Agenda item

Purpose of report: Scrutiny of Services

This report is to give an update to the Select Committee on the North West Surrey Clinical Commissioning Group Locality Hubs Programme.

Declarations of interest:

None

Witnesses:

Jo-anne Alner, Director of Quality and Innovation, NHS North West Surrey Clinical Commissioning Group

Key points raised during the discussion:

 Bob Gardner left the meeting at 11.20 am.

1.    The Director of Quality and Innovation at North West Surrey Clinical Commissioning Group (DQI) provided the members with a brief introduction to the report. The Committee were advised that the three locality hubs are designed to integrate health and social care service in North West Surrey as part of the Better Care Fund plan with the aim of transforming the delivery of these services to approximately 15,000 frail/elderly residents so they receive a transformed, GP led multi-agency service that aims to help them be independent, functional and mobilised for as long as possible.

2.    The Committee requested information on how locality hubs would sit within the provision of existing health and social care services in north west Surrey. The DQI advised Members that locality hubs are designed to take pressure off and complement existing health and social care services. It was highlighted that GPs would remain the primary point of contact for elderly and vulnerable patients but that locality hubs offered the chance to provide a more integrated and proactive platform for delivering health and social care services to elderly and vulnerable residents.

3.    The DQI was further asked who the locality hubs were specifically designed to target. Members were advised that work was taking place by GPs to identify an initial cohort of  one thousand individuals who would benefit from locality hubs and that these individuals would then be given the choice to sign up to receive care being delivered through these hubs. In terms of target groups, the DQI indicated that the frail/elderly were the target group that GPs had been asked to identify initially but that locality hubs would not be limited to those elderly patients over 75 years old, but it would be fair to assume the majority would be.

4.    Members asked whether locality hubs would support the discharge of patients from hospital. The DI confirmed that they would indeed support the discharge of patients from hospital, that patients could be flagged on entry and the Locality Hub would proactively visit the patient to ensure discharge could happen in a  timely manner. Locality hubs will also give doctors the confidence that care and treatment packages were  in place to provide support to patients once they have left hospital with the idea that patients can be released from hospital earlier.

5.    The Committee expressed concern about the length of time it was taking for the hubs to become operational and inquired as to why the three locality hubs would not be up and running until the end of 2015. Members were advised that locality hubs represented a whole new system for the delivery of health and social care services in Surrey and that it inevitably took time to develop this new system. The DQI advised that the first locality hub, in Woking, was anticipated to be operational by the end of March 2015 and that, while it may take less time to open the remaining two hubs, NHS North West Surrey CCG felt that it was important to be realistic with timeframes.

6.    Members requested more information on how the three locality hubs would be financed and whether they would simply another layer of healthcare provision that would take money and resources away from frontline services. The DQI advised that the existing contracts with providers would be optimised and given unplanned healthcare costs arising from patient visits to acute hospital care works out to be significantly more expensive than the proactive care to be provided by locality hubs. In doing so the hubs are consistent with the BCF plan which aims to keep people out of hospital and in doing so make savings in acute care provision. Money was also available from a transformation fund that would be used to fund some of the initial costs of setting up the hubs. The Committee were further advised that conversations have taken place with partners to explore the staffing levels that will be required for the hubs and ensure that staff with the right training are available to provide the best possible care for patients. The Cabinet Member for Public Health and the Health and Wellbeing Board highlighted that it was right to try something different to care for Surrey’s frail and elderly patients and that other local authorities were successfully operating similar models of care delivery.

7.    Members asked when the system supporting locality hubs would come together and when patients would start feeling the effects of these changes. The DQI indicated that patients in Woking who signed up to the locality hub would start to see a change in the delivery of health care services from March 2015.

8.    The Committee asked why NHS North West Surrey CCG doesn’t already have an urgent care delivery model. The DQI advised that the significant increase in the numbers of frail and elderly patients in North West Surrey had required them to focus on a new delivery model for these patients first but the CCG is also currently in the process of examining its delivery of urgent care. A key component of this new model will be how walk-in centres are used with the idea of better publicising them as well as up-skilling staff and increasing the number of doctors at walk-in centres so that patients can go there to be treated for a wider range of medical issues.

Recommendations:

·         That the Committee supports the approach being taken to providing better services for frail and elderly patients in north west Surrey.

·         That the Committee reviews the financial and quality outcomes of the three locality hubs throughout 2015 and 2016.

Actions/ further information to be provided:

·         Mr Tim Evans and Borough Councillor Karen Randolph to take part in stakeholder engagement with North West Surrey CCG and report back to the Committee as appropriate.

Committee next steps:

None