1. Richard Main Informatics Integration Lead NHS Wakefield CCG
Our vision
For citizens of Wakefield district to live longer, healthier lives and to be supported by people with the right skills, in the right place
One team - GPs, community nurses, social care workers, therapists, volunteers and pharmacists
One care plan designed around the person
One care co-ordinator for every person with multiple, on-going health problems
Single ‘gateway’ to care
Same day response if needed
Faster access to home adaptations and equipment
Care at home or near home wherever possible
Care in hospital only when really necessary
Discharge home as soon as possible
Utilise digital technologies to provide the appropriate information, to the right person, at the right time, and in the right location to support the care of the citizen.

2. Where we are now… SystmOne - large district-wide footprint
34 out of 40 GP practices (other 6 on EMIS Web)
Significant footprint in Acute >25 modules including all Inpatient areas, Diabetes, Health Visitors, Community Nursing, EoL and Hospice care.
South West Yorkshire Trust – Rio and SystmOne
Sunquest ICE Order Comms
Integrated within Acute Trust (and 7 local acute trusts) and with Primary Care
Discharge
e-Consultation
Scope for further development
Adult Health & Social Care Hubs
Community Nursing, Therapy, Social Care, 3rd Sector, Social Housing
Childrens & Families Integrated Early Help Hubs
Health Visitors, Social Care, 3rd Sector, Police, Social Housing, substance misuse etc
PMCF (West Wakefield)
Extended hours, additional access routes, Unified Communications, digital care navigation.

3. Overall rating for Community health services for adults
What we’ve done so far…
Integrated Adult Health and Social Care Hubs Mid Yorks NHS Trust CQC report November 2014
Overall rating for Community health services for adults
“Good”
“The Proof of Concept team was an innovative way to provide integrated services including pharmacy support and the independent/charity sector.”
But
“Barriers to integration had been identified, including …..managing different computer systems, particularly health and social care.”

4. What we think we’re doing well
Real integrated working through joint CCG & Council appointments supporting the districtwide ICT strategy group.

5. What we’re planning to do…
Double Vanguard success
Two Wakefield initiatives were amongst 29 nationwide to be selected from 269 entrants who bid to participate in the prestigious Vanguard programme to promote radical redesign of care services
To effectively deliver these programme of requires:
Technology advancements to support new models of care - “Needed Now” vs & 2020
Digital Care Records - All team members able to view and input to shared electronic record
Patient Held Records – Patient able to hold, input to, and control access to their personal health data
Optimisation and integration of existing systems - not wholesale replacement - Open Approach ?
Proportionate approach for care homes and small organisations to IG requirements
Culture change – eg GP view of sharing “NHS data” with non-NHS organisations.
Enhanced Care Home Vanguard (NHS Wakefield CCG)
Joining up services for older people in supported housing and care homes.
West Wakefield Health and Wellbeing Ltd, a federation of six GP practices
Multi-specialty community provider (MCP)