STP - Conversation Events - Stoke-on-Trent

1November 2016

Conversation Staffordshire and Stoke-on-TrentWorking together to improve local health and social care

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The purpose of this event

• Understand the challenges facing our local health and social care services

• Look at some of the potential options available to us

• Begin to think about some of the more difficult decisions we may have to make

• Listen to your views, feedback and ideas

• Work together going forward to help bring about long-lasting, positive improvements for everyone

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Our local NHS and social care services

• Everyone deserves good quality, safe health and social care, regardless of background

• We must make the best possible use of taxpayers money

• Standards of care should be consistently high

• Most services should be as close to where you live as possible

• You should be able to go home as soon as treatment is completed and it is safe to discharge you

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Who is involved?

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…and you

• We all need to think and act differently if we are to improve our health and well being

• We need your help and ideas

Please note:

• This is not a consultation event

• No decisions about major changes to local services will be made without extensive public consultation and feedback

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Challenges facing the local health and care system

1. We’re spending too much money but not seeing enough improvements as a result

2. Our major hospitals are struggling to meet quality standards and demand

3. We’re not always providing the right care at the right time in the right way

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A growing, ageing population…

• By 2019 the number of people aged 85+ will rise by 22%

• 30% of health and care costs for those aged over 65 years are spent on hospital care

• Half the local CCGs exceed the average for injuries due to falls in people aged 65+, Stoke-on-Trent was 30% above the national average.

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…with more complex health needs

• People are living longer – this is good

• Many are living with complex long term conditions

• Too many people end up in hospital, particularly A&E, when there are other, more appropriate and far less expensive alternatives

patients are admitted to our local hospitals every day

800330 60 33

are of these are unplanned

are readmitted within 30 days of discharge% of people in a hospital bed at any one could be treated better elsewhere

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The challenges facing our health & care systemHealth and Wellbeing

Cancer

• Main cause of premature deaths

• Only 75% of patients seen within 62 days

• Local CCGs have poor cancer detection rates

Mental health

• 30% higher number of suicides

• Many patients wait longer than 90 days for assessments

Frail and elderly

• Injuries from falls 30% higher than national average

• Reablement spend is 59% lower than national average

Smoking

• Higher rates of death due to smoking related illnesses

• Need improved education about health risks

Obesity

• One in ten children aged four to five is obese

• This rises to one in five by age 11

• Two out of three adults have excess weight problems

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Readmissions

• Hip fracture readmissions are up to 35% more likely

• Mental health unplanned readmissions worse than national average

A & E

• Poor performance locally against 4 hour wait targets

• 30% more attendances at A&E than other areas

• More education needed around alternatives

Access & wait times

• Large variation in the number of GPs per head of population

• Non-elective admissions, 62 week wait, all higher than national average

• Improvements here would make a real difference

The challenges facing our health & care systemQuality of care

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• £157 million debt – not including social care

• If we do nothing, the recurring deficit in 2020/21 is currently forecast to be £286 million

• Add in the cost pressures in social care, this forecast increases to £542 million by 2020/21

High levels of hospital

admissions

High costs of

emergency care

Duplication& planned

care

Estates – Buildings and

land

H

The challenges facing our health & care systemFinance and efficiency

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Having an honest and difficult conversation

• Can we really continue to try and run a system that was put in place almost 70 years ago?

• Where could our money be better spent?

• What can we do without, do less of or do in a more effective and efficient way?

• We need to be brave enough to rethink the idea that a hospital is always the best place to go when you are unwell

• We need to recognise that we could all do more to look after our own health to help ease the burden on local services

• There are lots of opportunities to improve the way health and social care is delivered, including the use of technology – bringing services to people rather than the other way around

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Emerging hypotheses

• We all need to work together to reduce demand

• Right care, right place, right time

• More education needed around alternatives to A&E

• Take more responsibility for our care, where possible

• Help people stay at home and independent for longer

• Improve quality

• Help people to stay fit and healthy for as long as possible

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How do we solve this? Our five priorities are…

FOCUSED PREVENTION

ENHANCED PRIMARY & COMMUNITY CARE

EFFECTIVE & EFFICIENT PLANNED CARE

SIMPLIFY URGENT & EMERGENCY CARE SYSTEM

REDUCE COST OF SERVICES

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New models of care

Principles

• Rights vs. responsibilities

• Beds

• Relationships

• Affordable care vs. transforming care

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We will work with you to help you stay healthier and more independent

• Prevention

• Shared responsibilities

• Care plans

• Trust

What this means

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We will deliver more care in the community

• Local services

• Investment

• Community capacity

What this means

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We will make our services more joined up

• Community teams

• Redesign care

• Health and social care

• Integrate physical and mental health

• Care record

• Collective responsibility

What this means

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We will improve the quality of care you receive

• Access

• Simplify

• Safe care setting

• Workforce plan

• Clinicians in charge

• Standards

What this means

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And if you go to hospital…

We will treat you more efficiently and discharge you as soon as you are ready

• Admit?

• Take your mental health as seriously as your physical health

• Recover at home

• More day cases

• Separate planned and emergency care

• Centres of excellence

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Things to consider…• This is not a consultation – but our discussions may help to inform

future consultations

• We want you to give us your views, feedback and ideas

• What have you seen that could be done better? Where do you think money could be better spent? What services mean the most to you and how can we improve them?

• If most of the care you need is closer to home, how far is acceptable to travel for specialist care?

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Would you like to know more?