Agenda item

The Interim Accountable Officer from North Staffordshire Clinical Commissioning Group and the Clinical Lead from Stoke-on-Trent Clinical Commissioning Group will be in attendance.

The Chair welcomed the Interim Accountable Officer from North Staffordshire Clinical Commissioning Group and the Clinical Lead from Stoke-on-Trent Clinical Commissioning Group to the meeting.

The name “New Model of Care” had been changed to “My Care My Way – Home First”.  A Member raised concern over the renaming, as those who worked within the NHS still recognised it as Step Up and Step Down and asked how was the CCG going to roll it out to individual people?

The Interim Accountable Officer advised the title “Step Up Step Down” was a nationally accepted term.  The Step Down model of care, saw the patient’s journey from the point of admission to discharge, supporting less transfers of care between multiple organisations which would result in a reduction in delays. As part of the wider system reconfiguration the model Step Up was developed, which saw a diagnostic and assessment centre introduced within the community and a continued increase in easily accessible home based services within the community, improving the quality of care for all patients.

The stakeholder group working with the CCGs suggested My Care My Way – Home First, as it was felt that this name better described the service in northern Staffordshire, giving it a unique identity rather than the generic term Step Up Step Down.

The following questions were raised by Members and response provided:-

Q1:      What was the cost to the CCG of implementing this service?

A1:      CCGs pay for a Spell (the length of time in days from admission date to discharge date) and HRG (a means of aggregating health data into groups of interventions that are of a similar cost and of a similar nature and complexity).  When patients are discharged within the trim point (Spell) they often move into a community service and a similar payment is made to the community trust, this is known as a complex discharge.   In effect, the CCG pays twice for each complex discharge. My Care My Way will save money as more people will be discharged home rather than into another service.

Q2:      What would be the savings and were there plans to reinvest into the community care?

A2:      There would be a saving of c£15m for the full year.  This was a combination of savings of patients returning home rather than into a community bed and admissions avoided.

Q3:      This would affect a vast amount of people, had there been sufficient communication with the patients?

A3:                  All patients and their families are routinely communicated with regarding their ongoing care. Specific communications about My Care My Way have been issued via the CCGs’ websites, briefings, public meetings and public facing documents and advice leaflets.

Q4:      What impact had there been on the staff?

A4:      Redeployment and retraining of staff was being considered.  There had been an increase of 30% more staff.

Q5:      The consultation document advises that 37 beds at Longton would be lost.  Are we going to be looking at more closure of beds in the community hospitals?

A5:      As a commissioner the CCG buys services.   The CCGs do not own or operate the community hospitals, SSOTP does, My Care My Way will see more people receive their care at home rather than in a community bed. As such, the use of the community beds will be reviewed, as will the role of the five community hospitals.

Q6:      North Staffordshire had invested £190,000 into the dementia service.  How had the funds been allocated?

A6:      The funding had been invested into memory clinics.  As a consequence of My Care My Way a range of commissioned services had received additional investment over the last two and a half years.

Q7:      The carer would be their partner and it is important they receive adequate support.

A7:      General Practitioners were trying to diagnose dementia in its early stages and were now diagnosing more patients than was the case a few years ago.

Q8:      Patients remain on medication longer than they should.

A8:      This was being investigated to perceive if patients still required the drugs. Patients were regularly reviewed to ensure they still required their medicines or if they need changing.

Q9:      How do you envisage improving access to psychology services?  How many staff was qualified and was those posts met?

A9:                  The North Staffs IAPT service is performing well and achieving national standards. Across all community services, we are confident that the staff was in place to deliver My Care My Way. We are also confident that there was the appropriate balance between qualified and non-qualified staff to deliver safe patient care.

Q10:   How many qualified staff was there in district nursing?

A10:                The CCG agreed to supply the number of qualified staff following the meeting.

Resolved:-

(a)          Interim Accountable Officer to provide Committee with the number of qualified staff investing in district nursing.