Partnership Update - Early Winter 2019

Our Healthier South East London Partnership Update Early winter 2019 Edition

Our updates provide an overview of the work of Our Healthier South East London, the Sustainability and Transformation Partnership for south east London, over the past couple of months. They are designed for sharing with boards, governing bodies and other key partners and stakeholders.

At a glance

  • The NHS Long Term Plan was published on 7 January 2019 and we now need to agree how best to deliver the plan in south east London. Our existing programmes already cover many of the areas in the plan, but we will be working with the public and local stakeholders to ensure we have everything covered in a way that meets the needs of our residents.
  • In December, we completed an 11 week aspirant integrated care system programme. The vision set out in the newly published NHS Long Term Plan is for all STPs to become ICSs by 2021. As part of the programme we looked at delivering better joined up care at borough level as well as networking more specialist services.
  • Following guidance from the Department of Health and Social Care we are working with health and care organisations in south east London to prepare for different scenarios that may arise as a result of the country leaving the EU (‘Brexit’) at the end of March 2019

Meetings

The OHSEL Board is our key decision-making group for the programme and includes representatives from across our partner organisations. Details of the meeting held on 9 November 2018 are available on our website. The next meeting is due to take place on 23 January 2019. Further information about this can be found under the meetings section of the website.

Update from programme groups

Community Based Care

In early December representatives from across the health and care sector in south east London contributed to an all party parliamentary group roundtable discussion on obesity. The group recognised examples of best practice in south east London including a pilot to provide intensive support for patients undertaking weight management programmes, and obesity awareness training for front line staff in Southwark. The Community Based Care Board has agreed to develop a bid to be part of an at scale pilot site for very low-calorie diets as part of NHS England action to reduce obesity and Type 2 diabetes.

We have also received funding to accelerate our approach to primary care network development. This will enable Primary Care Networks, which are local Practices working together to deliver for local populations of 30,000 – 50,000 residents.

Digital

Working with colleagues across London, our digital team is playing an important role in developing the One London local health and care record exemplar (LHCRE) programme including the technical infrastructure and information governance and data sharing principles. Our engagement leads are starting to work with London colleagues to develop the engagement and communication plans for the programme.

The Health and Social Care Network project to replace the N3 network is progressing with the first of the new computer lines for our providers to be installed in January and February 2019. We will also be installing new computer lines in GP practices to help the adoption of on-line systems and new technologies.

Planned Care: Orthopaedics

To ensure all orthopaedic patients receive appropriate support and understand how their care will be delivered, clinicians from our three NHS hospital trusts, supported by our patient representative for the orthopaedic network have reviewed and updated patient pre-operative education called “joint school”.

All hip and knee joint replacement patients are strongly encouraged to attend a ‘joint school’ prior to attending surgery. The changes made will support more patients to have a positive experience of care and achieve best outcomes from their surgery.

Mental health/emergency care

On 19 December 2018, we held a workshop with key stakeholders and partners, including patient representation and NHS England, to develop shared principles to ensure that patients get the very best care when accessing inpatient facilities for their mental health. An example principle is that we want patients to be admitted to the mental health Trust nearest their home wherever possible. Other principles suggested at the workshop will empower teams to work together more closely as the most effective way of supporting mental health patients in emergency departments.

We will be looking at how best to communicate the principles to all relevant staff and agree how they can be consistently applied.

Maternity

The South East London Maternity Better Births Delivery Plan focuses on supporting maternity services in several areas which will improve safety and the experience of giving birth. This includes the development of models of care that will enable women to have a named midwife and/or buddy who will support them throughout their pregnancy. Continuity of care has been shown to improve a woman’s experience, reduce her risk of having a pregnancy loss and reduce her risk of premature birth.

We are continuing our work on the ‘Halve It’ programme which aspires to halve the rates of stillbirth, neonatal deaths and babies born with brain injuries. A package of care called Saving Babies Lives has been recognised as a clinical care pathway that reduces the rates of these catastrophic events. Providers in south east London are currently working on ways to fully implement this care package.

Workforce

We are supporting new ways of working through five local projects that will benefit GPs, the wider primary care workforce and patients. The projects will develop working at scale, reduce GP administrative and clinical workload, implement a centralised approach to managing prescriptions and other documents, better support new GPs and establish a forum for sessional GPs. We hope that the learning from these local projects will have wider and longer-term benefits across south east London in terms of GP and primary care staff recruitment and retention.

We have completed our analysis of the south east London STP GP workforce survey and will be writing to all practices about our findings and our plans. These include three workshops aimed at GPs, practice managers and GP Federations to focus on maximising the benefits of primary care navigators, medical assistants and physicians associates and exploring GPs’ working patterns to create more sustainable personal practice.

Estates

We will be publishing a summary of our estates strategy in the next few weeks. In brief, it is designed to support:

  • Delivery of transformational change through the development and implementation of new models of care
  • Delivery of high quality, accessible, integrated care closer to home
  • Delivery of solutions to improve quality and reduce variation
  • A focus on prevention and long-term improvements in health and well-being
  • Delivery of solutions to achieve long term financial sustainability across the SEL health economy
  • Reduced reliance on hospital-based care and therefore, reduced estate costs overall.

As part of this strategy, the STP worked with local CCGs and providers to prioritise their estates schemes and submitted several associated bids for national capital funding.

We were delighted to be informed that five of our bids were successful and are now working together to progress these:

  • Bromley Health & Wellbeing Centre - Development of a community hub to support implementation of Local (Integrated) Care Networks
  • Patient Centric Supply Chain - An integrated supply chain model which will help free up space and realise clinical efficiency and potential cost improvements
  • South East London Estate Optimisation – to optimise delivery of community-based care at Beckenham Beacon, Akerman Health Centre, Gracefield Gardens and Waldron Health Centre
  • Consolidation of Streatham Common Group Practice (SCGP) at Baldry Gardens Health Centre - Relocation of SCGP main site into Baldry Gardens purpose-built LIFT building
  • Kidbrooke sub-hub - Development of a new community sub-hub to support implementation of a Local (Integrated) Care Network

Cancer

From late January, GPs will offer patients free home testing kits if they display signs of colorectal cancer but are considered at a ‘low risk’. The simple ‘faecal immunochemical test’ – which requires patients to collect a stool sample and return it to their GP for analysis – aims to reduce the number of patients referred for invasive and potentially unnecessary hospital treatment, while resulting in fewer cases being missed.

The Rapid Access Diagnosis Clinic has opened a new clinic, which runs fortnightly at Queen Mary’s Hospital Sidcup. The clinic replicates the successful model at its first site, Guy’s Hospital, which has seen referral rates grow and recently reviewed its 1,000th patient.

A new academy based at Guy’s Cancer Centre aims to enhance excellent cancer care by developing a cancer curriculum for staff education and training. The Cancer Academy, which launches officially on 4 February (World Cancer Day), will also run ‘symptom of the month’ education sessions – the first of which will focus on managing cancer-related fatigue through physical activity. Resources from the sessions will be made available to clinicians, patients and carers.