In the 10 Year Health Plan, the Government highlighted its aims to implement a new Neighbourhood Health Service across the country. In the Midlands, work is taking place through Community Health Partnerships (CHP) and local NHS systems to maximise and make best use of existing estate through adaptation and collaboration to find innovative ways to deliver healthcare in challenging circumstances for those that need it most.
Throughout the region, distances between the nearest hospital and patient’s homes are prohibitive and services often opted to work in isolation from other teams which created inefficiencies in patient care across Birmingham (Source: West Midlands Combined Authority). Similar was seen across the East Midlands in Nottinghamshire and Derbyshire.
Working collaboratively across systems and identifying local healthcare needs has led to the delivery of innovative solutions which address patients’ needs, improve experience and alleviate pressures on local acute hospitals, in many instances removing the need for acute hospital care.
Innovation through collaboration
At Long Eaton Health Centre, Nottingham, CHP alongside partners from Derbyshire Community Health Services NHS Foundation Trust, University Hospitals of Derby and Burton NHS Foundation Trust, NHS Derby and Erewash Primary Care Network (PCN) and NHS Derby and Derbyshire Integrated Care Board (ICB) have led to the facilitation of “Team Up”.
The project faced the challenge of bringing together services that had previously not been aligned and where was best placed to house the integration of the teams. Meeting as a group, each service worked in partnership to understand how the initiative would benefit their service moving forward, helping to abate any previous fears.
This initiative brings together services, each with their areas of care and expertise into a single facility, having previously been in separate places. This creation not only benefits patients by providing many services under one roof, without the need to travel across multiple sites, but also supports the Government’s aims of a neighbourhood health service.
The clinical team at Long Eaton, as part of the Team Up initiative, work alongside colleagues to support housebound patients through phone calls, visits to care homes and providing proactive support to nearly 2000 people across the Erewash locality. This level of care has, up to now, required a GP appointment and multiple trips to hospital. Through coming together and delivering early intervention in a joined-up way, the team have managed to reduce pressure on the NHS and reduce time constraints on both patients and clinical teams.
The services based within Long Eaton Health Centre have saved over 1000 hospital attendances and 700 admissions as well as, an approximated, 3500 hours of GP time saved per month through Team Up.
Provision of end-of-life palliative care alongside low-risk ambulance calls, including falls, grazes, minor injuries and illnesses and infections, enables patients to be comfortable at home where they would usually use an appointment slot.
The East Midlands Ambulance Services (EMAS) team who operate from the building are often the first to attend a patient who can be helped at home which also helps with the reduction of unnecessary acute admissions.
EMAS can then transfer cases to their Team Up colleagues for lower risk incidents, allowing them to deal with other more urgent or life-threatening calls. GPs in the area previously had a high number of care home visits but by working together, the Team’s activities mean fewer of these visits for the team as well as creating up-to-date risk stratified information. Care delivery is now coordinated and allows the services involved to talk about the same person, in the same place, to create care plans that are unified and joined up.
Utilising capital to avoid unnecessary acute admissions
Washwood Heath Health and Wellbeing Centre tells a similar story, but one with a technological backbone to streamline the risk stratification process. As a locality health hub for East Birmingham, it delivers a wide variety of services within the community to avoid the need to travel to the local Heartlands Hospital. This example shows how facilitation and collaboration across the healthcare system using capital can create extra space in existing buildings to increase productivity.
Much has been written about Washwood including in our case study. Over the years, CHP have supported a multi-phase implementation programme which has included a £2.15m investment from NHS England and £1.2m from CHP to create space for a Community Diagnostic Centre (CDC) and rooms for the use of vital mental health services delivered by Forward Thinking Birmingham as well as café space being repurposed to create four new treatment rooms for a relocated Urgent Care service, utilising space more effectively.
There is also a Locality Coordination Centre acting as a command-and-control point, coordinating the work of Integrated Neighbourhood Teams, with admissions avoidance teams, virtual ward services and single point of access (SPA) teams.
The statistics speak for themselves. In a year as a neighbourhood health hub, the building delivered 41,500 additional appointments out of hospital, GP visits from local patients fell by 31% and Emergency Department attendances reduced by 20%. Moreover, an additional 2,000 patients have been scanned per month following the changes, as well as a 21% decrease in hospital admissions.
It is clear the investment from NHS England and CHP capital has enabled local NHS systems unlock local challenges, maximise existing NHS estate to enable greater service delivery within the community. One of the most impressive parts of the project is its use of data to identify the 500 most high-risk patients in the area, helping to prioritise care and improve the lives of many.
There are roughly 300,000 people in the East Birmingham locality and using a digital platform allows neighbourhood teams to coordinate daily population health in a more advanced, modern way. This is a further development from Derbyshire’s Long Eaton Health Centre and demonstrates the different ways in which collaboration is possible, and how systems are working closely together in NHS LIFT buildings to deliver wrap-around healthcare as well as emergency intervention when needed.
Maximising existing space across the NHS LIFT estate
The work undertaken at Washwood Heath shows how CHP have utilised capital to unlock potential blockers and support the delivery of the neighbourhood model within primary care settings. However, the ‘Team up’ initiative and projects, such as one delivered at Hodge Hill Primary Care Centre, demonstrate how existing spaces can be repurposed quickly, at low cost to support NHS provision for the benefit of patients.
Hodge Hill is located three miles from Heartlands Hospital, which helps run Same Day Emergency respiratory services at Washwood Heath, and will see healthcare for older people services moved into former bookable space. This will increase access to care, but the changes have not required vast capital investment. Works costing only £3,000 from CHP have allowed meeting rooms to be repurposed for clinical use and five rooms to be adapted to accommodate new service, at speed, without major reconfiguration. This rapid delivery demonstrates the flexibility of the NHS LIFT estate in meeting changing local healthcare needs, achieved through collaboration and mutual understanding.
Capital investment is vital to helping our partners deliver the Government’s ambitious plans for neighbourhood health, but it is smaller projects, such as the utilisation of existing space at Hodge Hill, that will provide value for money across the NHS estate as the NHS moves towards the development of a Neighbourhood Health service and integrated care. It has allowed a service to move from a hospital to a more accessible, comfortable, community setting, whilst not displacing patients.
Enabling the shift from hospital to community
In the Autumn last year, the Government committed to the delivery of 120 neighbourhood health hubs over the next three years through its NHS Rebuild Programme. Five CHP NHS LIFT buildings are at the forefront of this programme to deliver Neighbourhood health, including two in the Midlands, Stockland Green Medical Centre in North Birmingham and Summerfield Primary Care Centre (PCC) in West Birmingham, along with Washwood Heath Health and Wellbeing Centre which is already leading the way as a ‘blueprint’ for Neighbourhood Heath in the locality. We will continue to work with local NHS teams to ensure existing space is utilised to it’s potential across Stockland Green and Summerfield PCC.
The results across the midlands are evident and collaboration across the system throughout the region is an example for other regions to follow. Across the LIFT estate there are opportunities to deliver the shift from hospital to community, using capital when necessary or utilising existing space, through joined up collaborative working across partners.
Through the NHS LIFT estate, CHP can provide flexible space where multiple trusts, organisations and NHS partners can work together to deliver services in one place for the benefit of patients, in the development of a Neighbourhood Health service.
Read more Insights from CHP
Read more about our insights on core asset optimisation, place-based care and how CHP supports sustainable NHS infrastructure to enable care for patients closer to home in their local neighbourhoods.
