Patient Public Involvement with Leicester, Leicestershire ...

Patient Public Involvement with Leicester, Leicestershire & Rutland

Alliance

Helen Mather

Alliance Director

Our Aims and Objectives

Patient Public Involvement with Leicester, Leicestershire & Rutland Alliance

The LLR Alliance is not a provider of health services itself. It is a partnership of the clinical commissioning groups in Leicester, Leicestershire and Rutland, who plan and buy healthcare for their local populations, plus the key providers of healthcare. Together we work to innovate and improve the quality of elective care services for our patients in conjunction with improving value for money for the local health economy.

Our Aims and Objectives….continued


Our Objectives are to:- • Offer our patients greater choice • Bring care closer to home • Improve the patients experience by being responsive and ensuring respect and dignity • Listen to what matters most to patients through continual cycle of engagement • Use patient insights to help shape and develop services • Achieve value for money for the LLR area through innovation and most efficient use of

resources • Support the LLR Better Care Together Strategy

The LLR Alliance Contract


The LLR Alliance contract enables LLR to achieve its objective of providing more care in the community, in a collaborative and co-operative way rather than through competition between providers. Alliance contracts are unusual within the NHS, but there is a growing interest in them as ways of supporting integration and collaboration between providers, in the interests of better patient outcomes and better value care. All the partners to the LLR Alliance are part of an overarching agreement, with shared risk and reward. The provider participants each have a ‘pillar contract’ based on the NHS national contract, with the same performance standards and there is a work allocation schedule, which lays out which services each provider will be responsible for delivering.

The LLR Alliance Contract….continued


The Alliance Leadership Board


The Alliance Leadership Board….continued


The Alliance Governance Structure


Services are delivered from the following sites:-


Our services are delivered from the following sites……continued


The Partners’ Values


Our Key values underpin the way that the collaborative partnership works to ensure that LLR Alliance Services best serve and meet the needs of our patients • Trust • Collaboration • Innovation • Mutual Support • Clinical Participation in all we do • Transparency • Collective ownership of risk and reward

Our Services:-


Our achievements


• Ensuring a positive experience for patients, consistently achieving satisfaction

scores of 97% and above throughout the year in the friends and family test.

• Supporting delivery of the Sustainability and Transformation Plan in Leicester, Leicestershire and Rutland by enabling the delivery of more care in the community rather than in acute settings, for example urology services

• Providing 117,787 outpatient appointments, 8853 day cases and 71,016 x-rays • Being responsive to patients’ needs, including 96% achievement against the 18

week referral to treatment target.

Our Achievements…continued


• A strong focus on patient safety, achieving excellent results against all safety targets

and ratings, including zero serious incidents • Improving outcomes for patients, including a <30 day mortality rating of 0.35%

(proportion of patients who have died within 30 days of entering the hospital).

• Carried out PLACE assessments on Alliance sites

What is happening in 2017/18


During 2017/18 we will build on this by making further improvements to services and care for our patients by: • Moving at pace • Connecting the system • Doing more for less and better

Progress in service delivery 2016/17


Gastroenterology • Additional gastroenterology outpatient sessions have been introduced (at the newly

opened) St Luke’s Treatment Centre in Market Harborough, Hinckley District Hospital and Loughborough Hospital.

• Additional endoscopy sessions at all three site and over the last year we have increased

their provision of colonoscopy by over 100%



Ophthalmology • We have provided additional oculoplastics service, YAG laser and glaucoma services at

Hinckley District Hospital as well as extra paediatric ophthalmology at Loughborough Hospital

• Additional adult and paediatric ophthalmology, day case oculopastics and laser therapy at

Melton Hospital

• Currently helping to plan a single point of access for ophthalmology services



Urology • We have delivered additional urology services in the form of cystoscopy in our endoscopy units Musculoskeletal • In the last year they have assessed and embedded a Integrated Musculoskeletal (MSK) Triage Hub

and are working to deliver an Integrated MSK Physiotherapy Service alongside this Dermatology

• Over the past year the Alliance has been preparing to deliver over 3,000 dermatology outpatient appointments in a primary care setting.

• Developed a Nurse led Dermatology clinic in Oakham

Our Partnership With Patients and the Public


Members of the Patient and Public Partnership Group (PPPG) have continued to play an integral and important role in providing a patient perspective and enabling the LLR Alliance to achieve the aims set by its Partner organisations. The PPPG recognises the current pressures being experienced by the NHS/ social care, financially, in patient expectation and staffing, as well as the need for modernisation. Our work programme has been undertaken and adjusted to reflect these changes. Member representatives attend and play a role in all key Boards of the Alliance: Leadership, Management, Clinical Reference, Infection Control, Audit.



• All Alliance Community Hospitals have had Patient Led Assessment of the Patient Environment

(PLACE) visits which identified a number of patient facility improvements required to meet nationally set standards. Working with partner trusts, all units now have a hearing loop facility. St Luke’s Treatment Centre and Melton Hospital have had much needed patient refreshment facilities installed.

• Patient Dignity remains a high priority, with on-going work to support and address dignity issues.

• In April 2017 the Alliance was pleased to welcome Leicester City CCG as a partner to the Alliance. The

PPPG have welcomed two new patient members to their Board and look forward to future constructive partnership working. This is important as a significant part of PPPG members’ role is to act as a conduit to ensure information sharing is a two-way process and patient views will be able to contribute to decisions. This is achieved by members working with patient representatives in GP practices.



• A key role in the establishment of the LLR Alliance was that patients must be included in contributing

to ALL planning, assurance and communication. Owing to the rapid changes and restrictions of the NHS, the PPPG have tried to ensure good communication with patient representatives in practices and other patient representative groups e.g. CCGs, trusts, individual PPG groups. Further work on this significant challenge is planned for the coming months in collaboration with Better Care Together (BCT), GP federations, clinical commissioning groups (CCGs) and locality groups. Changes created by the STP also impact on the need for improved communication between organisations of the highest quality. We are working with the UHL initiative of co-operation and co- ordination of patient representation groups to avoid confusion, and to educate colleagues and the public of the changes that have been made or are being considered. We would welcome expressions of interest in becoming a PPPG member.

Quality and Patient Experience


The Alliance actively engages patients, carers and other stakeholders in order to seek their views on what they want from our services and how the Alliance services should transform and develop. In the last year, this engagement has included a month long patient survey of all patient groups, a cataract patient focus group, comments cards and Friends and Family tests. Additionally, meetings have been held with a number of complainants to understand where we have failed to get it right and identify changes required. The Patient and Public Partnership Group (PPPG) is also actively involved in gathering patient feedback through events such as the National Dignity Day and meet regularly with the Management Team to discuss their views and thoughts on the services provided. All of this feedback is utilised to improve the quality of care delivered.

The LLR Alliance has achieved consistently high levels of patient satisfaction as measured by the Friends and Family test (FFT) as indicated in the table below. By year end, the FFT score was 97.5% of patients who stated that they were either extremely likely or likely to recommend our services to their friends and family. This represents an increase on 2014, 2015 and 2016.

Quality and Patient Experience…continued


To consistently maintain an overall recommended level in excess of 97% is a fantastic achievement. We are working hard to increase and maintain the number of outpatients who respond to the Friends and Family Test and this is showing a month on month improvement. To consistently maintain an overall recommended level in excess of 97% is a fantastic achievement. We are working hard to increase and maintain the number of outpatients who respond to the Friends and Family Test and this is showing a month on month improvement. The table below shows the Friends and Family test scores over the 2016/17 financial year.

What Our Patients Tell Us


Listening to patient feedback is fundamentally important to us and the following are typical examples of comments that we continually hear

Our Priorities for 2017/18


Priority 1 – Improved Access To improve access to services across Leicester, Leicestershire and Rutland (LLR) in line with the Sustainability and Transformation Plan (STP) priorities, while maintaining high levels of performance and quality standards. Our key areas for service transfer are: Rheumatology, Ear, Nose and Throat, Medical Day Case, Orthopaedic Surgery (minor hand). Priority 2 – Lift, Redesign and Shift into Primary Care To develop services offered within primary care settings by transferring activity into the LLR Provider Company Limited (LLR PCL) pillar contract e.g. dermatology clinics, ear syringing, non-obstetric ultrasound, hand surgery, vasectomy, echo and H Pylori testing. Priority 3 – Lift, Redesign and Shift into LPT To explore opportunities with Leicestershire Partnership Trust (LPT) to transfer services into the LPT pillar contract e.g. redesigning physiotherapy services.



Priority 4 – System Wide Service Redesign To work in partnership with the system to undertake a review of key services to ensure long term sustainable provision across LLR including the following areas: Diagnostics, MSK Physiotherapy, Cardio-respiratory, Hearing Services. Priority 5 – Clinical and Financial Sustainability To support service reconfiguration by enabling the left shift of activity and increase the range of treatments that we offer. To implement a programme of productivity that reduces our cost base and delivers services in a lower cost setting. To support the STP programme for planned care by working towards 1) A reduction in the level of new and follow up outpatient appointments and 2) Compliance with the low value treatments policy. To deliver better value care, including achieving financial balance.



Priority 6 – Workforce Development To implement our workforce development plan, so that we are developing the right workforce to deliver our priorities. Priority 7 – Improve the Alliance Profile Locally To improve the Alliance’s profile locally by demonstrating a collaborative approach to delivering health care across LLR and to be a positive choice for more patients. Priority 8 – Organisational Development To continue to develop the organisational culture of the Alliance, to support collaborative service improvement and transformation with all Alliance Providers Priority 9 – Getting the Enablers Right To develop an IM&T Strategy that joins up the system. To develop an Estates strategy that addresses our key risks and opportunities


If you would like to contact the LLR Alliance please contact: Helen Mather, LLR Alliance Director Loughborough Hospital Hospital Way Loughborough Leicestershire LE11 5JY Tel: 01509 564302 [email protected]

If you would like to know more about our Patient and Public Partnership Group or get involved in its work please contact: Kieley Bowers [email protected] Tel: 01509 564493

Patient Public Involvement with Leicester, Leicestershire ...

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