Agenda item

To consider a report of the Head of Scrutiny and Member Development on an update on the work of the Transformation Board

(report attached)

The Board considered a report of the Head of Scrutiny Support and Member Development providing an update on work being carried out by the Transformation Board which was a city-wide agreement between health and social care partners intended to deliver solutions that sustained quality whilst substantially reducing the overall cost in the city of the health and social care economy by the end of 2014.  Appended to the report was a copy of the Transformation Board’s programme update and an extract from a House of Commons Health Committee report relating to public expenditure, for Members’ information

Attending for this item were:

• Matt Ward (Associate Director of Commissioning ) – NHS Airedale, Bradford and Leeds
• Dennis Holmes (Deputy Director) – Leeds City Council, Adult Social Services
• Claire Walker – (Programme Management Officer) (Transformation Board ) – NHS Airedale, Bradford and Leeds

Apologies for absence were received on behalf of Phil Corrigan (NHS Airedale, Bradford and Leeds) who was unable to attend the meeting due to a recently sustained injury

Matt Ward presented the report and outlined a number of current developments detailed in the report and along with Claire Walker and Dennis Holmes, responded to questions from the Board.  The main areas of discussion were as follows:

• Clinical value in elective care – with the Board being informed that a reduction of around 12,000 face-to-face follow ups had been achieved since 1 April 2011, through using more appropriate and innovative follow-up care, including by telephone and primary care intervention

It was highlighted that the alternatives to face-to-face follow-up appointments had been running for almost 12 months.  Members were assured of safeguards in the process and advised that a blanket approach was not being adopted, rather it was for clinically led teams to consider the most appropriate way of following up appointments based upon the needs of the individual.  Where telephone follow-ups were used, patients would be contacted by hospital staff and asked specific questions.  Depending on the responses, a face-to-face appointment might be made, or a referral made to their GP if considered appropriate

• Urgent and emergency care – that the 49 adult ambulatory pathways had been considered and were now being prioritised around where the greatest impacts were likely to be seen

It was confirmed that the schedule of ambulatory pathways provided was a nationally defined list of pathways and other than self harm, did not include any other mental health pathways.  Other work on mental health was taking place but this was part of a different workstream

• Older people and long term conditions – that integrated care was being developed with the aim of providing a better experience for patients.  For those with long-term conditions, this involved using available data to predict those who would be at risk of developing health problems and might benefit from a more proactive diagnostic and management of disease approach.  Through early intervention and advice, the aim was to help patients to better manage their own health needs

Members were advised that a range of sources were being used to gather local intelligence in order to help predict future illness.  This included a number of different agencies, including ALMOS and mechanisms were in place for Councillors to alert the NHS and Social Care where there were concerns about constituents

Members were further advised that structural changes in the working model were being piloted, as presented elsewhere on the agenda (minute 72 refers).  This consisted of integrated teams, co-ordinated by an individual at GP practice level with a wrap around of professional disciplines in order to treat patients holistically

It was highlighted that integrated working had been achieved in the area of people with learning disabilities but that to achieve this cultural and organisational change citywide was a significant undertaking

• Diabetes – the improved model of care was nearly complete and reductions in associated secondary care costs had been achieved

• Home oxygen service –  aimed at improving patient care by enabling patients to more effectively manage their own health and reduce the number of hospital-based reviews needed, whilst increasing visits to homes where oxygen use could be monitored more effectively

Members were informed that further advice would be available to clinicians and Adult Social Care staff around home oxygen, through an up-coming Oxygen Awareness Week and the importance of reiterating key messages to patients around safety and smoking cessation

It was highlighted that while the Diabetes and Home Oxygen Service projects were relatively small, the projects provided good examples of where integrated teams were working with patients to develop models of care and assessment

The Board welcomed the report, the work being undertaken and the progress reported.  However, it was noted that a significant aim of the Transformation Board was to make efficiency savings within the health and social care economy by the end of 2014.  This aspect was not addressed in the update provided

RESOLVED -  

a)  To note the report and the information presented at the meeting

b)  That a further report be presented to the April 2012 meeting clearly identifying the efficiencies identified and generated through the work of the Transformation Board and the supporting projects and where resources had been reinvested to improve the patient experience

On behalf of the Scrutiny Board, the Chair sent best wishes to Phil Corrigan for a speedy recovery