Sunday, 25 May 2014

Healthcare in Devon: proposed framework for services now open to consultation

A concerned comment from Cllr Claire Wright earlier this month:

Devon NHS proposes major new changes in healthcare - but no local information included

Thursday, 15 May 2014 1 Comment by Claire
The NHS in Devon has launched an eight-week consultation, on a set of proposals for a new “strategic framework” in patient care.
It is likely to represent the biggest set of changes locally to community based healthcare in decades and proposes a shift away from hospital based care, to care in people’s homes.
However, no information about how the proposals affect communities has been included.
The document, which was published yesterday, has been expected for the last few months, but has been delayed a number of times.
We have discussed the thinking behind the process - known as “transforming community services” many times at Devon County Council’s health and wellbeing overview and scrutiny committee.
The NEW (North, East and West) Devon Clinical Commissioning Group, which has put together the document, has said it will publish proposals on how the proposed service changes might apply in each locality “in the near future.”
However, the document (or at least a draft version of it) must be submitted to NHS England for consideration by late June.
I have written to the chair of the health overview and scrutiny committee about my concern over the short deadline of 8 July for comments, combined with the lack of detail about how the proposals will affect communities.
A summary of the plans and full document can be found here - http://www.newdevonccg.nhs.uk/involve/community-services/101039
1. At 08:02 pm on 15th May Sandra Semple wrote:
I have never seen such a strange document: there is nothing in it that anyone can be consulted on!  It uses no figures, gives us no evidence and is mostly just dreadful jargon which is used to distract us from the fact that it is actually saying nothing. 
Buried in it is one reference to our area and I would be very grateful if anyone could tell me what it means:
We propose to move to a model consistent with Northern locality. This would mean re-procuring services for adults with complex needs within Eastern locality with the locality acute provider, accompanied by health and social care integration within the locality. This proposed geographically integrated model of delivery would support simplified patient flows and clinically enhanced services in Eastern Locality.
Devon NHS proposes major new changes in healthcare - but no local information included - Claire Wright

This is the BBC's reading of the policy proposals coming out of Devon NHS, or "NEW Devon CCG":

Plans to cut Devon community hospitals' inpatient beds

15 May 2014 Last updated at 16:43

Medical consultation. Pic: ThinkstockNHS managers said they would have to deal with increased demands on services

Related Stories

Plans for fewer inpatient beds in community hospitals in Devon have been put forward by local health bosses.
The proposals by the Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG), also include changes to minor injury units.
Managers said the idea was to treat more people in their own homes.
The group, largely run by GPs, covers the entire county, except for Torbay and south Devon.

Start Quote

We won't be taking all the hospital beds away”
Dr David JennerNEW Devon CCG
'Discussion process'
It said the proposed changes were not being made to save money in its £1.1bn annual budget, although it ended the last financial year with a £14.7m deficit.
Dr David Jenner from NEW Devon CCG said: "What we're really trying to do is look at options that don't require people to be in hospital where is safe and appropriate to do so.
"We won't be taking all the hospital beds away. We are looking at improving community services."
The group said it did not yet know how many beds might be removed and all plans would go through a "discussion process" with the public.
The CCG added it was looking at having to provide treatment for an estimated 22,000 people who would reach the age of 75 within the next seven years, increasing demand on current services.

BBC News - Plans to cut Devon community hospitals' inpatient beds 

These are the proposals from the NEW Devon CCG:

Public urged to have their say over community services framework
NHS HEALTHCARE commissioners in Devon want to hear from the public after they published a proposed framework to ensure services are right for the future.

The publication of the report, ‘Integrated, personal and sustainable; community services for the 21st century’comes after 12-months of discussions with public, clinical and professional communities about what patients really need.

It was produced by NHS Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) and offers proposals to change the way community hospitals, community nursing and urgent care services are delivered - to continue to improve quality for patients and against a backdrop of rising demand, demographic change and economic austerity.

The framework is based upon six recurrent themes from discussions with the public and other stakeholders, namely that future community services should:

Help people to stay well
Move towards prevention, self management and early help

Integrate care
Coordinate and integrate care to remove organisational barriers

Personalise support
Give people more choice and control over areas such as personal health budgets

Coordinate care pathways 
Get the patient flows right and include responses to crises and ongoing care

Think carer, think family
Create mainstream services that are much more ‘carer aware’

Home as the first choice
Greater emphasis on more personalised and responsive care packages at home.

Dr David Jenner said: “GPs have been commissioning local health services since this time last year.  We have listened local people and believe we can continue to improve services for patients, design services to meet health needs and improve quality too.

 “We’ve listened members of the public, GPs, and other important stakeholders before putting pen to paper on the draft strategic framework and now we want to test this with others.

“There is the potential to really address the challenges of the 21st century - and to make every penny count so we can achieve integrated, personal and sustainable services for our patients, friends and loved ones in future.”

The report says that by 2021 – just 7 years from now – there will 22,000 more people (26 per cent increase) aged over 75 living in the area – we need to plan effective services for the older generation. We know people prefer to be at home with the right support, but we also know that we need to rethink the way care is designed.

If not addressed quickly, we know that the number of over 65s being admitted to hospital will rise by 2 per cent a year – we need to make a change.

To address this, the framework recommends:

·         Putting a greater emphasis on preventing disease and ill health and giving people more control through personalisation of their care.

·         Increasing the availability and range of out-of-hospital services to ensure people are able to live independently for longer

·         Developing community hospitals in new ways - inpatient beds where they are needed but with some innovated models of ‘health and wellbeing hubs’ so as to serve local people for the future.

·         Establishing a small number of urgent care centres which can see, treat and complete care for more people, while reducing the overall number of MIUs.

Some of what is proposed in the strategic framework is already underway in parts of Devon although the document proposes that the work should accelerate.  More in depth work is needed for other areas and we will be sharing more detailed proposals and giving opportunities to comment in the coming weeks and months.

Health and wellbeing hubs are being developed in Budleigh Salterton and
Moretonhampstead – with local groups leading the way, working with the NHS to plan and organise future service provision.

 In Tiverton, local people worked with the NHS to develop a specification for a 8am-10pm GP-led minor injuries unit. For case studies see appendix a.

The CCG wants people to have their say until on the overall strategy from now until July 8.

For full details go to http://www.newdevonccg.nhs.uk/involve/community-services/101039
Public to have their say over community services framework
NHS NEW Devon CCG - Northern, Eastern and Western Devon Clinical Commissioning Group
Healthcare commissioners seek public opinion (From This is The West Country) 

Together with ideas for Budleigh:

Development of a health and wellbeing hub in Budleigh Salterton Hospital
Doctors, NHS managers and the voluntary sector have joined with local people and organisations to help secure the future of Budleigh Salterton Hospital by turning it into a hub for community services.

The community-led vision within Budleigh Salterton is to create a well-being hub based around the community hospital, which is run by Northern Devon Healthcare NHS Trust, bringing together the social care and the voluntary sector, including an intergenerational aspect appealing to all members of the community.
Local people in Budleigh Salterton asked for their opinion on new town health and wellbeing hub

See also:
Futures Forum: The Future of Health in Sidmouth: Clinical Commissioning Group for Eastern Devon
Futures Forum: The Future for Health in Sidmouth: Clinical Commissioning Group: Lay Member

1 comment:

Chris Gifford said...

You have made some good points there about health care. it’s a good idea!