Agenda item

6.1

The Committee received a report on the progress of work undertaken in connection with Phase 2 of the Right First Time Programme. 

6.2

In attendance for this item were Kevan Taylor, Chief Executive, Sheffield Health and Social Care NHS Foundation Trust and Right First Time Programme Director, and Zak McMurray, Joint Clinical Director, NHS Sheffield Clinical Commissioning Group.

6.3

Kevan Taylor reported on the aims of the Right First Time Programme, referring specifically to the agreed priorities in respect of Phase 2 of the Programme.  The main priority was to develop effective and timely discharges from and through the acute hospitals and intermediate care provision across the City, with the aim of reducing the average length of stay in hospital and/or intermediate care, and to maximise individuals potential to return home and live as independently, and as long, as possible.  Mr Taylor reported on the work being undertaken under the Programme to achieve this aim. He made specific reference to Project 4 under Phase 2, which involved  focussing on patients with serious mental illness and their physical health needs as such people could be particularly vulnerable to becoming seriously ill with physical health conditions, such as heart disease or diabetes, and the aim of Project 4 was to make sure all organisations and service users work together to change this.  Zak McMurray added that there was a need to identify high risk patients as there were high numbers of people in hospital, who did not necessarily need to be there.

6.4

Members of the Committee raised questions and the following responses were provided:-

·                     One of the main aims of the Programme was, by using patients’ profiles, to try and target emergent risk patients, investing resources in the community and drafting a care plan and an escalation plan.  The Virtual Ward model was able to target those patients who were not known to mainstream services and/or who would be best supported by an intensive co-ordinated approach from the ICT.  Whilst this model was being tested at two GP practices, it was likely that it would be rolled out to other practices.  Efforts were being made to ensure that GP practices were more assertive and targeted such people.

·                     In the light of the increased risk of potential death and a reduced life expectancy of 16 years for women and 20 years for men for people suffering from a serious mental illness, special efforts were being made to look at ways of making it easier for such people to access health services.  A high number of people having a serious mental illness smoked and the drugs a number of such people took had an adverse impact on their physical wellbeing, such as making them hungry, which often led to weight problems.

·                     In terms of the involvement of the voluntary sector under the Programme, some Support Workers were employed by voluntary sector organisations.

·                     There were no plans at the present time to appoint any Admiral Nurses, who worked with family carers and people with dementia, in the community and other settings, but significant developments in dementia services have been made in the community, such as rapid response teams.

·                     Sheffield will follow the guidance on each “at risk” patient, having a named practitioner, as recently announced by the Government. In Sheffield, all patients in primary care have had their degree of risk “stratified”. The NHS Trust was rolling out a programme where GPs and their teams identify those people at emergent risk, and develop a care plan to help such people to stay well and healthy at home.

·                     Although quarterly figures regarding emergency admissions and length of stay in hospitals could not be produced at this meeting, such information could be provided. 

·                     The request relating to whether the work of the 50+ Group to reach missing voices could be passed to the Community Support Workers as another method of getting people some involvement would be forwarded to the relevant Service in the City Council responsible for the Workers.

·                     The additional investment identified to expand the Community Nursing Service would be provided by the CCG.

·                     The suggestion of having one name for intermediate care services – such as the Re-enablement Service – would be reconsidered in the light of potential confusion.

·                     There were still some outstanding areas regarding the age range of people seen by the Child and Adolescent Mental Health Service (CAHMS) and the Adult Service that needed to be resolved, and these would be reported back to the Committee when agreement had been reached.

·                     In terms of sharing the work undertaken under the Programme, there was a national pilot under the auspices of the NHS Improving Quality. This would involve networking and sharing learning. Although Sheffield was more advanced than other areas on risk stratification and primary care, lessons could, and would, be learnt from work being undertaken under the Programme in other areas. 

6.5

RESOLVED: That the Committee:-

(a)       notes the information contained in the report now submitted, the information reported as part of the presentation and the responses to the questions raised; and

(b)       (i) thanks Kevan Taylor and Zak McMurray for attending the meeting and responding to the questions raised and (ii) requests that they attend a future meeting to report on the progress in respect of Phase 3 of the Right First Time Programme, including data/statistics on the impact of the Programme to date.