Why we need to change
Across Lancashire and South Cumbria, we face some real challenges which mean we can't carry on delivering health and social services the way we do now.
- Financial shortfall because of increased demand
- Poor health in our region
- Lack of joined up care
- We're living longer with complex needs
- More need for mental health support
- We struggle to recruit and retain staff
"3500 deaths in Lancashire and South Cumbria are considered preventable"
Our health and care services are struggling to address the level of illness and poor overall health we face.
This means that people don't always receive the quality of care they need.
We need to overcome these challenges to move towards a health and care system that is fit for now and the future.
It isn't all about money, even if it appears that way.
Funding for the NHS is set to increase over the next few years. However, the need for our health and care services is higher than ever and is predicted to increase.
"The population of Lancashire and South Cumbria is approximately 1.7 million and is increasing”
Even with increased funding, if demand increases but we don't change the way we provide services, we could be looking at a financial gap of £572 million by 2020/2021 for Lancashire and South Cumbria.
We need to talk honestly about these challenges as we move forward.
In addition, funding for care services is decreasing leading to people staying in hospital longer than they need to, through no fault of their own.
We spend large amounts of money on treating illnesses linked to poor diet, lack of exercise, smoking and alcohol. Smoking costs us £290 million every year, with £495 million being spent on alcohol misuse.
Some people experience ill health from an early age and die younger, especially in areas with higher levels of deprivation (that is, where incomes are lower and unemployment is higher). There are high levels of physical and mentalhealth problems, and we have even seen increased levels of suicide in our communities.
“In Lancashire and South Cumbria, cardiovascular disease, heart failure, hypertension (high blood pressure), asthma, dementia and depression are more common than the national average.”
We know that it isn’t always easy to cut down on drinking or stop smoking, so we need to support people and communities to help them make changes. Others in our community are also at risk. We know that people with a learning disability are likely to die younger than those who don’t have a learning disability.
What works now
The heart failure service has a text messaging system in some areas. It sends patients reminders and health advice tailored to their needs. It also records readings of, for example, their oxygen level, pulse rate, blood pressure and weight. This has resulted in patients being more confident and able to manage their conditions. It also resulted in reducing hospital admissions and unnecessary visits. This meant that doctors and nurses could see more patients overall.
The challenge of recruiting and keeping a skilled workforce are a real problem. We have an aging workforce and not enough younger replacements coming through. If we can’t increase the workforce we need to look at how we can create new roles, train staff and work more effectively together.
“20% of GPs are 55 or over and are likely to retire over the next 10 years”
Increased use of technology will allow staff to share information with each other and patients. This will result in less duplication and a better service for patients. We realise this won’t work for everyone, but it could benefit many.
Older people with complex needs
For most of our area, the quality of life for people with long term health conditions is worse than the average across England. We aim to find a way of joining up the care they receive from different organisations to give them a better quality of life.
Many people with long term health conditions are frail and elderly patients. When their care isn’t joined up around their needs, they often end up in hospital beds because they can’t be treated closer to their homes.
It isn’t always easy to decide which service to use...
We know that it isn’t always easy to decide whether you should see your GP, but if people used their local pharmacies or online services more it could make a big difference. The health and care system is confusing, meaning people are not sure where to go. Just over a quarter of all people seen by their doctor could have had the issue solved in another way.
“Also about a third of people who go into A&E departments could have been seen by their GP or another community service.”
People will need to be helped to understand what help is available and where to find it, so it is easier for them to choose well.
Increased need for Mental Health Support
Children’s, young people’s and adults’ physicalhealth needs are not being treated together with their mental health needs. This can lead to a variety of issues such as selfharm and feeling isolated from society. This also results in physicalhealth conditions being left untreated and people dying early.
We will support people with teams close to home. We will also provide support for mental health in A&E departments.