Vicky Willett and Steve Winterson presented the update from the Implementation Group. Vicky advised that since the Executive had met last, excellent progress had been made by the Implementation Group in designing and developing activity against the workstreams. Since the last meeting, the two hub formats have been mobilised with the primary care hub now operational. These include:
· Collocated Hub
· Primary Care Support Team
· Integrated Community Wellbeing Service
· Building Community Capacity
· Workforce Development
The programme update was very positive, although it also included some considerations from the Executive around any concerns on work delivered to date, in particular around the establishment of the integrated hubs. Shared case management solutions; additional service resource; and constraints around estates and accommodation were highlighted as potential future issues for wider system level integration activity.
Updates on key workstreams were provided:
John Buck and Mike Adamson reported that a lot of work had been progressed to reach the point of bringing in services that would be set up in the hub initially. A recent meeting with services was very positive and had commitment from all involved. John was assured that the right services are involved and Mike advised that additional services could be linked when required. This has enabled operational considerations to be identified, including limitations on a PFI building (legal agreement needed); how the hub will work operationally, including referral process/process mapping/case identification; access to shared case management; links with other hubs (Integrated Community Wellbeing Service/IAT/Primary Care); co-ordination resource; and Wi-Fi access.
The hub is working to a go live date of1st March, subject to relevant IT and occupancy agreement being in place.
A meeting has been arranged to discuss operational issues further. The main issue around case management for integrated services was discussed further. To work effectively together as an inter-agency group, teams and services will need to have a central point to record and view case activity. Understanding that a potential longer term solution will be Liquid Logic, which is an LCC system. Councillor Martin advised that this system has been brought into essential services as a priority, but third party access to support integrated hubs could be considered, and has been piloted in Preston.
ACTION: Councillor Martin to provide LCC contact regarding access to Liquid Logic system to support integrated hub activity.
Gary advised should any issues be flagged which may cause delay to this collocated hub, that support could be identified to help progress i.e. legal support.
Primary Care User Support Team
Dr Shashidhar Khandavalli advised that the Primary Care User Support Team has been established from 9th January, operating three days each week, with involvement from Lancashire Wellbeing Service, experienced health care workers, with admin support. The work focuses on supporting patients from being managed in the acute sector, to community based services, with a view to creating capacity in primary care, to help meet needs quicker and at an earlier point of intervention. Process maps have been developed, including case identification across four surgeries and consent to being involved. Cases need to have 20 or more GP appointments in a 12 month period, and three elements of need are in place (Clinical, Social and Psychological). Key metrics to manage and report against the activity have been identified, and updates will be provided to the partnership.
The involvement from Lancashire Wellbeing Service has been very positive in terms of understanding potential support available outside clinical pathways, and it is hoped that involvement from mental health services can also be agreed due to the circumstances being identified. LCFT are progressing this, although Lancashire MIND may also be an option to consider.
Steve Winterson advised that understanding the skill level of people involved is essential to capture as part of the pilot activity, as this will be key to understanding how the work can scale up in the future.
Gary advised that this work would be good to link in with the Our Health, Our Care Programme to support the clinical re-design activity. Sarah James confirmed that the clinical manager is linked in with the project.
Dr Khandavalli advised that EMIS are looking to automatically pick up information held on the system, as the current approach to understand actions already taken is time consuming. If there are any issues with what can be done by the EMIS team, it was agreed that Gary would be informed to consider alternative IT solutions.
Integrated Community Wellbeing Service
Gary Hall advised that a number of teams from both Chorley Council and Lancashire Care Foundation Trust are coming together from 1st April to become a new service. Consultation with staff is taking place, and there will be approx. 200 staff located in the town centre. This service will be a spoke and hub model, and will link in with the two smaller hubs previously discussed. A more detailed update will be presented at the next meeting of the Executive.