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GP Bulletin - November 2016

Shared vision for health and care services across West Yorkshire and Harrogate launched

The West Yorkshire and Harrogate Sustainability and Transformation Plan (STP) will be delivered by local health and care organisations working together across the region. It aims to support changes needed to improve services for the 2.6 million people who live here - and BTHFT is one of 13 health providers to be involved at the heart of its delivery.

West Yorkshire and Harrogate STP covers eleven clinical commissioning groups, six local council boundaries, as well as services provided by a number of health and social care organisations. It is built from six local area place-based plans – Bradford District and Craven; Calderdale; Harrogate and Rural District; Kirklees; Leeds; and Wakefield.

Its vision for West Yorkshire and Harrogate is for everyone to have the best possible outcomes for their health and wellbeing, and closer partnership working is at its very core. The draft STP has nine priorities, which are:

  • Prevention
  • Primary and community services
  • Mental health
  • Stroke
  • Cancer
  • Urgent and emergency care
  • Specialised commissioning
  • Hospitals working together
  • Standardisation of commissioning policies

We know that pockets of deprivation and affluence across these areas are key in determining people’s life chances. The draft STP aims to address this health and wellbeing gap with a focus on supporting people to live longer, healthier lives, and ensuring a good and equitable service for all, no matter where people may live.

An ageing population and people living longer with complex health and social care needs means demand is increasing faster than resources. The draft STP offers an initial view of how local and regional services can be improved, what this means for the health of people locally, and how we will need to collaborate to balance the books. The draft STP builds on local plans that have been developed in each of the six local areas it covers and these attempt to tackle long-standing issues and improve care.

They look at prevention, better co-ordinated services, preventing unnecessary hospital admissions and supporting people to stay well.  For further information, the draft STP, a public summary of the STP and an easy read version are now available to access.

Meet our new Chairman

We are delighted to announce to you that Professor Bill McCarthy has been appointed by our Council of Governors as the new Chairman of Bradford Teaching Hospitals NHS Foundation Trust. Bill is already known through his work as one of the Non-Executive Directors on our Board over the past year. He has a genuine passion for the NHS, and a real interest in the Foundation Trust and our people.

An economist by training, Bill has held a number of senior public service appointments. These include Director General in the Department of Health; Chief Executive of York City Council; Chief Executive at NHS Yorkshire and the Humber; and, most recently, National Policy Director of NHS England. He is Deputy Vice-Chancellor (Operations), and Honorary Professor of Health Policy at the University of Bradford.

Bill’s insight into the NHS, wedded to his experience of working here in the heart of the Bradford community, will be a major asset as we continue to improve the services we offer our patients. He becomes our Chairman at an important time for us, as a number of major developments in our journey of improvement draw ever closer – not least the imminent opening of our new £28m hospital wing at Bradford Royal Infirmary and the introduction of electronic patient records across all our hospitals.

Unit sets new record as it grows its role meeting patient flow challenges

Four times as many patients are now benefitting from our Ambulatory Care Unit (ACU) compared to when it first opened its doors a little over a year ago – making it one of our biggest success stories. The unit was launched in April last year to treat those patients who do not require an overnight admission and are not unwell enough to necessitate a bed – but who do need urgent assessment, diagnosis and treatment.

After quickly cementing its role at the heart of acute medicine – the fastest-growing hospital specialty nationwide – it is now seeing an ever-increasing number of patients referred from our Emergency Department as well as directly from GPs. Since its first month, which saw it treat 123 patients, the unit has grown month-by-month and has now seen a total of more than 6,400 patients. It has been processing up to 55% of our entire intake during its opening hours.

Its creation has enabled us to discharge patients on an evening, but bring them back to hospital for investigations the following day. Previously, these patients would have had to remain as an inpatient, taking up a valuable hospital medical bed when they are able to sleep in their home. This innovative way of working is helping to ease pressure on the rest of our hospitals – more important than ever as we approach another significant challenge this winter – as well as improving the patient experience.

Located opposite the existing Acute Medical Unit in the former pathology offices suite, the ACU is themed around the Yorkshire Dales and boasts a very calming and welcoming environment for patients and visitors. Working in partnership, the collocated units act as the first port of call for many people with an urgent referral from both ED and GPs. They are a shining example of the improvements that are now being realised as a result of the major investment we have made to enhance the emergency and urgent care patient pathway.

Top award for our invention that’s breaking new ground in older people’s care

A shining example of a “home-grown” Bradford invention – now used by around 90 per cent of GPs across the country – has scooped a top healthcare award. Our researchers based at the Bradford Institute for Health Research (BIHR) had led the development, validation and implementation of the Bradford Electronic Frailty Index (eFI.) We are now delighted to reveal that the team has been recognised at the highest level for their hard work and innovation.

Their invention has won the national EHI Healthcare Product Innovation award. This is a prestigious accolade in the world of health informatics and is a ringing endorsement of the rich pool of home-grown talent that exists in Bradford.

Put simply, our award-winning eFI uses information about an older person’s health problems, disabilities and impairments to calculate their risk of important complications including admission to hospital, length of stay in hospital, nursing home admission and mortality. Against a backdrop of a growing and ageing population, it is leading the way nationally in older people’s primary care as it is now available to around 90 per cent of all GPs across the country.

Consultant Geriatrician, Andy Clegg, along with colleagues, Dr Tizzy Teale and Professor John Young, who was previously the Government’s Frailty Tsar, developed and refined the programme which started three years ago.

Andy explained: “We are thrilled to have won the award. It’s brilliant to be recognised in this way, and of course we are really pleased that the eFI is making such a big difference, helping to improve care for older people. When we set about developing the eFI, our thinking was that there was already a wealth of information captured in GP medical records, such as vision problems, hearing, dementia, falls, problems with mobility etc. It was just a case of developing a tool that could collate and interpret this data. Nationally there has been a big push to identify frailty and give older people better services by keeping them at home for longer, improving the quality of their life and preventing admissions to care homes and hospitals. The problem was that historically there were a number of tests looking at this but they all took time and resource so our approach was to use the GPs’ primary care records and identify frailty through these, and as you might expect, this was not a straightforward task.”

But with the help of TPP, the company behind the SystmOne GP IT programme, the team used anonymous data from around 900,000 patients registered at GP practices across the country. From this data, they extracted information which was narrowed down to 36 deficits, which assess a person’s clinical signs of frailty, including their symptoms, disease and disabilities, as well as their requirement for care. These assess a person’s clinical signs of frailty, including their symptoms, disease and disabilities, as well as their requirement for care.

Andy continued: “The eFI identifies older people who are fit as well as those with mild, moderate and severe frailty who are at increased risk of future nursing home admission, hospitalisation, longer length of hospital stay, and mortality. It represents a major advance in frailty care because, for the first time, it identifies frailty using routinely available data, without the need for an additional clinical assessment. By implementing the eFI in routine primary care, we are catching people early, before they reach crisis point, which in turn is enabling us to better target evidence-based interventions. These not only improve planning within our health services but help us to create and develop more appropriate, proactive, goal orientated care pathways for older people with frailty.”

In addition, the eFI has also been included in the recently published NICE multimorbidity guideline as a recommended tool to identify people who require an approach to care that takes multimorbidity into account.

Trust Grand Round November 2016

The next Grand Round will take place on November 29 2016. The subjects will be Diagnostic Virtual Ward presented by Stefan Williams and Improving the Patient Experience through Volunteering presented by Christine Heaton/Shelley Bailey. These meetings provide an excellent opportunity to meet with fellow professionals whilst remaining up to date with key issues and developments.

The Foundation Trust invites all local GPs to attend the Grand Round which are held monthly. The Grand Round is held in the Sovereign Lecture Theatre at Bradford Royal Infirmary. Meetings start at 12.45pm and last for an hour. Lunch is available from 12.15pm.

This monthly bulletin aims to keep local GPs up to date with the trust’s new services and developments. If you’d like any further information about any of the items in this month’s briefing contact Naveed Saddique on 01274 272635, email gp.comments@bthft.nhs.uk.