Acting without delay – How the independent sector is working with the NHS to reduce delayed discharge

NHS Confederation, June 2017

This report from the NHS Partners Network highlights examples where the independent sector is working with the NHS to avoid delayed discharges of care.  Reducing delayed discharge – where often frail and elderly patients are unable to leave hospital due to necessary care, support or accommodation in the community being unavailable – is arguably one of the biggest priorities for the NHS.

Delayed discharges and transfers of care (DTOCs) have a significant impact on the ability of NHS acute trusts to provide routine treatment such as elective surgery. It is vital, both for the patient and the trust, to be able to discharge patients speedily to avoid adverse effects to patient flow.

NEXT STEPS ON THE NHS FIVE YEAR FORWARD VIEW

NHS England, March 2017

As the NHS approaches its 70th anniversary the health service has today published the plan setting out how it will deliver practical improvements in areas prized by patients and the public – cancer, mental health and GP access – while transforming the way that care is delivered to ease pressure on hospitals by helping frail and older people live healthier, more independent lives.

These measures, probably the biggest national move towards integrated care currently underway in any Western country, will also help to put the service on a more sustainable footing for the future.

With the NHS under pressure this plan, Next steps on the NHS Five Year Forward View, also details an accelerated drive to improve efficiency and use of technology in order to deliver better care and meet rising demand within the constraints of available resources.

Two-and-a-half years on from the publication of the widely-welcomed NHS Five Year Forward View, the plan spells out what has been achieved and the changes which will take place across the health service in key areas:

  • Improved cancer care aimed at saving an extra 5,000 lives a year through new one-stop testing centres, screening programmes and state of the art radiotherapy machines.
  • Boosting mental health services by increasing beds for children and young people to cut out of area care, more beds for new mothers and more mental health professionals in the community and hospitals to prevent crisis admissions.
  • Better access to GP services with everyone benefiting from extended opening in the evenings and weekends, newly designated ‘Urgent Treatment Centres’ and an enhanced 111 service to ease pressure on A&Es.
  • Better care for older people by bringing together services provided by GPs, hospitals, therapists, nurses and care staff, cutting emergency admissions and time spent in hospitals.
  • Driving efficiency and tackling waste to make money invested in the NHS go further in delivering the services and staff that patients want, including the latest treatments and technology.

Funding available for innovations to improve health care

The Health Foundation has £1.5 million available for up to 20 teams to test and develop innovative ideas to improve health care delivery in the UK.

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  • £1.5m available for up to 20 teams to test and develop innovative ideas and approaches to improve health care delivery and/or the way people manage their own health care in the UK.
  • Each project team will receive up to £75,000 of funding to support the implementation and measurement of the project.
  • Teams should demonstrate how their projects will lead to direct benefits or impact on patients.
  • In this round, we are particularly interested in applications that make use of data analysis.
  • Applications must be completed online by midday, Tuesday 28 March 2017.

Read about the full application process here

Sustainability and transformation plans in the NHS

Sustainability and transformation plans in the NHS: How are they being developed in practice, King’s Fund

Sustainability and transformation plans (STPs) have been developed by NHS and local government leaders in 44 parts of England. The plans offer a chance for health and social care leaders to work together to improve care and manage limited resources.

Despite the importance of STPs for the NHS and the public, little is known about the process of developing the plans and how the initiative has worked in practice. Based on a series of interviews with senior NHS and local government leaders which took place throughout 2016, this report looks at how STPs have been developed in four parts of the country.

 

Key findings of the report are:

  • Local context and the history of collaboration within STP footprints have played a major role in determining the progress of the plans.
  • Despite the focus on local ownership, key elements of the process have been ‘top-down’.
  • National requirements and deadlines for the plans have changed over time, and guidance for STP leaders has sometimes been inconsistent and often arrived late.
  • The approaches of national NHS bodies and their regional teams have not always been aligned.
  • Tight deadlines have made it difficult to secure meaningful involvement in the plans from key stakeholders, including patients and the public, local authorities, clinicians and other frontline staff.
  • Organisations face fundamental policy barriers to working together on STPs; existing accountability arrangements focus on individual rather than collective performance.

Effective Health and Wellbeing Boards: findings from 10 case studies

Local Government Association, 2016

Building on the research published in the LGA’s ‘state of the nation report’ on health and wellbeing boards (HWBs), ‘The Force Begins to Awaken’, these ten pen portraits of effective (HWBs) provide an understanding of what an effective HWB looks like and highlight some of the outcomes that HWBs have been able to secure.

The pen portraits of each of the ten HWBs provide an understanding of what an effective HWB looks like and explore the conditions for effectiveness. The pen portraits also highlight some of the outcomes that effective HWBs have been able to secure.

Read more here.

New care models: Emerging innovations in governance and organisational form

The King’s Fund | Published online: 11 October 2016

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Image source: The King’s Fund

The 23 vanguard sites chosen to develop the multispecialty community provider (MCP) and primary and acute care system (PACS) new care models have been working to pool budgets and integrate services more closely. Some are continuing to use informal partnerships, but others are opting for more formal governance arrangements. Commissioners are grappling with how to contract for the new systems, while providers are exploring how to work together within emerging partnerships, how to allocate funding, and how to share risk and rewards.

Key findings

  • Many of the vanguard sites would like to bring together the budgets for core primary care services and other local services, but it seems unlikely that GPs will give up their core General Medical Services or Personal Medical Services contracts in the immediate future.
  • Many of the sites would like to bring together the budgets and contracting for some health and social care services, but only a small number have made substantial progress in incorporating social care.
  • Many commissioners plan to contract with a single provider or entity to hold the budget and oversee or deliver a broad range of services, although most are still deciding which organisation or partnership should do this.
  • Commissioning and developing new care models involves risks as well as opportunities, underlining the importance of how these models are governed, their organisational form and how risks are shared.
  • Building and strengthening collaborative relationships is just as important as focusing on the technical elements of integrated care.

Read the full summary here

Read the full report here

Enhanced Health in Care Homes model

One in seven people aged 85 or over is living permanently in a care home. The evidence suggests that many of these people are not having their needs properly assessed and addressed. As a result, they often experience unnecessary, unplanned and avoidable admissions to hospital, and sub-optimal medication.

The enhanced health care homes model  lays out a clear vision for providing joined up primary, community and secondary, social care to residents of care and nursing homes, via a range of services.

Seven key components and eighteen sub-components which define the care homes model are put forward, with practical guidance explaining how organisations and providers can make the transition and implement the whole model.

These plans can help transform the way care is delivered, with staff from across health and social care organisations working together as part of multidisciplinary teams  to deliver high quality and financially sustainable care.

The enhanced health in care homes (EHCH) care model is one of a number of new care models that are delivering whole population healthcare. It will become a core element of the multispecialty community provider (MCP) and primary and acute care system (PACS) models.