Presentation by Ed Millensted, Programme Manager, Innovation Agency at the Innovation Scouts: Collaboration and learning event on Thursday, 10 October at The Royal College of Physicians, Liverpool.
2. Who we are
We are a collection of Commissioners and Providers of health and Social
Care, Local Authorities and Partners –Third sector –Academia –Public
sector -Policing etc.
Serving the 2.5million people who live in Cheshire & Merseyside
@InnovationNWC
3. To reduce health inequalities
To improve life expectancy and experience
To help people live healthier –more independently for longer
To have safe –high quality sustainable healthcare provision –where and
when people need it
Doing all this within the financial resources available to us.
@InnovationNWC
4. Unless we have a long term plan that can deal with demand in a different
way by 2028, we will need 34,000 additional acute beds the equivalent
of 76 new hospitals
@InnovationNWC
5. Focussed on:
• Collaboration and partnership
• Joined up care
• Targeting localised priorities
• Implementing a place based
care matrix
7. Growing demand upon services and increased waiting lists
An ageing population
Greater number of patients with multiple complex conditions
Variation and duplication in the quality of care
Gap in life expectancy is rising
Healthy life expectancy has reduced in Liverpool
Fragmented care
Service sustainability - £35 million deficit
8. Address the wider determinants of health – the social factors that can impact
upon people’s physical health e.g.
education/transport/housing/debt/employment/family
Tackle health inequalities - deprived neighbourhoods: higher obesity
rates/lower screening uptake/more smoking.
Our health behaviours and lifestyle choices
Empowering self care
Radical upgrade in population health and prevention is required - 40% of
cancers are avoidable only 4% spent on prevention
10. Good things going on to improve services
Development of Place Based Care – collaboration and integration
£8 million place transformation fund
Primary Care Networks – 55 x PCNs , clinical directors
Investing in system-wide programmes - £7.4 million transformation fund
Learning & Improvement Programme – supporting system leadership
5 year health & care strategy
11. Strategic ‘At Scale’ Programmes
Elective Care system wide service redesign and currently has 5
specialties in scope;
Endoscopy, Haematology, Ophthalmology,
Orthopaedics, Nephrology
Mental Health Whole system MH transformation; crisis care,
CAMHS Tier 4, MUS
Cardio-vascular disease Decrease strokes, increase AF detection, increase
AF anti-coagulation
Respiratory – Physician Associates unnecessary admissions, improve resp prescribing
and improve lung health
Cancer increased screening and early diagnosis, improving
access to optimal treatment & personalised care
Editor's Notes
Organised to deliver care more effectively and in a coordinated manner across C&M
Beyond organisational silo’s and breaking down barriers
Purpose for more seamless care and less fragmentation
The ambitions of the partnership and overall purpose
How are we operationally starting to develop working as a system
Places set up to support more care being delivered in the community.
May’s Partnership Meeting chose a few areas for targeted interventions with the greatest impact
CVD as a clinical priority and the single biggest condition where lives can be saved over the next 10 years. Reduce BP/Cholesterol increase AF detection
Stroke is a leading cause of disability and the fourth largest cause of death in the UK.
Cheshire & Merseyside’s population is at higher risk of stroke. By 2035, the number of first time strokes is estimated to increase by over half and stroke survivors are set to double.
80% of strokes are preventable if we work on lifestyles, early detection, access to healthy food, green spaces.
Most people at increased risk can be identified and managed effectively within primary care.
Snapshot of challenges from across the system all written in 9 x plans. Stream line areas of focus.
Ever changing, lots of reading
A&E target has not been met nationally for over 3 years.
Commitment in LTP to get elective waiting lists down to May 2018 levels by April next year.
Ageing population – particularly in Wirral, S’port & Eastern Cheshire
Eliminate variation and duplication in care delivery to improve health outcomes
Fragmented care – need more joined up care, results in extra delays, sharing data between orgs
Gap in life expectancy between most deprived in L’pool & least deprived in Cheshire is 13 years for men & 12 yrs for women
The healthy life
expectancy (HLE) of residents is lower now than in 2010
Population Health …
...is an approach aimed at improving the health of an entire population.
It is about improving the physical and mental health outcomes and wellbeing of people, whilst reducing health inequalities within and across a defined population…
Walton centre – multi-service clinics.
Tackling the social/cultural/economic components that impact upon health and wellbeing
Our ambition is not only to improve
population health but also to reduce avoidable demand
behavioural change to prevent onset of ill-health or exacerbating existing conditions.
the balance between and making the connections between the four pillars of population health
It would be really useful for us all to think about the projects or innovations you are thinking of, which area does your work fit into?
We believe that the best way to improve health outcomes is to take an entire population health approach, working together in partnership with individuals, communities and wider partners to understand in detail the health of our population and put together plans to improve health in priority areas.
Recognises health has many complex influences - but that the wider determinants of health are the most important driver of health and wellbeing
Better links and communication with local authorities and social services
PCN’s serving communities of 30-50K, 7 day services
Providing care closer to home and more services in communities, bringing health & care professionals together such as clinical pharmacists, community physio, community paramedics, supporting early cancer diagnosis through >screening uptake, social prescribing link workers
5YP – single unifying vision for C&M built up from the 9 x place plans and partnership events to agree major priorities
£8 million place transformation fund – to develop capabilities and projects for local residents
Doing things differently approach
Strategy – how do your projects/work programmes align to the strategy, investment may come out from those so creates an opportunity.
This can all be found on the C&M HCP website, in their business plan, I’ve pulled it all together these are some key bits going on. Do you have anything going on in these areas?
EC – Collaborative, system wide approach to p’ways, address fluctuations in cap/demand & to standardise services
Path – better access to diagnostic tests, faster turnaround times, digital pathology, reducing duplication, fundamentally better access to resources
CVD – reduce no. of strokes
Cancer: breast/bowel/cervical
Establishing rapid diagnostic services
Achieve prescribing savings