transforming your nhs and care services across devon · transforming your nhs and care services...

Transforming your NHS and care services across Devon Seeking your ideas on how we will assess our plans for the future

Organisations across the wider Devon health and care community are united in a single ambition and shared purpose to create a clinically, socially and financially sustainable health and social care system…

A range of other key partners are involved, including NHS England, 160 GP practices, Virgin Care, Livewell Southwest CIC, Healthwatch (Devon, Plymouth and Torbay), Devon Doctors and Care UK

What the meeting today is all about

Introduce our plan to transform health and care services across Devon

Set out the challenges we face

Explain why we are reviewing acute services

Hear your views on what is important to you and how we will use that feedback to inform our plans

Encourage you to become involved

What is the Sustainability and Transformation Plan? It is one of 44 STPs in England STPs are designed to enable NHS

England to deliver its ambitious ‘Five-Year Forward View’

10 statutory organisations, and a range of key local partners, are working collaboratively for the population of Devon

The plans will test current thinking and will design how health and care services need to be shaped to meet demands up to 2021…

… all within the financial allocation given to wider Devon

Devon’s health and wellbeing challenges

Devon’s health and wellbeing challenges

Our vision for the future

Aims of the Sustainability and Transformation Plan (STP)

Health and Wellbeing Care Quality Financial Sustainability

Needs of ageing and growing population

Rising demands on the care system

Health inequalities across Devon

Variability of quality in different areas

Mental health as important as physical

health

The best bed is your own bed

‘Doing nothing’ means a £557 million

overspend by 2020/21

Huge impact across our services

Fair resource allocation

Priorities

Why we need to review our acute hospital and specialist services…

We need to manage the demand for our

acute services better

Hospital services designed for the needs of people many years ago

Need to modernise to comply with rising

standards, new drugs,

treatments and diagnostics

Failing to meet key NHS targets and quality standards

Not enough staff - impact on core and

7-day services

Our four acute hospitals across

Devon are costing more than they

receive in funding

The acute services being reviewed

Urgent and emergency care services Stroke services Maternity, paediatrics and neonatology services Vulnerable acute services Normally small, low volume and/or highly specialist

e.g. breast services (surgery and radiology), ENT, interventional radiology, histopathology, neurology, interventional cardiology and vascular surgery

Urgent and emergency care

National requirement to meet new standards for 7-day services, for example a review by a consultant within 1 hour for critical patients

Staffing shortages – becoming critical in some of our hospitals

Inability to ‘flex’ to meet peaks in attendance Not meeting key national targets eg four-hour

wait – leading to poor patient experience High numbers of very sick people with

complex needs Inappropriate transfers of care …. right care in

the right place at the right time

Some of the challenges identified by a working group of clinicians across Devon, led by Adrian Harris, Medical Director, RD&E…

Stroke services

Not enough consultants or nursing staff An increasing number of older stroke patients Different hospitals have different treatment

pathways leading to a variation in the treatment stroke patients receive

Variation in stroke services provided and what it costs

People don’t come to hospital quickly enough following a stroke – suggesting more education and awareness work is needed

Access to the right speciality and treatments at the right time quickly improves outcomes

Some of the challenges identified by a working group of clinicians across Devon, led by George Thomson, Medical Director at Northern Devon Healthcare NHS Trust:

Maternity, paediatrics and neonatology services

Staff shortages in all three services – and many of those staff work part-time

A high use of agency staff to ensure safe services It is becoming more difficult to provide a resilient

service 24/7, and this is vital for patient safety A reduction in trainees means further staff

shortages in future We are not offering pregnant women enough

birthing choice More patients with more complex needs Changes to the role of health visitors – less close

working with our acute services

Some of the challenges identified by a working group of clinicians across Devon, led by Rob Dyer, Medical Director Torbay and South Devon NHS Foundation Trust:

Discussion

Have we explained the STP well enough? Do you understand the challenges we face in our acute

services? What questions do you have? Thinking about the seven priorities of the STP, how

would you want to be involved in the plan for Devon over the coming years? Please let us know on the feedback form

Our timeline for engagement

Time Plan

November 2016

Plan to review acute services announced and published

Nov-Dec 16 Plan presented to Councils, Boards and Governing Bodies

Nov 16 -Mar 17 Clinical workshops reviewing need for change and best practice evidence

Feb-Mar 17 Public engagement on decision-making criteria

Spring 2017 Incorporate public feedback, workforce and finance issues with the clinical consensus to develop options for changing services to improve acute care

Summer 17 Publish options for change with recommendations

Summer 17 Public consultation on options for change if considered significant service change

How do we make decisions about change?

Before making decisions, we need to decide what criteria we will be judging any new proposals against

This helps us make better decisions Our clinical leads have suggested some decision-

making criteria We would like your views

The suggested clinical decision-making criteria

Patient safety

Service quality, patient outcomes and proven clinical benefit

Access as measured by both waiting times and travel times

Service sustainability

Effective training and development of future clinicians

Cost-effectiveness

Patient choice

User experience

Discussion Discussions on the criteria: what does ‘good’ and ‘bad’ look

like for you? Have we missed anything important to you? Do you want to remove anything from our list? If so, why?

Thank you for your feedback Next steps We will collate all your responses and present to the STP

clinical cabinet Clinicians will be using your feedback to inform the plans in

the workshops We will be able to describe how your feedback has

influenced our plans If the plans entail significant changes to the way our current

services are delivered we will consult with the public.

Keeping in touch … next steps

Visit our website: www.devonstp.org.uk Take part in public events: Tuesday 7 March, 14:30 – 16:30 Lantern Centre, High Street, Ilfracombe, EX34 9QB Wednesday 8 March, 18:00 – 20:00 Bideford College, Abbotsham Road, EX39 3AR Friday 17 March, 11:30 – 13:30 Petroc, Sticklepath Hill, Barnstaple, EX31 2BQ

All events across Devon