Delivering better care out of hospital
Another major challenge facing the system is the number of people who are admitted to hospital who don't need to be there because there is currently no alternative.
Currently, too many people are admitted to hospital when, with appropriate out of hospital care, they could be treated in the community or looked after in their own home.
A move to more out of hospital care would improve quality of care and save money. For every £1 spent in hospitals, alternative community care can be provided for 70p.
In North West London we have consulted on a large out of hospital investment strategy as part of Shaping a Healthier Future and over the past two years we have been doing both the planning and delivery of these changes.
Over the next five years, we will be investing £190m more a year across North West London on out of hospital services, including integrated care and more access to general practice. These investments will result in more staff and better facilities to deliver it.
How we are delivering this in Central London
Our plans to deliver better care out of hospital are outlined in our out of hospital strategy.
Central London CCG has already made considerable progress in delivering this:
- Improving access to quality primary care is at the heart of our out of hospital strategy. We have introduced weekend opening at a number of practices across the borough for walk-in patients, unregistered patients and visitors to the area. Local urgent care centres at St. Mary’s and Chelsea and Westminster Hospitals, and the walk-in centre at the Soho Centre for Health, will continue to provide our patients with alternatives to busy A&E departments.
- We are supporting patients with mental health illnesses through the introduction of the Primary Care Plus mental health service, which improves the capacity and capability of mental health provision provided in GP practices. Primary Care Liaison Nurses (PCLNs) are based in GP practices and support patients who require further assessment for therapeutic options or brief support, and those who are ready to be discharged from secondary care. The PCLNs will review care plans and support recovery in the community.
- Central London CCG, along with other CCGs in the Central London, West London, Hammersmith and Fulham, Hounslow and Ealing Collaborative agreed to commission a common out of hospital services portfolio to ensure that patients are able to access the same range of services, regardless of which practice they are registered with.
- We will be replacing our existing musculoskeletal services expanding the scope to include pain management and rheumatology. We will also be re-commissioning our community gynaecology to include uro-gynaecology and will also be commissioning new ophthalmology and urology services in 2015/16. These services will provide approximately 20,000 appointments in the community, closer to people's homes.
- We are reviewing, with input from patients, the benefits of investing in improving community transport services, especially for those with mobility or social isolation issues.
- We have invested more in homelessness services and are currently working on a number of initiatives related to improving our homeless population’s experience of healthcare, keeping them well and reducing demand on healthcare services.
- Together with the local council we are working together to specify a new home care service model and pathway, with a focus on regaining independence following a stay in hospital.
Find out more
You can find out more about our plans to continue the delivery of our out of hospital strategy in our 2015/16 commissioning intentions.