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For citizens of Wakefield district to live longer, healthier lives and to be supported by people with the right skills, in the right place Our vision One team - GPs, community nurses, social care workers, therapists, volunteers and pharmacists One care plan designed around the person One care co-ordinator for every person with multiple, on-going health problems Single ‘gateway’ to care Same day response if needed Faster access to home adaptations and equipment Care at home or near home wherever possible Care in hospital only when really necessary Discharge home as soon as possible Utilise digital technologies to provide the appropriate information, to the right person, at the right time, and in the right location to support the care of the citizen.
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Richard Main Informatics Integration Lead
NHS Wakefield CCG
Health & WellbeingChallenges for Wakefield
Life expectancy lags behind the national average for both men and women Wakefield’s health generally is worse than the England average Premature mortality rates from cardiovascular diseases, cancer and
respiratory disease are all higher than the England average. Levels of lung cancer in Wakefield are significantly worse than the England
average.. 25.0% of adults in Wakefield smoke, compared to 18.4% across England as
a whole. Ageing population and unhealthy habits are contributing to increasing
prevalence of long-term conditions The resident population is projected to increase from 325,600 to 366,000
by 2030 There is a high level of attendance at A&E from within our most deprived
areas
For citizens of Wakefield district to live longer, healthier lives and to be supported by people
with the right skills, in the right place
Our vision
•One team - GPs, community nurses, social care workers, therapists, volunteers and pharmacists•One care plan designed around the person•One care co-ordinator for every person with multiple, on-going health problems•Single ‘gateway’ to care
•Same day response if needed•Faster access to home adaptations and equipment•Care at home or near home wherever possible •Care in hospital only when really necessary •Discharge home as soon as possible
Utilise digital technologies to provide the appropriate information, to the right person, at the right time, and in the right location to support the care of the citizen.
What we think we’re doing well
Real integrated working through joint CCG & Council appointments supporting the
districtwide ICT strategy group.
The Local LevelMid Yorkshire CQC report - November 2014
Integrated Adult Health and Care hub
“Outstanding”But …Barriers to integration had been identified, including:• “managing different computer systems, particularly
health and social care.” • “some of these barriers were not resolvable locally”• “managers had identified imaginative ways of
mitigating these problems to ensure the effective working of the team”
So what is changing ?• Pioneer status– Sharing knowledge - access to subject matter
experts– But perhaps we should have been doing this?
• Vanguard– A chance to implement and test change at pace.– Transformation funding, but need to prove model
and then sustain and mainstream
Integration & Interoperability
• There will continue to be a large number of disparate systems
• There won’t be wholesale change• So we must have interoperability between systems –
not just in health• Open Source will be valuable• Open APIs are critical• GPSoC contract and techUK charter
Innovation• What really makes a difference?• How can we encourage use of digital?– What do our citizens want?– What will our citizens use?– What will our clinicians value?– Can channel shift ease demand?
