The next major challenge facing the system is the number of people who are in hospital who don't need to be there because there is currently no alternative.
Currently, too many older people are admitted to hospital when, with appropriate out of hospital care, they could be treated in the community and looked after in their own home. Around 25% of patients could be looked after in their homes or supported in the community.
A move to more out of hospital care would improve quality of care and save money. For every £1 spent in hospitals, alternative community care can be provided for 70p.
In North West London we have consulted on a large out of hospital investment strategy as part of Shaping a Healthier Future and over the past year we have been doing both the planning and delivery of these changes.
Over the next five years, we will be investing £190m more a year across North West London on out of hospital services, including integrated care and more access to general practice. These investments will result in more staff and better facilities to deliver it.
How we are delivering this in Hounslow
Our plans to deliver better care out of hospital are outlined in our out of hospital strategy.
Hounslow CCG has already made considerable progress in delivering this:
Diabetes is consistently identified as one of the most important issues of concern for Hounslow CCG. As part of our overall strategy for tackling this disease and reducing avoidable admission into hospital we intend to train primary care clinicians to improve management of diabetes. We will also increase access to diabetes education for both Type 1 and Type 2 patients, supporting the promotion of diabetes education in hard-to-reach local communities and where there are language barriers. At the same time we will encourage multi-disciplinary working across localities to ensure the delivery of coordinated, planned care for patients with diabetes.
The development of a new primary care centre in Heston (HPCC) is a top priority for the local health economy and in 2014/15 we will be looking to move this exciting project forward. The development of the HPCC will transform local primary care services and facilities serving almost 25,000 local people in one of Hounslow’s areas of highest deprivation and health need. HPCC will allow five local GP practices to deliver their core service to the high standards expected in Hounslow and deliver the radical new model of out of hospital care outlined in Shaping a Healthier Future where extended primary care GP services play a major role reducing the use of local acute hospital services.
With our partners in CWHHE we intend to commission a musculoskeletal service that will seek to reduce the number of referrals to acute orthopaedic services by making practical best practice improvements to existing services (central booking service, GP direct access physiotherapy, CATs, pain management service) to achieve the reduction in referrals.