Local General Hospitals

Dr Steve Laitner and Jacqui Bunce

Hertfordshire PCTs

PUBLIC HEALTH (Health Promotion, Vaccination, Screening…)

SELF-CARE (Home or “Over the Counter” remedies

TRIAGE (Assessment of health needs, telephone or “face to face”

PRIMARY CARE (GP surgery, dentist, optometrists, minor injuries

INTERMEDIATE CARE (Home/ NH/ C. Hosp)

INTERFACE(CASS/ CATS) and Urgent Care Centre

SECONDARY CARE ( Hosp.)Health Care

Pyramid

Dr S Laitner 2007

Meeting health needs in Hertfordshire

• Health inequalities to be addressed• Access• Nearest hospital may not be in Hertfordshire so

working with all providers on care pathways• Utilisation of community hospitals and other

health facilities to enable care closer to home

Feedback from consultation

Everything as clinically safe and as local as possible

• Diagnostics

• Outpatients

• A&E

• Urgent care

• Surgery

• Maternity services

• Intermediate care services

Decision from 19th December

The PCTs are committed to maintaining and developing a vibrant mix of health services in Hemel Hempstead and Welwyn Garden City as the non-acute hospital sites

Core services

• Outpatients• Urgent care• Diagnostics

Plus key opportunity for local health campus development

• Pathology• Minor surgery• Ante-natal and post-natal care

Local General HospitalMinor

Surgery

Intermediate Care

Services & beds?

Support Groups

Local authority services

Social services Outpatients

Adults &Children

Maternity services

Ante NatalPost Natal

Urgent Care

Diagnostics

Palliative care

Mental health

services

Therapyservices

Local General Hospital

Intermediate careNext steps

• Short term provision at Hemel Hempstead and existing facilities

• Review of existing facilities throughout the county

• Integration with social care

• Local provision

Intermediate careAdditional requirement

East and North Hertfordshire West Hertfordshire

Beds Home Care Beds Home Care

2008/09 8 209 16 195

2009/10 9 209 3 195

2010/2011 17 417 5 390

Total 34 835 24 780

Master plan• LGH development linked to changes in services

at acute hospitals inc Barnet & Chase Farm• New care pathways being developed across

primary and secondary care• Services will change – buildings will come later• Dual running is planned where appropriate to

ensure effective transition i.e. Urgent Care at Hemel Hempstead

Financial modelling

• Costs to build new facilities – £30m per PCT

• Service shifts – £65m investment over 6 years in community services, primary care and transport

PCTs Affordability• FUNDS AVAILABLE:

– One-off benefit from debt repaid in 2007/08 approx £52m

– Growth – 2% p.a. (approx £28m each year)= £169m by 2013/14

– Savings on acute care currently provided in secondary care setting = £14m

• RESERVES: uncommitted estimated at £46m

How we will manage the process• Service model finalised with Practice Based

Commissioning Groups• Confirmation with other stakeholders of services

to be on the campus and at other community facilities

• Capacity planning of sites• Outline business case & planning permission

Future vision

• Vibrant health campus development vision – not a poor second best but a real community resource

• Phased development hand in glove with acute hospital changes

• We want to involve the community in making these changes happen

• We have the resources to make these changes happen