Healthy Weston - Update
Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group have published the following letter regarding the Healthy Weston scheme.
"As you will be aware, over the past year clinicians and health leaders across North
Somerset have been working on developing new ways of organising health and care
services. Services need to better meet people’s needs in the future and respond to the
changing health and care needs of our communities.
Our local population is growing, ageing and has increasing vulnerabilities and needs. For example, within the range of services we provide we need to ensure we can support those who are living with frailty, who have long-term health conditions, who have mental health needs, or drug and alcohol dependencies.
We have challenged ourselves to think through how a wide range of services could work better together and how some might be delivered differently in the future. We want to provide more joined-up care for patients across different services. As part of our Healthy Weston programme we are looking at how GP services, community healthcare, mental health, maternity, the community and voluntary sector and social care services, as well as services provided at Weston General Hospital and other main hospitals in the area, can work better together.
Outcomes from the first phase of our Healthy Weston work programme
Late last year and earlier this year patients, carers, members of the public, staff, providers of health and care services, and other stakeholders took part in a widespread conversation about the future of health and care services. This was led and facilitated by Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group following publication of their ‘Commissioning Context’ document (see https://bnssgccg.nhs.uk/library/healthy-
weston-joining-up-services-for-better-care-in-the-weston-area/) in October 2017. People discussed how they would like to see services delivered in the future.
Through this process, three clear programmes of work were identified:
- Improvements to services that can be implemented immediately or imminently. For example, a new unified approach to GPs providing services to local care homes; standardising telephony and shared back office IT systems for GPs to increase resilience; and training primary and community staff in more advanced and standardised frailty assessments .
- Ideas and suggestions requiring further work and a supporting business case to ensure they are viable and have appropriate funding and support. For example, establishing a mental health crisis café, better integration of children’s services, and social prescribing (a means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services for example, volunteering, gardening befriending, or a range of sports).
- Delivering clinically and financially sustainable services that best meet the needs of the local population for the long term. Over the past year by working together we have made some immediate improvements and identified some potential new ways of delivering services. But there are still significant challenges that need to be addressed. We need to make sure that all services can be delivered in a sustainable way, particularly at Weston General Hospital where some of the current challenges are felt most. For services to be clinically and financially sustainable for the long term they must: have enough qualified and specialist staff; be organised and delivered in such a way that they meet national quality and safety standards; and have recurrent funding that is spent in the most efficient way, so we get best value for every taxpayer’s pound.
We are now building on the good work to date but recognise we need to be bolder, and
more creative, if we are to deliver sustainable health and care services in and outside of hospital in the future.
Work progressing through the summer and into the autumn
Throughout this summer clinicians and health and care professionals from across the area are meeting to continue to look at how our existing health and care services might be designed and run differently in the future. This group includes clinical Commissioners, GPs from local practices, hospital doctors, nurses, allied health professionals such as physios and other therapists, paramedics and social care professionals from Weston Area NHS Health Trust, University Hospitals Bristol NHS Foundation Trust, Avon and Wiltshire Mental Health Partnership NHS Trust, North Bristol NHS Trust, South West Ambulance Service NHS Foundation Trust and North Somerset Council.
As well as our focus on the Weston area we are working with colleagues in Bristol and
North Somerset to identify the services that Weston General Hospital is best placed to
provide so it becomes a stronger, more focused hospital and which services may be more effectively provided to local people by one of the other hospitals.
In July, taking as headline themes, the clinical and professional group looked at different areas of care for those needing:
- frailty and long-term conditions services
- maternity and paediatric services
- planned care services (for example, planned operations and treatments); and
- urgent and emergency care.
They looked in detail, from a clinical perspective, at the ideal journey patients should take from the start to the end of their care. The focus of the discussion was on ‘what good looks like’ in terms of clinical quality. This involved looking at:
- how and when diagnostic tests and interventions should be started
- who in the wider clinical team (GP, practice nurse, paramedic, hospital doctor, specialist consultant, community services etc) has the right skills and expertise to assess and treat patients
- if, when and how patients should be escalated or transferred from one team of experts to another.
They also discussed:
- how variation in clinical quality and outcomes could best be reduced
- interdependencies between clinical services which would require them to be co-located
- what the scope of clinical roles could be in the future; and
- how innovations in technology could support and enhance the sharing of information and the delivery of services in new ways.
The clinicians examined and discussed national and international examples of good
practice and the spectrum of how services are delivered in other parts of the county and parts of the world. They looked at examples of ‘service models’ that have been developed in recent years to meet the needs of similar populations to ours with similar challenges, such as a coastal location, or small district general hospitals needing to adapt to remain clinically and financially sustainable.
At meetings in August the clinicians will be looking in more detail at the data (such as
population need, activity, workforce and finance) that sets out the evidence that change is required. This will help to identify where the opportunities are for improving clinical
outcomes, patient experience and more joined-up working between services and
organisations. In addition, the clinicians will begin to look at how some aspects of the
service models they have learnt about in other parts of the country could be applied
locally.
This will enable us to develop a bespoke model of care for our area to suit current and
longer-term needs. It will be designed by clinicians with the aim of delivering improved
health and care services in a sustainable way.
Once this clinical work has progressed, we want to test it further with a wider group of
clinicians, stakeholders, staff, patients, carers and local people as part of the ongoing
Healthy Weston programme in early autumn.
A series of potential options for the way services could be delivered in the future will be
developed. From this, a short-list of options will become part of a ‘pre-consultation
business case’ (describing the detailed workforce, activity, workforce, capital requirements etc to deliver them) for formal public consultation in 2019.
No decisions have yet been made on the future of services. We will continue to provide
updates on our work over the coming months and if you would like to be involved in the
next phase of design and discussion in the early autumn, please email
bnssg.healthyweston@nhs.net so we can ensure you receive further information when this is available.
Yours faithfully
Julia Ross, Chair of the Healthy Weston Steering Group
