What is Lincolnshire Health and Care?
Lincolnshire Health and Care is a programme of work which started in 2013 (at that stage under the name “Lincolnshire Sustainable Services Review”) as result of health and care organisations in Lincolnshire recognising that current services did not adequately meet the needs of residents. Due to growing demands and financial pressures the different organisations realised that doing nothing about the issue was simply not an option. By the time the programme started early financial modelling had established that in five years’ time, health and care organisations in Lincolnshire will have a combined budget deficit of over £100m per year. This figure is currently being evaluated however it is likely to have increased and will only continue to grow if nothing chnages.
Because of this, all the health and social care organisations in Lincolnshire (Lincolnshire County Council, United Lincolnshire Hospitals Trust and Lincolnshire’s four health Clinical Commissioning Groups (CCGs), Linconlshire Partnership Foundation Trust, Lincolnshire Community Health Services and East Midlands Ambulance Services) agreed to come together to design a new model for health and care in Lincolnshire which would enable people to access the right services at the right time now and in the future.
What do we aim to achieve?
Quality, safety and sustainability for health and care services
Improved joint working for health and care professionals - a more ‘joined up’ service for Lincolnshire residents
Provide the right care at the right time closer to peoples’ homes
Seven day a week services for local people through ‘community neighbourhood teams’, supported by urgent care centres across the county.
Hospitals ‘freed up’ to provide specialist or genuine emergency trauma and time critical services
How will we achieve our vision?
Phase 1 - creating options for change
The early work in 2013 (Phase 1) involved health and care professionals, patient and carer representatives and interested groups coming together to agree a vision for health and care in Lincolnshire. They identified 22 ideas for delivering this vision and this work was presented in a document called the Blueprint. All organisations agreed that this would be the five year plan for health and care in Lincolnshire.
Phase 2 - detailed design and testing of the ideas
After the blueprint was produced phase 2 of the programme involved starting to understand how the 22 ideas could fit together to achieve a whole new model for health and social care. Using a series of workshops involving lots of people from across Lincolnshire including; specialists, patient representatives and providers of services the programme started to develop these ideas. We have also reached out to members of the public, patients and carers to get their views and input (please see the ”have your say” section on the home page for more information on who we have spoke to). Lots of other things have has to be looked at to help make sure the programmes developing ideas are a success.
These pieces of work include;
Staff - Understanding what we need and what we have currently and how can we ensure our colleagues are appropriately trained and supported to fulfill thier roles.
Transport - How do people get to services currently and what are the main transport links. This is especially relevant when working with out emergency services colleagues.
Information Technology (IT) - Understanding what is now available which may make sharing data easier across organisations while still keeping it safe and secure. Also looking at how else can we support people using new technology to save unnecessary visits to the GP or hospital.
Buildings - Like with staff we need to understand what we have currently and what we may need in the future whilst making sure we are making the best use of what we do have.
Phase 3 - Implementing the new model
This phase has already begun on some aspects of the programme. The roll out of neighbourhood teams has allowed us to start testing out some of the ways we want to work together in community settings. We are still in the early stages but are hoping to have all the teams in place by the end of 2015 (please see the ”Neighbourhood Teams” page for more information).
Lots more work is still needed before we are ready to look at making any other changes and a full public consultation will allow the residents of Lincolnshire to have their say before any final decisions are made. This consultation is set to happen over the summer period in 2015 and we will be using lots of different ways to make sure everyone can get involved. Keep an eye out for more information on the website in the coming months.
The problems facing Lincolnshire and its health and social care services are not unique and lots of other areas across the country are also having to evaluate and redesign the models of care being used locally. National government has recognised this drastice need for change and has set out plans for the NHS and social care to help drive integration and improve the quality and safety of services for the whole country. The NHS 5 year plan found at the bottom of this page sets out how and why things need to change and we can now see how Lincolnshire’s own plan for change aligns to these national requirements.
What the review covers
- Quality and safety - the Lincolnshire health and care community is committed to delivering high quality services across the county. This can only be achieved by the whole health and care community working together.
- Joined up working - it's vital that health and care professionals are working directly together to give people the care they need quickly and easily.
- Money - we have a projected financial gap of over £100 million in a few years' time if we carry on providing care as we do now. There is no rescue fund and only radical rearrangement of the way we provide care will achieve financial sustainability.
- Staff – it's difficult to recruit the staff we need. For our services to be sustainable we will need to change them to make recruitment easier.
Frequently asked questions
Is this type of review only happening in Lincolnshire? No, from April 2014 this year nationally and locally major change has taken place, and these changes will continue over the next few years. In Lincolnshire the whole health and care community has agreed to work together to create a health and care system that works in a joined up way.
What services are being looked at?
We are looking to design services which provide better and more efficient health and care services to people, making the best use of funding available. By providing the right service, at the right time, in the right place we can deliver the best care for people. We also want to build on the large number of innovative and successful initiatives already happening. Key areas being looked at are:
- Urgent Care - an example of this would be when a patient goes into hospital at short notice
- Planned Care – this is when patients are admitted on a known date for an inpatient stay or to attend a booked outpatient appointment
- Women and Children's service – an example of this would be maternity services and care of children
- Prevention and Long Term Care – this is about making sure that patients receive the right care, by the right person, at the right time, in the right place
Who have we listened to?
We have talked to representatives from all provider and commissioner organisations, the Local Area Team and designated patient representatives. We have also included the views of HealthWatch, the voluntary and third sector, carers and district council colleagues who have been involved in the Care Design Groups and have helped to develop a blueprint for the future of health and care services in the county.
What have the Care Design Groups suggested?
A key theme that has emerged has been the development of neighbourhood teams that will help to deliver the right health and care to patients at the right time in the right locations. To make this work we would need to explore new ways of flexible working amongst all organisations across the health and care community.
What happens next?
The blueprint document is now being formally considered by all the key partners after which there will be more detailed work to develop sustainable options for Lincolnshire. We will be actively seeking the views of the public on any proposed changes in 2014.
Click on the image below to watch Sam's story on integrated care and the benefits of joined-up health and care services.