Transforming Your Care
A Review of Health and Social
Care in Northern Ireland
1
Case for Change
2
Key reasons for Change
1 Better at
preventing ill
health
2 Importance of
patient centred
care
3 Increasing
demand in all
POC
4 Current
inequalities in the
health of the
population
5 Giving our
children the best
start in life
6 Sustainability
and quality of
hospital services
7 Need to deliver
high quality
services based
on evidence
8 Need to meet
the expectation
of the people of
NI
9 Making best
use of resources
available
10 Maximising
the potential of
technology
11 Supporting
our workforce
3
Principles for Change
1.
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6.
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Placing the individual at the centre of any model
Using outcomes and quality evidence to shape services
Providing right care in the right place at the right time
Population-based planning of services
Focus on prevention and tackling inequalities
Integrated care- working together
Promoting independence and personalisation of care
Safeguarding the most vulnerable
Ensuring sustainability of service provision
Realising value for money
Maximising the use of technology
Incentivising innovation at a local level.
4
Model – Integrated Health &
Social Care
5
Key Recommendations – Population
health and wellbeing
Renewed focus on health promotion
and prevention to materially reduce
demand for acute health services.
An expanded role for community
pharmacy in the arena of health
promotion both in pharmacies and in
the community.
Maintenance of existing and
implementation of new screening and
immunisation programmes where
supported by clinical evidence.
Support for the health promotion and
prevention role played by Allied Health
Professionals, particularly with older
people.
Incentivisation of Intergrated Care
Partnerships to support evidence
based health promotion, for example,
clinician-led education programmes in
the community.
6
Key Recommendations – Older People
Move towards independent living – at
home or in supported housing.
Promotion of Direct Payments
scheme.
Reduce nursing and residential
places.
Increase support services for carers.
Extension of reablement schemes to
reduce hospital stays for older people.
Increase the use of
Independent/Voluntary sector.
7
Key Recommendations – People with
long term conditions
Emphasis on prevention and the
promotion of healthy living options.
More focussed use of GPs with a
special interest (GPSIs).
Support for self-care approaches.
Use of new technology – telemedicine/
electronic care record (ECR).
Personal care planning.
GP direct hospital admissions.
A multi-disciplinary approach –
coordinated through GP surgeries.
8
Key Recommendations – Physical
Disability
Greater role for the voluntary and
community sectors in providing
support services.
Promote Direct Payments.
Joined-up approach, working with
other Government departments.
Increased support for carers.
9
Key Recommendations – Maternity and
child health
An increase in choice for women for
childbirth.
A regional review of inpatient
paediatric care.
A need to address public health and
social issues for women.
An extension of childhood screening
programmes.
Better education to support good
parenting.
Closer working between hospital and
community paediatricians.
10
Key Recommendations – Family and
child care
Emphasis on new Headstart
programme for 0– 5 years.
Strengthening CAMHS services.
Early intervention – family support
model.
Increase use of fostercare resulting in
a move away from residential care.
Promotion of positive parenting.
11
Key Recommendations – People using
mental health services
Greater emphasis on early
intervention.
An increased role for the voluntary/
community sectors.
Better access to information on
services.
Continued resettlement from
institutional settings resulting in the
closure of longstay institutions –
savings re-invested in community
programmes.
Better promotion/ uptake of Direct
payments.
12
Key Recommendations – People with a
learning disability
Increased emphasis on early
intervention.
The development of a wider range of
day support services.
The promotion of Direct Payments to
provide a greater level of financial
control for individuals.
The closure of longstay institutions by
2015.
The development of better information
resources.
13
Key Recommendations – Acute care
Establish a Northern Ireland-wide
trauma network with RVH as the hub,
RVH should become a regional
trauma centre.
Consider establishment of emergency
telephone number other than 999;
professional advice, redirect to
appropriate service.
Move towards having between 5 and 7 A managed clinical pathway for
acute hospital facilities or networks.
pathology.
Better, more targeted communications
on the range of unscheduled services,
appropriate to need.
Range of care services available
closer to home – GPs to handle some
outpatient appointments.
Direct admissions for chronic
conditions.
More procedures undertaken as day
cases.
Pivotal emergency care management
role for NIAS.
Clinical networks supported by use of
new technology – diagnostics/
telemedicine.
14
Key Recommendations – Palliative and
end of life care
The development of a palliative care
register.
Introduce electronic patient records.
Reduce inappropriate hospital
admissions for those approaching end
of life.
Additional palliative care support for
the nursing home sector.
15
Roadmap for the Future
Population Planning Process
16