SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Correct care setting to deliver high quality care
Use existing sites
Enough major hosp. to support population of 1.9million
Number of major hosp. must be viable in medium term
Ensure good geographical spread
Use sites currently delivering major hospital services
Minimise access impacts for residents
Confirming ‘do nothing’ is not an option:
The Case for Change describes how the consequences of doing nothing are
unacceptable. No viable alternative was proposed.
The evaluation against Stage 1 – the Case for Change, has been completed and we
proceeded to Stage 2 – the vision. We confirmed this decision and the validity of the Case
for Change with the Clinical Board and the Programme Board during the decision making
phase.
9.4 Stage 2 – the vision
This section describes the analysis for the second stage of the process – the vision. Figure
9.4 highlights the relevant stage in the process.
Figure 9.4: Highlighting Stage 2 of the process described in this section
Key principles
Continue
expanding out of
hospital services
Located with, or
independent of
major hospitals
All specialist
services will
remain as they are
All 9 sites with an
A&E to provide
local hospital
services and a UCC
4
Service models
Out of hospital
2
1 Case for change 2 Vision
Vision
• Identifies how care
needs to improve.
• Shows that ‘donothing’
is not an
option.
1 Localising
2 Centralising
1 Localising
2 Centralising
3 Integrating
3 Standards
Out of hospital:
Acute:
• Urgent and
emergency care
• Maternity
• Paediatrics
Clinical dependencies
5
Hurdle criteria
8 Borough level, out of
hospital strategies
covering:
• Case for improving
OOH services
• Steps to delivering
better care
• List of initiatives
• Investment
• Next steps
6 Evaluation criteria
1 Quality of care
2 Access to care
3 Value for money
4 Deliverability
5 Research and education
Criteria include sub-criteria
7 Sensitivity analysis
• Tests 18 underlying
assumptions for
acute reconfiguration
• Test 3 sensitivities for
out of hospital
Recommended
option
3 Integrating
Number of options:
MILLIONS
Number of options:
< 20
Number of options:
~ 3
Number of options:
~ 3
Number of options:
1
9.4.1 The purpose and outcome of the vision
The purpose of the second stage of the process is to document the vision for achieving the
objectives stated in the Case for Change. The outcome is:
1. Confirm the vision created by local clinicians for Shaping a healthier future will deliver
the required improvements and clinical benefits
9.4.2 The vision for how to improve health of people in NW London
Chapter 7, section 7.1 details the vision for health services in NW London, describing how
patients will be treated in the future to ensure they receive the highest standards of care. In
summary:
Localising: Services will be provided locally where possible and centralised where
necessary. Localising routine medical services means better access closer to home
and improved patient experience
Centralising: Centralising most specialist services means better clinical outcomes
and safer services for patients
9a. Decision making analysis stages 1 to 4 277