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:
We intend to move towards a system of delivering health and care services that:
- 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
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.
- 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.
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.
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:
- Workforce and organisational development
- Communications and engagement.
In this edition we include:
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.
- 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 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.
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/