Meeting documents

Purpose:

In January, the NHS long term plan was published.  This 10 year plan sets out the ambition for the NHS during this period.  Key areas of focus are prevention, population health, improving clinical outcomes and reducing health inequalities.  This item is for Committee Members to receive an overview of the plan and to hear how the key areas will be delivered locally.

Attendees:

David Williams, Director of Strategy and Business Development, Buckinghamshire Healthcare NHS Trust

Papers:

Presentation attached

Intended outcome:

For Members to be reassured that the key areas of focus outlined in the NHS long term plan will be delivered locally over the coming years.

The Chairman welcomed Mr D Williams, Director of Strategy, Bucks Healthcare NHS Trust.  Mr Williams took Members through the presentation and made the following main points.

·         The NHS long-term plan, published in January, mirrored the priorities already identified in Buckinghamshire.  The Plan was in response to a 3.4% uplift in NHS funding signalled by the Government.

·         As Buckinghamshire was one of the first Integrated Care Systems (ICS), its focus was already on integrated services between health and social care and working closely as a system.

·         The main task over the next six months would be to develop a plan to implement change and partners within the ICS would be working together to produce a plan by the Autumn.

·         £2.3 billion of the NHS funding had been ring-fenced for improving access to mental health services across the country.

·         60% of people living in Bucks would die from cancer or cardiovascular disease so early diagnosis was a priority.  The target to be seen and treated for cancer was 62 days – in Buckinghamshire Healthcare Trust in January, 85.2% of patients are seen within the target compared to 76.2% nationally. 

·         The stroke unit at Wycombe Hospital was nationally recognised as an ‘A Grade’ unit.  A new therapy, which would improve outcomes for a proportion of stroke patients, had been introduced in conjunction with Oxford University.

·         A second Cath Lab had opened recently in Wycombe to provide more support for cardiac patients.

·         The maternity services were well regarded, particularly in terms of continuity of care.

·         There was a focus on urgent care.  Around 30,000 patients were seen in the Wycombe Urgent Treatment Centre each year as well as the A&E services at Stoke Mandeville Hospital.  A GP streaming service had been introduced at Stoke Mandeville Hospital and this service was seeing around 50 patients a day.

·         A capital investment of £5 million had been allocated to A&E services and these changes would improve the environment for patients.

·         Reducing child obesity, smoking during pregnancy and health inequalities remain priorities.

·         The joint IT strategy was having an impact and had received significant investment to deliver more projects to improve connections with patients to the service over the coming months.

·         Within the Hospital Trust there was a 17% vacancy rate for nurses and a 5% medical vacancy rate.

·         It was hoped that the 2019 spending review would provide more funding for public health and social care in line with the aspirations in the Plan.

·         In response to a question about how priorities were set, Mr Williams explained that there was a national template for delivering services but the local needs of the population were the starting point.  The Integrated Care System (ICS) had developed a delivery plan for Buckinghamshire.

·         A Member referred to the section in the plan which outlined 4 models of funding and asked which model Buckinghamshire would adopt.  Mr Williams explained that it would be the responsibility of the ICS to discuss and agree the most appropriate funding model but he went on to say that the partners within the ICS were all committed to delivering change to services at a local level.  He stressed the importance of recognising the increase in housing for Buckinghamshire and for partners to work to ensure that pressure on health and social care services were recognised and adequately funded for.

·         It was acknowledged that Buckinghamshire residents use services which were not within the Buckinghamshire Oxfordshire and Berkshire West Sustainability and Transformation Programme (BOBW STP) footprint, for example Frimley Hospital.  Mr Williams explained that it was the Hospital Trust’s responsibility to work across the boundaries and develop its partnership working.  He went on to say that there were different networks, for example, the Thames Cancer Alliance which works across geographical areas.

·         Next year, the Hospital Trust would be continuing to focus on quality improvement to ensure patients were treated at the right place at the right time.  The Trust ensures that it learns, develops and improves its services based on feedback from patients.

·         In response to a question about what "good" looks like in relation to service provision, Mr Williams explained that the Trust needs to continually improve its services and the digital revolution would help clinicians see more patients.  Innovation would be key to service improvement alongside culture and behavioural change across the organisation.  For example, all colleagues at the Trust were committed to improving patient care and this was enshrined within the objective and appraisal system across the Trust.

·         The challenging financial system in Buckinghamshire was recognised.  Mr Williams went on to explain about "Model Hospital" which benchmarks Hospital efficiencies nationally.  This data was used to prioritise and drive efficiencies locally.

·         500,000 outpatients were seen every year but Mr Williams explained that patients did not necessarily have to be seen in the Hospital setting.  For example, a virtual fracture clinic could assess patients without them having to visit the Hospital.  The Trust was looking at other different ways for people to receive outpatient information and consultation.

·         The NHS plan refers to each Hospital identifying one additional area of improvement.  In Buckinghamshire, the Trust would be focussing on improving patient pathways for ophthalmology and musculoskeletal (MSK) services which were high volume services.

·         A Member asked about the measurable objectives, who was accountable for each element of the work streams and where progress was monitored.  Mr Williams explained that the Integrated Care System Partnership Board was responsible for overall delivery of the plan.  An operating plan would be available which would set out how the plan will be achieved over the coming year.

·         A Member asked how outcomes for mental health patients would be improved and felt this should align with the "No health without mental health" project which focussed on more preventative and recovery work.  Mr Williams explained that the Plan outlined more support in schools for children experiencing anxiety and depression.  Improving Access to Psychological Therapies would continue next year.  Nationally, Buckinghamshire does well in terms of its mental health services.  Mr Williams stressed the importance of health checks, particularly for those people with learning disabilities.

·         Main areas of risk around delivery of the Plan:

o   Financial risks – aspirations needed to match the funding and resources available and the local system would need to prioritise.

o   Workforce – more nurses would be required over the next 5-10 years.  There was a focus on "growing our own nursing workforce" and making Bucks a good place to work where each individual could achieve their potential.  The Trust had a number of educational partnerships to enhance its ability to develop its staff. 

o   Capital investment – NHS capital funding was in short supply.  The system would be bidding for more funding to improve the environment for patients over the next 5-10 years.

o   Housing growth – collective responsibility with partners to meet health needs as part of the growth agenda.

·         In response to a question about the robustness of public and patient engagement across the system in redesigning the outpatient services and delivering the overall plan, Mr Williams emphasised that there were mechanisms in place to capture patient feedback, including patient experience groups to ensure the patient voice was central to any changes in services.

·         A Member suggested using patients to help develop the digital projects.

The Chairman thanked Mr Williams for attending.