MEETING THE CHALLENGE Improving NHS services in North Kirklees and Wakefield District NHS North Kirklees Clinical Commissioning GroupNHS Wakefield Clinical Commissioning Group
SETTING THE SCENE Jo Webster Chief Officer NHS Wakefield Clinical Commissioning Group
Eight public meetings Summary document with questionnaire to 242,000+ homes Website (with on-line questionnaire) Around 36 roadshows Dozens of meetings with groups and individuals Drop-in sessions Dedicated phone line and email Media How we are engaging with people
CCGs = local GPs Responsible for local NHS services Wakefield and North Kirklees CCGs are leading ‘Meeting the Challenge’ Dr Phil EarnshawChair of NHS Wakefield Clinical Commissioning Group (CCG)
Putting the pieces together • Promotion of good health • Strong primary care • Integrated community & social care • Communicating well • High quality hospital facilities
BMJ survey 2013 – 84% of doctors believe hospital is not the best place for the frail elderly CCGs have a duty to promote integrated care All authorities agree this is the key to a sustainable health service Care outside hospital
You have more control Care based on your needs Available when you need it One assessment Seamless Using and sharing information better Care outside hospital – key principles
Breathing problems Specialist teams of nurses caring for people in their own homes Telehealth for the most vulnerable. Daily link to the team Care outside hospital – new ways of working
Diabetes Most of care in your surgery or your home Consultants & nurses support GP clinics Standard is national best practice
Joined-up care Person at the centre with a single contact Social care & health in one team Community-based teams improving care for people with long-term conditions Intermediate Care Teams giving urgent short-term support in a crisis People feeling much more in control but supported all the way
Dr Richard Jenkins Medical Director Mid Yorkshire Hospitals NHS Trust CHANGES TO HOSPITAL SERVICES
Proposed Hospital changes • Maternity (births) • Children’s inpatients • A&E and unplanned care • Surgery
Low risk (60%) and High risk (40%) births Pontefract ‘Low risk’: Home/Pontefract /Pinderfields ‘High’ risk : Pinderfields Wakefield ‘Low risk’ : Home/Pinderfields ‘High risk’ : Pinderfields Dewsbury ‘Low risk’ : Home/Dewsbury ‘High risk’ : Dewsbury require NICU : Pinderfields 1. Births – what happens now?
Pontefract no change, midwife-led unit Pinderfields ‘high risk’ births – all to consultant-led unit ‘low risk’ births – midwife-led unit Dewsbury midwife-led unit ‘low risk’ : home, midwife unit or Pinderfields ‘high risk’ : deliver at Pinderfields Local antenatal/postnatal care Home births still an option for all ‘low risk’ Births – proposed changes
Why is this better? • Low Risk Births • Midwife-led units are as safe forlow risk births and provide better experience (local expertise) • Changes promotes choice for mothers • High Risk Births at Pinderfields • National recommendations met • More consultant presence (increased safety) • More specialist obstetricians • Improves care for high risk births & sick babies • More flexibility for women who need Caesarean section
2. Children’s Inpatients - what happens now? • Pontefract • Outpatient and emergency care • If child needs to stay in hospital they go to Pinderfields • Dewsbury • Outpatient and emergency care • Inpatient care, but children who need surgery already go to Pinderfields • Pinderfields • Outpatient, emergency care and inpatient care • All neo-natal intensive care (since 2010) • All inpatient surgery (since 2010) • (Very specialist care in Leeds)
Pontefract : no change Pinderfields: no change Dewsbury: inpatient care at Pinderfields Urgent assessment & outpatients at all 3 hospitals Children – proposed changes
Why is this better? • Less poorly children • Treated locally, more quickly • Able to go home sooner • Sicker children • Seen sooner by senior doctors • More consultant presence on wards • Safer service • Keeps as much of a child’s care as local as possible
People needing emergency care go to Dewsbury, Pinderfields or Pontefract People with very serious conditions are taken by ambulance to nearest appropriate hospital People who attend Pontefract A&E who need admission go to Pinderfields or Dewsbury 3. Emergency care – what happens now?
Pinderfields continue to see full range of cases specialist trauma and emergency care centre for Mid Yorkshire centre for emergencies who require inpatient care Dewsbury and Pontefract open access for emergency care full resuscitation facilities able to treat a wide range of conditions some ambulance attendances Around 70% of current patients Emergency care : proposed changes
If you call 999 : trained paramedics will assess and start treatment straight away they will decide which is the best place if you need further treatment more serious conditions will go to either Pinderfields or regional centre In an emergency
Patients treated in right place, by right teams, with the right support Seriously ill patients get straight to specialist care Inpatients : seen and managed by specialists quicker (eg cardiologist) Consultants on site for longer periods where they are most needed People would not travel further than Pontefract to Wakefield, or Dewsbury to Wakefield, for emergency and inpatient care Patients with less serious conditions seen more quickly and locally Development of ‘emergency day care’ Why is this better?
Many patients have very short stay in hospital (0-2 days), often waiting for tests In many cases, treatment could be carried out safely as “day care” Rule out more serious conditions quickly (eg chest pain) Aim to keep patients at home Reduces admissions + need for beds Works well in other places Due to start in Wakefield 2013 “Emergency Day Care”
Dewsbury has short stay & day surgery, inpatient general surgery, orthopaedics & gynaecology Pontefract has planned orthopaedics, (from April 2013), short stay & day surgery Pinderfields has short stay & day surgery, inpatient general surgery, gynaecology, orthopaedics, specialist surgery, trauma surgery 4. Surgery – what happens now? :
Dewsbury Planned inpatient surgery (more specialties) Day surgery Some unplanned surgery Pontefract Planned orthopaedics, ophthalmology and some short stay surgery Day surgery Pinderfields Emergency surgery, complex surgery (critical care) Day surgery Surgery : proposed changes
Why is this better? • Separation of emergency from planned surgery is better for patients • Rapid access for urgent surgery • More senior & specialist care for sickest patients • More specialist consultant rotas • Less variation & better weekend care • Less risk of cancellations • Less risk of infection • Local treatment for straightforward planned surgery • Reduces the time people need to stay in hospital • Increases available specialties at Dewsbury • .
The most serious A&E cases would be taken directly to Pinderfields The Clinical Decisions Unit will be retained and expanded to provide emergency day care and step up/down beds All other services remain as they are What changes in Pontefract?
OTHER ISSUES Stephen Eames Chief Executive The Mid Yorkshire Hospitals NHS Trust
From mid March you will only need three phone numbers: 999 for serious emergencies 111 for non-emergencies your local GP surgery
A group made up of patients and their representatives, councils, bus companies, the local NHS and the voluntary sector has identified some ways we might be able to help: Travel
More flexible appointment times • Training staff to give better • Extending the shuttle bus and route 111 bus • Bookable community transport for some patients • More use of voluntary transport • Support to get home for patients arriving by ambulance • Free Metro cards for A&E patients with no alternative • Better travel information • Travel helpline • Travel information with outpatient appointment letters
It’s all about saving money Pinderfields won’t be big enough to cope There won’t be enough beds This is the thin end of the wedge leading to Pontefract Hospital closing There is a hidden agenda to close A&E at Pontefract Hospital Some common concerns addressed
Fill in the questionnaire in the summary being delivered to people’s homes and send back using the FREEPOST address Fill in the questionnaire online at: www.meetingthechallenge.co.uk Email us at: email@example.com Call us on 01924 317757 How you can make your voice heard