Saturday 9 April 2016

Deja Vu - Moving care closer to the patient

Our local hospital, Buckinghamshire Healthcare NHS Trust (also the community health provider for the county) is holding a series of public meetings about developing care closer to the patient. I guess the need for this event comes from the publication last year of the ‘Five Year Forward View’ that describes the strategy for the NHS over the next five or more years.

 It is called ‘Your Community, Your Care – developing community hubs’.

The first meeting was held on Thursday evening in Thame. Thame is a lovely market town on the Oxfordshire/Buckinghamshire border. There were quite a few people there and the groups were buzzing with ideas on what services should be provided in their community. 


A few common themes emerged.
  • The services should be truly multi-disciplinary and joined up.
  • There should be rapid access.
  • It could support the promotion of good health & signposting for solutions.
  • The ‘hub’ could act as a true community facility. 

At the end of the meeting I was chatting to one of the facilitators about the results of the meeting.  I said that the things that people said were not a surprise. Indeed I said that we have known that this is what people want for many years and went on to add that what we should be doing is getting on with developing these community based services instead of having more public engagement meetings.

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Now I am a sad person and I keep lots of documents and stuff about health care, usually filed in heaps on the floor of the spare room. I knew we had had similar meetings in the past so I went through the piles of papers and found the feedback from a previous meeting (August 2010) on: wait for it!

‘Developing community healthcare services’

The views of the public then are the same as the views expressed at the meeting on Thursday. In fact the hospital could save itself the trouble of writing a report on the meeting and just recycle the old one from 6 years ago.

Amazing!

Not!

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They are holding another five of these meeting in the next few weeks.  What a waste of time.

The question is why have they not developed these community hubs?

Now I am guessing here but perhaps the reason that they failed to do this six years ago and a distinct risk to doing it now, is the fact that the various providers of services cannot agree to share the scarce resources i.e. staff and budgets.

They talk about joined up working and integrated care but still won’t take the risk with the money.

All the talk at the meeting was about care.  Not ‘health’ care or ‘social’ care but ‘care’.  As we get older, and I am a pensioner now so in the next few years that will be me, we need care and support. It becomes harder to distinguish between health care and social care as we become frailer and less able to cope on our own.

So until we get the Directors of Finance and the CEOs to come to these meetings and tell us that they will share the resources we need to have our community hubs I cannot see these ideas being implemented.

I wonder how many more times I have had these Deja Vu moments?

Friday 8 April 2016

NHS MSCP Vanguard funding

The NHS has to work differently in order to provide good quality services for all within the current funding limits.

In different parts of England there are lots of different models being tried out to see which works best.  These are called Vanguards and are receiving extra funds to transform the health care systems locally.

I thought I would try to find out how much extra funding they were receiving.  It was a harder job than I thought.  In the end I used the Freedom of Information Act to obtain the information from 14 Vanguard who were piloting one type of model.  The Multispecialty Community Provider (MSCP) model of care.



It was difficult finding out who to approach for the financial information, sometimes I got it right first time but for others I had to go through several organisations before getting to the right person.

Vanguard
Population
Funding £ (2015/2016)
Calderdale Health & Social Care Economy
200,000
150,000
Erewash MSCP

No reply
Fylde Coast Local Health Economy
330,000
4,300,000
Modality (was Vitality)  (Birmingham)

No reply
West Wakefield Health & Wellbeing
153,000
2,829,000
Better Health & Care for Sunderland
284,000
2,305,000
Dudley MSCP
315,000
2,700,000
Whitstable Medical Practice
169,806
1,850,000
Stockport Together
300,000
3,900,000
Tower Hamlets Integrated Provider Partnership
284,000
2,990,000
Better Local Care (Hampshire)
220,000
6,960,000
West Cheshire Way
255,000
4,900,000
Lakeside Surgeries

No reply
Principia Partners in Health (Nottinghamshire)

Not received

There were 14 Vanguards and I received 11 responses. 
 

One Vanguard had only received a small initial payment and one had not received any funding at the time they responded and I excluded them from my analysis..


So for the remaining 9 Vanguards the funding varied from £31 a head to £8 a head.