Agenda item

Purpose of the report: Scrutiny of Services

To describe the progress to date on North East Hampshire and Farnham CCG’s Vanguard Primary and Acute Care System new models of care project to review its community beds model.

Declarations of interest:

None

Witnesses:

Charlotte Keeble, Associate Director of Integrated and Urgent Care, NHS North East Hampshire and Farnham CCG

Key Points raised during the discussions:

1.    The Board were advised that this project forms part of the CCG’s Vanguard programme which aims to reduce the number of people who are admitted to hospital. The main aim for the community bed review was said to be to ensure improvements of people’s experiences and to make sure the use of beds and facilities was meeting local needs.

2.    The Board inquired about the scale of the review and the development of future options. They were advised the project was about admission avoidance – who could be cared for at a lower level. The CCG reviewed anonymised patient notes. There were flexible timescales attached to the project due to complexity and engagement has been extensive including working with the Wessex Clinical Senate. 

3.    A number of issues were identified by the review including the scale of the community portion of the health system and understanding the impact these services have on acute activity. The CCG had to deal with complex geography with different access criteria operating under different providers in different areas of the patch.  For example, Farnham Hospital is a shared resource across neighbouring CCGs so there is a difficulty in controlling patient flows. Community bed stock needs to be seen alongside Integrated Care Teams – Frimley Outreach and Southern Health are merging services to transform Out of Hospital Care – to reduce admissions.

4.    The Board inquired about the use of ‘step down beds’ - patients who are discharged from acute hospitals for specialist help or care - and whether this was hampered by delayed transfers of care. The Associate Director of Integrated and Urgent Care advised that this was not necessarily the case and that step down care did not always mean community beds and advised that Farnham hospital was underutilised as patients are inclined to travel longer distances to use their local services.

5.    The Board were informed that Farnham Community Hospital had opened another ward for the overflow of winter with 22 new beds. A strict criterion had been introduced for patients admitted onto this ward (14-17 days use for those reabling) but these were closed at the end of March 2015 and were now under evaluation and engagement with the community and partners would continue over upcoming months to consider further options.

6.    The Associate Director of Integrated and Urgent Care commented that local health and social care services would make the most impact, following this report and the development of new options, by giving people the right care at the right place.

Recommendations:

The Board welcomed the Vanguard work on community beds and the simplifying/standardising the pathways across geographies and providers.

The Board recommended that:

·         A request on an update in the second quarter of 2016 in order to help publicise the results across Surrey.

·         An update on the broader Primary and Acute Care System (PACS) Vanguard programme.