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

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Figure 9.18: Impact on private car travel times for each borough when A&E destination is changed (peak) 15 Harrow PCT - Northwick Park Hospital: Cumulative population (%) vs. travel itme (mins) Hillingdon PCT - Hillingdon Hospital: Cumulative population (%) vs. travel itme (mins) 100% 80% 60% Current configuration Without Northwick Park 100% 80% 60% Current configuration Without Hillingdon Hospital 40% 40% 20% 20% 0% 0 10 20 30 40 50 60 Average peak private car travel time (min) Maximum peak private car travel time(min) 0% 0 10 20 30 40 50 60 Average peak private car travel time(min) Maximum peak private car travel time (min) Current configuration Without Northwick Park 22 36 35 46 Current configuration Without Hillingdon 26 34 54 58 Brent PCT - Central Middlesex Hospital: Cumulative population (%) vs. travel itme (mins) Hounslow PCT - West Middlesex Hospital: Cumulative population (%) vs. travel itme (mins) 100% 80% Current configuration Without CMH 100% 80% Current configuration Without WMUH 60% 60% 40% 40% 20% 20% 0% 0 10 20 30 40 50 60 Average peak private car travel time min) Maximum peak private car travel time(min) 0% 0 10 20 30 40 50 60 Average peak private car travel time (min) Maximum peak private car travel time(min) Current configuration Without CMH 22 25 32 36 Current configuration Without WMUH 22 26 41 41 15 TfL HSTAT travel times data. Notes from Figure 12.4: 1. Peak time = Morning peak = 7am – 10am 2. Current configuration of major hospitals = Northwick Park, Hillingdon, Ealing, West Middlesex, St. Mary‟s, C&W, Charing Cross , except for Brent PCT where current configuration is assumed to also have CMH in order to provide a comparison 3. Hospitals outside of NWL included in analysis = Barnet, Guy‟s, Kingston, Royal Free, St George‟s, St Thomas‟, St Peter‟s, UCLH, Watford, Wexham Park and Wycombe 4. Travel times from areas outside of London not yet included (will be updated with all LSOAs where >20% patients use NWL hospitals) 5. Population weighted average used for travel times 9b. Decision making analysis stage 5 306
Figure 9.18: Impact on private car travel times for each borough when A&E destination is changed (peak) 9b. Decision making analysis stage 5 307
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North West London Shaping a healthi
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Table of contents Volume 1 Foreword
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Foreword Dr Mark Spencer The Clinic
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6. Consultation, feedback and how w
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13. Equalities implications This ch
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1. Executive Summary Introduction t
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The overall programme timeline is b
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The process was used before consult
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• Delivery of multi-disciplinary
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Stage 1 - Case for Change Our work
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For Quality of care, clinicians hav
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1 2 3 4 5 A 6 B 7 C 8 Quality of Ca
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Assuring the proposals Throughout t
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Programme implementation arrangemen
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5. To agree that Hammersmith Hospit
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DMBC Chapter 2 - Introduction to th
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2. Introduction to the NHS in NW Lo
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Figure 2.3: Clinical Commissioning
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West Middlesex University Hospital
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major hospital, elective centre and
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DMBC Chapter 3 - Introduction to th
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3. Introduction to the Shaping a he
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3.3 Programme governance The Joint
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The JCPCT is advised by a Programme
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Consultation - during this phase, t
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Ensure consistency of communication
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Stakeholder Group Political Individ
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o o o o o Rationale for options dev
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The implications of the options in
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DMBC Chapter 4 -The Case for Change
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4. The Case for Change This chapter
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Stroke Services: The provision of s
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We need to do more to support patie
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In NW London, however, the NHS is s
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Figure 4.6: Emergency general surgi
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attack or stroke to designated cent
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Figure 4.9: Evaluation of primary c
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Inequalities would continue and pro
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DMBC Chapter 5 - Process for identi
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5. Process for identifying a recomm
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Figure 5.1: Basis of decision of wh
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We confirmed this decision, and the
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5.5 A detailed description of the s
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Correct care setting to deliver hig
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Figure 5.11: Ratings used in evalua
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DMBC Chapter 6 - Consultation, feed
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6. Consultation, feedback and how w
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6.2.1 Key findings from the consult
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times (particularly for patients tr
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Westminster City Council, Adult Ser
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Analysed and considered consultatio
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6.3 Our responses to feedback This
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Feedback received Stakeholders who
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6.3.3 Theme 3: Clinical vision and
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6.3.5 Theme 5: Proposals for local
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DMBC Chapter 7 - Clinical vision, s
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7a. Clinical, vision, standards and
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Local clinicians agreed that in ord
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▪ Expectant mothers should have t
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# Standard care services (111). As
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Figure 7.8: Development of the acut
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# Standard Adapted from source depa
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Figure 7.11: Shaping a healthier fu
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No. Standard Adapted from source Su
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No. Standard Adapted from source se
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# Standard All emergency department
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# Standard All non-urgent - within
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Figure 7.18: Shaping a healthier fu
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# Standard Adapted from source shou
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# Standard Adapted from source Comm
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The final standards are more demand
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Figure 7.26: Proposed services to b
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Each CCG is taking steps to help pr
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in major hospitals) and equipment t
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tangible differences for patients
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Referral A&E Illustrative patient j
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Illustrative patient journey matern
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Illustrative patient journey in mat
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Illustrative patient journey planne
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GP-led care Illustrative patient jo
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7.8.1 Scope of the CIG’s work The
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Theme Clinical outcomes Staff attit
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Further stakeholder engagement is n
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Figure 7.31 E&UC CIG Responses to N
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NCAT recommendation CIG response Se
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Conditions suitable for UCC Clinica
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Exclusion criterion Mental health A
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Diagnostics 7.14.3 Streaming, regis
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Biochemistry Microbiology Radiology
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The Provider must deliver appropria
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Figure 7.41: E&UC CIG recommended k
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will be able to establish a service
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The UCC provider will be responsibl
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Key differences Governance As with
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should be provided with appropriate
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Process map 1: Assessing UCC patien
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Process map 3: UCC to ED transfer p
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make an appointment with their own
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7.19 ED workforce A programme-wide
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The purpose of this section is to s
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Figure 7.45 Consultation results on
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Figure 7.46: Specific Responses the
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NCAT recommendation Original Progra
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7.25.1 London Health Programmes cli
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Future capacity in centralised serv
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3. There would be an additional "st
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in NWL will have a choice of delive
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Support for the proposal is higher
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Figure 7.49: Specific feedback the
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Sub-Theme Organisation Support Conc
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Sub-Theme Organisation Support Conc
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7.36.1 National Clinical Advisory T
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NCAT recommendation Further engagem
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edistributed nationwide. We envisag
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6. The Maternity CIG have considere
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DMBC Chapter 8A-E - Out of hospital
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Out of hospital improvements This c
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8.2. Settings of out of hospital ca
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practical solution for the site, wh
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Brent Health Partnerships Overview
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Consultation theme Standards for ca
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Consultation theme Integration Inve
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8.5.3. Workforce Following feedback
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Delivering this workforce shift wil
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Measure type Domain Potential measu
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8b. Primary care development 8.6. S
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consultation they could have receiv
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8.10. Next steps We are developing
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Figure 8.11: Hub/health centre requ
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some cases, these will be offered o
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Process for development of local ho
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The result is an emerging picture o
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Across NW London, these sites will
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need redeveloping or rebuilding to
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8d. Urgent care centres When indivi
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Figure 8.22: NW London urgent care
Page 285 and 286: Conditions suitable for UCC Clinica
Page 287 and 288: Key differences Governance As with
Page 289 and 290: processes of the CCG and as such th
Page 291 and 292: around the table accelerates the un
Page 293 and 294: Improved empowerment - specifically
Page 295 and 296: Figure 8.28: Realising our integrat
Page 297 and 298: Figure 8.29: Summary of CCG commiss
Page 299 and 300: DMBC Chapter 9 - Decision making an
Page 301 and 302: 9a. Decision making analysis stages
Page 303 and 304: Correct care setting to deliver hig
Page 305 and 306: “The Brent Health Partnerships Ov
Page 309 and 310: Royal College of Midwives “The RC
Page 313 and 314: clinicians wanted to take this into
Page 315 and 316: 9.6.3 Feedback received about the s
Page 317 and 318: Confirm the service models reflect
Page 319 and 320: Figure 9.9: The seven hurdle criter
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Page 323 and 324: We confirmed this decision with the
Page 325 and 326: Appropriate staffing is integral to
Page 327 and 328: The proposals are supported by Depa
Page 329 and 330: NW London to deliver high quality c
Page 331 and 332: 1. Support predicting where activit
Page 333 and 334: Figure 9.15: Example travel time ma
Page 335: The analysis shown in Figure 9.18,
Page 339 and 340: 33% support 10% opposed 57% of peop
Page 341 and 342: Figure 9.21: Watershed map for blue
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Page 345 and 346: 9.7.29 The implications of this fee
Page 347 and 348: Figure 9.25: Potential activity flo
Page 349 and 350: Figure 9.27: Changes in travel time
Page 351 and 352: Figure 9.29: Changes in travel time
Page 353 and 354: Figure 9.31: Possible choices betwe
Page 355 and 356: Either Charing Cross or Chelsea & W
Page 357 and 358: Figure 9.33: Option A, excluding ca
Page 359 and 360: Figure 9.36: Option C responses, in
Page 361 and 362: Richmond Upon Thames LINk Royal Bor
Page 363 and 364: Southall Black Sisters “The closu
Page 365 and 366: Figure 9.38: Ranking of evaluation
Page 367 and 368: Figure 9.42: Evaluation criteria as
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Page 371 and 372: 9.9.5 The analysis of the five eval
Page 373 and 374: Figure 9.45: Quality Dashboard data
Page 375 and 376: Response to feedback about the eval
Page 377 and 378: Figure 9.48: Quality of care - Acut
Page 379 and 380: experience. In order to use this as
Page 381 and 382: Figure 9.50: Time to major hospital
Page 383 and 384: Rationalising provision across the
Page 385 and 386: Figure 9.51: Blue light travel time
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Figure 9.52 shows the reduction in
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3 Value for money 9.9.26 The purpos
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Staff recommendation as a place to
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This analysis was agreed prior to c
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Figure 9.56: Ease of delivering eac
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Response to feedback about implemen
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Changes to the designation of the M
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5 Research and Education: Disruptio
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Figure 9.60: Evaluation of disrupti
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9.9.48 The outcome of the disruptio
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Greg Hands, MP for Chelsea & Fulham
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comprises more than 22 million cita
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Quality/Impact score Figure 9.65 Re
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9. Decision making analysis - stage
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There were six distinct parts of th
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Figure 9.69: 5 year gross savings,
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Figure 9.73: Commissioners intend t
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Figure 9.75: Beds bridge: 2012/13 t
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The key modelling assumptions appli
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Figure 9.79: DMBC NHS net capital e
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Figure 9.81: Approach to estimating
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Figure 9.84: Summary of net surplus
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Figure 9.86: Evaluation of total su
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9.13.9 Impact of the changes: Updat
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Figure 9.89: Effect of the expanded
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Correct care setting to deliver hig
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Sensitivity tests g) Tariff efficie
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Figure 9.93 summarises the impact o
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Figure 9.94: Change in expanded NPV
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The sensitivity analysis supports t
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DMBC Chapter 10 - The recommendatio
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10. The proposed future configurati
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The changes to the scoring before a
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10.3. Why this is the recommendatio
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In the rest of this section, the se
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