Shaping Health and Wellbeing in Herefordshire
News
Announcement: 28 September 2009
New board looks at health and social care provision.
The new vision for health and social care services in Herefordshire has taken a major step forward with the setting up of a new Transition Board. The board will produce proposals on how health services in the community, in GP practices and in hospitals can link up, together with social care services, to deliver modern and efficient ‘pathways of care’.
It’s all part of the Shaping Health and Wellbeing in Herefordshire programme, which involves the whole of the local NHS and the council’s adult social care services in reviewing how services could be brought together, designed and provided around the needs of individuals.
The Transition Board has an independent chair, clinical representation and patient representation, to ensure that GPs and other clinicians have a strong role in determining how their patients get the best possible care and treatment. There is also senior management representation from the strategic health authority, hospital, primary care trust and the council. The board will focus on how patients are supported through their ‘journey of care’ to provide improved services and better outcomes, whilst also reducing duplication. The board will also consider whether a new organisation needs to be created to achieve this. It will recommend a preferred option for approval by statutory organisations and prepare material for public consultation on behalf of the PCT.
The viability of any proposals, including whether a new integrated organisation should be established, will be stringently tested under a ‘due diligence’ programme. It is likely that any new organisation may aspire to be a Foundation Trust, which would be free from government control to manage its own affairs, but would still have a legal duty to provide a high quality of NHS service. The trust would have a membership made up of local people, patients and staff, all having a say in how services are provided and run.
To get to this stage, professionals in health and social care have been working closely together over the last two years, and have held several workshops in Herefordshire. When considering future models, the working groups favour the close integration of health and social care services across the PCT, the hospital and the council. This is intended to improve services and develop or personalise them around the needs of individual patients, usually closer to the patient's home. The programme also wants to develop stronger high quality networks of health staff - from GPs to health visitors and pharmacists. This is in order to make sure services are available throughout the communities of Herefordshire and that the expertise of specialists is used as efficiently as possible.
It is likely to mean exciting changes to services as they are delivered from the most appropriate locations, rather than a decision based on buildings or preferences of individual organisations. The key objective is to build on work previously undertaken and not to ‘reinvent the wheel’.
Around 100 clinical and social care staff will meet at a key stakeholder event to contribute to plans for the Shaping Health and Wellbeing in Herefordshire programme. The event is planned for Friday 6 November. A follow on workshop will be held in December to hear the output from the clinical task group work.
It is critical after all of the previous work that has been undertaken that we ensure these new ways of working are implemented in a structured way and that this process is led by clinical staff.
Further updates will be regularly available to colleagues. A project office is being set up and will coordinate the work across the programme.
News release: 16 December 2008
New vision for health and social care in the spring.
A vision for how health and social care services could be better designed and provided in Herefordshire is likely to be firmed up in April 2009.
This year, professionals in health and social care services have held several meetings on the project - called Shaping Health and Wellbeing in Herefordshire - which is being driven by NHS Herefordshire, the leader for health in the county. The primary care trust is working with Herefordshire Council and Herefordshire Hospitals NHS Trust, together with West Midlands Ambulance Trust, GPs and other clinicians, as well as voluntary sector organisations.
Eight working group have identified possible options for the provision of services based on themes ranging from maternity services to 'end of life' care. These new models have to ensure that the right high quality care can be provided for the Herefordshire population, and that optimal use is made of health and social care resources. Although the working groups cover a diverse range of care they have identified common themes around the need for more health promotion and education, and for appropriate information to be shared across organisations so that patients do not have to provide information more than once.
When considering future models, the working groups favour the close integration of health and social care services across the PCT and the council. This will improve services and develop or personalise them around the needs of individual patients, usually closer to the patient's home. They also want to develop stronger high quality networks of health staff - from GPs to health visitors and pharmacists - to make sure services are available throughout the communities of Herefordshire and that the expertise of specialists is used as efficiently as possible.
The unique challenge for improving health and social care is presented by the fact that that Herefordshire's population of 180,000 people is relatively old, with one in five people aged over 65, and this client group is likely to grow by a further 23 per cent over the next five years. Also, population density in the county is low, with 82 people per square kilometre (compared with the England average of 380), so the shape of health and social care services is linked to the geography of the county.
Preferred models of care are intended to be firmed up by April 2009. The project will then identify the best organisational configurations to to support the new models of care.
For further information please contact: Communications for Herefordshire Primary Care Trust on 01432 260006.
Progress Update: 1 October 2008
In the early summer, a strategic review was announced to look at how health and social care can be managed and provided more effectively. The steering group for the project - named Shaping Health and Wellbeing in Herefordshire - has agreed six statements to guide how new organisational structures will be developed.
The six statements are:
1. When considering future organisational models, the 'horizontal integration' of health and social care across the primary care trust and the council is highly desirable.
2. At the same time 'vertical integration' will be evaluated between primary care (the first point of contact for healthcare for most people and comprising GPs, dentists, pharmacists and optometrists) and secondary care (or acute care including emergency services, hospitals and specialist medical services or surgery).
3. Only organisational solutions for the whole of the local health economy will be considered - therefore partial solutions will be deemed unacceptable.
4. Clinical networks will continue to be developed. This is where a variety of health staff, including GPs, doctors, pharmacists, nurses, health visitors, therapists from primary, secondary and regional health care, work together to make sure that high-quality, clinically-effective services are fairly distributed. A condition of the network is to involve patients.
5. Eight workshops have identified possible options for the provision of services based on themes from maternity and newborn to 'end of life' care. The steering group recognises the value of the working groups and wants to build on their skills and knowledge for the future, so that they continue as 'key advisors' after the review has finished. The chairs of these workgroups will review their purpose and membership.
6. The outcome of the strategic review will inform the consideration of Hereford Hospitals NHS Trust's bid for Foundation Trust status (which devolves decision making from central control in line with local needs and wishes).
The review includes all PCT community services, such as care centres, community hospitals and mental health services, as well as Hereford Hospitals Trust, and the council's social care services.
In October, service users and carers will be asked about their experiences and what could be better or changed about how services are provided.
Press Release: September 2008
Hereford Times article on the review
Press Release: August 2008
Strong progress in Herefordshire's review of health and wellbeing
Professionals in health and social care services have come together from across Herefordshire to work on a local vision for how those services could be better managed and provided for the future.
Several meetings in support of the Shaping Health and Wellbeing in Herefordshire project have resulted in proposals for new care models and criteria for appraising them. And service users, carers and employees in health and social care are also being asked to contribute their views.
The last ten years have seen the NHS increase capacity and the next stage review by Health Minister Lord Darzi is focusing on improving the quality and personalisation of services, to give more power to patients and clinicians.
In November 2007, local health professionals came together to give their views. And in June 2008, those professionals met again together with colleagues from social care to share progress, in the light of the national and regional vision for future services.
Participants focused on specialist areas in eight workgroups. The groups worked on: end of life care; long term conditions; planned care; acute or emergency care; mental health; staying healthy and independent; children's health and maternity and newborn.
Membership consisted of staff from Herefordshire Primary Care Trust, Hereford Hospitals Trust and Herefordshire Council.
The groups were asked to think ahead and prepare a headline description of health and care provision in 2013 and throughout June the groups met to develop care models to support their vision, and identify where there were key changes in service delivery. These new models had to ensure high quality care for the Herefordshire population and optimal use of health and social care resources. Each group had a clinical lead and voluntary sector and patient/user participation where appropriate.
Although the working groups cover a diverse range of care they identified common themes around the need for more health promotion and education, and for appropriate information to be shared across organisations so that patients do not have to provide information more than once.
On 4 July, a workshop was held to determine the success criteria by which any future service or provider configurations will be appraised. Apart from the steering group set up to oversee the strategic review of provider services, the workshop involved a wider stakeholder advisory group, which included representatives from the voluntary sector, members of the Expert Patients Programme, members of the Hereford Hospitals Trust and staff representatives.
Following this meeting, draft criteria were prepared and sent to members of the groups for comment.
A further event on 17 July enabled the working groups to present their visions for future models of care to the steering group and the wider stakeholder advisory group, and from this a picture of how the overarching strategic model of care is taking shape.
In September, the proposals for how future services could be provided will be judged and further work identified if necessary. In the meantime, service users and carers will be asked about their experiences and what could be better or changed about how services are provided.
For further information please contact: Communications for Herefordshire Primary Care Trust on 01432 260006.