Time/Date/Venue: / 19:30, 03rd September 2015, Heald Green GP Practice and Community Centre
Responsible Officer: / Lucy Cunliffe – Stockport Together Communications Lead
Details of Organiser: / Christine Morgan – Chair Heald Green PPG
Type of Engagement
o Open Meeting / X Focus Group / o 1:1 interview / o Postal survey / o Phone survey / o Email survey / o Online survey
Attendees
Sally Wilson (SW) – Head of Service Redesign ASC – Stockport Metropolitan Borough Council
Lucy Cunliffe (LC) – Communications Lead – Stockport Together
Demographic Breakdown of attendees
Age: / 60+
Disability: / Mixed
Gender: / Mixed
Race: / White British
Religion: / Not known
Sexual Orientation: / Not known
Comments and Proposals:
Sally Wilson, representing Stockport Together, gave an overview of the transformation programme in the form of a presentation to Heald Green Patient Participation Group, and then invited questions and feedback from the members.
These have been summarised below:
[a King’s Fund video ‘Sam’s Story’ was shown, which outlines the potential changes to be implemented under Stockport Together]
Sam has a computer at 87 – many people don’t..?
In the past it may have felt a little bit like the interests of the organisations have come before the interests of patients. And there hasn’t been enough honesty with the patients about the problems we have been facing – it’s true to say that a crisis brings people together, and it’s certainly bringing the organisations together.
Vanguard has given us the freedom to redesign our health and social care system to make it work in the way it should.
In addition to this, GM Devo is giving us an enormous opportunity to drive the public sector to work together, and ultimately eliminate the disjointed working practices we’ve operated in the past.
I had an operation recently at Stepping Hill but had a 10 – 12 minute walk from nearest facility to my appointment. Is anything being done to look at accessibility?
Yes, access to services is a crucial part of the changes being looked at under Stockport Together – this includes where services are physically delivered, as well as how people gain access to clinics and other services via waiting lists and referrals etc.
How do you divide budgets across the four programmes? Surely the Planned Care area is the most expensive to deliver?
In reality the services which are delivered in a hospital / acute setting are the most expensive.
The is a recognition across Stockport Together that getting the early stages right within a health or social care environment should reduce the level of demand for services at the later stages.
Are care homes being considered within this work? Do they sit mostly within Planned Care?
Yes, care homes are a huge part of this work – as they are big deliverers of care to a large part of the population of Stockport.
Care home involvement stretches across each of the four programmes, and is most heavily embedded within Proactive Care.
Does the Cheadle and Bramhall ‘early adoption’ cover Heald Green? It is very difficult for many people to get to one location
[Dr Owen advised that Heald Green will be a hub on its own within the Cheadle and Bramhall locality plan]
Was Cheadle and Bramhall chosen as a locality because it’s one of the easiest areas?
The choice depended on both how easily GPs could work together and how quickly the IT systems could be integrated across the different organisations.
[a further comment was made that the people of Cheadle and Bramhall would fit into the ‘easy to reach’ category, but the hard to reach people are based in areas such as Reddish and Brinnington]
The system approach has been drawn upon to help provide a top level view of how health and social care should be delivered, and it helps us to understand how the process currently flows.
Why has this initiative taken so long to come to fruition? It was introduced by Richard Popplewell and Terry Dafter over 2 years ago…
Over the years it is true to say that there have been a number of different priorities and to a certain extent, a lack of commitment to work together – but that has definitely changed now.
[it was pointed out by Christine Morgan, who had spent time at the NHS England Expo, that historically the organisational structures of health and social care providers haven’t made it easy to bring services together, but the time is right and processes are being put into place to address and overcome these difficulties]
[another point was raised that the stroke guidelines which govern the care process was drawn up in a fortnight, and has now been adopted as national best practice guidance – it was noted that the group is very impresses with the model proposed, but not with the timelines]
NHS budgets are protected, but social care budgets are not – what happens under the pooled budgets proposal when funding for social care is cut?
We are still looking at how this will be addressed. It should be understood that this is a national issue and not one that is specific to Stockport. That said, work is being done under Stockport Together which brings the Financial Directors (FDs) of each of the partner organisations together to discuss how budgets are managed.
How far into the future are budgets being looked at? And has the allocation of funding been agreed yet?
We have a budget for 15/16, and will be drawing on additional funding from Vanguard which will help us as we move into the implementation phase. The FDs are meeting to discuss how budgets are allocated, but they have not yet been agreed.
Modelling is being done to estimate how much funding will be required to allow us to implement the proposed plans. Evidence doesn’t exist in all areas to help us to predict the impact that our proposals could have, and therefore, in some instances we’re developing theoretical models which will need to be backed up with evidence – whether from a local or national base.
The biggest hurdle that have faced similar initiatives in the past has been confidence within the health and social care economy – for example, it appears that social work services are the most difficult to change..?
There is now a real commitment to work together, which extends to initiatives including joint training programmes across the partner organisations and a mutual respect across the professionals. By integrating teams we’re able to share skills and learn from the different professions.
For example, GPs will be working with staff on the ground and meeting regularly to understand how people can work better together to serve the needs of the people of Stockport.
Are you confident that Social Services are committed to Stockport Together?
Yes, very. As an equal partner, the Local Authority is committed to working with health colleagues to drive the initiative forward.
Social Services have a large remit for people who don’t have health needs…
You’re right – there is a huge amount of cross over, with many people having underlying health needs as well as those who just have social care needs.
We need to ensure we’re caring for the whole population of Stockport.
The disparity of health expectancy isn’t just linked to smoking and drinking etc., but a lot of it is linked to inadequate care in pregnancy.
There are a great number of factors which contribute to the discrepancies in healthy life expectancy – many of which are made up of complex social factors, including housing.