Community Health Services Update

Loughborough

16 December 2009

Dominic Cox, Deputy Director of Primary Care

Format of presentation

• Loughborough – what we said post consultation……• Community Hospitals Programme – progress (NHSLCR

and Loughborough)• Service priorities • Update on other Primary Care Developments in

Loughborough• Travel and Access Survey – key messages• Current financial situation• Next Steps

Loughborough – What we said post consultation………..

Loughborough Community Hospital as a ‘one stop’ Hub– Maintain inpatient beds– Extend outpatients and diagnostics– Accommodate the Walk-In-Centre within the hospital site

Update On Community Hospitals Programme• 5 one stop hubs (Coalville, Hinckley, Loughborough, Mkt.

Harborough, Melton)

• Integrated primary and community care in Oakham at RMH

• Final recommendations for all sites to Trust Board in February 2010

• Strategy moving forward and services already improved– e.g. investment in equipment, better access to diagnostics, more one-stop services, (including weekends and evenings), more outpatients seen in community settings, more specialities offering clinics in the community, falls clinics introduced, pulmonary rehab introduced, reduction in waiting times for therapy services.

• Impact: 20% rise in clinic activity, 28% rise in therapies and 45% increase in day case procedures.

Our progress to date – increasing activity locally in Loughborough

Between 2006/07 and 2009/10, we will have increased:

• the number of day case operations we carry out by 46% (1033 patients in Loughborough)

• first outpatient appointments by 70% (7,010 patients in Loughborough). In 2009/10 we plan to deliver around 17,000 first outpatient appointments in Loughborough, working more closely with consultants from Trusts in Derby and Nottingham.

• occupied bed days by 30%.• therapy activity by 28% at the same time as reducing our waiting

times from c 26 weeks to 4 weeks for routine and 5 working days for urgent referrals.

• availability of MRI scanning in the community through mobile scanners, with one visiting Loughborough Hospital and 2 other sites regularly. In August 2009 315 people had their scan in the community instead of travelling to Leicester’s hospitals.

In June 2009 referrals to our outpatient services topped 5,000 in one month for the first time. Approximately 75% of referrals come from GPs.

Service priorities

• Key commissioning TCS priorities include:1. Dementia2. Intermediate care3. Diabetes - control of blood sugar

• The 2nd Wave focuses on:4. Smoking Cessation5. Sexual Health6. Alcohol misuse and prevention 7. COPD8. Chronic Heart Disease9. Older people10. Falls11. Chronic neurological conditions including stroke and epilepsy12. Obesity

• CHS has produced a five year strategy which details plans for each of the national Transforming Community Services workstreams

• Local GP practices prioritised for individual premises development:– Pinfold Gate– Bridge Street– Storer Road

• Acute visiting service pilot across Charnwood

Update on other Primary Care Developments in Loughborough

Travel and Access survey

• Travel and Access survey undertaken as a result of comments received during the public consultation

• Survey carried out 3rd – 28th August 2009

• 633 responses received of which 481 for Loughborough

• Issues raised:– Car parking– Lack of direct buses– Proximity of bus stop to the hospital entrance– Distance to walk from the town centre

Travel and Access survey – key messages and next steps• A significant proportion of respondents

indicated a willingness to consider alternative modes of transport to car

• In conjunction with Leicestershire County Council, need to increase awareness of public transport alternatives, routes and timetables

• Project group to develop practical recommendations to address key messages highlighted

Our current financial situation

• Current economic climate – constrained revenue availability from 2010/11 and uncertain position on access to capital

• Affordability of Capital Schemes – Further work on the overall affordability of potential capital investments in community hospitals in light of estimated income and expenditure projections

• Focus will be on improving utilisation and retaining a significant element of its current estate. Any new building work is likely to supplement the refurbishment and reconfiguration of existing estate

Next steps

• Continued increase in activity and introduction of new services

• Final plans for all sites to the Trust Board in February 2010 (Community Hospital Programme)

• Trust Board Discussion in February 2010 re Primary Urgent Care Strategy vision and potential consultation • Primary Urgent Care Strategy (OOH, Minor Injuries and

Extended Access)