Working together has given clinical staff the opportunity to be creative, think ‘system’ and move resources between organisations to deliver optimal pathways. Clinicians have come together to develop clinical work streams which will deliver tangible improvements to patient experience, clinical outcomes and financial sustainability. Work underway includes:
Clinical work streams
- High intensity users: A pilot project across acute hospital, ambulance and police services is developing a joined-up approach to supporting those patients who most frequently access the emergency department. The pilot will involve working on a 1-1 basis with individuals to de-escalate issues before a crisis occurs, empowering patients to self-manage and reducing their demand on emergency services.
- Integrated musculoskeletal service: Musculoskeletal (MSK) conditions are one of the areas of greatest spend for Berkshire West, with care currently split across primary care, intermediate services and acute provision. With an ageing population there are increasing levels of demand and variation in referrals and management of MSK conditions, which supports an overall case for change. Through a fundamental re-design of the MSK pathway, patients will have greater choice and control over their treatment This includes any non-medical intervention and the promotion of how you can manage your own health needs.
- Connected Care: is a new system for sharing information about a patient’s medical condition across subscribing health and social care organisations. The system gives healthcare professionals instant, secure access to patient and social care records across Berkshire. GPs, hospitals, community health, mental health and social care teams all hold important information about people. Connected Care takes a regular snapshot of individual records from each subscribing organisation and provides a single comprehensive record. This means patients don’t have to repeat their story each time they speak to a new health professional as all will have access to a complete picture of their interaction with all elements of the health and social care system. Only those directly involved with the care of a patient, and who are authorised to use the system, can access this information, ensuring patient confidentiality is maintained.
A range of ‘new business’ projects are underway to help deliver our clinical priorities and ambitions:
- Shared back office support: There is an opportunity to integrate some ‘back office’ functions and services that are currently provided by two or more partners. Any such integration will be designed to improve efficiency and free up money to spend on frontline services.
- Shared estates strategy: The aim is to maximise of the use of all NHS buildings in Berkshire West to ensure premises are fit for the delivery of modern healthcare services
- Workforce: An integrated care system workforce group has been formed to develop a shared workforce strategy that improves staff and workplace wellbeing and delivers a sustainable and highly skilled health and care workforce for Berkshire West.
The vision for GP services
GPs, community and social care services will work together to help keep people to stay healthy, and help patients to get the right care, from the right person, at the right time. New technology is being introduced so that patients only have to tell their story once, and two new roles are being introduced – practice pharmacists and physician associates, both of whom are working within primary care to help take the pressure off GPs and support patients. Watch a video about the Berkshire West vision for GP services.