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Three-year plan would change face of local health provision

A three-year plan unveiled by the Southern Health Trust is expected to see other key services come under the spotlight.

The 50-page Document, ‘Improving Through Change’, will change the face of local health delivery in this area.

And today, the Trust’s Interim Chief Executive Paula Clarke encouraged people to have their say.

It hints at a number of other consultations over the 2015-18 period, with children’s residential care and day care and social care for adults and older people among the services looked at.

The document highlights the plansin relation to the future of statutory residential care for the elderly which, among the proposals, will see the closure of Roxborough House in Moy. It also details the permanent closure of the minor injuries unit in Armagh.

But it points to the need for a complete redevelopment plan for the Craigavon Area Hospital site, a bid for which will be submitted, with short-term measures put in place.

It focuses very much on supported care services for living at home, and the opportunity for more ‘day surgery’ to avoid hospital stays.

This strategic plan sets out the Trust’s priorities for the next three years.

It reveals there are plans to explore further ‘one stop shop’ Community Treatment and Care Centres, bringing the number from three to five across the Southern Trust area, although none for Armagh City.

But there is hope for funding and progress on day centres for adults with learning disabilities in both Crossmaglen and Dungannon.

Armagh I has been examining some of the key points made in the document, which the Trust says will require public consultation to deliver on over the next three years.

This report follows on from the ‘Changing for a Better Future 2013-15’, which, among other things, led to the closure of the Gillis Unit for dementia in Armagh.

This latest plan will see consultation on potential changes to the training and development opportunities for adults with a learning disability through two of  schemes on the Bannvale site in Gilford (Zest coffee shop and the Horticulture Unit).

The report states: “We are currently exploring options to lease these facilities to an external provider, including the potential for development of a social enterprise, to increase the number and diversity of training and development opportunities available. This would enable these services to act as an important stepping stone to other day opportunities within the community, including accredited further education, volunteering and paid supported employment.

“We will also consult with you on the future options for delivering day opportunities for persons with disabilities in the future.

“Having undertaken ‘Community Conversations’ in Keady, Fivemiletown, Dromore, Craigavon and Kilkeel, where we have listened to the issues and concerns raised by older people about their community, we have established local implementation groups in these areas to help us build on our community development approach to local issues, such as home safety and security, road safety and transport.

“We will use this approach to enable local communities to grow their potential to develop social enterprises that deliver services for their local population, working closely with new councils via community planning processes.”

The Trust says it will continue to promote access to monitoring equipment through the further development of telehealth services for patients with long term conditions at home.

The report states: “Almost 1,400 people in the Southern area have already benefited from this service over the past 3 years and we plan to roll out these services into new areas to provide support to a new diabetic model, smoking cessation, acute discharge pathway models and GP monitoring models. We plan to review our existing use of telecare services to help create capacity to further extend this service to a greater number of patients.”

The Trust says it will work with the Housing Executive to develop housing options for adults with mental health and disabilities and to provide for a range of flexible options for children who are leaving care.

“We will support the completion of a new housing scheme for older people in Kilkeel and plan to bring forward schemes for older people in Craigavon/Banbridge and Armagh/Dungannon localities,” it says.

“Work is also ongoing to provide a new range of help and support within a person’s own home. This will include the enhancement of floating support services across the Trust which will support older people to continue living in their existing accommodation reducing the need for placement in a residential/nursing home.

“The practical support offered can provide help to older people to maintain security and safety in their home, with personal budgeting or assistance with shopping which will promote social inclusion in their local community.

“The Trust, by working with other partners to make alternative housing and support available for older people, may consult on the future provision of statutory residential care homes.”

The Trust says it plans to “modernise” day services for people with learning and physical disabilities and also for people with mental health issues.

It states: “Following the HSCB Public Consultation on Day Opportunities and the support given for the proposed approach, the Trust wishes to enhance the range of day opportunities available in local communities and ensure our day centres provide care and support for people with complex healthcare needs and challenging behaviours.

“We will be working with our service users and carers to develop more person-centred opportunities in work, leisure, training and education and we will provide support to individuals who could benefit from these services in moving from centre based care.paula clarke

“We will consult with you on any service changes we would propose to local day care provision as a result of these plans.

“We are planning to develop new purpose-designed facilities which will enhance environments for people attending our day centres, enabling us to refocus the role of our day centres to provide rehabilitation and care to those with the most challenging behaviour and complex healthcare needs.

“We plan to open a new Day Care Centre for adults with a learning disability (46 places) and adults with a physical disability (20 places) in Banbridge in 2015/16. This new centre will replace day care currently provided from Ballydown and Loughbrickland Social Education Centres, both of which will continue to provide temporary accommodation until the new building opens.

“Plans are well progressed for new day care centres for adults with a learning disability in both Crossmaglen and Dungannon and we are hopeful that funding approval will be provided to enable us to commence these projects in the near future.”

The Trust says it also plans to progress the development of ‘one stop shop’ Community Treatment and Care Centres (CTCCs) to provide for high quality patient environments and enable integrated working to support staff to deliver their best care.

The first opened in Portadown in March 2010, and a new Banbridge CTCC is due to open this financial year. Work is well progressed on the procurement and business case approval for another in Newry in 2017/18.

There are plans for two more, as the report states: “We have completed some early scoping work and a feasibility study to inform how primary and community care services could be best provided on the South Tyrone Hospital and Lurgan sites. We are keen to work with our commissioners to move forward with our plans and secure the necessary funding for new centres on these sites.”

The Trust there has been “only limited investment in our hospital buildings” and we “continue to be constrained by the condition, configuration and capacity of the present accommodation at Craigavon Area Hospital”.

It adds: “This means we are unable to support the level of change which would be required to facilitate necessary clinical adjacencies, meet increasing demands and support the development of new models of care on this site without significant investment.  We plan to submit an outline business case to DHSSPS seeking approval for the redevelopment of Craigavon Area Hospital under the HSC capital build programme.”

The report says current financial pressures mean it may take some years before a new hospital at Craigavon is fully implemented.

Short-term ‘solutions’ are planned,  including an upgrade of the electrical infrastructure at Craigavon Area Hospital to support future estates development; development of a new Pharmacy Aseptic Unit for the preparation of cancer drugs and biologic therapies; an expansion of Trauma & Orthopaedic services.

There are plans too for the expansion of the Clinical Decision Unit for patients who are unlikely to be in hospital more than 24 hours, increased availability of general medical beds and the development of an ambulatory care unit adjacent to the Emergency Department.

There will be seven day working across senior clinical and Allied Health Professional areas – particularly in physiotherapy, occupational therapy, radiology and speech and language therapy – to help reduce inpatient stays and support earlier discharge from hospital.

A 2nd CT Scanner at Craigavon Area Hospital will enhance access to diagnostic services.

New paediatric centres at Craigavon and Daisy Hill are due to open in 2016/17 and will enable the Trust to extend inpatient services to include treatment for children up to 18 years old and support plans for the further development of ambulatory care services at Craigavon Area Hospital, to enhance access to services and reduce the need for children to be admitted to hospital.

Day surgery will be developed further so people don’t have to stay overnight in hospital and can recover at home. This has been increased by 31% over the last five years it is felt there is furher potential to increase day surgery in ENT and urology.

“Additional accommodation will be needed to fully meet our requirements and we will continue to pursue this as part of our wider hospital redevelopment plans,” the report states.

One stop assessment clinics will mean patients see a consultant and have any diagnostic tests they need during a single visit rather than needing multiple appointments.

Chief Executive (Interim) Paula Clarke (pictured) said health and social care was constantly evolving, driven by changing needs of the population, advancing technologies and new ways of delivering care.

She said: “It is important that we anticipate and plan for these changes and that we openly engage with our local communities and staff on how we plan to develop and improve the services we provide in the future.

“Whilst our vision remains steadfast to deliver safe, high quality care which is accessible and responsive to all who use our services, we are faced with the challenge of meeting increasing demands within a very difficult financial climate.

“This Strategic Plan sets out how we hope to continually improve and how we would like our services to look three years from now whilst meeting the latest recommendations for health and social care across Northern Ireland as set out in Transforming Your Care, Quality 2020 and the Donaldson Review.

“We want to ensure that this vision is influenced by staff, service users, carers and all other interested stakeholders, so sincerely welcome everyone to share their views.”

‘Improving through Change’ has five key themes:

  • Early intervention and prevention
  • Live more independently
  • Better care outside hospital
  • Modernising our hospital network
  • Improving safety quality of services

 

  • To read the plan in full and find out how to share your views visit:

http://www.southerntrust.hscni.net/about/ImprovingThroughChange.htm

 

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