Our review of the effectiveness of the services we commission has been a thorough, ‘good housekeeping’ process. We are eliminating waste by duplication and by services not delivering what they were intended to deliver. A robust and constructive process, the review has enabled us to embark on service redesign with clinicians and was commended by NHS England.
A side benefit of this work is that we have strengthened our contract management and monitoring processes. Our review continues to be aimed at providing long term sustainability at a time when the NHS is operating on constrained budgets and we remain committed to commissioning the best possible healthcare for the people of Solihull.
The potential impact – clinical, financial or otherwise – of making any changes to services was initially assessed by an Effectiveness Review Group, which included local GPs, patients, the Director of Public Health, and CCG lay advisors. We have listened to our GPs and to hospital clinicians and managers at Heart of England NHS Foundation Trust (and continue to do so) and this has led to us changing some of the initial recommendations.
We continue to keep Solihull Council’s Health and Wellbeing Scrutiny Board updated as we implement the decisions. Quarterly reports go to the Governing Body and are available on our website.
Some of the changes we are making are summarised below. You can see what else we are doing and have already done here.
A diabetes working group is being set up to review and redesign the entire diabetes service (including primary, community and hospital care). We want to ensure the route from GP to hospital care is clear and that patients are cared for in the most appropriate setting by the most appropriate clinician. We are focusing on:
- Working with hospital specialists to support clinical training of practice staff
- Making effective education programmes available for patients
- Providing consultant and specialist support in GP practices
- Ensuring that anyone who is frail and those that care for them, are supported to manage their condition in the community (including care homes)
- Linking with our public health colleagues to ensure patients are supported to manage their conditions themselves, where appropriate.
Paediatric speech and language therapy
The effectiveness review has highlighted the need for a redesign of speech and language therapy services for children. Solihull’s five school collaboratives and the Schools’ Forum’s special educational needs work group are being involved in discussions regarding the clinical redesign.
Learning disabilities service for adults
The service at Gilliver Road is very successful and our review has highlighted that it has excess capacity that we are able to sell to other CCGs to help them meet their Transforming Care responsibilities. These are commonly known as Winterbourne responsibilities following a national review of that name. This will enable the CCG to save money without making any reduction in service.
New integrated community teams
Working together with Heart of England NHS Foundation Trust, Birmingham and Solihull Mental Health NHS Foundation Trust and Solihull Metropolitan Borough Council through the Integrated Care and Support Solihull (ICASS) programme we are designing a new integrated community team service. The Virtual Ward will be decommissioned and community matrons from the service will be brought together with community nursing, along with staff from the existing Single Point of Access (SPA) service, to form integrated community teams. A transition plan has been developed and patients will be informed about the new arrangements. Referrals to the virtual ward are expected to cease by June 2015.
The new integrated community teams will deliver community nursing services to patients in their own home, including people who are at the end of their life. They will also provide a rapid response (within two hours) to provide urgent care and support to those at immediate risk of an admission to hospital. This new rapid response element will be tested during May and June, with the service due to go live at the beginning of July 2015.