Both Fylde Coast CCGS have been involved in all the programmes outlined in the previous section with the benefits of working across Lancashire and South Cumbria being seen in the development of the services on offer to our residents.
The following are additional programmes that have taken place across the Fylde Coast only either as an addition to the partnership programmes or separate from it due to being specific Fylde Coast issues.
Pre and during winter 2021/22, there was a significant increase in demand across our health and social care provision on the Fylde Coast i.e., vaccination requirements on primary care, increased numbers and higher acuity of patients attending ED, increase demand on packages of care and crisis hours etc.
The impacts of COVID-19 continued to create significant challenges on workforce across all services, however, Place Based Partners worked collaboratively to develop a system winter plan and throughout the winter period identified resolutions to challenges being faced on a day-to-day basis.
The key focus areas agreed were:
- Respiratory Syncytial Virus (RSV) and management of COVID+ patients
- Mental Health
- Discharge/patient flow
- Care Home Sector
- Frailty and;
- Same Day Emergency Care
Through a Winter Planning and Oversight Group, several schemes were identified to increase services and staffing capacity to meet the demand focussing on the key areas identified above. Of the schemes submitted, twenty-six were deemed high priority totalling circa £4.6m.
The schemes ranged from preventing admission, supporting patient flow and management of care following discharge i.e. increasing capacity in Urgent Treatment Centres, development of Same Day Emergency Care pathways, commissioning additional care sector beds.
Measures for each of the schemes are in place and an evaluation exercise will be undertaken April 2022 which will support and inform winter planning for 2022/2023.
Health equalities commission / population health management
The Fylde Coast CCGs have been a key partner in the development of the Lancashire and South Cumbria Population Health Operating Model. This has predominantly been coordinated through the Fylde Coast Population Health Management Forum (PHM Forum), a multi-agency collaborative group with a focus on developing approaches to tackle health inequalities. Discussions between partners at the PHM Forum have helped shape the Lancashire and South Cumbria approach, building on the local priorities identified.
The priorities of the PHM Forum are:
|To create a learning environment where people working in health and care services on the Fylde Coast, in both statutory and voluntary, charity, faith and social enterprise sector organisations, have the skills and knowledge to effectively use data-driven insights in their work.|
|To embed a population health management approach across the partnership through the use of data-driven insights in the planning, design, development and delivery of health and care services.|
Although the scope of the PHM Forum is not to directly plan, design, develop and deliver health and care services the various members of the PHM Forum do have this responsibility. The PHM Forum has therefore been able to identify the priorities and work with partners to carry out activities aligned with them. During 2021/22 these have included:
Blackpool CCG has had a practice close during the financial year. Elizabeth Street practice was experiencing staffing difficulties and made the decision to hand back the GMS contract to the CCG. The CCG put a caretaker in place for 6 months whilst a permanent solution was sought. It was agreed that the practice should close given the proximity to other practices in the area and disperse the patients. The practice closed on the 31st of October. Patients were registered at the 3 neighbouring practices.
The Primary Care Networks (PCNs) have run incredibly successful COVID vaccination programmes with Blackpool PCNs achieving very high vaccination rates given the deprivation and the issues we face with hard-to-reach groups.
The PCNs continue to recruit to the additional ARRS roles, and we have seen significant increase during the year across all ten possible roles. The staff are being embedded into Primary care. Once challenge that has arisen is the lack of Estates provision for the staff with some PCNs now employing over 20 staff it is a considerable number to find space for in existing premises.
Workforce retention and recruitment continues to be a barrier on the Fylde Coast with many practices having staff vacancies across all disciplines. This will remain a high priority moving into 2022/23
Fylde Coast CCGs continue to work together with place-based partners to implement the Fylde Coast vision for respiratory care:
|‘To reduce the future prevalence of respiratory diseases, and to improve quality of care, improve quality of life, improve outcomes and reduce health inequalities for those living with respiratory diseases.’|
In collaboration with partners Fylde Coast CCGs actively support the work of the Fylde Coast respiratory transformation programme and have commenced the process for procuring an Adult Integrated Respiratory Service (AIRS) bringing community respiratory services together to help prevent, identify, and manage respiratory disease within the community closer to home.
Community pharmacy consultation service
Since 2016, NHS England has funded and tested several operational service models throughout England that can be used to enhance community pharmacy’s role in urgent care provision.
Using the evidence from these pilots, the Community Pharmacist Consultation Service (CPCS) was commissioned as an advanced service from 29 October 2019. When the service first commenced the referrals to community pharmacies were made by NHS 111. In October 2020 the service was extended to cover referrals for low acuity minor illness from general practice settings.
During the pilot of referrals from GPs nine out of 10 patients were treated by pharmacists without the need for other referrals to other specialties. General feedback from patients involved was favourable.
The Fylde Coast was named as a pilot site by NHS England and Improvement in November to test further expansion of the service to incorporate referrals from urgent and emergency settings including A&E and Urgent Treatment Centres.
The service launched in December 2021 with 25 pharmacies taking part and receiving referrals from urgent and emergency settings such as the three urgent treatment centres and Blackpool Victoria Hospital’s Emergency Department.
Patients who attend the A&E or Urgent Treatment centre are triaged and assessed as being suitable for the referral to the CPCS and are assisted in choosing the most appropriate community pharmacist for their needs, based on locality and accessibility etc. The pharmacy of choice is notified of the referral and sent all relevant details. The patient then attends the pharmacy for a consultation and all being well the issue is resolved. Should the consultation reveal that a further intervention such as a GP appointment is required the pharmacist will have the ability to make an onward referral.