Update on the Future Hospital Programme
About this section
This part of the Future Hospital Journal is where you will find regular overview updates on progress made by the Future Hospital Programme of the Royal College of Physicians, together with its partners, in realising the vision of the Future Hospital Commission.
We very much welcome your feedback. If you have any comments, or would like to be involved in the work of the Programme, please contact futurehospital{at}rcplondon.ac.uk.
Introduction
Just as 2015 drew to a close, so too did our selection process for the next phase of the Future Hospital development sites. We have been overwhelmed by the quality of the shortlisted applicants and look forward to this next chapter in the Future Hospital Programme (FHP). In this update we are delighted to announce the successful sites, where projects will commence in March 2016, marking the start of our united journey towards innovation and learning.
The initial four Future Hospital development sites (‘phase one’) continue to flourish and remain at the forefront of building a robust evidence base of person-centred experience and outcomes. The focus of evaluation of these sites is closely aligned to the principles of the Future Hospital Commission report;1 including assessments of patient experience, staff health and wellbeing, and organisational culture. In this update we offer an overview of preliminary results and learning taken from the last 12 months.
This update includes:
reflections on the recent Future Hospital Strategic Advisory Group meeting
a special contribution describing a novel approach to integrated care by the diabetes team at Oxford University Hospitals
news on the Royal College of Physicians’ (RCP's) Medicine 2016 conference.
Phase-2 development sites announcement
In late 2015, healthcare teams were invited to apply to be development sites, with a focus on implementing:
person-centred integrated health and care services in the community, supported by a multidisciplinary team including GPs and specialist physicians
partnerships between specialist physicians, primary health and care providers, and commissioners that ensure coordinated services reduce fragmentation and duplication
more efficient and cost-effective healthcare models for people with long-term conditions or complex health needs.
The selection process included interview by a panel comprising clinicians from primary and secondary care, FHP team members and patient representatives. The selected phase-2 development sites were announced in January; see Box 1.
We welcome the phase 2 sites to the programme and look forward to reporting on the progress of these four additional sites, and to sharing their learning to support others in developing integrated care projects.
Phase-1 Future Hospital development site findings
Since September 2014, the FHP has been working closely with four selected development sites. Our collaborations with these teams have centred on realising the principles of the Future Hospital in practice. All four sites have a focus on care for frail and elderly people.
As part of our partnership with these pioneering locations, we are working closely together to evaluate and learn from their experiences. In their annual reports, the sites reflected on their successes to date, how they overcame the practical challenges of setting up and delivering on new models of care and their ambitions for the next phase of the programme.
Key achievements at Mid Yorkshire Hospitals NHS Trust include comprehensive geriatric assessment for all patients over the age of 80 and those over 65 who are care home residents.
Olwen Williams at Betsi Cadwaladr University Health Board describes how ‘the potentially biggest gain lies in the streaming of multiple follow-up appointments into a specialist geriatric or general medical clinic, thus setting free multiple outpatient appointments per patient.‘
‘The multidisciplinary aspects of the emergency floor (at Worthing) have worked well and through a process of constant reassessment of working practice we now have excellent MDT working across the floor.’
John Dean at East Lancashire Hospitals NHS Trust reflected that, ‘involvement in the programme has supported us to focus on the needs of frail older people wherever they need care, learning from other sites and networks to develop joint working as a health and care community.’
Future Hospital Strategic Advisory Group
The Future Hospital Strategic Advisory Group (SAG) comprises national leaders from across health and social care. Drawing on expertise from their fields, members of the SAG provide an objective overview and advice on the direction and shape of the FHP. This advice has been crucial in shaping FHP activity, ensuring its relevance across healthcare settings and professions, and maintaining focus on the provision of services structured around the needs of patients.
Last November, the SAG received presentations from two of our development sites: Worthing Hospital (Western Sussex Hospitals NHS Foundation Trust) and Mid Yorkshire Hospitals NHS Trust. Dr Roger Duckitt described the development of the new Worthing emergency floor. The biggest impact of this new assessment model was in surgical patients, with a marked increase in same day discharge, reduced overall length of stay and a trend towards reduced mortality. Dr Duckitt emphasised that a purpose-built emergency floor was not essential to successfully deliver new concepts in teamworking and patient care. The priority should be to test new ways of working that make a difference and instilling a culture of regular reporting and review to assess progress towards agreed objectives.
The team at Mid Yorkshire Hospital NHS Trust are continuing to encourage teamwork and inspire innovation across the trust. They found that simple ‘quick fixes’ such as clarity of job descriptions and team structure greatly increased team engagement with the Future Hospital project. The RCP Patient and Carer Network representative for the site, Lynne Quinney, also provided a candid assessment of the value of public and patient involvement in the project, citing the benefits in bringing focus to the monthly team meetings attended by herself and the local patient representative. Lynne felt that all the attendees are working towards a common purpose with equal opportunities to contribute to delivery and share achievements. The FHP will continue to engage with national stakeholders throughout 2016, highlighting the achievements and challenges of the development sites.
Integrated care in Oxford
The Oxford group has been working on developing a new model of integrated care across hospital and community settings to better support patients with diabetes. The approach involves bringing primary, community, secondary and tertiary providers of care together under a single governance structure to align organisational priorities and resources with the needs of patients. This programme is led by Drs Rustam Rea, Garry Tan and Alistair Lumb, who are promoting integrated care for people with diabetes in Oxfordshire and advising the Oxfordshire clinical commissioning group on the shape of the new integrated diabetes service. As a result of this work, innovative ways of commissioning and providing integrated care are emerging.
The integrated care programme is composed of four work streams.
Understanding the decision-making processes involved in planning and delivering a new model of care.
Exploring a new model of integrated care and critical elements responsible for its sustainability.
Recognising the importance of evaluating outcomes of the new model of care for patients and their families, healthcare practitioners and the healthcare system. This work includes review of available tools for evaluating diabetes care and developing more appropriate methods for the integrated model.
Translating the evidence into education and training for those planning and delivering an integrated model of care in other parts of the country and for other patient groups with long-term conditions.
Medicine 2016: RCP annual conference
All four phase one Future Hospital development sites will report their progress in a ‘Big Conversation’ session, reflecting on the barriers and levers they have experienced to date at the RCP annual conference, Medicine 2016, held in Harrogate March 15–16 2016.
In a ‘Hot Topic’ session, the way in which physicians will deliver integrated care in the future will be explored, with case studies and practical advice focused on education and training; data sharing across primary, secondary and social care; and negotiating with and influencing commissioners.
Our recently announced phase-2 sites will also offer insights on the delivery of integrated care in practice.
Visit www.rcplondon.ac.uk/events/medicine-2016-rcp-annual-conference to download the complete programme and to book now.
Tell us your story
The FHP wants to hear from you! Tell us your story is our way of promoting and sharing the great work and learning which is bringing the Future Hospital principles and recommendations to life. Visit www.rcplondon.ac.uk/projects/outputs/future-hospital-case-studies-tell-us-your-story to read the published stories and to download a form to submit your own.
If you'd like to get in touch, please email: futurehospital{at}rcplondon.ac.uk
- © Royal College of Physicians 2016. All rights reserved.
Reference
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- Future Hospital Commission
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