Senate Forum Meeting

Clinical Senate Forum 26 January 2017: Developing high quality, value based out of hospital care

This Clinical Senate Forum  focused on how as a collective we develop high quality, value based out of hospital care, particularly exploring the factors that enable successful and sustainable change.

Expanding and strengthening out of hospital care is one of the most important enablers for the delivery of high quality, sustainable health and care services over the coming years. The NHS Five Year Forward View highlights the benefits a coordinated multidisciplinary approach can have on patient outcomes and system resilience, and efficiency. Outputs from local and regional good practice, have demonstrated how the implementation of new or enhanced out of hospital services and care models could transform health and care systems but also pose challenges that need to be overcome to have the intended population impacts.

Comprehensive out of hospital is a broad topic encompassing a wide range of services and issues, so we focusd on initiatives aimed at admission avoidance and facilitating discharge. The programme included:

  1. Sharing the vision for out of hospital care over the next 2-5 years in  London’s five Sustainability and Transformation Plans and priorities for development
  2. Considering different examples of out of hospital care that have been implemented, the impact they have had or are having
  3. What patients and clinicians identify as the most important issues to take into account as we place increasing emphasis on delivering care out of hospital
  4. Discussing how we make sure that the breadth of skills and experience available in our multi-professional workforce are recognised and utilised
  5. Identifying common features of successful change, key barriers and what we need to do to overcome them, particularly from a whole system perspective

The programme for the meeting is available here and the SUMMARY REPORT from the meeting can be accessed here. This includes information about the initiatives shared and discussed on the day with contact details of colleagues leading their delivery and links to supporting information (also provided below) and it sets out what participants identified as the most important issues, opportunities and enablers for improving out of hospital care, drawing out key themes.

Dr. Vin Diwakar (Medical Director, NHS England London Region) gave a presentation to set the scene for the Forum’s discussions.

Please see below a list of out of hospital care initiatives shared at the meeting:

  • Health 1000 : The Wellness Practice
    Further information can be found in the overview and Q&A.
  • Camden & Islington Psychosis & Long Term Conditions Integrated Practice Unit – Click here.
  • Children and young people’s health partnership – Click here.
  • ESCAPE-pain – Click here.
  • East London primary care mental health service – Click here.
  • Islington Children’s Hospital @ Home service
    • Overview – click here
    • Evaluation – click here
  • Falls Specialist Response Care – Click here.
  • Islington Practice based mental health team – Click here.
  • Community Independence Service – Click here.
  • The Living Well Network
  • Innovation in medicines optimisation

    • Lewisham Integrated Medicines Optimisation Service (LIMOS)  – click here
    • Guy’s and St Thomas’ NHS Foundation Trust Pharmacy Model for frail older people – click here
  • Bromley-by-Bow, DIY Health
  • Improving care home access to urgent care – Click here.

In preparation for the Forum we identified serval other examples of good practice and related work being undertaken across London. Links to this work are provided below:

  • A&E Avoidance Schemes across London – Click here.
  • Delayed Transfer of Care and the discharge process – Click here.