developing our local nhs long term plan...developing our local nhs long term plan spring 2019 public...

Developing our local NHS Long Term Plan

SPRING 2019PUBLIC ENGAGEMENT BOOKLETwww.onegloucestershire.net

@One_Glos

What matters to you?

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Early this year, we welcomed publication of the national 10 year Long Term Plan for the NHS, which is consistent with how support and services are developing locally.

The plan highlights the ambitions to make sure everyone gets the best start in life, to deliver world class care for major health problems and support people to age well. The plan acknowledges there will be challenges along the way across the country.

In Gloucestershire, these challenges also present great opportunities to make the county a healthier place to live, increase support in local communities, improve care in our hospitals and make the most of the skills and expertise of our great staff.

Introduction

The ‘One Gloucestershire Way’ Working together, we have made real progress in recent years, but there is more to be done.

To make our communities healthier and to make sure the NHS is there for future generations, we need to look afresh at how we engage with you and with all our community partners.

We have an important responsibility to make sure

What matters to you? We’d like your views on how we develop our NHS Long Term Plan for Gloucestershire.

Whether it’s your take on health priorities at each stage of life or how you and your family get health advice, support and services – get involved in the conversation. Find out how on Page 4.

We are working with Healthwatch Gloucestershire, the county’s independent health and social care champion to ensure that local people are at the heart of everything we do and that your voice is heard.

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How care is provided

We will continue to provide more support and care in people’s own homes, GP surgeries and local neighbourhoods in familiar surroundings - supporting people to keep their independence for as long as possible.

When people are really unwell, we want to make sure specialist hospital and

mental health services are truly outstanding and comparable to

the best in England.

Finally, we will continue to embrace the latest technology and best practice to support world class healthcare and make our communities and centres a magnet for staff to work, thrive and innovate.

We want to be ambitious for Gloucestershire residents as we

develop our plan and your views are greatly appreciated.

One Gloucestershire partners

(see listing on back cover)

Introduction

support and services are there when you need them, but to meet the challenges ahead, we need everyone to take personal responsibility for their own health and keep active and well, wherever possible.

Prevention is better than cure and we will continue to place a greater emphasis on reducing the likelihood of ill health – physical and mental – at every stage of life.

That can take many forms and working with a wide range of Gloucestershire partners, we are also tackling other things that can have a big impact on your health and wellbeing like housing, education, crime and social isolation (loneliness).

We think that most of your health priorities can be met in your local neighbourhood or community (Place), using local knowledge, networks and skills.

Our approach to ‘Place’ is fundamental to meeting local needs and making sure health and care services are set up to succeed for the coming years.

We want to hear your views about:

How you and your family get health advice, support and services when you need them – in your home, neighbourhood, community and county (THE PLACE) – from Page 7

Your health priorities at every stage in life. This relates to the health of you, your family, someone you care for and your local community (THE LIFE COURSE) – from Page 16.

You can tell us by:l Completing the FREEPOST Feedback Form

in the middle of this booklet

l Going on-line at www.onegloucestershire.net

l Coming along to one of the many events taking place over the next few months. Details can be found on-line, in the local media, on Twitter – @One_Glos and posters in local venues

l Look out for the Information Bus and Healthwatch Gloucestershire ‘campervan’ at a place near you soon.

Your feedback will be used to develop our NHS Long Term Plan locally and to develop solutions for how we organise services and support in the future.

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How to use this booklet

Our challenges

l A growing population with more complex needs, in all age groups

l Increasing demand for services and people unsure what services to use

l Recruiting and keeping enough staff with the right skills and expertise – where there are national staff shortages in key areas

l Pressure on money.

What we want to achieve – our priorities

l People taking greater control of their own health, and that of their family

l Healthy, active communities with strong networks of support

l A simpler way to get advice, support and services, 7 days a week

l The vast majority of care available in, or near, home

l High quality, joined up services with the right care, staff skills and equipment in the right place

l Best use of the ‘Gloucestershire pound’ for health and wellbeing priorities.

For our staff:

l The best professional support and learning and development opportunities in great working environments to keep and attract the best staff.

These priorities represent a common thread throughout the pages that follow.

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Fact File

£226m*

2653 km2

Area covered by the STP

20% The increase in the 75–84 age group by 202177,000

47,500Current no. of people over 65

with a long term condition

Projected rise by 2030

Projected rise

+42,000632,500

674,500

Registered population (2015)

Projected population (2030)

To fund new developments, meet rising demand and the needs of a growing population, we need to change the way we deliver services and support by £226m over the next 4 years.

*Based on the 2016 plan. The figure will be updated by Autumn 2019.

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What people have been telling us

We sought local people’s views in 2016/17 and these are the headlines from what you told us:

If you need to see a specialist, the most important thing to you would be:

If you need urgent or emergency care services, the most important thing to you would be:

The expertise of the specialist I see

The time I have to wait for an appointment

The distance I have to travel

Having as few appointments as possible

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72% of respondents agreed:





59%

8%

29%

10%

8%

14%

4%

33%

35%

A greater amount of the budget should be spent on supporting people to take more control of their own health

There should be a greater focus on prevention and self-care

We should develop joined up community health and care services

We should bring some specialist hospital services together in one place

We should focus on caring for people with the greatest health and care needs

What you have been telling us

Prompt assessment and decision making about my treatment and onward care

Ability to access services - 7 days a week

Centres/services staffed by specialists in dealing with my illness or injury

Services that are joined up and can access information about my health and care needs

The distance I have to travel

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Part 1: ‘The Place’

When you need advice, support or services, we want to make it simpler and easier for you to get what you need.

We want the vast majority of support and care to be provided in familiar surroundings – your own home, GP surgery and neighbourhood.

When you have more serious illness or injuries, we think you should receive treatment in centres with the right specialist staff, expertise and facilities to maximise your chances of survival and recovery.

Specialist Centres(Regional)

Community Hospitals

GP Surgery Services

Public Health Nursing

Mental HealthInpatient Care

Gloucestershire Royal Hospital

Cheltenham GeneralHospital

Care Homes

Pharmacy

Telephone Support

(NHS 111 / CAAS)

Specialist Hospital Services(County)

Community Services and Support

Urgent Treatment Centres

Prevention andSelf Care

Cardiac CentreMajor Trauma

Centre

On-lineServices

Carers

Specialist Community Teams e.g. Diabetes,

Mental Health

Integrated Community Teams (including rapid

response services)

Social Prescribing/Community

Wellbeing Service

– how and where you get advice, support and services

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l Be staffed by doctors and nurses

l Give information on looking after yourself when you can, the right kind of services if needed and their availability in Gloucestershire

l Be able to book appointments for you in local services with access to electronic patient records

There will always be differences in how support and services are provided in each area to meet local needs, but we want to ensure you have simpler access to this.

You will be able to get what you need by:

Visiting your pharmacy for minor ailments

Going on-line for advice and ‘signposting’ e.g. NHS App

Calling your GP surgery

Calling NHS 111

This year, we are introducing a local Clinical Advice and Assessment telephone Service (CAAS) for local healthcare professionals and for patients through NHS 111. It will:

Getting access to advice, services and support

Calling 999 - if it’s a life threatening situation.

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We want every person in every community to receive really good support and services when they need them in, or as close to home, as possible.

GP surgeries in your area are coming together to work with a range of community partners, carers and local people (in Primary Care Networks) to meet local needs.

We call this the ‘Place based approach’ and it’s already making a real difference to people’s health and wellbeing and reducing the need to travel further afield for support and care.

These are some of the things we are doing:

Improving wellbeing through ‘Social Prescribing’ – local people referred by GPs and others to community activities or support – over 3,500 people supported in a year

GP surgeries working together where you live to offer more appointments in the daytime, evening and weekends – an additional 100,000 this year

Other health experts working in, and with, local GP surgeries e.g. clinical pharmacists, physiotherapists, paramedics, mental health workers

Offering on-line GP consultations – with some surgeries introducing the service this year

Using technology to make it easier for GPs to get specialist advice from the hospital, reducing the need for you to go there

Expanding ‘joined up’ community health and social care teams - including the rapid response service – supporting people in their own homes and neighbourhoods

Support and services in communities

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We think the benefits are: Quicker access to appointments with GPs and other healthcare professionals when needed

More time for GPs to spend with patients with long term health conditions e.g. diabetes

More people getting joined up care in their own homes and communities

More reliable services provided in hospital e.g. staffing levels, opening hours, equipment.

Joining up community support

Working closely with GPs in their networks, joined up Health and Social Care Community Teams are benefitting thousands of patients across the county, 7 days a week.

The service has received more than 46,000 referrals so far this year.

The Integrated Community Teams (ICTs) provide help to people in their own homes to reduce unnecessary hospital stays and support patients to return home sooner after operations and treatment.

Also this year, there has been an average of 1,300 patient contacts a month with the community rapid response service (response at home or the community within an hour).

CASE STUDY

Providing mental health support alongside community hospital services and making it easier to get help in a mental health crisis, at home or in the area where you live

Offering care support and advice to older people who are frail or have dementia in their own homes

Looking at how we provide a range of urgent injury and illness services in hospital (e.g. new Urgent Treatment Centres) or the community for people who are not seriously unwell (see page 11).

We need to consider:

l How many Centres would be needed, so we can offer these benefits

l Where they should be (including looking at travel and transport). We envisage Centres at Cheltenham General Hospital and Gloucestershire Royal Hospital and a number of other Centres at community hospitals in the county

l The relationship between the Centres and other services that are being developed in local communities. For example, in some areas, GPs and nurses could provide some minor injury and illness services in other settings e.g. GP surgeries or health centres.

Urgent Treatment Centres

We’re developing proposals for Urgent Treatment Centres which would offer an enhanced service compared to the current Community Hospital Minor Injury and Illness Units.

The Centres would bring together an increased range of injury and illness services, out of hours GP services and diagnostics e.g. blood tests, X-ray and assessment.

We want to offer you the following benefits:

l The right number of staff always available with the right skills to provide timely, safe, high quality care

l Centres always open as planned

l Ability to book appointments so people don’t need to wait in hospital when feeling unwell

l Access to the best possible facilities and equipment – e.g. faster access to diagnostics

l More patients able to return home after advice and treatment without a long wait to be seen.

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Specialist hospital care when you need it - development of Centres of Excellence

specialist teams have come together over

the years, for example cancer specialists in

Cheltenham and stroke specialists in Gloucester.

Our experience in developing Centres of Excellence so far has shown us that these centres work well for patients, whichever of the two sites they are located at.

We want to support local access to services, as long as it doesn’t compromise the quality of care you receive or your safety. Outpatient, day case and follow up appointments would continue to be available at both sites as well as in community hospitals.

When you need specialist hospital care, you will usually get this at the two large hospitals in the county – Cheltenham General Hospital (CGH) and Gloucestershire Royal Hospital (GRH).

We want to provide truly outstanding care comparable to the best in England – putting your health, your safety and your experience first and giving our staff the best working environment.

We also want to see two thriving hospital sites with their own strong identities – both specialist centres; giving as much opportunity as possible for Gloucestershire residents to be treated in the county.

These are some of the things we are doing:l Doctors and other professionals are developing options to

bring some services (and expertise) together onto either hospital site (we call this the Centres of Excellence approach) to make them stronger and better able to meet patient needs for the future

l as part of this, we are considering a greater separation between urgent care and planned care (care that can be planned in advance) to improve availability of beds, ensure fewer cancelled operations and improve waiting times.

The Centres of Excellence approach is not new; a number of

Urgent care at the large hospitals

We think that 24/7 ‘walk in’ services should continue to be provided at both CGH and GRH, providing urgent care for the vast majority of people in the local area who need to go to hospital.

Most urgent care advice and services will be provided over the phone, on-line, in people’s homes, in GP surgeries, in the community and in urgent treatment centres. This means that only the sickest patients would need to be seen in a specialist emergency care department in hospital.

We need to think about how to provide these specialist emergency care services and what level of care is provided where to ensure you get the very best treatment, experience and the best chance of survival and recovery.

CASE STUDY – Getting the best out of both our hospitals - Trauma and Orthopaedics (Pilot scheme to test benefits)

Having two main hospital sites, Gloucestershire Royal and Cheltenham General, presents opportunities to ensure that our patients benefit from the best possible care.

By moving elements of the trauma service (patients who have been injured in accidents) from Cheltenham to Gloucester and some planned surgery (hip and knee replacements) from Gloucester to Cheltenham, we’ve been able to demonstrate real improvements in patient care.

The scheme was introduced in October 2017 and benefits include a significant reduction in waiting times for trauma surgery, and in planned care an increase in the number of patients treated a month, fewer cancelled operations – average 7.5 a week compared to 40 – and a reduction in length of stay for hip surgery.

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We think the benefits of creating Centres of Excellence are:

Reducing waiting times and fewer cancelled appointments as a result of hospital pressures

Being able to book an appointment that works for you and ensuring timely assessment and decision making from senior professionals when you arrive at hospital

Ensuring safe and consistent staffing levels, including senior doctors – 24 hours a day

Supporting joint working between care professionals, including links to related services, facilities and equipment

Ensuring specialist staff see enough patients to maintain their skills

Creating flagship centres for research, training and learning, attracting and keeping the best staff in Gloucestershire.

A centre of excellence approach to breast cancer care

Our specialist cancer teams work together to deliver compassionate, high quality care for patients, their families and carers.

Established with the aim of creating a centre of excellence for breast screening, diagnosis and care of breast cancer patients, Thirlestaine Court, Cheltenham brings these services together under one roof.

Treatment for breast cancer has seen great improvements in recent years, with more patients living longer. Success is due to earlier diagnosis, improved screening and professional expertise. Centralising care on one site has played an important part in this success story locally.

The team at Thirlestaine Court see around 55,000 patients a year, including 20,000 through the mobile breast screening service.

CASE STUDY

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We cannot achieve better health and care without developing and supporting our workforce, making the most of new technology, reducing waste and making best use of the money available.


Supporting our staff

l Offering county-wide leadership, training and learning opportunities to support new ways of working and ensure staff have the right skills

l Helping staff to work better together (joint teams) and introducing new roles to improve care and support for people e.g. nurse associates, clinical pharmacists

l Joining up our approach to recruitment; promoting Gloucestershire as a great place to live and work.

Supporting better care

Making best use of technology l Leading the way in Joining Up Your information (JUYI)

including secure access to patient records for clinicians and care workers, where and when they are needed

l Giving patients and their carers access to their digital health records

l Helping people to take greater responsibility for their health through use of innovative technology e.g. diabetes

l Developing Apps and websites to guide people through their care and treatment, including community support information

l Increasing the use of technology to support patient care e.g. on-line consultations.

What matters to you?Please tell us “What matters to you...” about the things you have read about the NHS Long Term Plan, and most importantly “Why” they matter. If you prefer you can give your feedback on line at www.onegloucestershire.net

DEADLINE for receiving feedback is 19 May 2019.

Completing the survey:

The questions that follow reflect the information in our engagement booklet: Developing our local NHS Long Term Plan. In each question we have suggested some prompts to get you thinking. These are only suggestions. It’s important that we hear about what matters to you.

You may not have views on all the areas below. That’s okay, just tell us about the ones you are interested in. When you have done that, please tell us a bit “About You”. The “About You” section is optional, but the information you give us helps us to ensure that we hear from people with a wide range of experiences and circumstances.

The information you provide will be treated in the strictest confidence, stored securely and only used for the purposes of developing our plans and services. Further information is available at: www.gloucestershireccg.nhs.uk/about-us/privacy-statement/

Our priorities and approachDo you think we have identified the right priorities for developing advice, support and services?

Yes No Don’t know

What other priorities matter to you?

Do you think we have set out a clear way to develop advice, support and services locally?

Yes No Don’t know

What else should we consider?

The Life Course – Starting wellYou might want to think about reducing health inequalities, supporting pregnancy, family caring and support, young people’s mental health and wellbeing, or something else.


Why does this matter to you?

Living wellYou might want to think about healthy lifestyle advice, living with long term conditions, choice and control over care/support, or something else.



When you have completed the survey, simply pull it out of this booklet and send it to the FREEPOST address on the last page of this questionnaire – no stamp needed.

Ageing wellYou might want to think about maintaining independence, connections with family, friends and communities, caring for loved ones, end of life, or something else.



The Place – Getting adviceYou might want to think about preventing ill health, knowing what’s available locally to support you, online/telephone advice (e.g. NHS 111), or something else.



Getting support from your local GP practiceYou might want to think about access to your surgery, technology that could support your care, range of professionals (e.g. pharmacist, practice nurse) links to other community services, or something else.



Getting support and services in your communityYou might want to think about support for mental health, support in your own home, the range of community services (including the voluntary sector), local diagnostics (e.g. x-ray), outpatient services/therapies or something else.



Getting urgent advice and treatmentYou might want to think about access to online/telephone advice, walk-in services, specialist assessment and treatment, or something else.



Getting support in hospital if you need specialist careYou might want to think about planned appointments and operations, leaving hospital (either to your own home or elsewhere), or something else.



Supporting better care: best use of NHS resourcesYou might want to think about how we support the workforce, use technology, reduce waste, or something else.



About YouCompleting the “About You” section is optional, but the information you give us helps us to ensure that we hear from people with a wide range of experiences and circumstances. Your support with this is really appreciated.

What is the first part of your postcode? eg. GL1, GL20

Which age group are you?

Under 18

18-25

26-35

36-45

46-55

56-65

66-75

Over 75

Prefer not to say

Are you:

A health or social care professional

A community partner/member of the public

Prefer not to say

Do you consider yourself to have a disability? (Tick all that apply)

No

Mental health problem

Visual Impairment

Learning difficulties

Hearing impairment

Long term condition

Physical disability

Prefer not to say

Do you look after, or give any help or support to family members, friends, neighbours or others because of either a long term physical or mental ill health need or problems related to old age? Please do not count anything you do as part of your paid employment.

Yes

No

Prefer not to say

Which best describes your ethnicity?

White British

White Other

Asian or Asian British

Black or Black British

Chinese

Mixed

Prefer not to say

Which of the following best describes your religion or belief?

No religion

Buddhist

Christian (including Church of England, Catholic, Methodist and other denominations)

Hindu

Jewish

Muslim

Sikh

Other

Prefer not to say

Are you:

Male

Female

Transgender

Prefer not to say

Do you identify with your gender as registered at birth?

Yes

No

Prefer not to say

Which of the following best describes how you think of yourself?

Heterosexual or straight

Gay or lesbian

Bisexual

Other

Prefer not to say

Are you currently pregnant or have given birth in the last year?

Yes

No

Not applicable

Prefer not to say

Thank you for taking the time to tell us what matters to you. Your feedback is important to us.

Please return your completed questionnaire to the freepost address below (no stamp required) by 19 May 2019.

FREEPOST NO: RTEY-EBEG-EZAT, PPE Team, NHS Gloucestershire Clinical Commissioning Group, 5220 Valiant Court, Gloucester Business Park, Brockworth, GL3 4FE

NHS Prescription Ordering LineA convenient way to order your repeat prescription

0300 421 1215Call Monday to Friday, 9.00 am - 5.00 pm

How can patients help to reduce prescription medication waste?

z Please check your medication cupboard before ordering

z We ask patients to order their prescription when they have five days of medication left

z If you have a build-up of any medication please let us know so that we can adjust quantities so everything falls in line

z Please do not order “just in case”. If you need the medication in the future, you will still be able to request it

z Let us know if you have stopped taking any of your medicines

5DAYS

Calls charged at standard geographic rate

Please don’t ask for over-the-counter medicines like paracetamol and ibuprofen on prescriptionYour local NHS spends around £1.3m

each year on medicines which are easily available in local pharmacies and shopsThis could pay for:

211 MORE hip operations or

1,380 MORE cataract operations or

91 MORE treatments for breast cancer or

42 MORE community nursesThe NHS belongs to you, use it responsibly

GDH3585 - POL leaflet_221018.indd 1

25/10/2018 08:26:39

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Whether you work in health or care services, are a community partner or a member of public with an interest in these areas, we want to hear your views to help develop our plan.

Reducing waste and making best use of the money available

l Introducing the Prescription Ordering Line (POL) serving more than 125,00 patients, offering a quicker and easier way to order prescribed medicines

l Emplyoing dieticians to provide nutritional advice, reducing the prescribing of expensive nutritional supplements

l Reducing the number of people who forget to cancel GP and hospital outpatient appointments when they can’t make them through a high profile #NoShow media campaign

l Looking at how we provide tests and follow up outpatient appointments to avoid the need for face to face visits where appropriate e.g. use of technology – freeing up resources and time for patients and staff.

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Part 2: The Life Course

Starting Well

1 2 3Living Well Ageing Well

IntroductionThis section looks at how together we can prevent ill-health, help keep you and your community healthy and keep people independent for as long as possible.

The section also looks at how you can improve the way you manage your own health and wellbeing and what support can be put in place when needed at every stage of life.

We want to know what matters to you about the health of you, your family and community and local health and care priorities.

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The section covers pregnancy and early years. It is also about ensuring children and young people can fulfil their potential, have a healthy start and are well set for adult life.


Support for pregnant women and their families

l Supporting pregnant women, new mums and their families who may be experiencing postnatal depression and emotional distress through a specialist perinatal mental health team (350 women have benefitted so far)

l Developing ‘Community Hubs’ to provide women and their families with advice, support and activities

l Developing services so that more women and families have access to the same team of midwives throughout their journey to parenthood.

Starting Well

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Support more young people to get healthy and active

l Building on The Daily Mile (over 22,000 pupils from 120 local schools are already taking part), seeing children walk, jog or run their way to better health

l Encouraging 30,000 inactive people to be more active through the Gloucestershire Moves initiative, this includes the ‘Beat the Street’ initiative to encourage young people to walk and cycle more

l Continuing to support Facts4Life in Gloucestershire schools, helping children to understand their mental and physical health (the project has worked with over 160 schools and trained 1,000 teachers so far).

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Providing a better future for children and young people

Gloucestershire is leading the way on mental health support for young people.

There were 10,000 visitors to the ‘On your Mind’ website last year, 900 people received on-line and face to face counselling through Teens in Crisis, 19 schools were accredited as part of the Mental Health Champions Award scheme and we invested £300,000 to employ mental health workers in schools.

CASE STUDY

Tell us what matters to you about Starting Well

Early advice and support on mental health

l Extending on-line and face to face counselling and support

l Building on the Mental Health Champions Award scheme in schools to help both children and staff to talk about their mental health and recognise signs of anxiety and stress

l Extending mental health training for staff in schools

l Improving mental health support (four teams) in primary, secondary and special schools through a £5 million ‘trailblazing’ initiative in Gloucestershire.

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Living Well

The section looks at maintaining good health and wellbeing in adult life and living well with the right support if you develop a long term health condition.


Looking after our health and wellbeing

l Improving wellbeing through ‘Social Prescribing’ – local people referred by GP surgeries and others to community activities or support through the Community Wellbeing Service – over 3,500 people in a year

l Supporting businesses to develop a ‘healthier and happier’ workforce through the Workplace Wellbeing Charter – 34 local organisations already involved.

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Living well with a health condition

l Helping people learn techniques to manage their own health through our education programme ‘Live Better to Feel Better’ – 400 people joined the programme this year in Gloucestershire

l Cancer • Continuing our Macmillan GP masterclass sessions to support

doctors in spotting the early signs of suspected cancer

• Introducing new GP guidance and patient information to improve arrangements for referral to hospital

• Ensuring faster and more joined up care e.g. urology patients can now see a specialist and have tests in a single visit. In dermatology, some skins cancers can be diagnosed and treated on the same day

• Continuing to support early diagnosis of cancer – when a GP suspects bowel or lung cancer more patients will go straight for a diagnostic test, such as a colonoscopy or CT scan

l Diabetes • Building on the success of the local diabetes prevention

programme by making it available county-wide

• Rolling out the 12 week KiActiv health coaching programme to a further 500 people with Type 2 diabetes

• Delivering diabetes training to care home staff

l Eye Health

• Providing support for more eye conditions closer to home in local high street opticians reducing the need for hospital appointments e.g. glaucoma, minor eye condition service, cataracts

• Ensuring people can get support services and information quickly when experiencing sight loss

l Heart Health and Stroke • Launching a 2 year community testing programme to

increase detection of high blood pressure working with community pharmacies, the Healthy Lifestyles Service and other partners

• Making mobile heart monitors available in GP surgeries to increase detection of Atrial Fibrillation (a condition that causes an irregular and often abnormally fast heart rate), a major risk factor for Stroke

• Supporting a major education programme for GPs and practice teams on treating high blood pressure and Atrial Fibrillation

Living Well

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• Increasing uptake of Cardiac Rehabilitation (exercise and information sessions following a heart attack or heart surgery) through social prescribing and on-line resources

• Developing a specialist community Stroke rehabilitation ‘Centre of Excellence’ at Vale Community Hospital

l Mental Health

• Continuing to improve access to the county’s Let’s Talk service to help people with stress, anxiety and depression (7,000 supported last year)

• Offering mental health support every evening at The Cavern Café in Gloucester (pictured)

• Spending more money on mental health liaison services in hospital, mental health services for people in crisis; including better links with the emergency services and criminal justice liaison services

l Musculoskeletal (MSK – problems which affect bones, muscles and joints)

• Supporting more people to look after their MSK conditions, including information on exercises and referring themselves to physiotherapy and podiatry services in Gloucestershire

• Improving ‘triage services’ so that when people visit their GP surgery they get the right support in the right place

• Offering improved information on preventing and coping with back pain, including sessions run by physiotherapists and psychologists

• Making education classes available to more people with osteoarthritis to help them manage pain and maintain their independence

• Improving services for patients who require artificial devices such as splints, braces and insoles

l Respiratory care (conditions which affect breathing)

• Developing an integrated (joined up) respiratory service so more patients can get specialist care in the community, rather than needing a hospital stay

• Offering training and education to GP surgeries to identify people with lung disease

• Offering people with lung disease a new guide on how to look after themselves well and when to seek help.

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Living well with a learning disability

l Working to ensure 75% of people with a learning disability have an annual health check (currently 63%)

l Giving individuals greater control over the support they receive through personal health budgets

l Providing 365 day a year support through the Learning Disability Intensive Support Service (LDISS) to prevent the need for stays in hospital and facilities outside of the county

lWorking together with the county council and local businesses to increase employment opportunities.

Huge strides made to tackle type 2 diabetes

Real progress is being made in Gloucestershire to tackle diabetes – 3,000 people so far have been referred by their GP surgery to the diabetes prevention programme, which aims to reduce or reverse the risk of people developing the condition, with sessions covering nutrition and exercise.

Meanwhile, the 12 week KiActiv health coaching programme for people with type 2 diabetes has helped hundreds of people so far to improve their health through reducing weight, blood glucose levels and increasing physical activity levels.

CASE STUDY

Tell us what matters to you about Living Well

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Ageing Well

The section is about maintaining physical and mental wellbeing and independence in older age, the health conditions that people can develop as they get older and support for people when they reach the end of their lives.


Staying physically active

l Working with Active Gloucestershire to encourage older people in the county to keep active and exercise more – increasing the number of Strength and Balance classes and encouraging more people to attend

l Producing targeted information to help increase awareness of strengthening exercises at home and how to prevent a fall

l Piloting the use of technology (exercise trackers) to help people get stronger after a fall

l Organising training sessions for healthcare professionals so they can recognise people at risk of falling and know where to signpost people for support

l Increasing the number of people having comprehensive assessments by the Falls Education and Assessment Service after a fall so they get the advice and support they need.

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Living well with frailty

l Supporting people with on-going and complex care needs to live independently and safely at home through ‘joined up’ teams of health and care professionals

l Improving assessment and support for older people at the Emergency Department (see Case Study).

Improving support for people with dementia

l Working with healthcare professionals to continue to improve the diagnosis rate for people with dementia (currently 67% – the highest ever figure)

l Using the learning from a pilot community dementia nurse scheme in Stroud and the complex care at home service in other areas to extend support for people with dementia in their own homes

l Introducing a Community Hospital Mental Health Liaison Team to work with GPs to reduce the likelihood of people needing to go back into hospital

l Developing ‘dementia friendly’ communities – including trained volunteers, memory cafes and be-friending groups.

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Supporting hundreds of people with frailty and dementia

A number of community schemes are underway in the county to support the health and wellbeing of hundreds of people living with frailty and dementia and to help them remain independent at home for as long as possible.

They are led by community matrons/nurses in partnership with GPs, therapists, social care workers, wellbeing co-ordinators, hospital staff as well as local authorities and voluntary and community services.

Working with the individual to understand their specific needs, the professionals provide advice on how to manage health conditions, co-ordinate care, monitor health and support access to community resources and activities.

Specialist assessment and support for older people who arrive at the Emergency Department with signs of frailty is also underway. The right treatment and support can allow people to return home more quickly and maintain their independence.

CASE STUDY

Tell us what matters to you about Ageing Well

End of Life Care

l Making sure Hospice at Home services are available across the county for those who need it working with two local hospices

l Introducing a 24 hour telephone line to provide specialist advice and support for people nearing the end of their lives

l Launching a new shared care record for patients, families and carers

l Supporting people to have personal health budgets.

One Gloucestershire is a partnership between the county’s NHS and care organisations to help keep people healthy, support active communities and ensure high quality, joined up care when needed:

• NHS Gloucestershire Clinical Commissioning Group (CCG)

• Primary care (GP) providers

• Gloucestershire Care Services NHS Trust

• 2gether NHS Foundation Trust

• Gloucestershire Hospitals NHS Foundation Trust

• South Western Ambulance Service NHS Foundation Trust

• Gloucestershire County Council

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