1. Presented by Peter Lewis, Head of Contracts
Bromley’s new
Community services
Presented by Peter Lewis, Head of Contracts

2. Why Change Things? Current Contract coming to an end
Services working individually and not in an integrated way
Patients having to tell their story more than once
Increasing need for services, impacting on waiting times
Seamless planning to support patients needs
Supporting patients to achieve their personal objectives

3. How do we demonstrate success?
Delivery of High Quality Services
Patient Centred Care
Integration
(Service providers working together, communicating more and sharing
information where appropriate.)
Organisation Leadership and Culture
Giving service flexibility to change
Measurement of Success and Continual Improvement
Patient feedback e.g. survey, telephone call, focus group.
Demonstrate Value for Money
Reduce waste e.g. clinical time, medicines, use of IT, IPADs

4. Key changes expected for children and young people’s services
Services will work together more effectively, providing more joined up care for children young people and their families. Service users will only have to tell their story once.
Services will have more of a focus on early intervention and prevention, this approach is to support children, young people and their families by preventing problems worsening, as well as to access help earlier for more serious need.
The Children’s Community Nursing Team will operate 8AM-10PM, 7 days a week and with telephone advice available out of hours.
More involvement of CYP and their families in their care and service design Establishing a Youth Forum (13-18 years old) to meet to discuss how services can be developed and improved.

5. Key changes expected for children and young people’s services
Access to Children and Young Peoples Services
Flexible to provide Saturday morning clinics
Patients and service users will be able to contact Bromley Healthcare 24/7 through the Care Coordination Centre. The centre will function as one place of contact for patients if they are unsure who to speak to. It will also result in a more straightforward process for GPs and other healthcare professionals to refer to community services.
Waiting times will decrease for services where these have historically been longer.
Services will be provided from easy to access locations e.g. Children and Family Centres, as well as in the home, early year’s settings, schools, and colleges.

6. Key changes expected for adult services
There are three Integrated Care Networks (ICN) in Bromley; this is a method of healthcare professionals working together across organisations and services to provide more joined up care to patients.
Each Integrated Care Network will have a Community Nursing Team, previously divided into District Nursing, Community Matrons, and Twilight Nurses. The Nursing Team will also work closely with other healthcare professionals that may care for the patient in other services.
The service will operate from 8am to 10pm, 7 days a week.
There will be one therapy team that works across all adult services to ensure more joined up and coordinated care.
The lymphoedema service, previously delivered by St. Christopher’s, will now also be provided by Bromley Healthcare and will be part of the Tissue Viability Service, providing more integrated care.

7. Key changes expected rapid response GPOOH and transfer of care services
The GP Out of Hours Service will see an increase in the pool of GPs available, improving the stability of the service.
The in-reach / supported discharge service will feed into a single, integrated pathway for bed-based rehabilitation, home rehabilitation, and reablement. Operating 8am-8pm, 7 days a week.
The rehabilitation service will now include neuro-rehabilitation and the service will accept patients from the community avoiding hospital admissions as well as supporting patients being discharged from hospital to enabling recovery and rehabilitation goals to be achieved.

8. Benefits
There will be a single point of access, the Care Coordination Centre (CCC), which will:
Provide clinical triage of referrals; the referring GP/Health Care Professional will be able to view the patients referral/triage outcome via the shared care record
Operate 24/7, providing a point of contact inside and outside of core hours. Both referrers and patients can contact the CCC, avoiding visits and admissions to A&E where appropriate
Adopt a ‘no wrong door’ policy – if it is identified that a patient’s needs are best met by another service, the CCC will arrange access to this service and inform the referrer

9. Benefits
Full and effective information sharing is being established through a shared EMIS clinical record, enabling GPs to review a patient’s record in real-time for any outcomes/interventions undertaken by BHC.
A range of clinical forums and networks will be established, including enhancing the GP reference group, to facilitate cross-organisational clinical debate and to take feedback on community services from general practice and other providers.
Longer core operating hours, including weekend clinics, for community services will relieve pressure on Primary Care e.g. issues can be resolved over the weekend rather than through Monday morning GP appointments.

10. Mobilisation strategy
Implementation of a Communications Plan ensuring the right method of communication with all relevant stakeholders. (Patients, Public, Professionals)
Facilitate Change in Culture with recruitment of Change Manager
Monthly Board Meetings Oversee Delivery of all Services
Individual Lot Operational Weekly Meetings
Manage and Mitigate Risk (Treat, Tolerate, Transfer and Terminate)
Learn from service users, patients, public, professionals during and post implementation.
Reflect on achievement and performance of new services delivering high quality, safe, personalised care in the right place at the right time