Acute and specialised care in hospitals
(Theme 3)
Jen Parsons and Mell Patterson
Context - GM Health & Social Care Partnership
• February 2015, historic signing of the MoU for the devolution
of health and social care to Greater Manchester
• December 2015, 5-year plan outlined: Taking Charge of our
Health and Social Care in Greater Manchester
Theme 3:
Standardisation of Acute
and Specialised care
2
What is Theme 3 about?
The Greater Manchester (GM) health and care
system - commissioners, hospital providers, the
voluntary sector and patients are collaboratively
working to improve the quality, safety and
efficiency of patient care…through improved
models of care and adopting standard ways of
working.
3
Context
Prevention and self care significantly improved
Localities delivering improved primary care community
care services
Co-design between patients and carers with lived
experience of acute care
Different processes and different speeds for
implementation
4
PRIMARY CARE
ACUTE & SPECIALISED SERVICES
LOCAL CARE ORGANISTIONS
We are one part of a much larger system…
…driven by localities delivering improved primary,
community and social care services
COMMUNITY
MEDICINE
SURGERY
CORNERSTONE
CORNERSTONE SERVICES
(Critical SERVICES
care, diagnostics etc)
(Critical care, diagnostics etc)
SPECIALISED SERVICES
MENTAL HEALTH
WOMEN’S AND
CHILDREN’S
SOCIAL CARE
5
7 clinical priorities have been developed in collaboration
with clinicians, providers and commissioners
6
Ongoing work includes…
Healthier Together - the
transformation of high risk
general surgery, A&E and
acute medicine,
The transformation of
specialised cancer surgery to
improve outcomes and
patient experience
Before March 2017 the programme will commence a
new phase of work focused on the new priority areas
7
Healthier Together
What is changing and why?
• Previously most of our hospitals offered general surgery (tummy surgery) but our
workforce was overstretched across multiple sites and patients didn’t always get the
best care
• Our A&E workforce was also overstretched and the standard of care offered in A&E
and associated “acute” medicine varied
• In 2015 GM agreed that we will tackle this by significantly increasing Consultant
staffing and adopting a higher set of A&E, acute medicine and general surgery
standards at every A&E site
• In addition, four sites would specialise in high risk general surgery - with each site
working in partnership with another site in a “single service” to ensure staff can gain
experience of both types of site
What progress has been made
• The GM decision was subject to judicial review; this was concluded in January this year
• Since January we have been doing the detailed design at each hospital e.g. refining
the workforce requirements and recruiting
What’s next?
• Improvements will start to be made from April 2017
|8
Specialised cancer surgery
What is changing and why?
• c. 150-170 patients a year undergo surgery for OG (stomach or oesophagus/gullet)
cancer
• Our three centres do not comply with national clinical standards – and we know that
patient experience and outcomes vary across GM
• In the last month GM has agreed to the design of a single centre of excellence for OG
surgery
What progress has been made
• A new contract, with a higher set of clinical standards and standards written by
patients has been awarded to one of our hospitals
What’s next?
• Next steps are to implement the new design
• Our urology cancer services are facing similar issues – we also hope to finalise the
design of a world class urology cancer service in the next few months
|9