Consultation Outcome and Implementation Plan

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Consultation Outcome and Implementation Plan
Hertfordshire HOSC Simon Wood
17.12.08
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Our journey so far..
PCT Strategies
Formal Public Consultation
March
April
September
March
May - September
September - January
2007
2008
2009
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A better patient experience
Improving peoples health
Reducing unfairness in health
We will deliver year on year improvements in
patient experience
We will ensure fewer people suffer from, or die
prematurely from, heart disease, stroke and cancer
Working with our partners, we will reduce the
differences in life expectancy between the
poorest 20 of our communities and the average in
each PCT
We will extend access guarantees to more of our
services
We will make our health service the safest in
England
We will ensure healthcare is as available to
marginalised groups and looked after children as
it is to the rest of us
We will ensure that GP practices improve access
and become more responsive to the needs of all
patients
We will improve the lives of those with long term
conditions
We will cut the number of smokers by 140,000
We will ensure that NHS primary dental services
are available locally to all who need them
We will halt the rise in obesity in children and
then seek to reduce it
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12 May 300 stakeholders
65 recommendations
12,426 Web hits
86 meetings 1,100 people
10 JOSC meetings
3,600 Telephone interviews
7,200,000 Opportunities to see
185 public - 4 day long events
454 face to face Interviews with
Marginalised groups
993 staff Members surveyed
503 online Public surveys
241 response forms
76 organisational responses
Over 7,000 staff, patients, and public directly
engaged
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Principles support 93 public 83 staff 63
marginalised groups
84 staff support case for change
1 staff oppose case for change
Both staff and public say Mental Health and
Healthy Living need most improvement
65 staff 52 public say yes it will make the
NHS better
97 of public want better support for carers
99 93 and 66 say yes to AE at all acute
trusts
85 public and 94 of summary responses say yes
to maternity at all acute trusts
97 of public support greater choice in place of
death
Only 2 of public put agree and measure a new
set of patient outcomes indicators to measure
performance of treatment and patient experience
indicators in top three priorities for Long Term
Conditions
66 of public supported NHS action on climate
change
Some top line numbers
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Staying Healthy, we will

• Ensure we focus on improving health and
  wellbeing, through better prevention and
  treatment services for the whole population and
  wellbeing services targeted to reduce unfairness
• Guarantee access to early screening and
  immunisation for all, to detect risk factors,
  early on-set of disease or prevent disease
• Offer an assessment for the risk of heart disease
  to everyone aged 40-74 and provide lifestyle
  support and treatment for those who will benefit
• Cut the number of smokers by 140,000 and seek to
  reduce childhood obesity
• Deliver packages of integrated lifestyle support
  services to targeted groups
• Create an innovation fund to support new
  approaches to staying healthy
• Strengthen health partnerships across local
  authority, voluntary, private and public sectors
• Launch Staying Healthy in the Workplace with
  employers and our own staff
• Do all we can to fight climate change and reduce
  its impact on health

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Mental Health, we will

• Recognise the importance of prevention and the
  need to tackle the stigma associated with mental
  health problems
• Ensure mental health services are recovery
  focussed
• Introduce a set of clinically appropriate
  maximum waiting time standards for all mental
  health pathways, ranging from 48 hours to 18
  weeks
• Seek to detect dementia earlier
• Help more people with dementia live at home as
  long as possible
• Recruit hundreds of new professionals including,
  at least 350 new psychological therapists older
  peoples mental health teams support, time and
  recovery workers and carer support workers
• Deliver a new deal for carers through an expert
  carers programme

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Maternity and Newborn, we will

• Ensure all 17 Acute Trusts will keep an obstetric
  unit, with a co-located midwife-led unit
• Guarantee 11 midwifery care in established
  labour and recruit the necessary number of
  additional midwives to do this
• Maximise care for ill babies by increasing level
  3 intensive care cots and level 1 special care
  units and reducing level 2 high dependency units
• Offer pre-conception care to women with
  pre-existing health problems and lifestyle issues
  
• Increase the overall number of NHS-funded IVF
  cycles against standard criteria
• Guarantee women direct access to midwives and
  choice of antenatal care
• Promote normality of birth and guarantee women
  choice of where to give birth, based on an
  assessment of safety for mother and baby
• Guarantee choice of postnatal care to women,
  especially those most in need
• Establish networks covering maternity and
  neonatal services

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Childrens services, we will

• Ensure childrens services are truly designed for
  children, taking into account their needs
• Implement the Child Health Promotion Programme
  for all
• Split non-urgent from urgent care by providing
  more of it in the community rather than in
  hospitals
• Develop new Children's Assessment Units and
  review whether every acute hospital needs an
  inpatient ward
• Create clinical networks for sub-specialty
  childrens services, including surgery
• Strengthen Child and Adolescent Mental Health
  services
• Ensure the needs of adolescents are properly
  catered for and there is a seamless transition to
  adult services
• Have common information systems, integrated care
  and co-located staff to deliver better services
  for children

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Planned care, we will

• Deliver more care closer to home, away from acute
  hospitals
• Guarantee better access to GPs, dentists and
  radiotherapy services
• Provide direct access to specialist advice and
  diagnostics and ensure more local provision of
  diagnostics
• Guarantee a maximum 18 week wait for more of our
  services including speech therapy, podiatry,
  orthotics,wheelchair services and orthodontics
• Ensure that all patients have a full and free
  choice of where to go for planned care
• Develop better local support for post-operative
  recovery
• Agree, and measure, new clinical, quality of life
  and experience outcomes
• Ensure that there is appropriate centralisation
  to improve clinical outcomes for patients who
  need rare or complex care, particularly
  specialised surgery

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Acute care, we will

• Ensure all Acute Trusts will continue to have an
  Accident Emergency department
• Make access easier by creating a new memorable
  telephone number for urgent care ensuring
  consistent triage across all services
• Create a series of Urgent Care Centres
• Work towards providing 24/7 access to a fuller
  range of key acute services
• Create new specialist centres for primary
  angioplasty and major trauma
• Introduce universal 24/7 coverage of stroke
  thrombolysis
• Create clinical networks for specialised services

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Long Term Conditions, we will

• Remember that people with long term conditions
  are people first a person with diabetes and
  not a diabetic
• Ensure personal health plans for everyone with a
  long term condition
• Extend expert patient programmes
• Improve timely access to specialist advice and
  diagnostics in primary care
• Guarantee access to cardiac and pulmonary
  rehabilitation
• Ensure that comprehensive disease registers are
  in place for long term conditions
• Increase the emphasis on self care and pilot
  patient held budgets
• Agree and measure a new set of patient outcomes
  and patient experience indicators
• Ensure all relevant staff have training on
  delivering a self care approach

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End of life, we will

• Deliver world class standards in meeting choice
  of place of death
• Set and monitor core best practice standards for
  all end of life providers
• Create and extend support services for all
  families and carers, including bereavement
  support
• Ensure needs assessments and advance care
  planning for all identified as being in the last
  year of life
• Guarantee better access to supportive and
  palliative care services, particularly
  out-of-hours
• Work with the public and partners to raise
  awareness of end of life issues
• Create managed Palliative and End of Life
  networks

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Implementation Plan

• System wide, what will have been done / achieved
  by when
• Combination of process and outcomes
• Live document and an annual report
• Standard format key proposal / work area,
  actions / milestones, responsibility, timeline
• Links to ILSL pledges identified and key ones
  highlighted
• Published shortly

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Issues to consider

• Positive JHOSC process
• Cross border issues with London, e.g. trauma
• Regional issues, e.g. primary angioplasty
• Sub-regional issues, e.g. neonatal services
• Local PCT issues, e.g. urgent care centres
• Linkage to PCT strategies

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