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Spotlight on the Future Hospital development sites: Patients at the centre of their care

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In this new blog series, we put a spotlight on the work of the Future Hospital development sites. Following a key recommendation from the Future Hospital Commission, this instalment highlights how the teams in Mid Yorkshire and central and south Manchester are putting patients at the heart of their improvement work.

A decisive criterion in the selection process to be a Future Hospital development site was a clear demonstration of patient involvement. The development site teams at Mid Yorkshire and central and south Manchester are exemplars of putting patients at the centre of their work

A new assessment service for frail patients

The team at Pinderfields Hospital, part of Mid Yorkshire Hospitals NHS Trust, have developed an assessment service as a part of an acute care hub to:

  • support frail older patients 
  • transford care at the 'front door'
  • reduce the amount of time they spend in hospital.

In 2013, the trust decided to centralise all acute care at Pinderfields Hospital and move elective patients to other sites. The new hospital configuration included an overarching vision of moving patient care to where it was needed most. This evolved into REACT: the Rapid Elderly Assessment Care Team. Now, the REACT team have a dedicated on-call geriatrician and a 7-day multidisciplinary service.

The team includes an RCP Patient and Carer Network representative, Lynne Quinney. Although they joined the team after the project had started, Lynne and two local patient representatives now attend monthly project meetings to offer advice and support, and sometimes challenge things. Building relationships has been crucial and the REACT team have found it very helpful to have patients speaking to patients for input.

Mapping the patient journey

As part of the service improvement, the whole multidisciplinary team (MDT) spent time mapping the patient journey. Together they have developed materials to help patients know what to expect. The clinical team continue to learn from patient feedback – both good and bad.

The team have implemented a ‘praises and grumbles’ mechanism, which is really valued across the MDT. They are using information from what they are not scoring well on to make changes. They are now looking into developing phone contact direct to GPs, and healthy ageing information.

Effective collaboration with patients

The respiratory project in central and south Manchester spans two large trusts: Central Manchester University Hospitals and University Hospital of South Manchester. The team is currently trying to dissolve the line between the areas of central and south Manchester. The new model of respiratory care will allow seamless transition across the patient pathway from diagnosis, acute and chronic disease management to palliative care, which is standardised and reduces healthcare inequality.

Lead by Dr Binita Kane, the teams are focused on effective coproduction with patients: delivering public services in an equal and reciprocal relationship between professionals, people using the services, their families and their communities. An integrated steering group with patient representatives is trying to embed patient leadership within the project.

There have been some recruitment challenges – it’s a lot to expect people to give up a whole day, travel to a venue and do it for free. The team have held two events so far and mapped out services, looked at what was already good, and mapped out a ‘perfect’ pathway. They received clear messages that there are great services but they are not joined up. The team also looked at the chronic pathway and included the views of an expert patient with a respiratory condition. They have now developed a model for the community. 

Benefits of person-centred approaches to health and social care

  • Patient involvement has transformed the way that the teams think about healthcare design
  • Both teams found that staff in secondary care often had different perspectives to what GPs and patients actually wanted.
  • The teams have had high levels of engagement and forged new relationships.
  • The central and south Manchester CCG has been encouraged to start to think differently.

The team want to improve:

  • the number and diversity of patients involved
  • the involvement of carers and the voluntary sector.

This blog is inspired by the presentations/conversations captured at a meeting of all eight development site teams in September 2016.