Planned Care Transformation
What is planned care?
Planned care is the name the NHS gives to health services and treatments that aren't because of a health accident or emergency. This type of care is arranged in advance and, generally, follows a referral from a GP.
We know that on average, people in Croydon use hospital services more than people in other areas. Croydon residents visit A&E more often and visit other health services for health conditions that have worsened and need more treatment. With an ageing and growing population, the demand for healthcare in Croydon is growing faster than the NHS can currently provide.
The local NHS wants to improve outcomes for patients but also we need to deliver safe and sustainable services within the money we have.
We need to be better at helping people stay as healthy as they can, act quickly when people's health worsens and keep people as independent as possible. This will help people live longer, healthier lives and be more affordable for the NHS so that we can further invest in improving vital services.
To do this we need everyone's help to:
- Think carefully about their own health and that of their families, friends and communities
- Identify and reduce waste and duplication, where it exists
- Make best use of existing services and healthcare appointments
We need patients and carers, clinicians and other professionals, statutory and voluntary bodies to work together to help improve the health of people in Croydon.
Transforming planned care in Croydon
We are working with our partners in the NHS to transform planned care services for Croydon residents. Our aim is to improve patient care and health outcomes.
By changing the way we use community and GP facilities we can bring more care closer to home. This will free-up space at Croydon University Hospital for patients needing emergency and specialist services including treatment for cancer, neurology and complex maternity services.
As well as bringing more services into the community, we are improving the way different parts of the local NHS work together. This will give patients more control over their care, and make sure that they are always seen by the right person, in the right place at the right time.
We are also working on new ways to help patients take control of their health, helping them make better, more informed decisions about their health and care.
Why do we need to change planned care?
We need to change the way we deliver planned care in Croydon to improve the care patients receive, improve their health outcomes and get better value for the NHS. There are several issues we are trying to address:
- The NHS is struggling to keep up with increasing demand – this means waiting times are steadily getting longer and patients aren't being treated quickly enough
- Not everyone has the same access to services and the standard of care varies depending on where patients go – this can increase inequalities for some communities
- Different parts of the NHS don't work together well enough – this can be very frustrating for patients and cause unnecessary delays to their care
- Our services cost too much to run because of the way they are organised – this isn't sustainable
- Some staff working in GP practices need more support and skills to help reduce referrals to hospital – this would mean patients could be treated sooner and reduce unnecessary hospital visits
Croydon's population is growing quickly. We have one of the youngest populations of any London borough, with more than 120,000 residents aged under 25. At the same time, people in our community are growing older, with over 65,000 Croydon residents expected to be aged over 65 within the next ten years.
Caring for this many people will put unsustainable pressure on our local hospital. How we provide services now is also unaffordable faced with limited growth in funding and a national shortage of trained clinicians. We have to change our approach.
How can we address these challenges?
We have been providing outpatient and planned care services in the same way since the NHS was formed nearly 70 years ago. Medical advances and new technologies mean that most outpatient appointments can take place nearly anywhere, and more diagnostic services like blood tests can be taken in your local health centre or GP surgery.
Our health needs are also very different now. The biggest demand on the NHS now is from people with health conditions that stem from our own lifestyle choices, like smoking, diet and a lack of exercise.
Waiting to treat people when they become unwell does not make sense. Instead, we have to do much more to help people live well and stay well – this includes bringing more health and support services closer to where people live to help keep people healthy and out of hospital.
We know that for every 50 patients we treat in hospital, 20 could be better cared for at home or in the community. Offering more of our services out in the community, where clinically appropriate, will help us to bring services closer to you and prevent you from having to make unnecessary trips to hospital.
This will also help us free-up space when you need hospital care, and help the team at Croydon University Hospital concentrate on emergency and specialist care. This will help us to keep waiting times shorter and get people the treatment they need faster.
Providing many services in the community also costs the NHS less money than caring for people in hospital. This would release funding that could be reinvested elsewhere to improve NHS care in Croydon.
The right person, in the right place, at the right time
In some services, four out of every five referrals to a consultant do not need a follow-up appointment. This shows that many non-urgent referrals would be better managed by a different health professional, like a senior nurse or assistant physician. This would free-up consultants' time to treat and manage patients with the most complex needs. It would also reduce waiting times for both initial outpatient appointments and surgery for those who really need it.
Moving more services closer to home allows us to make much better use of the expertise and services available at Croydon University Hospital. This means the hospital focusing on providing emergency and more specialist care for patients who are very unwell and need to be looked after in a hospital setting.
Of course, all outpatient appointments would still take place in a clinical, fit-for-purpose and clean environment.
Our proposals will give GPs and community nurses, like practice nurses,
district nurses and health visitors, a bigger role in coordinating and
providing healthcare. We know from best practice in other areas that this
approach is particularly successful at managing long term conditions and
improving outcomes for patients.
Providing more diagnostic services in the community will reduce travel and waiting times for local residents in Croydon.
Who is designing these proposals?
No decisions have been made on how we should shape planned care services in Croydon, and our proposals will be shared and tested at local engagement events to get your views.
We are working on proposals now which are being developed by GPs, consultants, nurses, therapists, NHS managers and patient representatives from NHS Croydon CCG, Croydon Health Services NHS Trust, Croydon Council, South London and Maudsley NHS Foundation Trust, private providers and the voluntary sector. We have also been working alongside other regional NHS transformation programmes to make sure that our plans align and that there is no duplication or waste.
The slide pack below is used during workshops. Outputs of the workshops can be found below.
Planned Care - Future Model of Care
The engagement structure we've developed for the Planned Care transformation:
The terms of reference for the patient working groups:
Summaries from Transforming Planned Care workshops:
If you would like to get involved, you can find an application form and more information here.