A proposal for changes to improve local health services will be considered by NHS Dorset Clinical Commissioning Group Governing Body members as the next step before a public consultation later this summer.
Since the launch of the Clinical Services Review in October 2014, over 300 GPs, hospital doctors, nurses, therapists, paramedics along with social care staff and public and patient representatives from in and around Dorset have been looking at the local healthcare system. They have been considering how hospitals, GPs and community services could deliver greater benefits to local patients by improving quality and access within the available funds.
On 20 May, if the CCG Governing Body approves the options for new ways to deliver care, the proposals will then be subject to a robust NHS assurance process and a Gateway review undertaken by independent reviewers. Following this review a full public consultation will take place later this summer in order to gather views and any additional information from local people. A Dorset CCG Governing Body decision-making meeting will then take place in spring 2016.
The CCG Governing Body will be asked to consider the evidence and proposals including:
· the need to change – evidence shows some care is not as good as it could be and isn’t always designed to best suit patients’ needs; there are also challenges because of staff shortages and the fact that demand for services is rising at a faster rate than the funding for services is increasing;
· the vision of how better care could be delivered in Dorset – by the NHS and social care working better together in patient’s homes, GP, community and hospital settings;
· the care that needs to be provided by GPs and in the community;
· the care that needs to be provided by Dorset’s acute hospitals.
To improve GP and primary care services for patients in Dorset the proposals outline:
· how to offer patients seven day access to primary care services;
· how to offer more services closer to people’s home;
· how to reduce unnecessary and unplanned admissions to acute hospitals;
· how to work more closely with social care services;
· how to get greater efficiencies by sharing some facilities and support services.
This may include having networks of GP surgeries organised around new health ‘hubs’ where patients could see a wide range of health professionals including health visitors, pharmacists and dentists and receive care that currently requires a visit to an acute hospital such as physiotherapy, blood tests, minor operations or rehabilitation.
To improve acute hospital services for patients in Dorset the proposals outline:
· how to offer patients high quality care delivered by specialists (available 24 hours a day, 7 days a week where appropriate to the medical condition);
· how to further improve patients’ treatment, recovery and survival;
· how to improve patients’ access to specialist care;
· how to meet national quality standards for key specialist services that are not currently met.
The proposals set out that this can be delivered by:
· Developing a major planned care hospital at either The Royal Bournemouth Hospital or Poole Hospital to focus on treating patients needing scheduled operations. This hospital would also be a centre of excellence for treating the increasing number of frail and older patients who often have multiple different medical conditions. Additionally it will offer an Urgent Care Centre (as part of Dorset’s A&E network) to deal with approximately 80% of conditions that are currently seen in A & E and operate as a ‘hub’ providing a wide range of primary and community care services;
· Developing a major emergency hospital with A & E services at either The Royal Bournemouth Hospital or Poole Hospital to deliver day-to-day acute services and very specialist care with consultants on site 24 hours a day, 7 days a week as needed by a small number of very seriously ill patients. Currently in Dorset we do not have this level of consultant on site provision and it will help to ensure that patients get the highest standards of care day or night and that national quality healthcare guidelines are met;
· Continuing to have a planned care and emergency hospital with A & E services at Dorset County Hospital to maintain the broad range of day-to-day acute services, scheduled operations and emergency provision that are currently offered.
Dr Forbes Watson, a local GP and Chair of Dorset CCG, said “Our local services must work better together to meet our patients’ needs and quality standards within available funds.
Doing nothing is not an option because the way we currently deliver care in Dorset isn’t as good as it should be and isn’t sustainable in light of changing and increasing needs from our growing and ageing population, and we have a shortage of specialist staff available for some services.
As the GPs responsible for deciding on the care that is provided in Dorset we have worked hard since October 2014 to identify solutions to our challenges. These are based firmly on national and international evidence and good practice and will enable us to organise our services more effectively and efficiently to improve care for the people of Dorset. The proposals have been led by local clinicians and their discussions and ideas shared at every stage with NHS staff, patients, carers and members of the public. We look forward to hearing the views of local people during the consultation later this summer. If you want to take part and provide your views please sign up to our Health Involvement Network so we can send regular updates, the consultation papers when they are available and information about how you can get involved.”
