Copy
View this email in your browser
Foreword
We have much to be proud of in the NHS in Lincolnshire.  There is a strong dedication and commitment to patient care and improving the health of our population from NHS staff and GP practices across the county, and many of our patient services rate very highly.  It was great to be able to celebrate the fantastic work and success of staff and partners across the NHS in Lincolnshire at the recent Lincolnshire Health Awards.
 
However at the same time, our NHS system is very challenged as:
  • Standards of health and care services provided are not the same across the county
  • Quality of our services is variable
  • We spend more than our financial allocation
  • There are significant staffing recruitment and retention challenges in Lincolnshire
  • Estates and IT services could be used more effectively
We intend to move towards a system of delivering health and care services that:
  • Deliver more care in local community settings, rather than in hospital
  • Are more proactive in managing the health of patients and the population, rather than reactive
  • Are integrated, rather than fragmented.
Following several years of work on the Lincolnshire Health and Care (LHAC) programme and the subsequent development of the Sustainability and Transformation Plans (STPs) as a national requirement, the Lincolnshire STP (one of 44 in England) was published in December 2016.  Put simply, it is a plan of actions to address the significant challenges we face, and to ensure that a safe and sustainable NHS is secured for the future.
Lincolnshire has been working on seven key priorities since April 2017:
  • Mental Health - to improve the quality of care for people with severe and enduring mental health problems by providing a clear pathway from community to crisis care, through to inpatient and rehabilitation care, then back into community care. The objective is to reduce the number of adult patients admitted out of county for mental health inpatient care when the service is delivered locally. 
  • Integrated neighbourhood working – including the implementation of integrated neighbourhood teams and self care networks across Lincolnshire, which brings together health and care professionals, the third sector, local authority and independent organisations.  Each team will serve a local population of 30-50,000 people.  Supported by the Better Care Fund to deliver at least four operational teams by April 2018, with county wide coverage by April 2019, the key outcome is to enable people to remain fit and well and at home for as long as possible.
  • Implementation of the GP Forward View - -to ensure sustainable, accessible and high quality primary care services are available across Lincolnshire in line with the GP Forward View.  GP services are the bedrock of the NHS, delivering over 90% of our patient contacts, skilfully assessing undifferentiated patient presentations.
  • Service reconfiguration - the potential reconfiguration of a small number of vitally important services to support the delivery of high quality care and ensure sustainability into the future.  Work continues to finalise the preferred options that will be consulted on with the public and staff.  The services being considered are hyper acute stroke services, breast care services, Grantham A&E services and women and children services.
  • Urgent and emergency care transformation - A&E constitutional standards are not currently being met within the county and all partners are focused on improving performance to meet these standards over the coming winter. A range of actions is being undertaken, including implementing urgent care streaming at Lincoln County and Pilgrim Hospital A&E departments, strengthening the clinical assessment service (CAS) and increasing seven day access to primary care.
  • Operational efficiencies - to improve operational efficiency and value for money across the system, contributing £60 million savings by 2021 from areas such as prescribing, estates, back office support functions, procurement and workforce efficiencies.
  • Planned care - manage demand and growth to achieve the best outcomes for patients.  There will be an increasing emphasis on self care, closer clinical integration to deliver advice and support plus deliver treatment closer to home.  Lincolnshire has been successful in a bid to NHS England to take part in a 100 day improvement programme that empowers frontline staff to implement improvements and drive forward change.  Three specialties have been identified to go through the 100 day programme: dermatology, diabetes and ophthalmology, with work commencing in November 2017.
These seven priorities are all supported by a number of enabling work streams, including:
  • Technology
  • Estates
  • Workforce and organisational development
  • Finance
  • Communications and engagement.
The purpose of this newsletter is to provide you with an update on just some of the work which has recently taken place across our health system.  
In this edition we include:
  • Integrated neighbourhood working
  • National recognition for local health professionals
  • Lincolnshire’s care portal
  • Lincolnshire’s first psychiatric intensive care unit (PICU) opened
  • International recruitment
  • Improving care for people with a learning disability
  • New telephone clinics take the stress out of coming to hospital
  • Maternity transformation programme
  • New remote access for NHS staff.
We have tried to be clear in all our communications with stakeholders, with staff and with the communities we serve about the areas we are looking at. More information is available on our website www.lincolnshirehealthandcare.org and we will continue to keep you updated through this stakeholder newsletter as well as other means.
 
We are absolutely committed to ensuring we give patients, staff, volunteers, service users, carers and other stakeholders the opportunity to be involved in the design and implementation of our future services.
 
We will be reaching out to as many people as we can in the communities we serve to listen to views on any changes we are proposing, and we encourage you to take the opportunity to have your say.
 
John Turner
Senior Responsible Officer
Integrated neighbourhood working
Health, care and voluntary organisations across Lincolnshire are making significant progress in moving towards integrated working through core neighbourhood teams and wider supporting networks.
Those working in Gainsborough will reach the 100 day point in their implementation plans in November, while five other areas - Lincoln South, Boston, Grantham, Stamford and Spalding - have also been selected to develop Neighbourhood working by March 2018.
Early feedback in Gainsborough has found improvements in communication between professionals, fewer delays when working with others or following up for decisions and better outcomes. Staff have also praised the ability to complete joint assessments which means individuals who are being supported only need to tell their story once.
Clare Credland, lead for the Gainsborough integrated neighbourhood care team, said: “This programme sees all organisations working differently to help navigation into and between services, making the process much easier and simpler, with less duplication.
“This is based on a holistic approach to care, which supports both the clinical and non-clinical needs that a person has. In particular, self care addresses the non-medical causes of ill health with non-medical interventions.
“Our core group in Gainsborough feels very privileged to try something new and they are committed to developing this concept to improve services and achieve better outcomes for people within the local community.”
Integrated neighbourhood care teams and supporting self care networks bring together health and care professionals, the third sector, local authority and independent organisations within a local area.
This is a flagship programme which takes the best practice elements of existing neighbourhood teams and is building on them for the next phase, to broaden integrated neighbourhood working to encompass prevention, supporting networks and the care team.
The programme is supported by a £4million Better Care Fund national investment over the next two years.  The longer term vision is to establish 13 teams and supporting networks countywide. 
Lincolnshire have also been chosen to be part of a national programme run by the National Council of Voluntary Organisations (NCVO), in partnership with the Kings Fund, after a successful bid to be part of a team focusing on how to increase voluntary sector involvement in health transformation.
This is testament to the excellent partnership working and collaboration that has been developing in Lincolnshire over the last 18 months.  The programme runs from November 2017 until March 2018.
National recognition for local health professionals
Therapists championing the roles of different health professions across Lincolnshire have been praised by judges at a national award ceremony.
The team, working together as the Lincolnshire AHP (Allied Health Professional) Strategic Forum, were finalists in the Workforce Transformation Leader category of the recent Chief Allied Health Professions Officer (CAHPO) Awards 2017.
Their nomination highlighted a number of achievements which are supporting the development of AHP roles within health and social care in Lincolnshire.
The team represents allied health professions including physiotherapy, speech and language therapy, occupational therapy, orthoptics, dietetics, diagnostic radiography, therapeutic radiography and podiatry across the Lincolnshire NHS, Lincolnshire County Council, Health Education England and higher education institutions.
Among the work celebrated by the nomination is the development of MSc post-registration programmes with the University of Lincoln, leadership of the degree apprenticeship trailblazer for physiotherapy and occupational therapy and promotion of Lincolnshire as a great place to work and live.
The group has also led return to practice opportunities for those who would like to come back to their profession and renew their registration after a period of absence.
Lincolnshire’s care portal
Lincolnshire’s integrated care record portal will soon be live across the county.  The care portal computer system provides health and care workers with a view of selected information from patient records contained in existing electronic systems.  Using the portal will support staff to deliver more joined up, coordinated care, with time saved to focus on patients.  Early adopters of the care portal include small cohorts of staff from primary care, the mental health trust, community hospitals trust and the acute trust.  Staff are now able to view information held within United Lincolnshire Hospital Trust’s (ULHT) patient administration system, radiology reports, laboratory results and the national Summary Care Record.  More systems will be available to view in the portal soon, including discharge documents and outpatient letters from ULHT, mental health information and electronic end of life care plans.
Early feedback indicates that the care portal is easy to use and navigate and staff time is saved by being able to see information stored in other systems.  For example, staff in GP surgeries are able to see if patients have outpatient appointments booked without needing to contact the hospital directly.
The future of the care portal includes patients’ access to their own records to view, including test results and upcoming appointments. 
For more information, including the patient information leaflet, please go to
https://lincolnshirehealthandcare.org/care-portal/
Lincolnshire’s first psychiatric intensive care unit opened
Mental health patients in the county will now travel less for specialist psychiatric support with the opening of Lincolnshire’s first psychiatric intensive care unit (PICU).
Lincolnshire Partnership NHS Foundation Trust (LPFT) has developed the brand new 10-bed male unit, which will be known as the Hartsholme Centre, within the existing footprint of an unused ward on the St George’s site in Lincoln. It comes following discussions between LPFT and commissioners as part of the Sustainability and Transformation Partnership, to reduce out of area treatment for people with severe mental health problems. It means that patients will no longer need to travel sometimes hundreds of miles, to receive this vital support, which until now had not be available through LPFT’s existing wards.
The Hartsholme Centre provides 10 individual en-suite bedrooms. It also features a gymnasium, multi-faith room and lounge area for patients, as well as a secure and safe outdoor space.
The Mayor of Lincoln officially opened the Hartsholme Centre and dedicated the service to former LPFT Chief Executive, Chris Slavin, who sadly passed away in 2015 following a 13 year career in charge of the Trust. A plaque in his memory was unveiled as part of the opening ceremony.
The development is a key part of the STP and national five year forward view for mental health, which sets out an ambition to eliminate inappropriate out of area placements for adults in acute mental health inpatient care by 2021. It forms part of a suite of options being considered by commissioners, which also includes a similar female service, psychiatric clinical decisions unit, community rehabilitation and expanded crisis offer.
Clair Raybould, Chief Operating Officer, South West Lincolnshire Clinical Commissioning
“We are delighted to have worked with LPFT on the development of this new psychiatric intensive care unit, a first for Lincolnshire. The unit will provide comprehensive care to patients closer to their home, friends and family which is key to the recovery of patients.”
International Recruitment
Lincolnshire is leading the way in respect of International Recruitment of GPs, last year the County, led by Lincolnshire Medical Committee, undertook one of the first attempts at International Recruitment and successfully recruited 26 new GPs to work in Practices across the County.
The lessons learnt from Lincolnshire are now being used to undertake a national recruitment process over the next 6 months.  Lincolnshire is bidding to take on a further 39 colleagues to support Practices to ensure delivery of high quality care, particularly for those who have found it difficult to fill vacant GP posts.
This project is seen as a key element of a wider GP workforce plan to ensure sustainable general practice into the future through innovative solutions to widen the more traditional members of the team, for example Clinical Pharmacist roles, Advanced Nurse Practitioners.
Improving care for people with a Learning Disability
A new enhanced community service has been implemented to better support people with learning disabilities.  The new service is made up of four enhanced community teams across Lincolnshire. The teams include doctors, nurses, psychologists and other professions such as physiotherapy and speech and language, working together to support people with a wide range of specialist needs. These teams are supported by a home assessment and treatment team which can provide short term intensive care to keep people safe and well at home and out of hospital.
This new enhanced community service has been funded using existing monies and includes staff who previously worked in the Long Leys Court inpatient unit in Lincoln.
John Turner, Chief Officer for South West Lincolnshire Clinical Commissioning Group said:
“The interim arrangements in place since the Long Leys Court closure in 2015 have enabled us, with Lincolnshire Partnership NHS Foundation Trust (LPFT), to introduce an enhanced community service for people with a learning disability in the county, with a greater emphasis on local support at home and less dependence on hospital based care. This has meant that a significant number of people who would previously have received treatment in an inpatient unit have been supported in their own communities and are now able to enjoy greater independence.
“As lead commissioners for learning disability and mental health services in the county we are working with LPFT and their patients and carers to ensure that the alternative community provision is meeting the specialist needs of people with a learning disability and that people are only admitted to a specialist learning disability unit when absolutely necessary. This is a key priority and is in line with the national agenda for people with learning disabilities called ‘Transforming Care’.  Transforming care recognises the importance of helping people with a learning disability to remain within their community and supporting them to live healthy, safe and rewarding lives.
“To date we have received extremely positive feedback from service users, their families and our staff about the service and the care and support it provides.” 
Following discussions and support from the Health Scrutiny Committee for Lincolnshire we have agreed to undertake further targeted engagement with people with learning disabilities, their carers and families and other key stakeholders, over the continuation of this new model and the proposed permanent closure of Long Leys Court.  A decision will be taken following this further targeted engagement.
New telephone clinics take the stress out of coming to hospital
New telephone clinics are taking the stress out of coming to hospital by allowing some patients to access their appointment and advice from the comfort of their own home.
The rheumatology department at Lincoln County Hospital is providing telephone clinics for eligible patients.  Patients are selected based on their condition being stable,not suffering from any recent flare ups and there not being any recent changes to their medication. More complicated patients will continue to be seen in a traditional face to face clinic.
Consultant Rheumatologist Dr Shaza Obaid said: “Before the telephone appointment I can go through the patient’s notes, access any blood results, x-rays or any other scans. I can then talk to the patient about their results and see if they have had any problems since we last saw them, review any medication and decide what to do next.
“If they are having a flare up or any other issue we can book an appointment for them to come in and be seen at a face to face clinic. Sometimes they just need advice on medication and we can discuss their options.
“After the telephone appointment we will send a letter to the GP and a copy to our patient so they are kept up to date. If the patient is stable and is happy we can also discharge them back to the care of their GP with a management plan in place.”
The telephone clinics have been welcomed by patients, particularly those who have no means of transport or live far away from the hospital. Being in a rural area public transport can be difficult, but by having a telephone appointment patients no longer have to rely on friends, family or a taxi service to help them travel to the hospital.
Dr Obaid added: “If patients are stable there is no need for them to have to be seen in a face to face clinic. They can relax in their own home and talk to us, without the stress and cost of having to travel to the hospital.
“At the moment we are running one telephone clinic every week. This means we are able to free up clinic space to be used by those who need to be seen face to face, enabling us to see these patients sooner. Running the telephone clinics from our office means we do not need a nurse in attendance and most importantly it is easier for our patients.
“In a rural community like Lincolnshire we are very well suited for these types of clinics.”
Maternity transformation programme
The Lincolnshire Maternity Transformation Programme launched with a stakeholder event in Woodhall Spa in the summer.  At the event a local vision for improved maternity services was developed, based on the principles of the national Better Births programme and planning was started about how Lincolnshire will put in place the infrastructure needed to support services working together.  During the event a Facebook and Twitter page under the names of Better Births Lincolnshire and @betterbirthlinc were launched.
The new Better Births Lincolnshire website will launch in November.  The aim is to make this an integral hub for all and it will boast a page where mums-to-be can log on and self-refer into the midwifery system as soon as they know they are pregnant. The intention is for the website to really put Lincolnshire on the map for its innovative and dynamic use of online functions. 
The good work is already underway; the number of babies who are stillborn is decreasing and there is some really positive partnership working with the University of Lincolnshire, including paediatric and midwifery courses from September 2018.
The Better Births team in Lincolnshire has picked up a number of parent champions for the project – who will talk about their experiences at future engagement events. Examples include a homebirth champion and breastfeeding champion, however the team is always looking for more.  Contact sue.jarvis@lincolnshireeastccg.nhs.uk for further information.
New remote access for NHS staff
Staff working for NHS provider organisations in Lincolnshire have completed their transition to a new remote access platform.  United Lincolnshire Hospitals NHS Trust (ULHT), Lincolnshire Community Health Services NHS Trust (LCHS) and Lincolnshire Partnership NHS Foundation Trust (LPFT) are now using Junos Pulse which allows seamless login through remote connections without the need for the NHS Care Records card.
This new, shared system is more reliable, has reduced licensing costs and management overheads plus improved access across more sites across a wider range of devices and will serve over 2000 users across 111 sites spread around the county.
Darren Steel, Portfolio Director for Operational Efficiency, a trial user of Junos Pulse said, “This is a great improvement on the old system, it’s quicker and easier to connect, plus more stable and convenient.  The system is also more flexible than before; all in all, a very positive experience which also saves money for the Lincolnshire NHS.”
Our mailing address is:
STP@LincolnshireEastCCG.nhs.uk
 






This email was sent to <<Email Address>>
why did I get this?    unsubscribe from this list    update subscription preferences
Lincolnshire STP · Suite 2, Wyvern House, · Kesteven Street, · Lincoln, Lincolnshire LN5 7LH · United Kingdom

Email Marketing Powered by Mailchimp