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Challenges in SW

Challenges in SW. Ian Biggs Area Director BGSW. 10 April 2014. Guiding Principles. Walk in the shoes of the people we serve: Think like a patient. Act like a taxpayer. Financial. Clinical. Political. Social. Challenge status quo. Viable local hospitals that don’t all have to be huge.

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Challenges in SW

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  1. Challenges in SW Ian Biggs Area Director BGSW 10 April 2014

  2. Guiding Principles Walk in the shoes of the people we serve: Think like a patient. Act like a taxpayer Financial Clinical Political Social NHS | Presentation to SW Senate NHS England | 10-04-14

  3. Challenge status quo • Viable local hospitals that don’t all have to be huge. • Mental and physical health, unified. • Employers actively engaged in health of employees. • Faster uptake of digital technologies. • The critical role of the Third Sector, and the innovation value of new providers. NHS | Presentation to SW Senate NHS England | 10-04-14

  4. Challenges: changing demography • Older population (over 65s) • Increased demand: Between 1999 and 2008 the number of GP consultations per patient rose from 4.1 annually to 5.5 annually. • Increased survival with long term conditions leading to increased complexity and comorbidity • Recruitment challenges to key clinical roles NHS | Presentation to SW Senate NHS England | 10-04-14

  5. Challenges: Older people & frailty • ‘Everyone Counts: Planning for Patients’ frailty as a priority. Long lengths of stay. High readmission rates. High rate of long-term care after discharge. • Variations in practice: NHS England guidance (DCIoS) Four key components: identify those who are frail, assess, personalise care planning, keyworkers. • Variations in access to services e.g. transport, specialised services, sensory impairment, rurality • Changing carer population: shrinking carer population, older, socioeconomic geographical motility. NHS | Presentation to SW Senate NHS England | 10-04-14

  6. Frailty and older people: Questions • How do we know the experience of frail, elderly patients?. • How do we balance clinical effectiveness with easy timely access to services? • How do we work together across health and social care? • How do we keep people at home and reduce admissions? • How do we measure outcomes resulting from service change? • How do we improve quality, especially in SW with rural and ageing population? NHS | Presentation to SW Senate NHS England | 10-04-14

  7. Challenges: Dementia • 1 in 3 people aged over 65 will suffer from dementia • Approx 25% of hospital beds are occupied by people with dementia. Stay in hospital longer. More readmissions. More likely to die. • The national cost £19 billion per year. By 2030 this cost is expected to treble to over £50 billion per year. • Currently less than ½ of people living with dementia in England receive a formal diagnosis. NHS | Presentation to SW Senate NHS England | 10-04-14

  8. Challenges: No health without mental health • Single largest cause of disability • Wide economic costs (£105.2 bn) • People with severe mental illnesses die on average 20 years earlier than the general population. • Associated with other long term conditions NHS | Presentation to SW Senate NHS England | 10-04-14

  9. Challenges: LTCs, complexity and comorbidity • Increasing comorbidity: 2/3 of older people currently live with more than one LTC. • LTC’s account for 50% of all GP appointments, 70% of all hospital admissions and 70% of spend on health and social care. • Variations in preferred place of care in last year of life. • More complexity means one size does not fit all NHS | Presentation to SW Senate NHS England | 10-04-14

  10. Questions: Complexity and comorbidity • How do we ensure personalised care planning and patient choice? • How do we tackle fragmentation between organisations / services? • How do we empower patients to self-manage and access services in a timely way 24/7? • How do we anticipate need of our population both clinically and strategically? • How do we balance the need to improve quality and reduce spend with increased demand? NHS | Presentation to SW Senate NHS England | 10-04-14

  11. Questions…Specialised services • How do we ensure patients experience joined up care throughout the pathway? • How can we solve complex issues, hub and spoke models? NHS | Presentation to SW Senate NHS England | 10-04-14

  12. Simon Stephens’ inaugural speech ‘It’s time to get serious about patient power, prevention and community partnerships……So it’s time to chart a new course. One that combines hard-headed realism about the here-and-now with a sense of shared purpose and – dare I say it – even optimism about the future.’ ..’ NHS | Presentation to SW Senate NHS England | 10-04-14

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