Ambition, Action, AchievementLeading your local NHS

Our Vision:

Havering will be a healthy place to live for all

To commission best in class services that give people personal choice and control of their healthcare needs in the most appropriate settings

Working with our partners we will radically redesign our Primary Care Provision, align the targeted and open access services with the Borough and operate jointly 7 days a week

Delivering best in class services will mean that we will make informed evidence based investment decisions, delivering clearly defined outcomes

We will empower our residents to access health and wellbeing, education and training opportunities

Ambition, Action, Achievement

Key points from JSNA• Oldest population in London and numbers are growing

expected 29% increase people aged 65 or over • 57% increase aged 85 or over with long term limiting

illness by 2025• Diabetes levels predicted to rise 48% by 2025 and stroke

levels predicted to rise 31% over the same period. • 2nd highest in London % of obese adults (22%)• Cancer mortality higher than expected for bowel/breast

at 1 year• 2nd highest rate in London of overweight children at age 5

(ticking timebomb)• Havering deprivation (IMD) 200th out of 354 PCTs

Actions are needed to deliver the outcomes for our population

• Increase– Improved identification/diagnosis of dementia– % of deaths that occur at home – Breastfeeding at 6-8 weeks– Uptake of DTP at age 5 (proxy for MMR) – Self reported experience of patients/users

Our eight local outcomes:• REDUCE

– COPD mortality– Stroke deaths within 30 days– Premature cancer mortality

Key Actions speak louder than words – must be

realistic

• Polysystem model implement during 2010/11

• LTC care transformed with 50+ strategy actions & modernised community services

• Health4NEL shifts linked to CSP initiatives

• Organisational including Board development

• Clinical & Public engagement strategies delivered

What’s a Polyclinic/Community Hospital

Post acute stroke beds Step down and palliative care

beds Advanced physiotherapy services Day Hospital Plus services available in the Hub

DDA Compliant Induction Loop fitted to reception Treatment room At least one consulting room Minimum of 1 disabled parking

space per clinical room Baby Changing Facilities Breast-feeding friendly Secure pram/pushchair/cycle

storage Satisfactory Infection control

report IT compatible with hub to allow

reciprocal appointment booking and records access

Confidential reception facilities Energy efficiency audit action plan

completed On-line booking facilities for

patients

Ambition, Action, Achievement

Features for all new facilities

Polyclinics and spokes across Havering

Ambition, Action, Achievement

Polyclinic Hub

• Min 12hr x 7 days a week, Urgent Care Centre, with direct links to A/E

• X-ray, ultrasound, possibly mobile MRI and mobile breast screening

• Full range of near patient testing• Dedicated disability facilities • Access to health information

available in leaflet or electronic form

• Range of Borough service• Voluntary sector services• Community based services e.g.

physiotherapy, audiology, sexual health, pharmacy

• Consultant led outpatients• Direct links with Out of Hours

services• All GPs offering full range of

enhanced services• Range of services for children and

young people with direct links to the Children’s Centre

• Mental health including dementia support

• Long Term Conditions working through multi-disciplinary groups

• End-of-life support network• Maternity with close links to BHRT

and children’s centres • Diabetes – up to level three

services

Ambition, Action, Achievement

Spoke GP Practice Tier 1

Min 12hr x 7 days Blood tests & ECG Access to health information

available in leaflet or electronic form

Full range of Enhanced GP services

Walk in GP services

Consultant led outpatients Minimum of 8 wte GPs Premises that can be

expanded Long Term Conditions Diabetes – up to level two

services

Ambition, Action, Achievement

GP Practice Tier 2

Min 12hr x 6 days Blood tests & ECG Access to health information

available in leaflet or electronic form

Full range of Enhanced GP services

Minimum of 4 wte GPs Long Term Conditions Diabetes – up to level one

services

Ambition, Action, Achievement

GP Practice Tier 3

Core Primary Care Services Range of agreed additional

services

Long Term Conditions where appropriate

Single handed practices up to 4 wte GPs

Ambition, Action, Achievement

Community/Home

• Tailored education to support patients and carers in managing long term conditions and end of life care supported from the Hub/Spoke

• Rehabilitation services for stroke patients• Mental health assessments e.g. dementia• Children and young people with complex

health needs• Ability to single point of access for information

and advice to self manage - e.g. telephone, web, tele health, NHS Direct

• Home births

Ambition, Action, Achievement

Urgent Care Centres

Ambition, Action, Achievement

Urgent Care Centres

Our plan for Urgent Care Centres is: • North-west System

Urgent Care Centre will be based at Queen’s Hospital• North-east System

Urgent Care Centre will be based at Harold Wood Polyclinic• South System

Urgent Care Centre will initially be provided at South Hornchurch operating from 6am to midnight, but the services will be moved to St. George’s

Hospital site when appropriate

Urgent Care Centre will be provided at Cranham operating from 6am to 9pm.

All 3 Polysystems will have one Urgent Care Facility fully operational by December 2010. Future Urgent Care Centres will be considered at Collier Row, Maylands and Harold Hill.

Ambition, Action, Achievement

Joint Priorities with Council

• Advice Services (including dementia)• Keeping people out of hospital (includes

intermediate care, integrated case management, DTOC and falls prevention)

• Polysystems  (to ensure maximum reach and success of moving services into the community)

• Speech and language therapy  (for children)

Partnership working - the key to a healthy Havering

• What’s in it for the voluntary sector?• How can the NHS and Borough ensure the

voluntary sector is bidding on a level playing field

• What are the timescales – this year?

World Class Provider

• Fit for Purpose

• Good governance

• Financial Stability

• Meet our vision, goals, priorities, actions and outcomes

• Mirror image of World Class Commissioning competencies