Moving Forward with PBC 5 March 2008 Welcome
INTRODUCTION • Housekeeping • Agenda • Aims for Today
AGENDA • 12.30 Registration & Lunch • 1.15 Welcome and Introduction to the Day – Dr David Rooke • Reflection on 07/08 Plans – Board Members • Review Plans for 08/09 • Board Members • Tea & Coffee • 3.00 World Class Commissioning • ‘Adding Life to Years and Years to Life’ • Paul Bearman – General Manager • 3.15 Workshops:Early Planning for 09/10 • Health Promotion- Dr Sue Davies & Janet Loe • Screening/Diagnosis- Dr Geoff Sharp & Dr Nick Matthews • Hospital/Specialist Care- Dr Mike Gorman & Dr Matthew Dolman • Continuing Care/Rehabilitation/Palliative Care- Dr David Rooke & Dr Anne Salkeld • Next steps- Paul Bearman • Close- Dr David Rooke
PURPOSE OF THE EVENT • To raise awareness of progress made since the last county-wide event • To inform practices on implementation of the plan for 2007/08 • To engage practices in the progress made in developing the Plan for 2008/09 • To consider priorities to inform planning for 2009/10 • To discuss practice commitments to WH.C for 2008/09
PROGRESS TO DATE • Established a new Board • Formed a company limited by guarantee • Sign up from practices • Logo and website developed • General Manager & PA appointed • Regular meetings with the PCT • Communication via locality meetings, briefings and newsletters • Implementation of the 07/08 Plan
IMPLEMENTATION OF THE 07/08 PLAN • Project Management • Stakeholder Engagement • Communication • Performance Management
SOMERSET PRIMARY LINK • Generally positive feedback • Capacity issues • Survey to practices? • Activity levels – 75% target in PBC LES for 2008/09?
ACUTE CARE GP • Yeovil started 7 January 2008 • Taunton due to start 21 April 2008 • Up to 10 February, the service in Yeovil has seen 92 patients and avoided 76 admissions • Need to make locum GPs aware of the service
CHEST PAIN • In Taunton for sometime • Yeovil in process of recruiting due to start 31 March 2008
CATU • Bridgwater – additional staff recruited, now nearly at full complement; extended the opening hours; 51 admissions in January • Dene Barton- opened 4 beds on 21 January 2008
COPD • Launch event 28 February 2008 • Phased implementation across the county • Respiratory lead in each practice being identified
ENHANCED COMMUNITY CARE • Still at early stage of development • Links with Community Matrons, Unique Care and uses information from Somerset Primary Link • Issues around Social Care budgets
PLANNING FOR 2008/09 • Emergency Admissions • Primary Care Mental Health Services • Diabetes • Interface Services • Diagnostics • Public Health and Wellbeing
EMERGENCY ADMISSIONS – THE SCHEMES • Community DVT pathway • Enhanced support for palliative care patients • Additional clinical support to nursing / residential care homes • Development of the falls prevention service
EMERGENCY ADMISSIONS – NEXT STEPS • Further work on DVT pathway • Commissioning proposals to PBC Approvals Committee • Further work on falls services
PRIMARY CARE MENTAL HEALTH SERVICES • Consultation concluded 8 February 2008 • Themes emerging • Next steps
KEY EMERGING THEMES • Triage and assessment – current arrangements vary but are already in place for most practices – no common system. Support for assessment in the practice, particularly from GPs and counsellors • Treatments and interventions on offer vary considerably. Wide support for improved self help and community based initiatives and improved links beyond the practice setting • GPs support practice based services, citing better communication, least intimidating and accessible setting and facilitated primary care team working as the reasons for this. They also value having a dedicated counsellor for their practice. Service users sometimes valued the anonymity of a referral to another professional or service outside of their practice setting.
NEXT STEPS - jointly with the PCT • Complete the analysis of responses – involving stakeholders (March 2008) • CSIP led workshop with stakeholders (April 2008) • Prepare draft specification with practice based commissioner reps and others (May / June 2008) • PEC Approval (September 2008) • Decide procurement route (September 2008) • Procure service and implement (by January 2009)
DIABETES – WORK IN PROGRESS • Model of care • Year of Care project • Service specification – 1 September 2008
DIABETES – EMERGING THEMES • Shifts care closer to home • Promotes self care and patient choice • Ensure equity of access and consistent standards • Improves capacity and capability of the diabetes healthcare system as a whole to meet the increasing numbers of adult patients with diabetes.
DIABETES – NEXT STEPS • Patient focus groups to further inform the model • Progress report to PEC • Development of care pathway • Financial analysis • Considering development priorities
INTERFACE SERVICES • Headache • Orthopaedics • Direct Access Physiotherapy • ENT • Gynaecology • Non-Melanoma Skin Cancer • PEARS
DIAGNOSTICS • Survey completed • Recommendations: • WH.C to consider developing commissioning plans for specific diagnostic services • Establish a direct access database for GPs • PCT review contracts for diagnostic services.
PUBLIC HEALTH AND WELLBEING • Young Persons’ Clinic - Glastonbury • Homelessness Service - Glastonbury • SIP Feed Assessment Service • Community Dietetics Service
PLANNING FOR 09/10 • Workshop to start planning for 09/10 • Freeing up resources • Care closer to home • Improving outcomes • Better patient experience
INITIAL THOUGHTS WERE: • Management of heart failure • Lower respiratory tract infections (without COPD) • Delivering choice programme – palliative care • Alcohol misuse; physical exercise; promoting healthy eating • Rheumatology interface service
FOCUS ON: • Health promotion / prevention • Screening / diagnosis / preparation • Specialist / Hospital care • Continuing care / rehabilitation / end of life care
PLEASE LOOK TO ANSWER THE QUESTIONS ON THE FLIPCHART FOCUSING ON THE RELEVANT PART OF THE CARE PATHWAY 15 MINUTES AT EACH TABLE
NEXT STEPS • Progressing the plan • Financial issues • Allocation of freed up resource for 2008/09
CLOSE • Evaluation forms • Thank you