Healthier Together:
Health & Social Care
Reforms in Greater
Manchester
December 2013
Programme Outline
About Healthier Together
Healthier Together is a review of health and social care, which aims to
improve and save the lives of people who access their local GP, hospital,
social care and community health services.
It aims to improve outcomes and reduce the current variation between
different parts of the population so all residents across Greater
Manchester can access and receive excellent health care
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Vision
For Greater Manchester to
have the best health and
care in the country
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Aim
To create a single service where you get health and care services at the
right time, in the right place, for the right treatment
NHS needs to change
• Francis Report
• Keogh Report
• Sir David Nicholson – specialise hospitals, improved community care
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GM Fast Facts
•
Variation in health outcomes — up to 14 years life expectancy
difference for men depending on where you live
•
Between April 2012 – March 2013 A&E visits increased by 43,7000
•
GM has among the worst rates of early deaths from cancer, heart
attack, lung disease, stroke and liver disease
•
¼ of all ambulance journeys are for older people who had a fall –
community services would be more appropriate
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GM Fast Facts
•
125 patients admitted to hospital beds every day but spend less than
24 hours there – many could have been treated out of hospital
•
None of our hospitals meet all the recognised national standards for
safety and quality
•
According to Dr Foster around 30% of people in hospital don’t need to
be there
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Outcomes
•
Improve the health and wellbeing of people in Greater Manchester
Safe services based on best practice, clinical standards and better specialist
care in our hospitals.
•
Improve equality of access to high quality care
Improved, timely access to appropriate staff, facilities and equipment across the
whole of Greater Manchester.
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Outcomes
•
Improve people’s experience of healthcare service
Integrated care provided in the most appropriate setting to provide better
outcomes and experience for patients.
•
Make better use of healthcare resources
Care provided by sustainable organisations that allow best possible use of the
total resource available to the health and social care system in Greater
Manchester.
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Case for change
• 550 lives a year in Greater Manchester could be saved if the UK meets
the European average survival rate for cancer. (Best = 1000).
• Heart Failure patients admitted to cardiology wards have a 20% lower
mortality rates compared to those admitted to general wards.
• 1 million attendances at Greater Manchester A&E Departments in 2011.
Over a quarter of these were for minor injuries and could have been
treated at another suitable location (e.g. Primary Care, Pharmacy).
• Mortality figures are affected by day and time of admission.
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Health & Social Care Reform
Integrated
Care
Secondary
Care
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Primary
Care
Healthier Together & our
Modernisation/Planning
Network
Health & Social Care Reform
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Integrated Care
Example of some work streams:
• Local level agreements on the common assessment framework
• Agreeing on a core skill set for self-care in-patients
• Possibility of commissioning self-care common frameworks at FEIs/HEIs
• Incorporating mandatory training in self-care for Bands 1-4 NHS Staff
• Offering CPD for volunteers in areas that require establishment of
networks e.g. modules in dealing with dementia
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Secondary Care
• System cannot sustain the level of demand placed on secondary
services
• Services are unaffordable in terms of workforce, technology and other
running costs
• Ageing population means increasingly complex patient needs for the GM
population
• Prevention & Self-care – looking after patients proactively and enhance
patient quality
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Secondary Care
So Far…
• Modelling undertaken to project what future services may look like
• A number of scenarios will be modelled that relate to Workforce, Finance
& Estates
• 5 keys areas of interest
Acute Medicine
Emergency Medicine
General Surgery
Paediatrics
Obstetrics & Gynae
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Secondary Care
• Clinical Reference Group have agreed a set of clinical standards across Greater
Manchester
• Each quality indicator is measured for the implication for workforce e.g. A&E
Waiting Times
• Programme of work launched 18 months ago
• Driven by 12 CCGs of GM
• Clinically led initial engagement with public
• Pre consultation business case will be produced by March-14
• Workforce element of the business case will be prepared by Kirstie Baxter and
will be consulted on by patients, public and staff
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Primary Care
• GM Area Team produced a Primary Care Strategy which looks at innovation and
managing 24/7 access
• GM has 6 demonstrator sites across primary care which are funded by a national
budget
• Demonstrator sites need to be up and running, ready for evaluation by March-14
• Further reading on the demonstrator sites:
• https://healthiertogethergm.nhs.uk/sites/default/files/Briefing%20Note%20%201%20October.pdf
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Understanding the existing workforce
•
•
•
•
Primary care workforce
Community workforce
Secondary Care
Volunteers and 3rd Sector providers
Various sources of data including online collection, ESR Data Warehouse,
validation of ESR data, GMCVO and Health watch
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Role of the LETB
• Health Education North West are partners in this programme of work,
providing the workforce expertise
• How will this programme of work impact on the planning, training and
education of the workforce?
• Preliminary analysis and data collection for workforce information
• Health Education North West lead: Kirstie Baxter – Assistant Director
of Education Management with support from the Workforce Strategy
team.
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National and Regional Work
Similar programmes of work taking place across the North West and
nationally.
•
•
•
•
Manchester and London have made the most progress to date
Liverpool – Healthy Liverpool
Cheshire – Care Together
Lancashire – Out of Hospital Strategy
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Saba Razaq
Senior Workforce Analyst
Workforce Strategy
Saba.razaq@nw.hee.nhs.uk
0161 625 7774
Any comments or
questions?
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@ewin_portal
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