The development sites teams at East Lancashire and North-west Surrey explain the importance of building good working relationships in sustainable service improvement projects.
The team at East Lancashire Hospitals NHS Trust aims to deliver better quality and more effective services for frail and older patients. The solution to that aim is the Integrated Neighbourhood Teams (INTs).
The INTs identify high-risk frail and elderly patients who require more support. The team then tailors a plan for that person which will prevent that person spending longer in hospital than is needed.
Good working relationships with community services are essential for the success of this work and the team is making great progress to this end. Most recently the project has focused on the frailest of the frail – improving care for people in the last 12 months of life – and preventative medicine.
The East Lancashire team have been working with the Future Hospital Programme for nearly 2 years. In that time they have learned a great deal:
In North-west Surry, the Bedser Hub team is establishing a general practice (GP)-led, fully integrated, person-centred service for frail, older patients. All locality general practices and their services are operating in a network supported by diagnostics, pharmacy and transport.
Due to delays with capital funding, only one hub is up and running so far: The Bedser Hub. The Hub is situated within a community hospital in Woking, and supports older people to stay well at home for as long as possible. Clinically-led by a GP (the medical director), it uses integrated IT systems and allows multidisciplinary teams of professionals to be co-located.
To develop the hub model, the team established three Locality Network Boards with representatives from all 42 GP practices in the area, and admin and programme management support from the CCG. Each board has its own chair, a key role as an ambassador for the project.
Initially there was cynicism from some GPs who felt that the funding should go directly to their practices instead. They questioned whether the hub could offer any improvement to what they were already offering locally. The chair worked closely with the medical director and this proved to be an important factor for getting positive messages out to grassroots GPs.
Hub GPs work on a sessional basis, delivering care and building up relationships with the home GP and operating the hub. Key learning so far includes:
This blog series is inspired by the presentations/conversations captured at a meeting of all eight development site teams in September 2016.