – care in the right place

0 3 5 6 9 1 1

F. Risks and impact to other areas within and out with NHS Grampian

0 1 2 2 1 7 12

G. Involving others 4 0 0 1 4 10 6

From the above results, a group average was calculated to identify the overall order of importance for the criteria. This order is shown below: A. Improved health outcomes for the patient B. Improved health for the population C. Improved patient experience E. Equity – care in the right place D. Best value for resources such as workforce, funding, equipment, buildings G. Involving others F. Risks and impact to other areas within and out with NHS Grampian The results from this exercise will be added to results from similar exercises being completed by other groups to identify the ranking of the criteria for the NHS Grampian Health and Care Framework.

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Participation Standard Laura Dodds, Public Involvement Manager, gave a brief overview of the Scottish Health Council Participation Standard, a new self-assessment process covering three aspects of participation - patient focus, public involvement and governance. Forum members heard four case studies and were asked to identify which of the four projects they would like NHS Grampian to report on for the public involvement section of the 2010-11 Participation Standard. Although only one project will be reported on, work will continue to involve patients, carers and the public in a wide range of projects across NHS Grampian. Results from Forum members who attended the meeting below: Children with Complex Needs 5 Maternity Services Strategic Review 3 Primary Care Redesign 5 Intermediate Care 14

These results will be added to those from other groups to identify which project will be assessed. Meeting Evaluation Feedback from the meeting evaluation forms will all be taken on board for future meetings. The comments included: Good group discussion and good interaction Good presentations Interesting and well organised meeting Better heating for the room More people (wider representation) to attend meetings More to include Aberdeenshire and Moray areas Interesting first Public Forum meeting

NHS Grampian Public Involvement Team

December 2010

NHS Grampian Public Forum News November 2010

Details of the next Public Forum meeting

Date & Time: Saturday 20 November 2010, 1.30pm-3.30pm

Topic: NHS Grampian Health & Care Framework

Venue: Recreation Hall, Staff Home, Woodend Hospital

A map of the venue is shown on the back page of the newsletter.

Get-togethers for patient and public representatives 52 representatives expressed an interest in attending the first get-together and training event organised for July at Horizons Rehabilitation Centre. Demand far exceeded places and so the session was repeated in September and again in October. In total, 48 representatives were given places at the three events but 10 failed to attend (we received just 2 last minute apologies). In all 38 representatives attended. The sessions provided an update on the policies and guidance which now give involvement work a more robust framework and there were discussions around the impact of involving people, supporting representatives, and other issues regarding involvement. The sessions were well evaluated and it was clear that representatives meeting others who are on different groups, was a key part of the success. The sessions were also attended by either David Cameron (Chairman) or Richard Carey (Chief Executive) to thank the representatives for all the work they do for us and to provide a short question and answer session. We will be looking to hold similar sessions next year and will be working with our colleagues in Moray to roll out the get-togethers to representatives there. A summary report on the three events will be available before Christmas.

Get your seasonal flu jab

All of those who are eligible for the seasonal flu jab are being encouraged to make sure that they protect themselves this winter. If you are aged 65 years or over, have a medical condition which puts you in an ‘at risk’ group, are pregnant or if you are an unpaid carer you are eligible for the flu jab.

Contact your local GP surgery or medical practice for more information.

MRSA & C.diff at all time low

The Scottish Government announced last month (October) that rates of MRSA and C.diff infection in Scotland’s hospitals have fallen to their lowest ever level. The statistics, issued by Health Protection Scotland, show that the rates of C.diff have fallen over 42% (compared with the same time last year) and MRSA rates are down nearly 45%.

NHS Grampian Public Forum News November 2010

Non–executive Board Members &

How to get involved open day NHS Grampian was selected as one of two NHS Boards to run non-statutory alternative pilot schemes at the same time as the Health Board election pilots. An extensive recruitment campaign was undertaken and over 90 people applied for the non-executive board member roles. Two non-executive board members have now been appointed. However, as there was so much in interest in there posts, an open day was planned to give all of the applicants an opportunity to find our more about other ways to get involved. The open day took place on Tuesday 26 October 2010. A number of the people who attended indicated an interest in arrange of NHS Grampian groups and some have joined the Public Forum. We would like to welcome all of our new members to the Forum.

Know Who to Turn To for Self Management

NHS Grampian has launched a new campaign to increase awareness of self management of long term conditions. Working together with the voluntary sector and people living with long term conditions, NHS Grampian have developed the self management campaign to help people living with long term conditions and their carers to ‘know who to turn to’ to find out more about the range of local services that are available to support them. As well as launching the extensive public information campaign, work has also been done with frontline NHS Grampian staff, including briefing sessions about the importance of supporting people to self manage. If you would like more information on self management, please call NHS Grampian’s free healthline on 0500 20 20 30, visit one of the NHS Grampian healthpoints or visit www.know-who-to-turn-to.com/selfmanagement.

Free prescriptions from April 2011 Health Secretary Nicola Sturgeon has confirmed that the introduction of free prescriptions will go ahead in April 2011. Prescription charges have been reduced over a three year period, and will be free to everyone from April next year.

Health Plan in the ‘Mither Tongue’

NHS Grampian non-executive Director Raymond Bisset has produced an alternative version of the NHS Grampian Health Plan.

As years hae passed tho’, change is faced, new waeys o’ treatment need embraced, For fowks are livin’ langer noo, echties, nineties swaal the queue,

New wonder drugs have come on stream, thit dae fit aence wis jist a dream, Their cost tho’ can be waa’ aheid, o’ fit we can afford indeed.

Taking a fresh approach to spreading the message of the latest NHS Grampian Health Plan to the people of Grampian, Raymond has produced a Doric poem to deliver the messages in the north east local dialect. If you would like a copy of Raymond’s Doric poem, please contact Sandra Harper on 01224 558813 or email [email protected].

NHS Grampian Public Forum News November 2010

Scottish Health Council sets standard for greater participation in the NHS

A groundbreaking national standard that will help to ensure that patients and the public have a real say in health services has been launched. The Participation Standard, which has been developed by the Scottish Health Council, sets out what NHS Boards have to do to ensure that people can influence the care they receive and shape how services are designed. It also means that, for the first time, comparable information on how NHS Boards involve patients and the public can be collected and analysed. For example, the Participation Standard will measure how NHS Boards involve people in improving the information and advice provided to patients about their healthcare, and how people are supported to be involved in health service planning and improvement. The format of the Participation Standard is similar to NHS Quality Improvement Scotland standards, which are familiar to NHS staff. NHS Boards will be required to complete a self assessment providing evidence against the Standard on how they have involved patients and the public in their care and in the design of services. The self assessments will be submitted to the Scottish Health Council which will report on the level reached and provide a commentary on its findings, including recommendations for improvement. The Scottish Health Council will also continue to work with patients, carers and communities to verify that these self-assessments accurately reflect their experience and help agree the level of achievement for each NHS Board. The self assessment will be considered alongside the Scottish Health Council‘s commentary as part of the Scottish Government’s annual review of each NHS Board. NHS Boards will be assessed against the Participation Standard each year, with the findings for how NHS Boards have performed in 2010-2011 due to be reported in the spring of 2011. Not all of the areas covered by the Participation Standard will be appropriate for every NHS Special Board. The Scottish Health Council is holding individual meetings with Special Boards to identify appropriate areas for them to report against the Standard in 2010-2011. Health Secretary Nicola Sturgeon says: “The launch of the Participation Standard marks yet another significant milestone in our collective efforts towards a mutual NHS – a service that is truly owned by and accountable to the people who use and pay for it, which gives quality care to every patient, every time. "I am very grateful to all those involved in developing the Participation Standard and I look forward to seeing what I'm sure will be high standards of involvement practice across Scotland.” Scottish Health Council Director Richard Norris says: “It is absolutely vital that NHS Boards listen and involve service users so that they continue to improve services and meet the needs of the communities they serve. The Participation Standard literally sets the standard for improved participation in services, bringing a consistent, national measure to participation for the first time. It not only gives us a baseline for how NHS Boards are performing in this important area, but will act as a driver for improvement, giving Boards the opportunity to demonstrate year-on-year progress.”

Scottish Health Council, 2010

NHS Grampian Public Forum News November 2010

PFPI Team updates

NHS Grampian’s Patient Focus and Public Involvement Team are currently working on a number of projects. Below is an update on some of the current developments. North of Scotland Child and Adolescent Mental Health Services As part of the North of Scotland (NoS) Planning Group project to improve Mental Health services for young people, NHS Grampian is taking part in a consultation as part of the NoS Planning Group Child and Adolescent Mental Health Services (CAMHS) Communication and Engagement Group. The aim of the project is to make it easier for young people with the highest levels of need to access the most appropriate types of services. A workshop was held in September with local CAMH service users to discuss the draft consultation questions. The workshop allowed service users to influence the wording and design of the questionnaire. This will now be used to gather the views of local service users and young people in Grampian. An option appraisal workshop is taking place on the 19th of November to identify the preferred location for the new inpatient unit in Tayside. Maternity Service Review As part of the review of maternity services, NHS Grampian is currently consulting on the draft strategy for maternity services. The consultation, which ends on the 22 November 2010, will inform a formal report being made to the NHS Board at its December meeting. The draft strategy outlines: how we will all support more women and families to choose healthier lifestyles, have safer

births, healthier babies and nurture their children the improvements needed to make this happen the challenges which need to be met to deliver these changes

For more information about the consultation, including the draft strategy and consultation questionnaire, and information about the review please visit www.nhsgrampian.org/maternityreview. Primary Care Redesign in Aberdeen Belmont Medical Group, currently based at Denburn Health Centre, and Ferryhill Medical Practice, currently on Bon Accord Street, will merge and start to move into new premises on Whinhill Road, Aberdeen on 7 December 2010. The merger of Belmont and Ferryhill Medical Practices will create Whinhill Medical Practice. This merger is part of an ongoing primary care redesign programme. The aim of the redesign programme is to deliver the right services, in the right locations with the right people to ensure that primary care is sustainable for the future. NHS Grampian is commitment to ensure the availability of general medical services to local communities with scope to improve and possibly expand the range of services that are currently offered. The merger will bring together a sizeable team of healthcare professionals, enabling a more flexible and responsive service for patients. The practice will continue to provide patient services from their existing premises on 7 December, with the aim of seeing patients from the new premises from 8 December 2010.

There will be updates on some of the other projects in the next newsletter.

NHS Grampian Public Forum News November 2010

NHS Grampian healthpoint

NHS Grampian healthpoint is a one-stop health information point, offering free confidential information, advice and access to reputable services in a friendly, welcoming environment.

What’s on at your local healthpoint?

Mouth Cancer

Throughout November your local healthpoint will have trained health advisors on hand to offer free, confidential information and advice to help all members of staff and the general public increase their understanding of mouth cancer, including prevention and treatment.

Winter Health

Throughout the winter season healthpoint will have trained advisors on hand to help the public be more prepared for the winter months whilst looking after their health. During the winter months a number of problems can arise that could affect your health, from having the ‘winter blues’, flu, colder weather, health risks and gaining extra winter weight. There are a number of things you can do to avoid these seasonal risks and healthpoint staff will be able to provide you with the information you need to stay healthy and prepare to you for winter. For more information on any of the above call the free healthline 0500 20 20 30, text Help to 0781 368 4274, e-mail [email protected] or drop into one of the healthpoints in Aberdeen Indoor Market, the Concourse at Aberdeen Royal Infirmary, the Hot Spot, 1-3 Kirk Street, Peterhead or Dr Gray’s in Elgin.

Website: www.nhsgrampian.org

KEEP IN TOUCH WITH US!

As always, we are delighted to hear your feedback on any aspect of our NHS services. We can provide you with more information or respond to any queries you may have. Please call Sandra on 01224 558813 or e-mail her at [email protected]

MEETING DATES

The first Public Forum meeting in 2011 will take place on:

Saturday 26 February 2011, 1.30-3.30pm

This meeting is scheduled to be held in the Recreation Hall at Woodend Hospital. The dates for the rest of the 2011 will follow. The final NHS Grampian Board Meeting for 2010 will take place on:

Tuesday 7th December

All Board Meetings are held in Committee Room 5, Woodhill House, 10am to 2pm.

Woodend Hospital