Loading in 2 Seconds...
Loading in 2 Seconds...
Clinical strategy FT member events April 2011. Welcome to the new acute and community County Durham and Darlington NHS Foundation Trust. The new Foundation Trust…. …an acute and community Foundation Trust for County Durham and Darlington
FT member events
“to shift the centre of gravity from hospital to community and develop fully integrated care pathways”.
Long term conditions
Care of older people
Women and children
Acute medicine and emergency care
End of life care
Quick win: Facilitated discharge, good referral guidelines for disease progression, pathway for minor acute events, access to specialist support 0900-1700 via bleep and phone line (being set up now),
Priority issue: Patient education, equity of care, community clinics across the county, decrease LOS in surgical patients (CQUIN), IT - common LTC pathway and paperless clinics with instant transfer of data across primary and secondary care
Outcomes and experience: reduced admissions through better accessibility to specialist staff, better screening and management
Workforce: development opportunities working across the pathway utilising district and community nurses and integrating them with hospital specialist nurses
Efficiency: Community rather than hospital follow ups; Nurse rather than Consultant follow ups. Working along with other workstreams - old age/ emergency and end of life care pathways to be put in place
Quick win: Dementia – training of all staff who are in contact with older people through e-learning etc
Priority issue: single point of access to range of services
Outcomes and experience: Early prevention /screening, future care planning
Workforce: better use of specialist skills through dedicated specialist direct assessment /admission unit
Efficiency: better use of community hospitals
Quick win: Use of DH ‘surprise question’ as a trigger into advanced care planning in the last year of life
Priority issues: Shared, real time access to information via IT systems; single point of access in the form of a coordination centre
Outcomes and experience: patients more likely to access preferred option/place of care at the end of life
Workforce: developing skills to facilitate patient choice of preferred place of care at the end of life
Efficiency: reduce number of avoidable admissions to acute care at the end of life
Quick win: integration of protocols between UCC and A&E
Priorities: joined up approach with all stakeholders including NEAS, social care
Outcomes and experience: reduced waits by quicker access to appropriate level of care
Workforce: access to senior experienced clinician opinion at earliest opportunity in the pathway
Comprehensive directory of supporting services in community and acute settings
Efficiency: reduced admissions from ED and urgent care
Quick win: Antenatal assessment for vulnerable families
Priority issues: Middle grade cover in paediatrics and maternity, training of advanced paediatric nurse practitioners, consultant numbers in paediatrics
Outcomes and experience: Community care pathways for women with low risk pregnancies
Workforce: Alignment of community midwives with integrated children’s teams
Efficiency: integrated Health Visitors and school nursing children’s teams with social care
Quick win: Redesigning pre-operative pathway; changes to urology pathway
Priority issues: Addressing pressures in vascular surgery
Outcomes and experience: more accessible service for patients, reducing unnecessary hospital visits ( pre-operative pathway), delivery of care closer to home (Urology pathway).
Workforce: changes to skill mix to meet pathway requirements, staff have the skills to deliver care in the appropriate setting for the patients
Efficiency: Reducing emergency admissions to hospital. Offering other services to manage surgical emergency activity, to deliver a better service for patients.