Presentation on the role of NELCS by the Executive Director – Community Services and Transformation, North East London NHS Foundation Trust.
Minutes:
The NELCS officer explained that the majority of services provided by the North East London NHS Foundation Trust (NELFT) were now community services across North East London and South West Essex. This allowed for a mental health input into services for areas such as stroke, heart disease and chronic obstructive pulmonary disease. Investment was also being made in mobile working such as electronic care records. The Trust and its NELCS subsidiary were also introducing more treatment solutions that could be delivered at home or in community settings.
NELCS provided a number of community services within Havering including district nursing, health visiting and smoking cessation. Service developments had included a new model of integrated case management being introduced from November 2012. This comprised of six clusters across the borough offering support to patients with long term conditions and those who were frequent attendees at hospital.
The continence service could now be offered any qualified provider which increased patient choice. A new falls service had also been launched in April 2012.
Discussions were in progress between NELCS and BHRUT around sharing resources to provide a pilot of an alternative service to A&E. This service would be available 8 am – 8 pm seven days per week. Support was also being given to extend the service at Queen’s Hospital to facilitate weekend discharges and avoid unnecessary hospital admissions. Phase 1 of the new service – the Community Treatment Team would concentrate on support for frail elderly residents. In the longer term, it was hoped to extend both the numbers of conditions and the age range covered by the service.
Progress made by the new team would be shared with the Committee in due course. The Havering Group Director for Adults and Health emphasised that detailed plans had not yet been agreed but that she did support the principle of more integrated working. The Council was keen to combine treatment and care and supported the overall principles from a commissioning point of view. The Integrated Care Coalition also wished to see more flexible models of care delivered closer to home.
The NELCS officer confirmed that work was being undertaken with the Council’s Social Care directorate. NELCS also employed some social workers directly. The Community Treatment Team would be led medically by Dr. Rob Fowler – a geriatrician and lead on chronic obstructive pulmonary disease. The new team was anticipated to be in place by the end of December.
The Community Treatment Team could be contacted by care home staff should they have concerns over the condition of a resident. The NHS NELC representative added that better coordination of community services may be needed as well as better measurement of outcomes from GPs and district nurses.
Members asked for clarity around the patient pathway, particularly for conditions such as chronic obstructive pulmonary disease. Officers responded that most patients with this sort of condition were referred to community services via their GP. The Community Treatment Team would be able to give referred patients advice over the phone after 5 pm and conduct home visits if necessary, in addition to dedicated clinics.
A directory of NELCS services for the use of GPs had nearly been completed and would be available on the NELCS website (www.nelft.nhs.uk). All clinics were also advertised on this website.
Officers emphasised that new technology allowed increased mobile working. A written care plan would be retained in a patient’s home and mobile solutions had also been introduced for patients with mental health issues. Mental health services were in the process of being remodelled with the aim of making outpatient clinics more multidisciplinary and multiagency. Clinics were operated from Harrow Lodge House in Hornchurch and monitoring and follow up work was carried out with discharged patients. The Trust also aimed to make services more accessible through redesign. People were encouraged to use services but it was noted that people could not be forced to unless they were suffering from a severe mental illness. Work was also undertaken with MIND and other voluntary sector groups to introduce people with mental health problems to the voluntary sector. A representative of Havering LINk added that, in his view, MIND would benefit from funding for programmes to provide practical support for people with mental health problems.
The Committee noted the presentation.