From respiratory assessments in local Wetherspoons to virtual wards that deliver hospital-quality care in patients' homes, NHS teams and partners in the North West are leading the transformation of healthcare delivery to deliver care closer to communities as part of the 10 Year Plan for Health.
The 10 Year Plan, which was published by the Government last month, sets out how more people will be offered care closer to where they live, including through neighbourhood health services, giving access to more health services via the NHS App, convenient prescriptions, quicker specialist referrals and round-the-clock mental health support. As a result of this shift to community, hospitals will be able to focus on patients who need hospital care and get them seen on time again.
Dr Linda Charles-Ozuzu, Regional Director of Commissioning for NHS England in the North West, said: “NHS teams and partners across the North West are coming up with ever more innovative ways to take healthcare out into the community so that we can reach the people who need our help closer to where they live and allow hospitals to focus on delivering only the best, personalised care for those who need it most.
“Through this work we are making it easier and more convenient for patients to get medical advice, diagnosis and treatment, as well as making it possible for them to access services that can help prevent ill health, like vaccination and cancer screening, on their doorsteps.”
The Morecambe Bay Respiratory Network brings assessment, diagnosis, treatment and care for a range of respiratory conditions including complex asthma and COPD into communities and people’s homes across North Lancashire, Barrow in Furness and South Lakes. This includes seven community Breathe Easy support groups, the provision of community-based pulmonary rehab chest physiotherapy immediately after hospital discharge to reduce the risk of readmission, and specialist services supporting people to ‘die well’ in their preferred place, rather than in hospital.
Following a successful pilot offering drop-in assessments in branches of Wetherspoons to identify people with undiagnosed or unmanaged respiratory conditions, the network now plans to offer further drop-in clinics in a range of community venues.
The network brings together GPs, hospital consultants, occupational therapists and specialist nurses, who meet to discuss and plan care for up to 26 patients every month. The approach helps people to get an earlier diagnosis and treatment, supports the most complex patients to receive care at home and improves access to services for those who may struggle to get to a hospital because of travel times or cost, with the number of referrals into secondary (hospital) care reduced by more than 70% as a result.
The initiative has enabled 92-year-old Mary Chrystal from Lancaster, Lancashire, who needs to be treated with oxygen due to fibrosis on her lungs, to return home from Royal Lancaster Infirmary with a full package of support, including the Advanced Respiratory Care at Home team and Dignity in Life carers.
Her daughter, Anne Banks, said: “After several weeks in hospital having investigations and treatment for low oxygen levels, Mum was desperate to go home. We knew she might not have long left and she didn’t want to die in hospital.
“A respiratory nurse who works between the community and hospital helped to put everything in place and although she is weak, Mum is so happy to be home and is doing so much better than in hospital. She has felt really supported and couldn’t have had better care.”
The award-winning virtual ward at Mersey and West Lancashire Teaching Hospitals gives people living in North Sefton, Knowsley, Halton, St Helens and West Lancashire medical, nursing and therapy care in their own homes, where they often recuperate better and more quickly than in hospital.
It has 75 virtual ‘beds’, overseen by a range of clinical experts who meet daily to assess patients’ needs, and helps people either avoid a hospital admission or supports them to leave hospital earlier to be cared for at home.
The service recently won a Health Service Journal Digital Award for its use of technology, which supports delivery of the ‘hospital at home’ service by enabling everyone involved in a patient’s care to see and update their record, send electronic prescriptions from hospital to the patient’s local pharmacy and letting staff in the community connect with hospital consultants for additional expertise.
Other examples of work to provide more services in the community in the North West include:
- Thousands of cancer patients in Greater Manchester and Cheshire can access life-saving treatments through cancer centre The Christie’s network of local centres. Radiotherapy is provided at Oldham, Salford, Withington and Macclesfield, and chemotherapy and immunotherapy treatments are provided at 12 treatment centres and for some patients in the comfort of their own homes. Blood tests are also done at 11 centres. The Christie treats more patients at home than any other cancer centre in the UK.
- A mobile mental health crisis response service offers immediate assessment and support to people experiencing mental health crisis anywhere on Greater Manchester’s rail network. The service, which is operated by Network Rail in partnership with Pennine Care NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust and British Transport Police, has helped 92% of people it has supported to date to avoid a hospital admission and 77% to avoid an A&E visit and instead receive community-based care.
- 60 community pharmacies across Cheshire, Merseyside, Lancashire and South Cumbria are among the first in the country to start offering the Respiratory Syncytial Virus (RSV) vaccine on the high street as part of a phased national rollout across community pharmacies in England. The initiative will make the vaccination, which is offered to adults aged 75-70 and pregnant women, more accessible and convenient for those at risk.
- Healthy Hyde, a primary care network in Tameside, Greater Manchester, works with its local community in multiple ways to provide everyday support in schools, care homes, and in its health and wellbeing hub in a shopping centre, as well as in its GP practices. Support is pulled around individuals, families and communities, especially those facing the biggest challenges, such as food poverty, lack of work opportunities, social isolation, those seeking asylum and refugees, as well as people in need of low level mental health support. Healthy Hyde provides what is needed locally, developing this with local residents. For example, English lessons, wellbeing checks and health drop-in sessions are provided with help from community groups, schools, the local council, and statutory services who come together to support the population.
Find out more about the 10 Year Health Plan at: 10 Year Health Plan for England: fit for the future - GOV.UK