Developing Neighbourhood Teams Barnsley 19/20 and beyond

1. Developing Neighbourhood Teams Barnsley 19/20 and beyond

2. Developing neighbourhood teams This slide pack covers: • The national plan for integrating community and primary care services. • The local plan for developing neighbourhood teams: • How neighbourhood teams can make a difference. • The scope of services involved. • The way in which the teams work together. • The timetable for developing neighbourhood teams. If you are reading this online or printing it you may find the speaker’s/reader’s notes helpful

3. What are the plans for neighbourhood teams? • NHS Long Term Plan states need for integrated working and to “finally dissolve the historic divide between primary and community health services”. • Community health services are for people with physical health conditions and are provided by nurses and allied health professionals (such as an occupational therapist for example) in people’s homes and in community clinics in the larger health care buildings. • Primary care services are all the things that your GP practice provides. • National plan in line with local discussions and developments (building on what has worked well and learning from areas like the Dearne).

4. What are the plans for neighbourhood teams? • The NHS Long Term Plan brought in Primary Care Networks in July 2019, where groups of GP practices work together to improve the health problems that are having the biggest impact on people’s lives in their area. • Barnsley Primary Care Network is now in place, underpinned by six neighbourhood networks. These form the building block to develop neighbourhood teams. • South West Yorkshire Partnership Foundation Trust (SWYPFT) and primary care teams are working with CCG and partners to develop neighbourhood teamsover the coming months.

5. Local context: shared vision Shared Barnsley model of what integrated care might look like in the future

6. Next steps: Making neighbourhood teams a reality Creating community services that effectively wrap around the new primary care network (PCN) will: • Deliver the NHS Long Term Plan. • Reduce duplication to deliver better patient experience and value for money. • Help people stay well at home and out of hospital - reduce the growth we are seeing in avoidable admissions to hospital through joined up care in the community. • Support workforce transformation. • Make better use of local estates (the larger health & care buildings which house multiple GP practices, community services, pharmacies and some council services)

7. Things to consider and feedback on: • What issues do you face day to day that closer working between community and primary care could help to address? • What would give you confidence that the system is working? • What does “one team” mean to you and what would you like to see in the future? • How do you see services using technology and digital innovation to improve care for people? • How could neighbourhood teams impact on the growing number of people being admitted to hospital and what is the role of general practice and the clinical networks in helping to achieve this? • What measures would you use to know if neighbourhood teams are achieving the objectives?

8. Barnsley Primary Care Network & Neighbourhoods 1 x Barnsley PCN 6 x neighbourhood networks (red outline)

9. What will neighbourhood teams do? • Introduce one single point of access and clinical assessment for community services. • Be everybody’s business, reducing multiple internal referrals. • Be supported by shared care records – one patient record that multiple teams can view and update. • Have a clear set of commonly agreed response times which are based on clinical need (routine, urgent, etc.) • Map to patient need – using a population health management approach to planning. • Include organisational workforce development – enhanced opportunities for staff. • Improve organisational resilience within and across teams. • Focus on patient reported outcome measures, as opposed to the ‘number of contacts’ included in current contracts. • Have a one set of key performance indicators instead of the many that exist now.

10. Community services in scope for neighbourhood teams • Community health services and memory assessment services for people aged 16 and over are in scope. • Mental health services are not currently in scope however there is a clear need to look at how areas will work together in the future. There are clear interdependencies with other services run by these other organisations: • Hospitals • Council • Hospice • Voluntary Sector • Others (care homes, pharmacies, health & wellbeing services, etc.)

12. Single point of access: contact, triage and allocation. One single point of access for the six neighbourhood teams Diagram taken from community services operating model guidance NHS Improvement 2019

13. Proposed phasing of community neighbourhood teams

14. Feedback so far • The next couple of slides show some of the questions and feedback received so far. • After these next four slides, we want to start to discuss the concerns and also recommendations you have to develop neighbourhood teams.

15. Things that have been fed back so far: Scope: We have received feedback about the different services included in neighbourhood teams. • We have received feedback that mental health services should also be included in the scope. Age threshold: We have received feedback in relation to the age threshold for people accessing the service. • Some of the current community services see people who are aged 16 and over, however, currently children’s services see people up to their 19th birthday. The NHS Long Term Plan states the need for children’s services to see people up to the age of 25. • We have received feedback that the service should see people aged 18 or over.

16. Things that have been fed back so far: Consistent waiting times or ‘clock speeds’: We have received feedback about ‘clock speeds’ or the time that people wait to be seen. Currently this varies depending upon which service team you are seen by and what health condition you have. • We have had feedback that all referrals should be assessed as being ‘urgent’ or ‘routine’ and be seen within according timeframes, rather than people with different health conditions being seen within a different number of days. • We have received feedback that clock speeds need to be aligned with the wider health system, such as people waiting a maximum of four hours when they attend the Accident and Emergency (A&E) department.

17. Things that have been fed back so far: Single Point of Access: The Single Point of Access (SPA) will operate 24 hours a day, 365 days a year service in order to support a range of response times based on patient need. It is expected that the core team will work: Core 08:00–22:00 Mon – Sun Night Service 22:00-08:00 Mon - Sun Staffing levels and skill mix will be adjusted to reflect patient need. Therapy interventions will be routinely delivered during the day time hours (08:00-18:00) with flexibility to respond to patient need at other times. We have received feedback about the Single Point of Access which aims to reduce multiple internal referrals. • The feedback questions whether a SPA which operates 24 hours a day, 365 days a year is necessary. A 24/7 SPA would support a key aim of the service which is that people are cared for at home, enabling them to stay well and out of hospital.

18. Things that have been fed back so far: These are additional areas for your consideration: • Clinical guidance (potentially out of date NICE guidance) • Governance (how governance links to PCNs)   • Information Management and technology (how the existing systems can support the new team) • Key performance indicators (benchmarking and consistency) • Mobilisation (how existing services work and how the new team will be mobilised) • Phasing (splitting service mobilisation) • Wider system interaction (how new team will slot into existing services across Barnsley).

19. What are your concerns and recommendations?

20. Proposed next steps • We will use your feedback to review and revise the specification for neighbourhood teams. • September – begin to mobilise an agreed neighbourhood team model. • April 2020 onwards – phase 1 of neighbourhood teams begins.

21. Contact details for neighbourhood team feedback • SWYPFT: Gill Stansfield gill.stansfield@swyt.nhs.uk • Barnsley Healthcare Federation: James Barker james.barker3@nhs.net • Barnsley member practices: Dr Nick Balac or email directly tobarnsleyccg.membership-council@nhs.net • Patients, carers and members of the public and anyone with an interest in developing neighbourhood teams can get involved by: • Email CCG barnccg.comms@nhs.net • Email SWYPFT comms@swyt.nhs.uk • Telephone the CCG on 01226 433770