November 2014

NHS workers in Devon recognised for outstanding achievement

28 November 2014

Staff at the Northern, Eastern and Western Devon Clinical Commissioning Group have been recognised for their dedication to patients in the county.
 
Three members of staff at the CCG, including a doctor from Budleigh Salterton, were finalists at recent awards ceremonies held across England.
 
Sam Cush, from High Bickington, is a patient communication specialist. He was named Communicator of the Year at the Association for Healthcare Communications and Marketing awards in Leeds.
 
Sam was nominated for the way he communicated patient stories through the use of films. The stories are seen by Board members and commissioners and help to inform the development of services based on the voice of patients and wider public.
 
Jerry Clough, chief operating officer for the CCG and managing director of its Western Locality, was named regional NHS Inspirational Leader of the Year at the South West NHS Leadership Recognition awards in Bristol.
 
Jerry took a lead role in the introduction of a programme of development at the CCG to make sure patients and individuals were always kept at the centre of decisions made about them, as well as the commissioning of services for them.
 
Dr Richard Mejzner, a GP from Budleigh Salterton and Board member of the CCG’s Eastern Locality, was a finalist for Clinical Leader of the Year at the HSJ awards in London.
 
Dr Mejzner was shortlisted following his work to develop a health and social care hub at the community hospital in Budleigh Salterton.
 
Dr Tim Burke, a GP from Devon and chair of NEW Devon CCG, said he was proud of the staff achievements.
 
“Giving patients a voice and making sure they are at the centre of everything we do is at the heart of our organisation’s values so we are pleased that our staff have been recognised in this way,” he said.
 
“We are all aware of the financial pressures on the NHS and this is a great example of how we are still listening to and involving our patients in important decisions.”

NEW Devon Clinical Commissioning Group Plans More Focus on Prevention and Management of Orthopaedic Conditions

26 November 2014

NEW Devon CCG is to increase its focus on the prevention and management of orthopaedic conditions. The move agreed by the NEW Devon Western Locality Board today will support patients to postpone and in some cases to remove the need for surgery completely.

Dr Gary Lenden GP and Elective Care Lead for the Western Locality of the NEW Devon CCG said “As clinical commissioners it is our role to ensure we commission the most effective and efficient healthcare services to meet the needs of local people.

“Our aim is to focus more resource on prevention and active management of orthopaedic conditions to where possible avoid or postpone the need for a person to have to undergo surgery.

“Having any surgery does come with risk and it is important that all other options are considered first. Locally we operate on more people and at a relatively young age in comparison to other areas of the country.

Orthopaedic surgery should always be considered as the last option and only carried out when clinically appropriate for the individual.

“We know that there is a need to put more resource into services such as physiotherapy, weight management and exercise and activity programmes and it is our commissioning intention to do this. We have seen the numbers of people requiring surgery fall and we expect this trend will continue.

“The backlog that once existed for orthopaedic surgery has been reduced and the majority of patients are now treated within 18 weeks of referral from their GP. We expect that this standard will continue to be met.”

In considering the options the CCG has engaged with a range of clinicians and staff from health service providers in Primary, Secondary and Community care. Patient and Liaison services (PALS), Healthwatch and patient and service user representatives have all been involved in discussing current orthopaedic services and considering the options for the design of the new model for elective orthopaedic services. This engagement has been an important part of deciding the commissioning options.

As a part of the commissioning options and as a result of falling demand for elective orthopaedic surgery the NEW Devon CCG Western Locality Board has taken the decision to not re-commission surgical capacity from the Peninsula Treatment Centre based in Plymouth. Patients will continue to have choice about where they wish to have treatment from a number of local providers.

In 2005 it was decided to commission an additional provider to carry out elective orthopaedic surgery as patients were waiting an unacceptable length of time for elective orthopaedic surgery such as hip and knee replacements.
A time limited contract to run the Peninsula Treatment Centre was put out to tender.

Since then waiting times for elective orthopaedic surgery locally have been reduced. The majority of patients are now treated within 18 weeks from referral of their GP to treatment. Clinical commissioners expect this trend will continue and believe this presents an opportunity to focus more resources into prevention and active conservative management of orthopaedic conditions.

The Treatment Centre opened in 2005 Care UK and UKSH (who were subsequently taken over by Care UK) have provided high quality orthopaedic surgery.

Throughout the process there have been collaborative discussions around the range of options that Care UK could consider. This has been to support them to decide what their preferred option might, if the outcome is not re-commission surgical capacity. Care UK can decide whether to operate as a choice provider as they have been; they are currently indicating that is their intention.

The NHS in Northern Devon agrees to change how Torrington Hospital is used to benefit the whole community

26 November 2014

GPs and clinicians in Northern Devon have this week agreed to support the continuation of an enhanced model of care for community services in Torrington and the surrounding area.
 
The announcement came following agreement at the respective board meetings of Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) and Northern Devon Healthcare NHS Trust (NDHT).
 
NEW Devon CCG and NDHT jointly implemented a test of change in July 2013 that involved temporary suspension of the hospital’s inpatient beds to be replaced by an enhanced model of community care in their own homes.
 
The test of change found that the majority of Torrington residents who may ordinarily have been an inpatient at Torrington Community Hospital or NDDH could instead be treated in their own homes by the Trust’s expanded community rehabilitation and nursing teams.
 
Over six months:
-       There were 97 fewer admissions to hospital than expected
-       Half as many residents of Torrington were admitted to hospital than expected
-       Those that were admitted to NDDH had their length of stay reduced by an average of 28 days
-       There was no material impact on urgent care services such as out of hours doctors, the ambulance service or A&E attendances
 
An independent evaluation of the data from the test of change confirmed that home-based care was quality and safe.
 
The decision to continue the enhanced community home-based care in Torrington means that overnight beds at Torrington Community Hospital will not reopen. This will allow the local community the space to develop different ways of using the hospital that will benefit the whole community – younger and older generations.
 
On behalf of both organisations Dr John Womersley, chair of the Northern Locality of NEW Devon CCG, said the decision to proceed with the enhanced model of community care and health and social care hub development would greatly improve care for people in Torrington.
 
“A number of outpatient clinics already run from Torrington Hospital and this decision gives us a great opportunity to deliver even more services from the hospital to benefit the whole community,” he said.
 
“The types of services that we could look at running from the hospital could include a day centre, dermatology clinic, leg ulcer clinic, chiropody, cancer outreach clinics, mental health clinics and much more.”
 
Dr Womersley acknowledged the concerns of some members of the community about the loss of the beds and said he hoped everyone would get behind the development of a health and social care hub at the hospital.
 
“We believe we are doing this because it is best for patients,” he said.
 
“We have tried to involve the community all the way through the process in what have been challenging circumstances for everyone.
 
“A full Equality Impact Assessment on the model of home-based care has been undertaken and this shows that just 26 patients were disadvantaged by having to be placed in a community hospital in other towns during the test of change.
 
“Many of these patients would have gone to Bideford or South Molton anyway because of the specialist community hospital care that is available in both these hospitals that has never been available in Torrington.
 
“We have held a number of public meetings and drop-in sessions, as well as involving elected members, clinicians, the voluntary sector and other organisations with an interest in health and social care.
 
“We have listened to people throughout this process and have made changes to the way we have approached it. For example we agreed to have the data from the evaluation independently reviewed, and extended the period before a decision was made to ensure the people had a chance to give us more feedback.”
 
In June 2014 the preliminary evaluation and engagement reports were also presented to the Devon County Council Health and Wellbeing Scrutiny Committee – the organisation that holds the NHS to account. This was passed by scrutiny members without restriction.

Urgent and necessary measures to prioritise services

Please note: The press release below contains information that is now out of date. 

24 November 2014

MEASURES are being put in place to protect essential NHS services in Devon.

 
The essential action is being taken by Northern, Eastern & Western Devon Clinical Commissioning Group’s (NEW Devon CCG) the organisation responsible for buying the majority of healthcare in Devon.
 
On 29 October 2014 the CCG announced its intention to take ‘urgent and necessary’ measures in order to protect essential services, and prioritise the requirements of the NHS Constitution.
 
Dr Tim Burke Chair of NEW Devon CCG said: “In order to prioritise essential services it is necessary to make decisions about what is given lesser priority. 
 
“For this reason, we are evaluating a series of temporary reductions in services. 
 
“Our review will focus on planned operations and treatments, not those which must be done as an emergency or to save lives.
 
“During November we will undertake a review of these services, including the impacts of their temporary withdrawal.
 
“I am committed to being open about what we are considering and how the decisions are being made. Where we do take a decision to suspend a service we will publish that and produce information for the patients affected about the available treatment options for them.
 
The CCG has a legal duty to live within its financial resources and prioritisation of services will be our focus for the remainder of this financial year and into next.”

Feeling under the weather? Visit your local pharmacy

20 November 2014

Doctors from Devon are urging people who are feeling under the weather this winter to visit their pharmacy for quick, early advice.
 
The ‘feeling under the weather?’ campaign is running this winter, highlighting the benefits of getting treatment for coughs and colds straight away, before they get worse.
 
This is particularly important over the winter months – when people are more likely to become ill or feel poorly.
 
Local pharmacists are a highly trained and trusted source of health advice and can provide help to people who have a bad cough, trouble breathing, a cold or sore throat.
 
They can also help people to manage their long term conditions and enable them to get the best from their medicines. Many pharmacies have longer opening hours than GP practices.
 
Dr Dafydd Jones, a local GP and clinical lead at the Northern, Eastern and Western Devon Clinical Commissioning Group said:
 
“There’s no such thing as wasting your pharmacist’s time.
 
“If you have a bad cough, trouble breathing, a cold or sore throat pop down to your local pharmacy for quick health advice or visit www.nhs.uk/asap. Early advice is the best advice.
 
“Pharmacists have longer opening hours than GP practices, you don’t need an appointment to see one, and most have a consultation area where you can speak privately. They’ll also tell you if they think you should see your GP.”
 
This winter NEW Devon CCG reissued its handy tips to help people choose the right NHS service for them.
 
  • Try your family or self-care - for minor illnesses, combine medicines for coughs, colds or flu with plenty of rest.
  • Pharmacist/chemist - pharmacists are trained to help people with minor illnesses and can advise on medicine that can be bought over the counter. Your nearest pharmacy can be found here: www.nhs.uk. Some pharmacies are open extended hours.
  • NHS 111 – for non-emergency health needs, which operates all day, every day, as well as help to find services. Go to www.nhs.uk or call 111.
  • NHS minor injuries unit (MIU) - for treatment of minor illnesses or injuries, without an appointment. For details of your nearest MIU, go to www.nhs.uk. The Plymouth MIU is based at the Cumberland Centre in Devonport, near Plymouth Albion rugby club – set your sat nav to PL1 4JZ.
  • Family doctor – Your local general GP surgery provides a wide range of family health services, including: advice on health problems, vaccinations, examinations and treatment, prescriptions for medicines, referrals to other health services and social services. Your surgery will make sure you get to speak to a healthcare professional on the same day if you have an urgent condition.
  • Hospital emergency departments or 999 – please only attend hospital emergency departments if you have an immediate and serious problem that cannot be dealt with by the other services. 999 only for critical or life-threatening situations.

NEW Devon Clinical Commissioning Group selects preferred future community healthcare providers

7th November 2014

NEW Devon Clinical Commissioning Group has completed the first part of a procurement process to decide who will run community health care services across the area. The Governing Body decided who the preferred providers will be at its meeting on 5 November 2014.

The CCG currently has contracts with a number of providers across Devon to run its community healthcare services. In our Western Locality there are two: Plymouth Community Healthcare CIC provides services in Plymouth and Torbay and Southern Devon Health and Care NHS Trust provides services in Kingsbridge and Tavistock. Northern Devon Healthcare NHS Trust provides services in our Eastern Locality as well as in our Northern Locality.

The CCG is committed to continue to commissioning the best possible community health services for local people including for the rising numbers of people with complex health needs. This will include building upon the foundations established by the current providers and the excellent work undertaken by staff to develop services that are joined-up and that will continue to improve quality, efficiency and effectiveness for local people.

This means the CCG is working to procure a community based delivery system designed to achieve a step change in integrated care with care in the right setting for the increasing numbers of people who are frail or otherwise living with complex health needs. The vision for complex needs services is set out within the Strategic Framework and the Case for Change. This aims to deliver a shift in emphasis of care towards pro-active, sustainable, integrated, personalised and local approaches. These documents are available on the CCG’s website – www.newdevonccg.nhs.uk

The Case for Change was considered and endorsed by the Governing Body on 5 November 2014. This included the outcomes of the Most Capable Provider process which confirmed the providers that will be taken forward as the Preferred Providers. The Preferred Providers for each locality are as follows:

Northern Locality
Northern Devon Healthcare NHS Trust

Eastern Locality
Royal Devon and Exeter Foundation NHS Trust

Western Locality (Including Tavistock, Ivybridge and Kingsbridge)
Plymouth Community Healthcare CIC

The decision as to which organisation is allocated preferred provider status is the start of the next phase of the process. Following this decision there will be a process of detailed due diligence and contract negotiation so that the CCG can have full confidence ahead of decisions on contract award. This will include an assessment that the organisation is able to deliver the services to the vision as they described in the most capable provider assessment and underpinned by key foundations for sustainable care including finance, workforce, and quality considerations.

Dr Tim Burke GP and chair of the NEW Devon CCG said “This procurement exercise is a key part of ensuring we commission the best possible community healthcare services for local people – this underpins our ambition for integrated healthcare services.

“Throughout the planning we have resolutely placed the patient at the centre and we believe our proposed approach will set the foundations now for integrated care joined up around patients and their carers, throughout northern, eastern and western Devon.

“We have worked hard to listen to all perspectives whilst recognising we cannot necessarily expect a consensus. We recognise that any change can bring with it some uncertainty but we consider the decision to be in the best interests of our patients and our population.

“We recognise that the future provision arrangement is important to staff and we know this could be unsettling for them. Now we have reached the preferred provider stage we will be working with both present providers and those assessed as the preferred provider to engage staff in shaping the future.”

Devon and Plymouth’s NHS sets out plans to meet national challenge over patient demand

6 November 2014

The NHS in Devon and Plymouth has set out how the local healthcare community will meet its part of a national challenge for the NHS to deal with rising patient demand on services.
 
With more people living longer, and with more complex conditions, it is estimated that if no action is taken to change the way some NHS services are run the demand could cost £30 billion nationally.
 
In Devon and Plymouth if nothing is done to manage the expected additional demand it could cost the local health economy almost £430 million over five years.
 
Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) is the largest CCG geographically in the country. The age profile here today, with its high proportion of retired people, will not be reached for another 20 years in much of the country.
 
Mark Marriott, NEW Devon CCG’s director responsible for developing the plans, said he was confident that by acting early the local health system could meet the challenge and safeguard services for future generations.
 
“We have spent the last six months identifying the Devon and Plymouth health community’s part of the £30 billion national challenge, so we are well placed to tackle it,” he said.
 
“Of course the £430 million figure over the next five years that has been reported in the media is just a prediction at this stage. We have five years to put measures in place that transform the way we support communities and care for patients, working with people and organisations across Devon and Plymouth to create a sustainable future for the local NHS. This represents a real opportunity to make changes for the better.”
 
“If a business projected that it would lose position in the market place in five years’ time it would start doing something about it now, and although the ‘business’ of the NHS is to treat patients, the idea is the same.
 
“Some of the ways we can meet the demand is through a longer term programme of whole system change, from health promotion, such as helping people to stop smoking and drink sensibly, to making sure we commission affordable quality services.
 
“We aim to commission the right care in the right place and this is not always in hospital. It may be that some procedures could be undertaken at a GP surgery for example, or care could be provided in the patient’s home if clinically appropriate.”
 
All NHS and local authority organisations are involved, working together, because they know that the whole system needs to change. It’s not just a case of doing things individually, or working in the same way but harder; it’s about rethinking more fundamentally how care is provided.
 
A series of urgent and necessary measures have already been agreed by the NEW Devon CCG Governing Body yesterday to address a £15million deficit this year.
 
Mr Marriott explained that these measures were separate to the £30 billion challenge as they needed to happen this year to make sure services were not affected in the future.
 
“We want to make sure that we don’t have to take urgent measures next year or thereafter, so we need to make up the £15 million funding gap that we face this year,” he said.
 
“But the real challenge is how we meet our part of the NHS chief executive Simon Stevens’ five year plan to meet a £30 billion rise in patient demand over the next five years.”

Exmouth couple delighted with health care at home

6 November 2014 
The GPs who lead the commissioning of healthcare services in northern, eastern and western Devon are proposing changes to transform the way patients are cared for. A key part of their proposals is to put more resources into caring for people in their own homes when it is clinically appropriate.

An example of how this type of treatment is when Exmouth resident Mr Dingle, who is in his 80s, hit his head on the garage door. At the time he and his wife didn’t think any more of it but a few weeks later he became unwell and had to be rushed into hospital. He was suffering from a blood clot under the skull.

Mr Dingle received treatment at hospital for his injury. He was very keen to get back to his own home and get back to full health but the injury meant he had initially lost his speech and was very unsteady on his feet.

Mrs Dingle said “We were told about hospital at home and really wanted to give it a go. My husband didn’t like the thought of having to be in hospital any longer than necessary but I knew we would need support at least in the first few weeks.

Hospital at Home is a where patients received treatment, rehab and care at home from community nurses, occupational therapists, physiotherapists and other health and social care workers. Patients are often discharged from hospital much earlier, receiving all the support they need to recover and rehabilitate at home.

Mrs Dingle continues “I was really pleased with the service we received. I was quite concerned that with my husband being less mobile he might fall so it was really important that everything was in place for his return. My worries were soon put to rest when even before my husband had returned home from the hospital the occupational therapist had been round to see what aids we would need. She arranged for lots of different things including an air mattress and chairs to be lifted so he sit down and get up safely.

“During the three weeks my husband received the hospital at home package carers came in a couple times a day to help him wash and shower and we also had visits from a physiotherapist, district nurses and I knew that we could call our GP at any time. We continued to receive additional care for another six weeks whilst he recuperated.

"We were both very pleased with the care my husband received. I'm sure his rehabilitation was swifter and more effective. The carers were lovely and I have nothing but praise for all the people involved. We both felt supported and looked after."

Dr Alison Diamond, Chief Executive said, “Hospital at Home is a successful service provided by the Northern Devon Healthcare NHS Trust, Royal Devon and Exeter Hospital, Devon County Council and the voluntary sector. It is not just Exmouth that benefits from this sort of service: our community health and social care teams are supporting 6,000 residents of Devon safely in their own homes and our nurses visit 100 patients every day. We are helping patients avoid hospital admissions and get home to their families sooner.”

Dr Tim Burke GP and Chair of the NEW Devon CCG said “We know that many patients want to be able to return home from hospital as soon as possible but they often need community health services to support them. Our recently announced proposals aim to refocus resources to increase capacity to do just that. We are currently involving and consulting with local people on the proposals and I would encourage people to let us have their feedback. They can do this right up until 12 December 2014 by writing, emailing or coming along to one of the meetings we are holding right across the area. And I can assure people all feedback will be considered before decisions are taken.”

Details of how to feedback on the proposals including date and locations for the meetings can be found at www.newdevonccg.nhs.uk/involve/community-services/101039.

Free jabs for over-65s, pregnant women, young children and people with underlying medical conditions

5 November 2014

Public health experts are urging people across Devon, Cornwall and Isles of Scilly to have the flu vaccination this autumn if they have an underlying medical condition.

 
Last year, only half of eligible people under the age of 65 took up the offer of a free jab, even though their condition makes them more vulnerable to flu and may get worse as a result. This compares to a take-up rate above 70% for people who are offered free vaccination because they are aged 65-plus.
 
Free vaccination is also available to pregnant women and to children aged two, three or four.
 
Although flu symptoms are usually quite mild, they can be very serious. Healthy people usually recover in two to seven days, but the disease can lead to hospitalisation, disability or even death.
 
The underlying conditions that make people of any age - including children aged six months and above - eligible for free vaccination include:
 
  • a heart problem
  • a long-term chest complaint or breathing difficulties, including asthma, chronic bronchitis or emphysema
  • kidney or liver disease
  • lowered immunity due to disease or treatment (such as steroid medication or cancer treatment)
  • a stroke or a transient ischaemic attack (TIA)
  • diabetes
  • a neurological condition, such as multiple sclerosis (MS), cerebral palsy or Parkinson’s
  • a problem with their spleen, such as sickle cell disease, or have had their spleen removed
  • a severe learning disability
 
Anyone who is unsure if they are eligible for a free vaccination should ask their GP practice.
 
A local project led by Devon County Council this year helped identify some of the reasons why people with these conditions don’t have the vaccination. The main reasons people cited were that:
 
  • They were concerned about side-effects. In fact, while there are some fairly common side-effects, these are mild. Your arm may feel a bit sore where you were injected, and some people get a slight temperature and aching muscles for a couple of days afterwards.  The vaccine doesn’t give you even a mild dose of flu, as it doesn’t contain the active virus. Any other reactions are very rare.
 
  • They didn’t have enough time. In fact, although vaccination will generally involve a trip to the surgery, a bout of flu can make you ill for days, even without complications.
 
  • They thought they would be immune from previous flu jabs. In fact, the flu viruses in circulation change each year, which means the vaccine has to change as well.
 
Other people just hoped they wouldn’t get the illness.
 
One of those people eligible is Becky Devereux, 39, who volunteers at Westbank Day Centre in Exminster.   Becky said:   “I make sure I get my flu vaccination every year, to protect myself and the people around me. I am asthmatic, and I look after my husband who is a kidney patient and has diabetes – we both know how serious flu could be for us if we came down with it. I also work with older people in my volunteering role, so I want to protect them too.”  
 
Dr Virginia Pearson, Director of Public Health for Devon, said: “I’d urge everyone who’s eligible to get their flu vaccination. If you are pregnant, it will protect you and your baby. And if you’ve got a two-, three- or four-year-old, they can have the nasal spray.
 
“I’m particularly concerned about people who have existing conditions that make them more vulnerable to flu. And if they do get the illness, not only is it likely to be more severe, but it can make the underlying condition worse as well as being passed on to their friends and relatives.
 
“Even a mild dose can be pretty unpleasant and knock you out for a few days. A severe case could lead to complications, hospitalisation or even, in some cases, death.”
 
Dr Mark Sanford-Wood, a Devon GP and Chair of Devon Local Medical Committee, said: “It’s really important that people who are in the eligible groups take up the offer of the free flu vaccination, even if they feel healthy. It’s quick, easy, and safe. The effects of flu can be much more serious than people think, and vaccination is the best form of protection against the risk.”
 
More information about seasonal flu and vaccination is available at:http://www.nhs.uk/conditions/Flu/Pages/Introduction.aspx

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