Agenda item

To review progress made with the implementation of New Care Models across Blackpool and allow effective scrutiny of the approach taken.

Ms Jeannie Harrop, Senior Commissioning Manager, BCCG presented an update on implementation of New Models of Care (NMC). These concerned new approaches to health (and social) care across Blackpool and also across the Fylde coast and Wyre districts. The Committee noted that update followed a report in March 2016 to the Resilient Communities Scrutiny Committee had previously requested an update on funding (‘Value Proposition’) and NMC impact including patient stories of their NMC experiences. Ms Harrop explained that communications staff were developing more channels for patients to feed back.

Ms Harrop explained that Blackpool and neighbouring areas were one of fifty ‘vanguard’ areas nationally leading on NMC pilots following successful funding bids to NHS England. The NMC aimed to achieved integrated approaches to health and social care, more community and neighbourhood based care i.e. healthcare ‘hubs’, better use of technology and reduced costs.

Members noted that there were two Extensive Care Service (ECS) centres – Moor Park and South Shore – covering six neighbourhoods that provided support to people aged over 60, with a small range of long-term conditions. Teams of health and social care professionals were based at the hubs and aimed to support people better manage their conditions and reduce the need for hospital-based care.

The Chairman noted the successful overall progress including numbers of referrals and asked if there were any specific demonstrable evidence of targets. Mr Fisher stated that progress was in line with expectations including cost savings and keeping patients out of unnecessary hospital trips and that it was a long-term transformational programme.

Ms Harrop explained that funding criteria limited the range of conditions that could be considered. Patient choice was also important although there was still room to reduce the number of people choosing to leave ECS and a number of older people did not wish to join mainly due to misunderstandings that they would be de-registered with their GP or simply preferred to be treated by their GP. She added that more detailed ECS progress along with patient stories were included in the report appendices.

In relation to the IT system challenges of compatibility referred to in the detailed progress appendix, Mr Fisher explained that patient records systems needed to work with community systems and work was in progress to deliver the changes needed. Ms Harrop added that the changes would allow healthcare professionals to work in communities with hand-held devices.

Ms Harrop explained that although substantial funding of £4.32m had been secured recently to continue NMC work, the amount was far less than the £9.6m originally bid for. Therefore it had been necessary to substantially revise elements of the proposed programme although the ECS programme would be mainly unaffected.

The emerging Enhanced Primary Care (EPC) programme had had to be considerably revised. EPC would link in with ECS and would be rolled-out from October 2016 to provide health and wellbeing support for people with challenging long-term conditions aged over 18. A ‘hub’ based approach would be developed with GP referrals and professionals able to directly respond to calls or sign-post registered patients.

The reduced funding meant less staff being recruited, instead staff would work more directly across various areas and more closely with operational partners such as NWAS. She added that the Care Home Team would be working more directly with all fifteen care homes fielding all healthcare calls.

In response to a question on whether there were sufficient Care Home Team placements, Ms Harrop explained that six staff were proposed at the current stage of the pilot. Often transfer delays occurred between care homes and hospitals so the proposed approach to directly manage call home calls would reduce the need for hospital transfers.

The Chairman queried the significant funding shortfall on the EPC outcomes sought. Ms Harrop confirmed that ECS had received all funding bid for but EPC had got less than half sought. Therefore a much more integrated approach to EPC would be required which included staff working across both schemes.

In relation to the effectiveness of multi-agency working and sharing information for patients’ benefits, Ms Harrop stated that understanding about the schemes was still developing and would involve partners such as the voluntary sector, Fire and Rescue and occupational therapists.

The Committee noted that other integrated approaches were being undertaken including those set out in the Health and Wellbeing Strategy, ‘one stop’ hubs involving partners such as Blackpool Council and NWAS and work being undertaken with care homes including the use of telecare.  Members noted that all ambulance crews had been trained and understood the health and wellbeing options including tackling issues such as social isolation and safeguarding people.

Ms Harrop confirmed that pathways remained open, e.g. if discharged from ECS the patient might then be accessing the EPC hub.

Dr Rajpura explained that episodic care was also community-based with community representatives working with the police, healthcare staff and other local services for example the Fire and Rescue Service used social care visits to look at wider health and wellbeing issues such as trip hazards and smoking. Mr Rigby added that opportunities were made to ensure access to community defibrillators, such as those in new build designs working with Blackpool Coastal Housing (BCH).