In collaboration with our GP members, local people and partners we have identified five priority areas.
- Transform the experience and care of adults with long term and complex conditions
- Improve the care of children and adolescents
- Increase the clinical cost effectiveness of elective treatment and prescribing
- Improve the quality, safety and performance of local health services in line with local and national expectations
- Ensure better prevention of disease and early identification of disease leading to reduced inequalities
To find out more about these priority areas we have provided some information on each within this page. We also have a ‘plan on a page’ that brings all this together into one document. You can view the document by clicking on the following link – 13 03 28 Complex Plan-on-page v13
1. Transform the experience and care of adults with long term and complex conditions by:
- Reducing unplanned hospitalisation for ambulatory care sensitive conditions (for example, diabetes, asthma, hypertension)
- Reducing the number of patients that go to Accident & Emergency (Emergency Department)
- Reducing adult non-elective admissions (patients not admitted from a waiting list i.e. from A&E)
- Increasing the number of people who feel supported to manage their health conditions
- Reducing the number of readmissions to hospital
To do this we will provide more active support for self-management of health conditions and work in a more united way with social care, mental health and the voluntary sector. We will provide additional primary care reducing the need for people to attend hospital, for example, for treatment like IV therapy (antibiotics administered via a drip).
At the heart of the improvements will be Integrated Health & Social Care. Click here for more information.
2. Improve the care of children and adolescents by:
- Reducing the number of non-elective admissions (patients not admitted from a waiting list i.e. A&E) for under 18 year olds
- Reducing unplanned hospitalisation for asthma, diabetes and epilepsy in under 19 year olds
- Reducing A&E attendance for under 18 year olds
- Reducing emergency admissions for children with Lower Respiratory Tract infections
To achieve these goals we will be working with Stockport NHS Foundation Trust to review children’s community nursing services alongside the enhancement of services for children and families in primary care. These will also be with a view to supporting children and their families to manage their long term conditions (for example, epilepsy and diabetes) in the community without the need for hospital visits. We will also be expanding children’s psychology therapy services later in the year.
3. Increase the clinical cost effectiveness of elective treatment and prescribing by:
- Reducing the number of unnecessary outpatient appointments
- Keeping spend down on prescribing to its current level over the next three years
- Reducing the number of unnecessary follow up appointments at hospital
- Keeping the number of elective admissions below its current level
To achieve these goals GPs will be looking at ways in which they can reduce referrals whilst improving patient’s experience. They will do this by reviewing their own referrals within the practice and with other GPs. Although your GP would not refer you for ‘no reason’ it may well be that there are alternatives that he/she may not have considered or be aware of and ‘peer review’ can help to address this.
Also ‘referral coordinators’ will be appointed to support this process and will be responsible for ensuring the quality of all referrals (for example, the information that is provided to the consultant upon referral).
On follow ups we are working very closely with the hospital to enable GPs to be more actively involved in decisions about their patients follow ups and to carry out some of those follow ups in the practice (click here for more information).
In prescribing, one example area of where we can improve is on the use of hypnotics (sleeping tablets). We are currently above the national average on the prescribing of these drugs and they can have some unpleasant side effects. Therefore we need to look to providing alternative support and advice to patients on getting a good night’s sleep (click here to view our leaflet).
4. Improve the quality, safety and performance of local health services in line with local and national expectations.
We will:
- Deliver the nationally set Clostridium Difficile target by 2016
- Deliver 100% of NHS constitutional requirements by June 2013 and sustain throughout the life of the plan
- Introduce the national Friends and Family Test
- Increase the number of people satisfied with their GP
GP practices in Stockport have worked hard to considerably reduce the number of C-Diff cases by following strict guidelines on the use of antibiotics. Work will continue to further reduce these numbers.
We will also continue to increase access to psychological therapies in line with national targets. This will include appointing new therapists to treat people with depression and anxiety disorders.
5. Ensure better prevention of disease and early identification of disease leading to reduced inequalities.
Our goals related this aim are to:
- Reduce potential years of life lost ahead of national levels of reduction
- Reduce mortality from cancer ahead of national levels of reduction
- Slow the increase in admissions for alcohol related liver disease
We will be working to increase uptake of rates for cancer screening, vaccinations and health checks in the more deprived areas of Stockport where uptake is lower. The CCG and GP practices will work collaboratively with public health to re-focus and promote the health check system.
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