The final summative report on the vanguard projects at North East Hampshire and Farnham has been published, giving an overview of the impact of the new ways of working explored over the last three years.
The evaluation underpins our approach to delivering care for local people in an integrated way with our partners, focusing on the needs of local people and not being constrained by organisational boundaries. We are committed to continuing to develop these new ways of working and extend them not only across the localities in the CCG, but also more widely across the systems of Frimley Health and Care Integrated Care System, and the Hampshire and Isle of Wight STP.
The evaluation has been completed by our independent evaluation partner the Academic Health Science Network.
- 50,000 patient contacts and interventions in 23 new services
- 3,300 patient reported outcomes demonstrated significant improvements in how they feel about their health status, confidence and wellbeing
- 530 staff reported outcomes from the new care model teams and primary care, demonstrated statistically significant improvements
- From the second year of the programme there was a significant reduction in the trend of emergency admissions.
- Qualitative interviews and case studies found positive benefits for patients, staff and the system
The evaluation highlighted the importance of allowing time to establish new teams and ways of working. GP engagement was a key ingredient in successful delivery.
For a snapshot of the overall programme's impact, click on the image (above right).
Clinicians, practitioners and other professionals from health and social care working together as a single team for Farnham patients with highly complex needs who require support from different agencies and organisations.
By working more closely together the team ensures that all aspects of a patient's care can be covered and all their needs met in a comprehensive and efficient way and that cross-agency solutions can be used to provide a better overall service.
The joint approach also prevents patients from 'slipping through the gaps' between organisations.
For some of the key achievements click on the image on the right.
A service established to support three of Farnham's GP practices by providing urgent same-day GP appointments to a population of 30,000 patients.
The centre was created in an unused part of Farnham Hospital and Centre for Health with funding through the Happy Healthy at Home programme to convert the area into a custom-built facility.
Staff are provided by Farnham Integrated Care Services, the local GP federation.
For further information, performance figures and patient feedback, click on the image on the left.
Established at Yateley Medical Centre in early 2017, the Yateley Urgent Care Centre works in a similar way to its younger Farnham relative.
The centre provides same-day (urgent) appointments for patients of Oakley Health Group (spanning three Yateley surgery sites) who might otherwise have attended A&E.
Patients call their surgery in the same way as they normally would and, if they need an urgent appointment one can be made for them.
The service also links with Frimley Health NHS Foundation Trust to see if there are Yateley patients attending A&E for medical needs that could have been met by the Urgent Care Centre.
The centre is staffed by Oakley Health staff on a rotating basis.
For further information, performance figures and patient feedback, click on the image on the right.
As with the Farnham team above, the Yateley Integrated Care Team brings together a range of different professionals to provide a joint solution to the problems faced by Yateley residents with complex and chronic health needs.
They discuss patients' conditions and combine their expertise and organisational capabilities to make the patient's experience of health and care services as smooth and positive as possible, with better outcomes.
Click on the image on the left for a summary of some of the team's successes.
Happy, Healthy, at Home has placed great emphasis on the benefits of preventative measures i.e. supporting people to be able to live healthier lives to reduce their risks of illness and injury, and if they do have an illness, injury or medical condition, to provide the necessary help and support to enable them to manage it better themselves.
The North East Hampshire and Farnham Recovery College runs educational courses and workshops to help people with a range of psychological, mental and physical health conditions.
For a summary of the Recovery College's achievements, click on the image on the right.
This service has been put into practice by Farnham GPs to review all non-urgent routine medical and surgical referrals to hospital.
The aim of improving the overall quality of referrals, reducing the numbers of avoidable planned referrals and making the service more efficient by ensuring that all referrals go to the right place first time.
To see some of the key achievements of this work, click on the image on the left.
Established in 2014 as an out-of-hourse mental health alternative to A&E, to support people experiencing, or on the verge of, a mental health crisis.
The Safe Haven is groundbreaking, in that it marks a shift away from conventional clinical support models.
It is based in a non-clinical town centre setting, it offers a range of support, from providing a safe place for people to sit quietly, to read, to play games, to have conversations with other service users, to discuss their situation with, and receive advice and guidance from, mental health support workers and, if necessary, to receive clinical support.
The model reflects the expressed wishes of mental health crisis service users for whom previous mental health crisis services were proving unhelpful.
Its success has led to the creation of similar services across Surrey, as well as the Young Persons' Safe Haven, in Aldershot, and The Oasis, in Farnborough.
This service was set up to support colleagues in acute services by reducing the number of non-urgent referrals to A&E from the 111 service by offering callers an alternative - in the shape of a call with a GP within 15 minutes of their original call.
With growing numbers of people calling 999 or attending A&E unnecessarily, attention was focused on ways to reduce the demand while ensuring that patients received treatment that met their health needs.
The service is only designed to catch those callers who do not need to visit A&E. If the GP on duty feels the patient needs to attend A&E then they will advise them to do so.
For more information and performance figures, click on the image on the left.
The best bed is your own bed and getting patients home is a key aim to all of those involved in their care, particularly in their rehabilitation and recovery following a stay in hospital.
Staying in hospital any longer than necessary can be detrimental to somebody's recovery and it also reduces the hospital's ability to treat other patients. Therefore the Enhanced Recovery at Home Service was set up, not only to enable more patients to benefit from timely hospital discharges but also to help avoid admission for those who can be supported to remain at home.
The team is made up of a range of health and social care professionals, all working together and assisted by their local Integrated Care Team (see other flashcards and reports), to support adults, particularly those with multiple medical conditions.