Out of Hospital Strategy
Sarah James advised that the ICP is the local response for Central Lancashire to support system wide change in the health economy. The partnership includes 2 CCGs, Hospital, LCFT, Primary Care, Providers, LCC, District Councils and VCFS. An independent chair has been approved and the partnership have now met for the first time. The strategic priorities over the next 12 months will include clinical programmes; out of hospital transformation; technical changes (economic/finances) and commissioning. Sarah offered to provide a more detailed update at the next Executive meeting.
Jayne Mellor advised that the Out of Hospital Transformation involves three elements: prevention and early intervention; out of hospital activity; and acute sustainability, although there are interdependencies between the three elements. This work supports the NHS five year forward view, and placed based commissioning approach, with the intent to provide care as close to home as possible and wrap services around GPs.
There are 63 individual GPs across central, and the new commissioning approach looks to standardise the primary care model, which will group GPs into collaboratives to serve the needs of the population. The CCG has also been working with LCFT to support the newly formed eight collaboratives with the integrated Care Teams (four in total).
Prevalence profiling has been completed on community needs, using the JSNA and service modelling and also staff profiling. This intelligence has been shared with the collaboratives, to understand resources available and needs of practices. It was noted that to ensure easy access for communities across the geographical footprints equality assessments have been completed to ensure that patients are not disadvantaged by the new approaches.
Budgets continue to support the secondary care, although in the new structure there will be funding to support prevention activity as part of the Integrated Care System.
Already the new approach has resulted in commissioning differently, examples include: GP 7 Day Service, Care Homes in reach model, Gynaecology Clinics in community, Diabetes model, and COPD MDT Model. These have been managed through collaboratives rather than secondary care.
Work is now moving at pace, and planned activity includes secondary care looking at further support to community teams and GPs, as well as the legal entity for the collaborations.
Andrea Trafford advised that the work completed on the profiling was well received by the collaboratives, and also that the commissioning changes have also been seen as good pieces of work to support community based services.
Jayne referred to the NHS 10 year plan which is due out in November which will still include place based commissioning, footprints in the Northwest, and subsequent commissioning levels.
Gary commented that the changes to clinical services are key to integrate what we are doing in the wider services in the localities involved, and that it is essential to link in with the leads. Jayne advised that the collaborative leadership teams will be announced soon and will share this with the partnership.
The Executive noted the updates on this work and welcomed opportunities to understand how the Public Service Reform partnership can supporting this further.