Issue - items at meetings - Long Term Conditions

Report of the Strategic Director, Resources, on plans to improve services for people with Long Term Conditions (copy attached)

75.1    This item was introduced by Jo Matthews, Brighton & Hove Transitional Clinical Commissioning Group (CCG) Commissioner for Long Term Conditions, and by Geraldine Hoban, CCG Chief Operating Officer.

75.2    Members were told that long Term Conditions (LTC) were a CCG priority. Previously services for people had been good in parts, but there was too much variation in the quality and type of services available across the city. In response to this, LTC services were being re-oriented around primary care teams based at the level of clusters of GP practices –3-5 local GP practices with similar demographics in each cluster. Each team would have a broad range of skills, including, but not limited to nursing. Teams will be very closely linked to their GP practices and will regularly discuss admission and discharge information with the relevant GPs. Early feedback on the introduction of this model was largely positive, although there had been some issues with ensuring that team/GP meetings took place as scheduled, and with some unanticipated impacts on other services. It was expected that there would be these types of pressure emerging, and it was always intended that the current year of operation would be used to fine-tune the system in preparation for going to procurement in the following year.

75.3    In response to a question from Cllr Marsh on the definition of LTC, members were told that there was no precise definition, but in essence the term LTC was used locally to identify people who were unable to travel to their GP practices, and who therefore required treatment delivered to their homes.

75.4    In answer to a question from Cllr Marsh on co-working with adult social care (ASC) services, the committee was informed that the LTC initiative has been developed in consultation with ASC. ASC will have a formal role in line-managing carer support managers who will work very closely with the LTC teams.

75.5    In response to a question from Cllr Marsh on the use of care-co-ordinators, members were told that, in some instances service users might choose not to have a care co-ordinator appointed, preferring to co-ordinate their own care, have their carer do so etc.

75.6    In answer to a query from Mr Hazelgrove regarding evaluation of the LTC programme, members were informed that formal evaluation would start in October 2012 and would draw on experiences of service users, GPs, and Sussex Community Trust. As well as soliciting views on the new service, the evaluation would seek to identify measurable improvements in patients’ lives, possibly using the well-established methodology of PROMs – Patient Recorded Outcomes Measures.

75.7    In response to a question from Cllr C Theobald about resource implications of this initiative, the committee was told that the introduction of practice-based teams would lead to a small reduction in nursing staff requirement – 3 FTE posts. Other savings would arise from the use of more appropriate staffing – currently, too many service users were supported by inappropriately senior staff (e.g. nurses providing non-nursing services).

75.8    In answer to a question from Cllr Pissaridou regarding how the practice teams would be alerted to patients being admitted to/discharged from hospital, members were told that the hospital activity data would be electronically uploaded onto the Urgent Care Clinical Dashboard every 24 hours and automatically shared with relevant GPs. In addition, the hospital discharge team should liaise directly with GPs for every discharge.

75.9    In response to a query from Mr Brown asking whether the local LTC programme was co-ordinated with national developments and whether it was designed to save money, the committee was told that, locally at least, the programme was driven by the need to improve the quality of services. In terms of co-ordination with national developments, the Brighton & Hove programme pre-dates national moves to improve LTC care. However, the two approaches tally closely, and Brighton & Hove is very much at the forefront of delivering these improvements.

75.10  Mr Brown told members that the LINk had been consulted at every stage of the development of an LTC programme, and LINk concerns had all been addressed. The LINk will continue to monitor the implementation of the programme.

75.11  The Chair thanked Ms Matthews and Ms Hoban for their contributions and requested an update on implementation of the LTC programme in Autumn 2012.

75.12  RESOLVED – That the report be noted and a further updated requested in Autumn 2012.