Quality Care - everyone, everytime
 
Hospital Pond
A new care model for hospital services to be recommended for the Island
26 January 2018

A proposal to improve the safety and quality of hospital based services for patients on the Island is published today, to ensure that Isle of Wight residents have health outcomes as good as any other NHS patients living in other parts of the country. The proposal will be considered by the Isle of Wight Clinical Commissioning Group and, subject to approval from its Governing Body, there will then be a period of further testing and consultation with staff, public and partners over the course of 2018-19.

The proposal would mean:

  • In future, acute services will be delivered on Island first wherever clinically appropriate and local residents will only have to travel to receive services when it is essential to do so.
  • Around 90% of current hospital activity would be retained on the Island
  • More joint working for the Island’s NHS staff with colleagues in NHS services with mainland hospitals will ensure patients receive the best possible care, and staff are able to retain and extend their clinical skills
  • Some of the more seriously ill patients requiring more complex, urgent specialist treatment would be transferred to the mainland to improve quality of care for patients
  • However, fewer patients would travel to the mainland overall, as more routine planned care would be provided on the Island and follow-up appointments undertaken face-face or with the aid of technology on the Island. At a conservative estimate, this would reduce the overall number of patient journeys to the mainland by approximately 500 each year.

Mr Stephen Parker, Interim Medical Director for Isle of Wight NHS Trust and Clinical Lead for the Acute Service Redesign programme, said:

“Providing access to high quality and safe care for patients is our priority. Wherever possible, we should continue to give people the very best hospital based care on the Island. Where outcomes for certain complex procedures are significantly better on the mainland, more of our seriously ill patients should be able to benefit from these services. But overall this proposal will enable us to reduce the number of times people are asked to travel to the mainland, as more routine care and follow up appointments will take place on the Island.”

The Isle of Wight faces particular challenges given the ageing profile of the population, the increase in associated complex healthcare needs and long-term conditions. It also struggles to recruit specialist staff which leaves some services under-resourced and overstretched. Many acute hospitals serve a population more than twice the size of that on the Island which also means it is easier for clinical staff at other hospitals to retain and extend their skills because of the volume of procedures undertaken. The cost of providing these services on the Island, without the advantages of scale, also leads to financial challenges. The Isle of Wight NHS Trust’s deficit is forecast to grow to an unsustainable £23.6m by 2022/23 unless changes are introduced.

The recommendation means the Island can improve the quality and safety of care for patients, address the significant staffing challenges and ensure services become more efficient and resilient through joined up working.

Mr Parker continued,

“We have considered a range of alternative options during this process and I would like to thank all the clinicians, staff, patient and community representatives who have got involved and helped us reach this important milestone. Given the significant challenges we face, we do not believe that simply staying as we are and doing nothing is safe or sustainable. But neither do we want to see the wholesale transfer of multiple services off the Island, given the huge impact that would have on the quality of life for patients and their families or carers, and the significant transport costs involved. We believe our recommendation is therefore in the best interests of patients as it stands but we fully expect this outline model to continue to evolve as we undertake further discussions during this year.”

Councillor Dave Stewart, Leader of the Isle of Wight Council said: “We need to give Islanders the same opportunities and access to safe, quality health and care as anywhere else in the country and this vision and framework gives us the opportunity to do that. We need to embrace technology within our health and care services to help us overcome some of the challenges we face as an Island, not just in terms of the surrounding water but the rural spread of our population in relation to services.”

Cllr Stewart continued: “Through our Local Care Plan we will also ensure that our community services are working most effectively and efficiently to deliver more care and support closer to home so that people only have to use hospital services when they really need to. We are also working to ensure people can return home safely and with the right support where they have needed to stay in hospital and we have already made great progress in ensuring we have fewer people waiting in hospital to return home.  It’s about putting in place a whole system approach to integrating care so that we can offer the best care to our residents. It’s not a quick fix to deal with the existing pressures, it’s a longer-term plan to enable us to tackle these and other challenges that we may face in the future.”

Chair of the Patients Council, Doreen Britton said: “We all need to recognise that change is important and inevitable if we are to improve the quality of care for local people. We have seen many changes in the NHS over the last 70 years and this is our opportunity to shape it further so that it can provide lasting support for Island residents for years to come.”

There will not be any immediate changes and no decisions have been made. The Governing Body of the Isle of Wight Clinical Commissioning Group, which includes clinicians and lay members, will consider the recommendation at its meeting on 1 February 2018. If the recommendation is agreed, the IWCCG and NHS will carry out further testing and work with partners, staff, community and patient groups over the course of 2018. The proposal will also be reviewed and considered by NHS England as part of an intensive process lasting several months.

Further work will also be carried out to define how staff would work together in the most effective way, especially in key specialties where change is most required, and to ensure robust, seamless arrangements for transferring and discharging patients between hospitals are in place to support any proposed changes before they are implemented.

The public will also be asked for their views during a formal public consultation later in 2018 before implementation plans are developed and finalised.

The Transforming Acute Services for the Isle of Wight and the covering paper going to the IW Clinical Commissioning Group (CCG) Governing Body meeting can be downloaded below.  Details of the meeting can be found on the CCG website at http://www.isleofwightccg.nhs.uk/about-us/our%20governing%20body/board-papers/board-papers.htm.

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