The NHS is calling for a new approach to health and social care in order to meet the increasingly complex needs of people as the population changes and grows (by 18 per cent in a decade in north east London, where I am based). Sustainability and Transformation Plans (STPs) are our opportunity to make a real difference to people’s lives by transforming the way care is provided.
It’s a chance to deliver improvements that matter – that make it easier to see a GP; access musculoskeletal physiotherapy, speed up cancer diagnosis; offer better support in the community for people with mental health conditions; provide care for people closer to their home; and empower people to manage their own health and wellbeing. Attempts to develop these have been made over a number of years and have been successful in parts, but not universally.
In north east London, our focus is on building strategic partnerships so we can use the resources we have to the maximum. We want to develop new approaches to working together more collaboratively in designing and delivering care, tailored to local people’s needs. Together, we are driving genuine and sustainable change, putting the patient and their experience at the heart of quality improvement.
At the moment, getting care in a crisis through A&E means our solutions tend to be too much about providing care around a few hundred hospital beds, rather than care around the 1.5 million beds in people’s homes. Getting capacity in the right place and utilising the skills of the collective workforce will allow us to bring more care closer to local people, where they tell us they want it. Specialist services can then be provided to cover a larger population which requires provider organisations to work in a collaborative way to share expertise and use resources in a better way.
In some boroughs we have services delivering high-quality, multidisciplinary, intensive rehabilitation in patients’ own homes. Daily, they receive home visits from a specialist team including physios. About 90 per cent of patients are able to recover at home without needing to go to hospital, helping them to stay independent longer. Patients who receive care and treatment from these teams not only benefit from avoiding unnecessary hospital admissions but free up valuable time and resources at local hospitals. We need to see this being delivered as the norm.
Working in this way also gives more autonomy to our staff, releasing them to innovate and provide whole-person care.
Multidisciplinary teams across health and social care, supported by the voluntary sector and our strong local communities, can deliver this care. This provides new challenges and opportunities for the NHS’s committed staff, who can work to outcomes, rather than following outdated processes. New training opportunities, roles and inventive ways of working will present themselves. It’s about the right care, at the right time, in the right place and – most importantly – the right team.
- Jane Milligan is chief officer for Tower Hamlets Clinical Commissioning Group and executive lead for north east London STP.