NEXT STEPS 

February 2016

Programme Update 

Updated plan for south west London

Under new planning guidance issued by NHS England, all NHS regions across the country are working together, and with local councils, on a five-year ‘sustainability and transformation plan’ for their local NHS. 

South west London Clinical Commissioning Groups, provider trusts and local authorities have formed a ‘Strategic Planning Group’ to deliver this work. The plan will be published later this year and will build on the five year strategy published by SWL Collaborative Commissioning in 2014.

To deliver clinical and financial sustainability it will need to focus on some short and medium term priorities:

• The configuration of acute hospital sites in south west London
• The productivity challenge
• The transformation of out of hospital services

Tackling these issues needs the involvement of Surrey Downs Clinical Commissioning Group and the support of key national bodies - NHS England, Monitor and the Trust Development Authority. The South West London & Surrey Downs Healthcare Partnership has therefore been set up to include these organisations and will focus on these key short and medium term issues.

Improving Learning Disability
Community Services 

The NHS in south west London, along with local authority colleagues, community organisations and people with 'lived experience', are working together on a plan to develop and improve community services for people with learning disabilities and/or autism.
 
The plan aims to help people (both adults and children) with learning disabilities in south west London stay out of hospital and live in the community with improved care and support.

NHS England published 'Building the Right Support' in October 2015. It outlines a three year plan to develop more community services for people with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition. 

A new national model of care has been developed. Our task is to work on a detailed plan for how this can be implemented in south west London. It is essential that we build on the good work that has already done in this area locally. We are keen to work with organisations who, through their work, have insights into the needs of people with learning disabilities and/or autism.  In addition we will  be talking directly to service users and carers about their experiences to ensure that the needs of service users and their carers are driving our plans.  

Implementing the national model will reduce the need for inpatient care and therefore in-patient facilities. Where hospital treatment is needed the plan highlights key principles for high quality, appropriate care and steps to reduce the length of stay.

The Plan will also see the continuing roll-out of Care and Treatment Reviews (CTR) for children and young people who are either admitted or at risk of being admitted to hospital including those in residential schools. A key focus is on identifying ill-health, timely care and treatment reviews with appropriate health engagement in preparation for adulthood transition reviews.

A new financial framework and investment will support the implementation of a new community-focused service model. NHS England will make available up to £30 million of transformation funding over three years. Financial underpinnings include growth in personalised funding approaches.

It is envisaged that this transformation of services for people with learning disabilities will ensure that they are supported to lead happier lives.

Going Green.... 

As part of our commitment to sustainability, South West London Collaborative Commissioning will not be printing out papers for meetings in future.

Clinicians and managers who attend meetings at our offices will be sent electronic papers in advance, rather than multiple copies being available in meetings.

SWLCC Programme Director Kay McCulloch said: 

“It’s clearly important for public bodies like the NHS to reduce waste.
We’re often left with reams of paper copies that are not used and the process of printing off papers is very labour-intensive. The reality is that many people now access papers on their laptops and ipads. Those who prefer printed copies will be sent papers in advance and can print them off if they need to.”

            What is Ambulatory Emergency Care? 

Ambulatory Emergency Care (AEC) is same day emergency care - consisting of diagnosis, observation, consultation, treatment, intervention, and rehabilitation services - provided without using a traditional hospital bed or outpatient service. This means patients can be more rapidly diagnosed and treated in a hospital and avoid having to stay in a bed overnight.  Patients can be referred to AEC through a number of routes including A&E, or directly from their GP.

Benefits of AEC
AEC is known to improve patient and staff experience, as assessment, diagnostics and discharge occur more rapidly and within a more predictable time-frame. At some sites, reductions in overnight stays have also contributed to a reduction in healthcare acquired infections.  The savings seen in bed days delivered by AEC helps to improve waiting times for other patients that require admission, and also results in significant cost-savings for local healthcare systems.

AEC in SW London
Recognising these benefits, increasing uptake in AEC is a key component of the SWL Five Year Strategic Plan.

Throughout 2015 site visits were made to all four Hospitals in south west London to understand the current models of ambulatory care being delivered and to understand the barriers to growing AEC within each hospital.  Shared service principles for AEC in SWL were also agreed through a joint workshop involving all SWL AEC units and Clinical Commissioning Groups (CCGs).

Currently, all four hospital sites deliver AEC to slightly different models, including the clinical pathways referred to AEC, and hours and days of operation.

Building on the principles discussed, a SWL-wide specification for AEC has been developed which aims to move hospitals beyond the pathway approach – which limits the potential number of patients who can be treated in an ambulatory way – to a ‘process’ approach whereby patients with any condition who might benefit from AEC are referred to the unit for a decision.

CCGs are also considering financial support for AEC in 2016/17 to help deliver the new specification and this expansion in the number of patients benefitting from same day emergency care.

In Step With... Carol Varlaam
PPI Lay Representative, Wandsworth CCG and Vice-Chair, SWL Patient and Public Engagement Steering Group

What role do you play in the SWLCC programme?
I am one of six CCG Lay Members for Patient and Public Involvement who sit on the Patient and Public Engagement Steering  Group (PPESG) of the SWLCC.  Our role is to develop and maintain two-way communication between the Programme and our local patch, trying to ensure that developments at the south west London level are widely shared and equally, that local issues and concerns feed upwards.  Healthwatch and the Voluntary Sector also have borough representatives on the PPESG and we work together, locally and at an area level. I am also one of two Vice-Chairs of the Group.  The Chair, other Vice-Chair and I are often expected to attend other SWLCC meeting and and play a role in developing engagement proposals and activities. 

If you had a magic wand what one thing would you change about the NHS?
I’ve been involved in the NHS in SWL for a long time, in various roles.  My magic wand would spread collaboration and shared creative thinking across organisations and services so we could all focus on ensuring that people across south west London have access to high quality services when they need them.  

What are your hopes for the programme?
I want us to make sustainable progress on designing and delivering care pathways which involve patients, their carers and the wider public.  This won’t happen overnight but, with energy, focus and goodwill we can make a difference.

Describe yourself in three words?
Temperate, insightful, pro-active.