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