Transforming services

This King’s Fund report looks at how mental health services have been transformed over the past 30 years, from an acute to a community based model. It’s based on a literature review and workshops with people who have experienced these changes first hand. It explains how lessons learned from changes in mental health services can be used to help transfer physical health services from the hospital to the community.

Service transformation: lessons from mental health. King’s Fund (2014). http://www.kingsfund.org.uk/publications/service-transformation

CCG case studies

NHS Clinical Commissioners has published a briefing containing 16 case studies, looking at best practice among CCGs across England. Examples include primary mental health in London, urgent care in Norfolk, frail elderly care pathways in Northumberland, and avoiding unnecessary admissions in Stoke-on-Trent.

Taking the Lead: How clinical commissioning groups are changing the face of the NHS. NHS Clinical Commissioners (2014). http://www.nhscc.org/policy-briefing/taking-the-lead/

Dementia-friendly Yorkshire

In this document, the Joseph Rowntree Foundation brings together 20 examples of dementia-friendly projects in different organisations in Yorkshire, including hospitals, cafes, schools, mosques and churches.

Dementia-friendly Yorkshire: first steps on the journey. Joseph Rowntree Foundation (2014). http://www.jrf.org.uk/publications/dementia-friendly-yorkshire

Diagnosing autism

NICE has just issued an Evidence Update on Autism diagnosis in children and young people. Go to http://www.evidence.nhs.uk/about-evidence-services/bulletins-and-alerts/evidence-updates to take a look.  The update reviews new research since NICE Clinical Guideline 128 was published but concludes that there are no changes required to the guideline at this stage.

Making integrated care happen

The current fragmented services in health and social care fail to meet the needs of the population, says this short paper from The King’s Fund.  A shift to an approach that develops integrated models of care for patients, especially older people and those with long-term conditions, can improve the patient experience and the outcomes and efficiency of care.

Making integrated care happen at scale and pace: Lessons from experience is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be taken to make integrated care a reality and draw on work by The King’s Fund and others to provide examples of good practice.

There are no universal solutions or approaches to integrated care that will work everywhere and there is also no ‘best way’ of integrating care, and the authors emphasise the importance of discovery rather than design and of sharing examples of good practice when developing policy and practice.

Finally, the paper acknowledges that changes are needed to national policy and to the regulatory and financial frameworks for local leaders to fully realise a vision of integration

Responses to the Francis report, nationally and in Sussex

Nearly a week on, it’s probably a good time to gather together the major responses to the Francis Report, or the Report of The Mid Staffordshire NHS Foundation Trust Public Inquiry, to give it its full title. Here they are, in alphabetical order of issuing organisation:

• Academy of Medical Royal Colleges
• AgeUK
• British Medical Association
• Care Quality Commission
• Centre for Mental Health
• General Medical Council
• Health Foundation
• Health Service Ombudsman
• King’s Fund
• Monitor
• NHS Alliance
• NHS Clinical Commissioners[pdf] (partnership of the NHS Alliance, National Association of Primary Care and NHS Confederation)
• NHS Commissioning Board: NHS Commissioning Board promises fundamental change in response to Francis Report and video message from David Nicholson
• NHS Confederation: Making it better? Assuring high-quality care in the NHS 
• NHS Leadership Academy
• Nuffield Trust
• Nursing and Midwifery Council
• Royal College of General Practitioners
• Royal College of Midwives
• Royal College of Nursing

A number of organisations in the Sussex health economy have also made statements:

• Brighton & Sussex University Hospitals NHS Trust
• Sussex Community NHS Trust
• Sussex Partnership NHS Foundation Trust

Service reconfiguration: what’s working?

The NHS Confederation has published on its website a page on service reconfiguration.

‘The NHS Confederation has developed a range of resources to help local NHS organisations communicate why we need to reconfigure services and the benefits it can bring; effectively engage staff, the public, stakeholders and partners in discussions about these changes; and meet important legal duties and obligations in terms of the consultation process’, they say.

Developing Clinical Senates: The Way Forward | NHS Commissioning Board

Developing Clinical Senates: The Way Forward | NHS Commissioning Board.

Kings Fund health and social care timeline, 2013-33

Time to Think Differently

New vision for district nursing

A new vision and service model for district nursing has been published today.
To quote the Department of Health, ‘This vision builds on ‘Compassion in Practice’, the national vision for nurses midwives and care staff. It was developed by a strategic partnership of the Department of Health, NHS Commissioning Board Authority, The Queen’s Nursing Institute, and with the district nurse leaders and practitioners’

It proposes a new district nursing model, comprising:

Population and case load management: Caseload management and providing population interventions to improve community health and wellbeing. Surveillance of caseload and local population needs. Working with partners for health protection and improvement for adults and their carers, at home and in other community settings.

Support and care for patients who are unwell, recovering at home and at end of life: Responding when specific expert health intervention is needed e.g. with short-term health issues, or sudden health crises or when patients are discharged from hospital, or have a sudden deterioration in a health condition. Providing interventions within the home including chemotherapy and intravenous therapy. Working with community specialist nurses including community matrons, to deliver specialist care including palliative and end of life care.

Support and care for independence: Leading and prioritising supportive care to help wellbeing and independence including advice on ‘assistive technology’ such as telehealth and telecare, working with patients and their families to help them care for themselves. Leading and co-ordinating care in partnership with health and social care, other agencies and specialist services. Working together with patients to deal with more complex issues over a period of time

Care in local communities: a new vision and model for district nursing [pdf]