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Clinical Innovation & Transformation in Lancashire and South Cumbria
1. 24th November 2017
Innovation and
Transformation
in Lancashire and South Cumbria
Tweet at
@HealthierLSC or use
#HealthierLSC
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@HealthierLSC #HealthierLSC
2
Welcome
Chris Maguire
Editor, Business Cloud
@editor_maguire
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3
Introduction
Dr Amanda Doyle OBE
GP and Lead for Lancashire and
South Cumbria STP
4. Delivering change across Lancashire and South Cumbria4
Five Local Delivery Partnership
areas
One Sustainability and
Transformation Partnership
called Healthier Lancashire &
South Cumbria
Three major gaps:
• Health and Wellbeing
• Care and Quality
• Finance and Efficiency
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5
Professor Sir Bruce Keogh
Medical Director for NHS England
@drbrucekeogh
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6
Primary Care for Tomorrow
Dr Mark Spencer
GP and Clinical Lead for Primary Care in
Lancashire and South Cumbria
@markspen999
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Primary Care for tomorrow7
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8 things that will define the future of Primary Care
8
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1) Integrated Provision at scale9
30,000 to 50,000 residents
Integrated Delivery units
Basic building blocks for
larger scale provision
Addressing the health needs
of that community
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2) GP Appointment times = 20 minutes10
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3) Every patient that needs to be seen on the day will be.11
Neighbourhood Urgent Care Hubs
8am til 8pm: 7 days per week.
GP Practices to focus on
Routine care
Complexity
Continuity
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4) Wider integration12
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5) Access to the Health Care Record13
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6) All services delivered in your neighbourhood where it is safe
to do so.
14
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7) Expanded workforce with everyone working at the top of
their licence
15
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8) Healthier, empowered communities16
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What would it feel like to be a clinician?17
Valued
and
supported
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What will it feel like to be a patient/resident/citizen?18
Being a doer rather than being done to
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19
Primary Care for Tomorrow Panel
Linda Bracewell
Chair of the Local Pharmacy Network
Dr Malcolm Ridgeway
GP and Lead for Primary Care for the STP
Dr Mark Denver
GP Clinical Lead for Better Care Together
Magnus Hird
Regional Clinical Advisor at NHS 111 & Superintendent Pharmacist
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Secondary Care for the future
Alistair Craig
Consultant in Interventional and Diagnostic Radiology
Dr Nick Wood
Consultant Gynaecological Oncologist and Chief
Clinical Information Officer at Lancashire Teaching
Hospitals NHS Foundation Trust
23. CASE STUDY 1
CANCER DIAGNOSIS
• Joe 54 – presents with jaundice
• Surely nothing could go wrong
with this seamless pathway……?
• One patient
• Relatively simple pathway
• Just 2 imaging modalities
• Testament to the diligence of NHS
staff that it does rarely go wrong
24. RISKS OF THE SYSTEM
• What happens to Joe if a trigger is not actioned?
• Many trips for Joe
• Data exists in many locations – and may not be the same
at each one
• Inherently will lead to delays
25. CASE STUDY 2
- ELECTIVE CARE
Anne 48 - Knee injury
- Claustrophobic
• Equipment available is
different at each provider
• Signposting to the different
imaging options is poor
• Integration between
primary and secondary care
is at various stages around
the region
26. Anne 48 - Knee injury
- Claustrophobic
• Different equipment available
is different at each provider
• Signposting to the different
imaging options is poor
• Integration between primary
and secondary care is at
various stages around the
region
CASE STUDY 2
- ELECTIVE CARE
27. COSTS OF SYSTEM
• Costs of performing scan are still incurred – no scan
completed
• Increased waiting times and wasted appointments
• Inequality in access to healthcare dependent on location
• Lost working days for Anne
28. BARRIERS TO CHANGE
• Information exchange does not always match clinical
urgency
• Data management is proactive – not reactive
• “Virtual regional teams” already exist
• But the infrastructure is not optimised to support them
29. (MY) PRINCIPLES OF WORKING
• The best care possible, as close to home as feasible
• Shared (secure) access to data will benefit patients and NHS staff
• Reduce unnecessary variation in care standards
• Increased connectivity (both digital and human) will facilitate transformation
• Increases organisational agility and responsiveness
• Ensures innovations can be implemented robustly and distributed evenly
30. “ACTUAL WORK”
• Commitment from all organisations to
streamline data sharing
•
• Shared application for imaging service
accreditation
• Review of regional MDT activity
• Shared equipment and personnel inventory
31. (SOME) FUTURE GOALS
• Seamless and consistent regional diagnostic service for
patients
• Integrated /coordinated department workflows
• Create regional communities of practice
• Alignment of diagnostic standards
32. £
Record Sharing - Patient Activation - Channel Shift - Population Health
Workforce Change- Health Literacy- Digital Inclusion - Economic Growth
sharing is caring32
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sharing is caring33
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sharing is caring34
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LPRES35
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EPaCCS36
“I can make the last stage of my life as good as
possible because everyone works together confidently,
honestly and consistently to help me and the people
who are important to me, including my carer(s)”
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Place of Death – L&SC STP April 201637
Other
Hospice
Home
Care Home
Hospital
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WelLPRES38
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patient/citizen activation39
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Technology enabled care panel
Dr Nick Wood Consultant Gynaecological Oncologist
Alistair Craig Consultant in Interventional and Diagnostic
Radiology
Anthony Rowbottom Associate Clinical Director for Pathology,
Consultant Clinical Immunologist
Eleanor Garnett-Bentley Associate Director for Transformation
(IHACS Lead)
George Dingle GP
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What is next?
Dr Amanda Doyle GP and Lead for STP
Dr Sakthi Karunanithi Director for Public Health in Lancashire
Liz Mear Chief Officer for Innovation Agency
Dr Andy Curran Medical Director for Lancashire and South
Cumbria STP
Dr Amanda Thornton STP Clinical Lead for Digital Health
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42
Thank you
Tweet at @HealthierLSC
use #HealthierLSC
Visit www.healthierlsc.co.uk
Editor's Notes
Neil Greaves – description of the landscape:
Setting the scene and background behind the STP.
In 2015, NHS England worked with other national organisations to produce The Five Year Forward View, this is a national plan to improve health and care services.
This plan says that services need to get better at preventing ill health, improve, overall quality, safety and become more efficient.
In January 2016, NHS England asked 44 regions, including Lancashire and South Cumbria, to bring together NHS organisations, local authorities, voluntary and community groups to produce a draft Sustainability and Transformation Plan.
Lancashire and South Cumbria was ahead-of-the-game as many organisations were already discussing plans through the Healthier Lancashire programme.
November 2016 saw a draft of the local STP published, it's purpose was to encourage further thinking about potential solutions to health and social care challenges and draw together local plans and the next steps were to have more local conversations about delivering these ideas further before coming up with firm proposals.
The STP has since been superseded by organisational operational plans which should be available on each of the providers websites. These broadly follow the principals behind the draft Sustainability and Transformation Plan.
In March 2017, NHS England announced that moving forward Sustainability and Transformation Partnerships will have the role to deliver the NHS Five Year Forward View and key national priorities. We are currently working to establish the governance around this partnership.
Therefore we now have:
One Sustainability and Transformation Partnership called Healthier Lancashire & South Cumbria
Five Local Delivery Partnership areas (LD Partnerships)
Three major gaps:
Health and Wellbeing
Care and Quality
Finance and Efficiency
Eight priority workstreams
Introduce Andy Curran to talk about why this is needed – about health outcomes being poor and how this needs to be a clinically led programme and not driven by finances but improving lives of local people.
Neil Greaves – description of the landscape:
Setting the scene and background behind the STP.
In 2015, NHS England worked with other national organisations to produce The Five Year Forward View, this is a national plan to improve health and care services.
This plan says that services need to get better at preventing ill health, improve, overall quality, safety and become more efficient.
In January 2016, NHS England asked 44 regions, including Lancashire and South Cumbria, to bring together NHS organisations, local authorities, voluntary and community groups to produce a draft Sustainability and Transformation Plan.
Lancashire and South Cumbria was ahead-of-the-game as many organisations were already discussing plans through the Healthier Lancashire programme.
November 2016 saw a draft of the local STP published, it's purpose was to encourage further thinking about potential solutions to health and social care challenges and draw together local plans and the next steps were to have more local conversations about delivering these ideas further before coming up with firm proposals.
The STP has since been superseded by organisational operational plans which should be available on each of the providers websites. These broadly follow the principals behind the draft Sustainability and Transformation Plan.
In March 2017, NHS England announced that moving forward Sustainability and Transformation Partnerships will have the role to deliver the NHS Five Year Forward View and key national priorities. We are currently working to establish the governance around this partnership.
Therefore we now have:
One Sustainability and Transformation Partnership called Healthier Lancashire & South Cumbria
Five Local Delivery Partnership areas (LD Partnerships)
Three major gaps:
Health and Wellbeing
Care and Quality
Finance and Efficiency
Eight priority workstreams
Introduce Andy Curran to talk about why this is needed – about health outcomes being poor and how this needs to be a clinically led programme and not driven by finances but improving lives of local people.