Healthier Together - why we need to change | 1

Why we need to change

Healthier TogetherBetter care in the right place

South East Midlands

2 | Healthier Together - why we need to change

Healthier together

Healthcare is constantly changing and advancing. We want to keep you healthy and continue to meet your health-care needs so it’s important to make sure that your health services keep up with the challenges around, and opportunities for, improvement. All this at a time when public funding is under pressure and demand for services keeps rising as our population grows and ages. To make sure that you receive the best possible care and that money is spent in the most effective and efficient way, it is inevitable that the way some of our health services are delivered will have to change.

This leaflet outlines how the NHS in Bedfordshire, Luton, Milton Keynes and Northamptonshire is working together for a healthier future, what this will mean for you and how you can have your say. We want you to help us get healthier together.

Our population is ageing and growing:

The population for the South East Midlands area currently stands at 1.6 million. This is expected to grow to 2.2 million by 2031.

Average male life expectancy is now 80 years in the UK. In 1948 when the NHS was founded, it was 66 years.

400 lives could be saved in the South East Midlands over the next five years by changing the way we deliver services to people who have had a stroke.

Better planning of services at the end of people’s lives would allow more than 2000 people a year across the South East Midlands to die at home rather than in hospital.

Fingertip facts

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Our ambition

Our ambition is clear. We want to improve the quality, safety and affordability of the services you receive. We want to bring care closer to your home wherever we can. And we want to develop some specialist centres which will improve the quality of care you receive.

We know we can do all of this by:

• increasing the opportunity to have tests, treatments and appointments carried out in a local or community setting, such as your local GP practice, rather than having to travel to a hospital;

• properly co-ordinating services for frail older people and those with long-term conditions so that easier access to specialist advice is available and fewer hospital stays are needed; and

• combining expertise across our five hospitals in Bedford, Kettering, Luton, Milton Keynes and Northampton to make sure that, in an emergency, you have access to a specialist opinion 24 hours a day, seven days a week.

My experience is that people generally prefer to go to the best rather than the nearest treatment centre. My patients mostly use hospitals for outpatient appointments and planned procedures or operations but more and more care traditionally associated with a hospital setting can now be delivered in their homes, local health centre or GP surgery. This has proved to be very popular, particularly with elderly and frail patients.

Frances Ross GP, Bedfordshire

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Closer to home

We don’t have to carry on providing health services in the same way just because that’s the way we’ve always done things. Changing services for the better can mean doing things differently. Looking closely at how we join our services up, for example for children and young people, could mean your child spending less time in hospital.

Ambulance services also have an important role to play in achieving our ambitions. Ambulance services across the UK are now much better at identifying who needs specialist help and who can be treated by more general services. This means that even when specialist centres have been set up, many people can continue to be treated locally without the need to travel further.

We want to give patients the very best care we can. We can’t do that if we stand still. Healthcare is always changing and responding to new advances and hospitals need to be part of this change.

Mr John PicklesMedical Director and Ear, Nose and Throat Consultant Surgeon,Luton & Dunstable Hospital NHS Foundation Trust

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New technology and ways of working will also help us provide many services currently delivered by your hospital in a more convenient place. None of us wants to spend any more time in, or travelling to, hospital than is absolutely necessary. We want to look at ways we can provide services such as outpatients, ultrasound, blood tests and other treatments in local GP and community settings.

If our health services stay the same, hospital workloads will rise by 50% over the next 30 years.

We are seeing a rise in conditions like obesity and diabetes, which will put more pressure on the health budget.

A quarter of all adults in England are obese. This significantly increases their risk of other health problems such as heart disease.

The number of people diagnosed with diabetes in England is estimated to rise from 2.6 million to 4 million by 2025. Diabetes leads to complications such as heart disease, kidney failure and nerve damage.

Throughout England, the NHS has been set a challenge to improve its efficiency by up to 20% by 2014/2015.

Fingertip facts

For most people, their family is their first priority. Getting the best care for them when they are ill so they can make a full recovery and go on to lead a full life is crucial. People don’t want to settle for second best.

Ann Brown, Luton LINk Chair

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Bigger but better

Large units can bring the right expert teams together. By seeing large numbers of people with a specific condition healthcare professionals gain more experience in treating that condition. The more experience they get, the better they become at what they do. Over time, this knowledge can be used to train and educate future generations of healthcare staff.

Bigger centres can also invest in the latest medical equipment and technology. Recent research shows the centres themselves are likely to be better managed. All of these factors help to improve the quality of service you receive so that you can expect to enjoy better results such as faster recovery times.

Cancer-care services across the country are already taking

Bigger, better, safer together

We’ve taken a lot of steps in the right direction. However, achieving our ambition means continuing to improve how we both design and deliver our NHS services. Evidence tells us that patients are better served if some specialist treatments for conditions like cancer or strokes are provided by fewer but bigger units – or centres of excellence. This is because specialist teams build up greater expertise and experience, meaning better results for patients.

It makes sense for specialists to work closely together, sharing good clinical practice and using our clinical resources to maximum benefit for patients and their families. We have a real passion for making sure our local health services are the best they can be, and look forward to working closely with patients and the public to shape how healthcare is designed and delivered in the future.

Mr Paul Tisi, Associate Medical Director – Consultant Vascular and General

Surgeon, Bedford Hospital

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advantage of this evidence, with specialist surgery for certain types of cancer provided by fewer but bigger hospitals. Care for people who have had strokes and some specialist heart surgery is now being provided like this in Northamptonshire. Other services that can benefit from the bigger and better model include emergency surgery at evenings and weekends, vascular surgery, children’s and young people’s surgery and high-risk maternity care.

Our ambition is to provide as many services locally as we can and only bring together services into specialist centres where we know it will make a difference to the care you receive. You might have to travel further to get specialist treatment or for a one-off procedure. However,

once you reach a bigger centre, you can expect to receive high-quality care with better and safer results. For example, the chance of contracting an infection after surgery on joints (such as hip replacements) can fall to as low as 0.2% in hospitals that serve large populations.

Safer and sustainable

Smaller units can face practical issues, meaning that their services are not always as safe and consistent as those of bigger units. It can be a struggle for smaller units to find the right specialist staff in the first place and even harder to find cover for them when they are on holiday or sick. Employing more staff is not an option because smaller units see fewer patients with specialist conditions so there would be times when there wasn’t enough work to be done and resources not used efficiently. It simply isn’t possible to provide the highest-quality care, around the clock, without the right specialist staff.

Now I understand the benefits of larger centres for specialist conditions, it sounds like practice makes perfect.

Patient member, NHS Northamptonshire Pulse Group

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For me, it’s all about safer births and healthier babies, full stop. Giving birth should be a joyful, celebratory event. Ensuring women have a positive experience means having the right staff, with the right skills, in the right place at the right time.

Miss Meghana Pandit, Consultant Obstetrician

and Gynaecologist, Milton Keynes Hospital NHS Foundation Trust

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• ‘Healthier Together’ is about improving health services. However, it is also about making sure those services have a long-term future. We must make the best use we can of the knowledge and skills of our healthcare professionals and of the funding our services receive.

• We will maintain services that are excellent but improve services wherever necessary

• All five hospitals will continue to deliver services (including accident and emergency).

• Health services and aftercare will be provided close to home whenever possible, although

you may sometimes have to travel to specialist sites for the best treatment and results.

• Health service improvement plans are being led by local doctors and nurses.

• We will continue to involve patients and the public in developing proposals for services. No changes will be made without giving you the chance to have your say.

• Our overall aim is to meet the health challenges of the 21st century and provide the best services possible for you, your children and your grandchildren.

Healthier Together at a glance

If a member of my family had cancer, I would want them to be cared for in a centre that regularly treats cancer, where they have the very best chance of both surviving and recovering. We must put the interests of patients first and the evidence shows that if you are treated by a specialist team your outcomes from cancer will be better.

Dr Christine Elwell, Consultant Clinical Oncologist, Northampton General Hospital

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Protecting the services you receive for the future and improving the quality of your healthcare are the two most important reasons behind our ambition to change services. But we can’t ignore the financial and economic pressures the NHS faces. This pressure will only increase as our population grows and we live longer. The Government has promised to protect the health budget in real terms, but funding will not match rising demands. In England, the NHS has been set a challenge to improve its efficiency by up to 20% by

2014/2015. Our plans will help meet this challenge and the further economic and financial challenges we will face over the next decade and beyond.

Making more of our money

Meeting the healthcare needs of the patient is at the forefront of everything I do as a chief executive. A big part of this is being able to recruit and retain the very best staff and provide them with the opportunity to continually develop their skills for the benefit of patients.

Lorene Read, Chief Executive, Kettering General Hospital

NHS Foundation Trust

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Getting better together

We’ve been talking to patient groups and hearing patients’ and service-users’ views but we want to hear from everyone in the community, including you! There will be many opportunities for you to get involved and help shape our plans.

If you want to know more about how we can get ‘healthier together’ or how to give us your feedback, there are lots of ways you can get in touch.

1 Email us at: healthiertogether@miltonkeynes.nhs.uk

2 Search online for Healthier Together South East Midlands and register your interest in being kept up to date.

3 Fill in the form on the right and send it to the Freepost address shown below.

4 Call us on 01908 278735.

5 Write to us at: Freepost RSCU-JUCG-RZCE Healthier Together NHS 155 Sherwood Drive Bletchley MK3 6RT.

Tell us what you think

Over the coming months we will be considering how we could improve the quality, safety and affordability of a wide range of local health services, for example:• services for people with

long-term conditions such as diabetes;

• maternity services; • children‘s services; • planned care including

general surgery;

• cancer services; and• emergency services such as

Accident and Emergency.

We want to hear your views on these local health services and how they could change. Please fill in the feedback form on the back or online by 20 April 2012. Your feedback will help us get ‘healthier together’.

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Healthier Together, Freepost RSCU-JUCG-RZCE, Healthier Together NHS 155 Sherwood Drive, Bletchley MK3 6RT

If you would like this information in other languages or formats (for example, large print), please contact Healthier Together on 01908 278735 or email healthiertogether@miltonkeynes.nhs.uk

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12 | Healthier Together - why we need to change

NHS Northamptonshire and Milton Keynes Cluster

NHS Bedfordshire and Luton Cluster

Luton & Dunstable HospitalNHS Foundation Trust

Bedford Hospital NHS Trust

Kettering General Hospital NHS Foundation Trust

Northampton General Hospital NHS Trust

Milton Keynes Hospital NHS Foundation Trust

South East MidlandsHealthier Together

Healthier TogetherBetter care in the right place

South East Midlands

Healthier TogetherBetter care in the right place

South East Midlands

Healthier TogetherBetter care in the right place

South East Midlands

Healthier TogetherBetter care in the right place

South East Midlands