Unique toolkit may help keep services local

The new care models programme was launched in 2015, with 50 vanguards testing and implementing new ways of working across NHS and care services.  Here David Probert, Chief Executive, Moorfields Eye Hospital NHS Foundation Trust and Jacob West, Care Model Lead, NHS England talk about a new Moorfields’ initiative which is supporting local hospitals to retain specialist services.

“Seeing the specialist at the hospital” – one of the most stressful experiences for a patient with its potential for both further worry and reassurance. How helpful it must be for those patients who can see their consultant close to their own home rather than after a long journey to an unfamiliar area.

However, it is increasingly difficult for some hospitals to deliver safe and cost effective care, particularly in the smaller clinical specialties. They’re just too small to offer the critical mass of patient numbers or specialist staff and equipment needed to keep going.

This can mean variation in clinical outcomes and effectiveness. Patients may have to travel more often and further for appointments. Opportunities to develop new treatments or participate in research could be missed. And services may not be financially sustainable, meaning hospitals may have to stop running them.

For more than 20 years, Moorfields Eye Hospital has been developing a different model.

It operates its services across a number of different sites – 32 at the last count in the UK and three in the United Arab Emirates.

In 2015, Moorfields was chosen as one of the 13 acute care collaboration vanguards. These sites are testing different ways in which hospitals can collaborate to improve the quality of care patients receive  to prevent ill health and to improve their financial sustainability.

Moorfields has spent the past year testing its belief that its ‘networked care’ model could help struggling specialty services stay local.

It has developed a unique toolkit, launched on 3 April, containing a wealth of learning not only from its own experience but also that of other providers here and overseas who offer a networked care model. It’s also learned from hospitals who might consider the model as a solution to their difficulties, particularly what they would look for it to deliver.

The toolkit has a wealth of practical advice, templates, films and guidance to help hospitals, sustainability and transformation partnerships (STPs) and other partners to decide whether and how this model could help them.

It addresses a range of the strategic and practical challenges to implementing networked services of this kind: from staff costs to technology; from making the space work to agreeing a contract.

This won’t be a solution for all specialties or hospitals. But for many it may be part of the answer to improving the quality and sustainability of local services.

And for patients that may mean taking a little stress out of that important appointment with the specialist.

David took up the position of chief executive at Moorfields in April 2016. He was the former director of strategic development at University College London Hospitals NHS Foundation Trust. David is a past fellow of the Institute for Healthcare Improvement (IHI) in Boston, USA and holds an MBA from the University of Leicester.

Jacob West

Jacob West is a national lead for NHS England’s New Care Models team. Jacob’s background is in public policy and health management. Prior to joining NHS England, he was strategy director at King’s College Hospital. From 2003 to 2010 Jacob worked in a number of roles at the Prime Minister’s Strategy Unit, ultimately as acting director. He advised two Prime Ministers on public policy in a range of areas including health, criminal justice, and education. He has also worked as a senior policy advisor to the Premier in Queensland, Australia. Jacob was 2014-15 Harkness Fellow in Health Care Policy and Practice at the Harvard School of Public Health and remains an advisor to the Harvard Global Health Institute.

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