Joint Services Review Update, Issue 2
April 2012
Welcome to the second update on the Worcestershire Joint Services Review.
The NHS in Worcestershire is reviewing four areas of acute healthcare services to make sure that the best possible healthcare is available for county residents into the future.
The Clinical Working Groups held their second meeting on 29 March when they discussed how services might be delivered to meet the challenges of the future and to ensure the highest quality, affordable services for Worcestershire. Following these discussions and conversations with patients and public an initial range of options will be made available in May. These will be subject to consultation before a set of proposals are confirmed. Formal public consultation will take place for three months from August 2012.
Elderly care
The Clinical Working Group looking at elderly care has been discussing how services can be provided to offer the highest quality care for patients. We have looked at national and international data about how different models of care for elderly patients can reduce inappropriate admissions to hospital and reduce length of stay.
To help design services in Worcestershire, we want to learn more about how two of the best performing healthcare systems in the country, in Devon and East Kent, are achieving shorter lengths of stay. We discussed how different ways of providing care could allow early access to specialist assessment, improve patient flow through the hospital, and improve pathways into community care.
As a group, we had a number of ideas for improving quality of care. To help us develop an initial range of options, we have requested further information and data analysis. We will use this information to help us develop our ideas further at our next meeting on 19 April.
Listen to Dr Simon Hellier, Clinical Director of Medicine, talk about the Clinical Working Group's thinking for future Elderly Care services
Planned care
The group has been considering how to best link up planned (or elective) care across acute and community care services to make sure that pathways of care in Worcestershire are effective, affordable and maintain excellent levels of patient experience.
Our combined group of doctors, nurses, therapists, social workers and other healthcare professionals looked at examples of other health trusts which are considered to have best practice and are centres of excellence. We discussed how these models of care might be used in Worcestershire to improve services to the level of the highest performing trusts in the country.
We discussed how the potential models for planned care could enable services to be provided locally in the community, offer rapid access to consultants for example through ‘urgent outpatient’ appointments, offer the highest quality specialist care with locally provided out-patient services, and make best use of existing facilities such as operating theatres.
For the third meeting on 19 April, we will develop potential models for each speciality that will offer patients a streamlined access to planned care with joined up support from other specialities and allied professionals.
Listen to Dr David Law, Co-Chair of the Clinical Working Group, talk about the Group's thinking for future Planned Care services
Women & Children
The Clinical Working Group includes a range of health and social care professionals who provide services to women and children in the county, including representation from the ambulance service and local authority staff. We started our second meeting with a discussion about clinical and service evidence from both the hospital trust and others like it across the country.
The group’s priority is that the quality and safety of care is the most important factor in planning services which will work for the next decade and beyond. With this an ambition in mind, we discussed a number of ideas for providing more specialist services while allowing more general services to be provided closer to home.
We identified that any potential models for care must offer high quality affordable services with good access for patients, improved levels of patient experience and good connections with supporting services both within the hospital and with community services. In respect of maternity services, we identified the importance of ensuring patient choice through the provision of midwife-led services.
Our ideas will be subject to more detailed modelling and analysis to see how they meet the objectives set out by the group and the wider Joint Strategic Review. This work will be looked at when the working group meets again on 19 April.
Listen to Dr Angus Thomson, Co-Chair of the CWG, talk about the Group's thinking for future Women and Children's services
Emergency care
The group, including representatives from Emergency Medicine, Surgery, Critical Care, Nursing, GPs, commissioners and key clinical support services, discussed how key acute hospital services could be provided to meet the potential healthcare challenges over the next ten years. We looked at the links between the different acute services on a hospital site and which other services would benefit from being located together.
We discussed how a full emergency package of services could be provided as well as how to best provide the services required to support an A&E department. We also looked at a number of models to improve the pathway of care for emergency patients, with a view to placing patients in the best care setting quickly and relieving pressure on A&E.
We discussed ideas for providing emergency surgery using the example of General Surgery and different staffing models to highlight some of the challenges, including the possible future availability of doctors, increasing specialisation of consultants, and the challenges of moving from consultant-led care to consultant-delivered care.
At our third meeting on 19 April, we will discuss options for delivering emergency care for a range of surgical specialities, including Trauma and Orthopaedics and Paediatrics, and how primary care within the community can be supported to reduce the number of emergency admissions to hospital.
Listen to Dr Chris Hetherington, Consultant Physician, Pete Byrne, Matron, and Sharon Smith, Matron, talk about the Group's thinking
Focus groups
Focus groups made up of patients and the public have been meeting to add their thinking to the option development process. Find out more about these groups here.
The next edition of this newsletter will contain details of how to get involved in these focus groups.
Whilst the amount of evidence and data to help the clinical decision making is growing, patient and public input into the Joint Services Review is very important as we know that the more we listen to patients, the public, professionals and our wider partners, the more sustainable options and future plans will be.
There are a number of ways to ‘have your say’:
