bringing services closer to communities: developing an intermediate tier of services kate lucy –...
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Bringing Services Closer to Communities:
Developing an Intermediate Tier of Services
Kate Lucy – Director of Development
Salford Primary Care Trust
About Salford
• About our motivation for reform
• Focus on new intermediate tier
• Working with communities
• Intended and unintended consequences
Motivation for Reform
• Belief that we can’t carry on as we are in Salford
• City Council commitment
• MAST LIFT breadth of vision
• Perception of Salford and partner ambition
• Strategic Health Authority rigour
• Financial stability
£200 millionHealth Service PFI
£200 millionHealth Service PFI
Mechanism for Whole System Planning
Mechanism for Whole System Planning
Salford Royal Hospital TrustSalford Teaching&Learning PCTUniversity of SalfordSalford City CouncilManchester University
Salford Royal Hospital TrustSalford Teaching&Learning PCTUniversity of SalfordSalford City CouncilManchester University
SHIFTBuilding a Brighter Future
SHIFTBuilding a Brighter Future
£200 millionHealth Service PFI
£200 millionHealth Service PFI
Mechanism for Whole System Planning
Mechanism for Whole System Planning
Salford Royal Hospital TrustSalford Teaching&Learning PCTUniversity of SalfordSalford City CouncilManchester University
Salford Royal Hospital TrustSalford Teaching&Learning PCTUniversity of SalfordSalford City CouncilManchester University
SHIFTBuilding a Brighter Future
SHIFTBuilding a Brighter Future
Key Features• Separation of elective and emergency• Redesignation of primary and secondary labels• Development of intermediate tier (diagnostics,
treatment and recovery)• Neighbourhood / locality focus• Active management of chronic disease• Public involvement• Integrated from perspective of customer• IT dependent• Requires joint capital planning
Key Features• Separation of elective and emergency• Redesignation of primary and secondary labels• Development of intermediate tier (diagnostics,
treatment and recovery)• Neighbourhood / locality focus• Active management of chronic disease• Public involvement• Integrated from perspective of customer• IT dependent• Requires joint capital planning
New I ntermediate TierNew I ntermediate Tier
Old = organisational f ocus New = Pathway f ocus
Neighbourhood
Local
District
30
10 20
New I ntermediate TierNew I ntermediate Tier
Old = organisational f ocus New = Pathway f ocus
Neighbourhood
Local
District
30
10 20
Key Enablers
LIFT
Community Plan
Tier 2 Resources
Children’s TrustPilot
PractitionersWith a SpecialInterest
LocalDemocracy
The Role of LIFT
• A procurement route for community based facilities
• Facilities for functions which can be provided away from hospital
• Focus for integration of service
• Timetable!
Suggested Criteria for Integrated Working
• Works from the perspective of the customer
• Centres have corporate (local) identity
• Local community governance is in place
• Space is a resource – not territory
• All functions promote health and well being
LIFT Funded Capital Developments
Hope Hospital
Ordsal
Broughton & Blackfrairs
Clinical Networks In SalfordLittle Hulton
Irlam & Cadishead
Swinton
Minor Surgery & diagnostics
Walkden
Rehab & therapies
Eccles
Teaching, Learning& Research
Pendleton
Children& Young people
LKAC
More About the Intermediate Tier
• Intermediate diagnostics
• Intermediate treatments
• Intermediate recovery
Intermediate Diagnostics
• Bottlenecks
• Access
• Procedures
• Interpreting
• PCT managed booking
Intermediate Treatments
• Assessing the scope
• Hospital or local?
• Minor surgery started
• Link to provision of “urgent care”
Intermediate Recovery
• Agreement to one system
• All ages
• Integrated workforce
• Beds and community provision and care packages
• Managed system being introduced
Working with Stakeholders
Stakeholders are defined by their interest and may have more than one interest!
• Geographic
• Special interest
• Providing/consuming
Who are the Stakeholders – in Salford?
• Residents
• Consumers
• Providers (contracted and independent)
• Commissioners
• Private partners
Foci for Stakeholders
• Procurement/evaluation of private partner
• Service design
• Building design
• Commissioning
• Governance
• Management
• Delivery
Salford’s Approach
• Establish locality arrangements• Ensure standard process through central
support• Engage practitioners• Develop clinical pathways• Work on integration• Explore what community ownership of
privately owned facilities means
Key Products
• Modern hospital facilities
• Modern health and social care facilities
• New intermediate tier
• Regeneration of town centres
By Products
• Redesign not relocation
• Noise in the system
• Citizen engagement
• More than a maintenance agenda
• Direction
• New public service ethos