New NHS Partnership heralds change to system

Most parts of the healthcare system are good but the different bits don’t always fit together…

GPs are good and passionate people and the same goes for nurses, consultants and social care professionals… indeed most who work in the health and care sector.

However, the NHS and the wider healthcare system in Staffordshire (and across the UK) doesn’t always fit and work together as well as you might think. It’s made up of numerous independent trusts and bodies that each have a responsibility to their own autonomous organisation as well as the wider healthcare system.

In effect the NHS is a franchise or an umbrella body and underneath sit many independent others. And then Social Care Services sit separately as part of top tier Local Authorities, ie the County.

Those organisational barriers and that autonomy, as well as an affinity to the status quo, often means it is organisational needs rather than the wider healthcare system that takes precedence.  That is why things don’t always work well for the patient and why too many individuals end up in hospital when there is no need. It’s also why changes which would improve that, don’t happen.

It’s not broken but it’s a six cylinder engine which is running on five. And that last cylinder is crucial beacause it also holds the key to long term financial sustainability and much better patient care. Quality, the patient experience and long term outcomes for getting people back on their feet sooner, and at less cost, could be so much better.

Older people services are the most challenging and are also often the area where the quality of service, and particularly the care and dignity provided in hospitals, is most criticised. The fact is that far, far more older people end up in hospital than should. It’s not about denying hospital care on cost grounds… it is about recognising that clinical practice and technology has moved on in the last twenty years meaning far more minor procedures can be safely carried out away from hospital. And conditions resulting from trips or falls can be treated in the home with intensive support from health and social care teams that work purely in the community. Both those scenarios are often safer and better for long term wellbeing than being in hospital.

But that’s not possible unless we fundamentally shift resource into creating more, and better, community teams. And that is why the new Trust is so important. It represents a massive shift of staff and resources into top quality community based teams providing care, treatment and reablement in the home and community settings.

It’s not even about reducing the number of professionals in the health and care system. It is about moving some treatment from what has previously been a default hospital setting to a flexible mobile community based one which causes less disruption for the people receiving care and support.

Evidence clearly shows that where it is safe and appropriate to do so, particularly patients who are older, get better quicker with less long term disruption to their independence in a community setting such as the home they know and love. That is precisely what this new Trust is about and it’s precisely what we had in mind 20 months ago after taking office when we started working on the formation of it.

Phase one, which is the health component, was launched recently and phase two would complete our plans. I’ll be taking my recommendation for that to County Cabinet in a couple of weeks around moving all of Staffordshire’s social care staff into the Trust as well.

That will mean a step change improvement to wrap around, multi-disciplinary personalised care in the home that will increase the chance for individuals to maintain their independence and normal way of life for far longer.

The new Partnership Trust is therefore a crucial step in shifting more resources and focus into community based healthcare services and, I hope, opens the door for improvements in the way the wider healthcare sector works together. That would help more individuals get well sooner and back on track to a normal and more independent life.

And, yes, it would also be more financially sustainable as the population in Staffordshire ages and demand for services grows.

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