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
9.5 Stage 3 – the clinical standards
This section describes the third stage of the process about the clinical standards. Figure 9.6
highlights the relevant step.
Figure 9.6: Highlighting Stage 3 of the process described in this section
Key principles
3
Standards
Continue
expanding out of
hospital services
All specialist
services will
remain as they are
Located with, or
independent of
major hospitals
All 9 sites with an
A&E to provide
local hospital
services and a UCC
Out of hospital:
4
Service models
Out of hospital
1 Case for change 2 Vision
• Identifies how care
1 Localising
needs to improve.
• Shows that ‘donothing’
is not an
2 Centralising
option.
3 Integrating
3 Standards
Out of hospital:
Acute:
• Urgent and
emergency care
• Maternity
• Paediatrics
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
7
Sensitivity analysis
Clinical dependencies
Acute:
• Urgent and
emergency care
• Maternity
• Paediatrics
Number of options:
MILLIONS
Number of options:
< 20
2 Access to care
3 Value for money
4 Deliverability
5 Research and education
Criteria include sub-criteria
Number of options:
~ 3
• Tests 18 underlying
assumptions for
acute reconfiguration
• Test 3 sensitivities for
out of hospital
Number of options:
~ 3
Recommended
option
Number of options:
1
9.5.1 The purpose and outcome of Stage 3 – the clinical standards
The purpose of the third stage is to document the clinical standards that will contribute to the
delivery of the vision for healthcare in NW London. The outcomes are:
1. Establish the clinical standards are in place and are based upon the latest evidence
and clinical thinking
2. Establish that if the standards are achieved they will contribute to the improvements
outlined in the Case for Change
9.5.2 The clinical standards
Chapter 7a details the clinical standards for:
Out of hospital
Urgent and emergency care
Maternity
Paediatrics
To drive the improvements in clinical quality and reduce the variation that has been
documented in the Case for Change, local clinicians developed a set of clinical standards,
including latest evidence from Royal Colleges, reviews by the NHS in London and NICE
guidelines.
The clinical standards were agreed by the Clinical Board and the Programme Board preconsultation.
9.5.3 Feedback received about the clinical standards during consultation
9a. Decision making analysis stages 1 to 4 281