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Community Hospitals in Cumbria A Bright Future. Dr John Howarth Director of Integration CPFT and Clinical Director of Adult Services. The past. Cumbria – Where we were in 2006. 2 nd worst performing PCT financially - £50 million historic debt with £17 million debt recurring year on year
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Community Hospitals in CumbriaA Bright Future Dr John Howarth Director of Integration CPFT and Clinical Director of Adult Services
Cumbria – Where we were in 2006 • 2nd worst performing PCT financially - £50 million historic debt with £17 million debt recurring year on year • 8 of our 9 community Hospitals ‘must close’ • Buildings to be sold off • ‘No investment in primary care for at least 3 years’
Widespread Support: • MPs, • Nuclear Agency • Unions • NFU • League of Friends (since 1954) • 70,000 signature petition
New PCT Leadership Team • New strategy of ‘Closer to Home’ • Community Hospitals a key part of this strategy • Centred on clinical leadership
"I would rather be kept alive in the efficient if cold altruism of a large hospital than expire in a gush of warm sympathy in a small one." Nye Bevan
Over to you! • Improve efficiency • Improve clinical and organisational quality • Maintain the caring aspects • Make these units sustainable
Cumbria – Where we are now • 9 existing community hospitals saved • 4 new community ‘step up step down units’ opened in Whitehaven, Carlisle, Barrow and Kendal • 250 community beds
Increased efficiency • More than double the number of admissions than in 2006 • Reduced length of stay in every hospital (average 9 days less) • More efficient use of our beds (80% improvement in the ‘throughput per bed’)
Efficiency and Quality Headlines • Major quality initiatives – nutrition, hydration, MEWS, nursing care indicators, infection control etc • 41 cases C diff 2009/10, 9 cases in 20010/11 • All patients screened for MRSA, no cases MRSA bacteraemia in last 2 years
The increasing number of elderly: • This will result in an estimated 60% increase in hospital admissions over the next 20 years • (Teamwork 2007)
Predicted Effects for Prevalence of Dementia in Cockermouth to 2029 Overall percentage increase of 134% in over 65 population by 2029. Overall percentage increase of 133% in over 85 population by 2029.
Being socially isolated is as big a risk factor as smoking!!
The Future: • Part of a whole INTEGRATED system for admission avoidance • Increased link to Acute Hospital beds and specialists • Increasing portfolio of services ranging from minor surgery to rehabilitation • Rigorous approach to quality and efficiency
Integration – Getting everyone on the same team, wearing the same shirt Strikers Defence Midfield Reactive care Proactive care ‘Virtual ward’ – Prevention ‘Virtual ward’ – Reactive Primary care in Hospital Front End Community Hospital The Hub Acute Hospital Care Asset Based Community Development e.g. Centre for the Third Age Home GP Rapid response team (STINT) Other professionals e.g. Fire Safety Officer, Housing, Transport
Cockermouth Centre for the Third Age Events 2011 • 2 Dec Open Day • 3 Feb Multi-Disciplinary In-patient Team - Talk • 11 Feb Age UK Bobble Day - Collection • 24 Feb Action for Health – Stand • 3 March Methodist Churches Together – Talk • 7 March Social Work Student (5 weeks) • 29 March Spring Wellbeing Event • 5 April Derwent House Surgery staff meeting – Talk • 6 April Abbeyfield – Talk • 25 May Women’s Fellowship – Talk • 27 May Joined Cumbria Advice Network • 2 June C3A Luncheon Event • 9 June Friendship Group (Weekly) • 15 June District and Community Nurses meeting – Talk • 21 June Falls Awareness Event • 11 July Year 11 work experience placement (1 week) • 25 July Age UK Roadshow – Broughton • 4 Aug Crime Prevention Event • 9 Aug Memory Lane Café (twice monthly)
Cockermouth Centre for the Third Age Events 2011 • 17 Aug Age UK Roadshow – Bridekirk • 22 Aug Age UK Shop meeting – talk • 13 Sept Lorton WI – Talk • 16 Sept Papcastle Pop-in – Talk • West Cumbria Older Person’s Forum – Talk • 21 Sept Tea & Biscuits Event • 23 Sept Cockermouth Rotary – Talk • Oct Embleton Senior’s - Talk • 3 Oct Bridekirk Friendship Group (weekly) • 10 Oct Cumbria Advice Network Event – Stand • 15 Oct Melbreak Communities – Talk • Nov Men’s Group (weekly) • Nov Age UK Roadshow - Brigham • 6 Nov Sunday Lunch Club (monthly) • 16 Nov Golden Music Club (monthly) • 21 Dec Golden Music Club & Christmas Party • 9 Jan Cockermouth U3A - Talk
Discussion and questions: What do you think we should use these hospitals for?
Thank You Dr John Howarth