Fylde Cost, strategy for 2020 - 2025
Contents
- Our partnership
- About us
- Quality challenges
- Financial challenges
- What you told us
- How we compare
- Our vision
- Our key areas of focus
- Our plan
- Population health
- Primary and community
- Quality
- National standards
- Our resources
- Partnerships
- How we will deliver this
- Aligning our priorities
- Next steps
Welcome
We spent several months across the end of 2019 and early part of 2020 working closely as a Fylde Coast health and care partnership to develop our five-year strategy, and we would like to thank everyone who contributed to its creation.
This strategy describes some really significant challenges here on the Fylde Coast, more of which you will read about later in this document. It also outlines our ambition to make sure people living on the Fylde Coast have the very best health and wellbeing and that we provide the very best care services possible.
Before we formally launched our strategy, the COVID-19 pandemic reached the United Kingdom and we were faced with extraordinarily difficult circumstances, the likes of which many of us had never experienced before.
The way in which people responded to these challenges was so positive. From people living on the Fylde Coast practising social distancing and good hand hygiene, to the highly specialised clinicians caring for the sickest patients in our intensive care units. We were overwhelmed by the way in which people worked together and supported each other through difficult and uncertain times. We cannot thank people enough for their efforts.
Throughout the pandemic, we saw the real benefits of collaborative working which enabled us all to recognise and fully appreciate the invaluable contribution of all of our partners. We saw how adaptable and innovative people can be when there is an urgent need to do things differently. And we saw how important it is to be kind and compassionate to one another, in our place of work and in our communities. We believe it is vital for us to build on these things as we look towards the delivery of our strategy.
We reviewed the content of our strategy based upon our experiences during the COVID-19 pandemic. We believe our ambitions and key areas of focus were made more relevant than ever.
We need to create health and care services that support people to be as healthy as possible with a greater sense of wellbeing. We want to make sure when people are unwell, they can get high quality treatment or advice as close to their home as possible. To do this we need more community based services. We also want to make greater use oftechnology which will make it easier for people to access services and stay at home for longer. We only want people to go into hospital if they absolutely have to. This will allow our hospitals to concentrate on services that only they can provide.
The ways in which we will deliver these ambitions will be significantly influenced by our response to the COVID-19 pandemic, as well as its lasting impact. But we are excited about the future, we are ready to make some big changes and by working together we are confident we will improve health and care for people living on the Fylde Coast.
Our partnership
The Fylde Coast Integrated Care Partnership brings together NHS and council organisations along with care at home and residential care providers to improve health and care for people living in Blackpool, Fylde and Wyre.
The challenges facing health and care are well documented and will probably not come as a great surprise. So it is crucial we make better use of our joint resources. This includes staff, services and money.
The local partnership is known as Healthier Fylde Coast. As a partnership we will work together to a common vision: ‘Improving health and care together’.
This document sets out our plans for the next five years for health and care services across the Fylde Coast. It looks at the challenges we are facing and how we aim to tackle them so people living here have longer, healthier lives.
Our plans are guided by:
- the challenges facing us on the Fylde Coast and the things our residents and staff have told us are important to them;
- the Lancashire and South Cumbria Integrated Care System;
- the NHS Long Term Plan.
All of this information has informed the creation of this overarching health and care strategy for the Fylde Coast.
By working more closely together we will deliver three key aims:
- We will have healthy communities across the whole of the Fylde Coast
- We will have safe, high quality services with better outcomes and experiences of care for our patients.
- We will have health and care services that are fit for the future. delivered by a skilled, motivated and resilient workforce.
About us
The Fylde Coast is a coastal plain in western Lancashire containing the towns of Fleetwood, Cleveleys, Blackpool, St Annes and Lytham, with Thornton and Poultonle-Fylde not far inland.
The central part of the Fylde Coast includes the smaller towns of Kirkham and Garstang. The rest of the Fylde Coast is mainly rural with many villages and hamlets.
We provide health and care services for approximately 354,000 people across the Fylde Coast. Understanding the needs of our people is so important if we are to effectively address the challenges we face and improve patient outcomes and quality of care.
The Fylde Coast has a vast amount of heritage and local attractions, making this a desirable place to live and to visit.
Yet beneath all of this, we are facing some major challenges with the health and wellbeing of our residents.
Our population
We will see continued growth in the elderly population resulting in a change in the type of services that are needed.
By 2041 the over 65s will make up around a 32% third of the population of the Fylde Coast.
Deprivation
We have significant levels of deprivation in some areas of the Fylde Coast which has an impact on population health, lifestyle and health inequalities.
Disease prevelance
We have high levels of disease prevalence across the Fylde Coast, particularly for coronary heart disease (CHD), hypertension, cancer, diabetes, and chronic obstructive pulmonary disease (COPD).
Health
We have poor life expectancy in some areas of the Fylde Coast.
We have poor healthy life expectancy. This means people are living much of their lives in poor health. Healthy life expectancy in Blackpool is only 55 for males and 59 for females.
The overall burden of disease is increasing – more than half of premature deaths are associated with potentially preventable risk factors.
Lifestyle
We have significant levels of alcohol and illicit drug consumption, along with high smoking rates, particularly smoking in pregnancy.
Wellbeing
We have significant levels of overweight adults and children, with a gradual worsening trend year on year.
Approximately twothirds of adults are overweight or obese on the Fylde Coast.
Significant levels of depression, severe mental illness, suicide and self-harm across the Fylde Coast.
10.4% of the population report having a long term mental health problem.
Quality challenges
We need to improve the health and wellbeing of our residents. We also know we need to improve the way we provide care so people can access the right support at the right time to meet their needs.
We are facing a number of challenges in relation to the quality and safety of care provided on the Fylde Coast. We have a shared responsibility to address these challenges no matter which organisation they come from. They affect our place and our people. We need to work more closely together to improve the quality of care and patient experience. The Care Quality Commission (CQC) inspected Blackpool Teaching Hospitals NHS Foundation Trust in June 2019.
The inspection highlighted a number of areas which need to be improved. The Trust now has 32 actions which it must do and 86 actions which it should do. The actions are broadly based around the following themes:
Governance:
- Policies.
- Duty of candour.
- Culture.
- Environmental risk assessments.
- Monitoring quality and safety.
- Safe storage of medical notes.
Safe care and treatment:
- Environment risk assessments.
- Bed rail practice.
- Consent.
- Medical record management.
- Mental Capacity Act.
- Critical care environment and facilities.
Safe staffing:
- Medican staffing.
- Nurse staffing.
Person-centred care:
- Patient-centred care treatment plans.
- Pain management.
- Mixed sex accomodation.
- Wait times.
These actions are now a priority for the Trust and form part of an action plan which is monitored by the Trust and the CQC.
In addition to the CQC recommendations, we have also identified some key areas of focus for improving quality and safety across the Fylde Coast:
- Reducing preventable deaths.
- Reducing avoidable harm.
- Improving the last 1,000 days of life.
We know the only way we can address these challenges is by working better together. So now we have a strong and common purpose to base our partnership working upon – improving the health and wellbeing of our residents together.
Financial challenges
We need to make sure we make the best use of the money that we are allocated. We also know we need to improve the way we make decisions about spending this money for the maximum benefit to local people.
We are facing a number of challenges in relation to the funding that is available for health and care on the Fylde Coast. Like the rest of the NHS, our finances will be tight for the foreseeable future. Yet we have many different demands on how we spend our money.
- We need to deliver the national expectations contained within the NHS Long Term Plan.
- We need to update some of our clinical equipment and our buildings.
- We need to address local needs, making sure we improve the quality of care and reduce the differences in people’s health across the Fylde Coast.
We also know we need to invest more in prevention, healthy lifestyles and the wellbeing of local people. We need to do this to try and stop an ever increasing demand for health and care services.
Finance strategy
The financial strategy for the Fylde Coast, and the detailed plans which sit under it, support the system as a whole to address our current challenges. The plans also address the fact that we are going through a big period of change. This will include changes to the way we pay providers of services, as well as changes to the contracts we hold with our providers.
Our plans recognise the financial positions of the organisations within the partnership. They make sure no one can make a decision which would have a negative impact on the system as a whole. Our approach will support the integrated care partnership in looking to create a different way of working which is fit for the future.
Underpinning the strategy there will be more detailed short, medium and longer term financial plans. These plans will look at revenue and capital to make sure that public funds are used in the most effective and efficient way to support our ambitions. Currently this strategy focuses on health partners.
As we have said, money is tight and we need to be able to make savings year on year, despite the increasing demand.
However, there are limits to the level of savings we can make. We need to make sure we don’t compromise the safety and quality of care which our patients expect and deserve. With this in mind, we need to think differently and take a more longer term approach.
We need to look at new and innovative ways of delivering services.
To make sure our finances are fit for the future we need to focus on what we have and be confident that we are using it responsibly.
Therefore we need to make sure:
- We only spend the resources we are allocated.
- Our spend represents value for money.
- We have robust systems and processes to enable the above.
What you have told us
We want to develop our health and care services in line with what people have told us they would like to see.
We have spoken to more than 8,000 people over the past three years about their experiences of health and care services on the Fylde Coast. We have teamed this with evidence around the health needs of our local population and the challenges we are facing. The result is a well-informed, evidence-based strategy.
To help us identify our priorities we looked back over the past three years at what you have told us is important when it comes to health and care. Below are just some examples of how we have engaged with you:
- Blackpool Citizen’s Inquiries – we asked people living in some of our more deprived areas what impacts upon their health and wellbeing.
- Community survey – we asked people about their communities and what would help them to live healthier lives.
- Your Voice – we hold monthly drop-in sessions across the Fylde Coast for people to share their views generally.
- Influence Panel – we hold a monthly session for a group of people who live on the Fylde Coast who want to ‘influence’ decisionmaking.
- Hospital staff engagement – we spoke with staff at the hospital about what they think the priorities should be.
- Fylde Coast ‘working together’ staff survey – we asked our staff across our partner organisations about partnership working.
- Prioritising workshop with clinicians – we spoke to a whole range of clinicians to help us prioritise our areas of work.
We then built on this by identifying groups of people we haven’t spoken to in that time:
- People who are in work.
- People with a common mental health condition.
- People who live in rural communities.
We carried out a number of focus groups with these people. We asked them about their recent experiences of accessing health and care services on the Fylde Coast and what they think could be done to make them better. Patients and the public tell us there are a number of common things really important to them:
- A focus on keeping well through health promotion and early detection.
- Supporting people living on the Fylde Coast to care for themselves and each other, recognising the importance of social prescribing and the role of the communities.
- Better care for the elderly, supporting older people to live independently and reduce the time they spend in hospital.
- Reducing health inequalities across the Fylde Coast, these are the differences in the health of people who live just a few miles apart.
- Timely and appropiate care in the community where possible, so less unncessary time is spent in hospital.
- Every is treated with dignity and respect throughout their care which should be consistent and coordinated.
- Better care for children and young people, supporting them to get a great start in life and as they move into adulthood.
- Efficient and effective services, providing 'high value' for people living on the Fylde Coast.
- Improved access to services, with shorter waiting times and better referral pathways.
How we compare
As part of how we plan and provide care for Fylde Coast residents, we use data which highlights areas where we can reduce variation in care and compares how we perform against other health and care organisations across the country with similar challenges.
There are two main places we get this information from. For CCGs we use the NHS Rightcare and Public Health England ‘Where to Look’ data pack and for trusts we use the NHS Improvement and NHS England ‘Model Hospital’ tool.
The data tells us we have good opportunities to make improvements in the following areas in Blackpool:
- Respiratory.
- Circulation.
- Endocrine.
- Trauma and injuries.
- Neurological categories.
In Fylde and Wyre we have identified opportunities to make improvements in the following area:
- Musculoskeletal.
- Gastro-intestinal.
- Respiratory.
- Trauma and injuries.
- Circulation.
By looking closely at this sort of information and comparing ourselves to other organisations we can explore lots of areas where we can make improvements to help us tackle the challenges we face on the Fylde Coast.
Just like the Where to Look pack, the Model Hospital tool allows trusts to compare their performance to others. This means we can identify common opportunities to improve patient care in the most efficient way.
There will always be some differences in performance between hospitals but the Model Hospital tool supports them to tackle those areas where there should not be a difference.
For Blackpool Teaching Hospitals NHS Foundation Trust, the main areas of opportunity are:
- Reducing the average length of time spent in hospital – whether it was an emergency or a planned admission.
- Doing more procedures in a day – instead of people staying overnight.
- Making outpatient clinics more productive – we currently have a slightly higher rate of people who do not attend their appointment or cancel it.
Only by working in a more integrated way across the Fylde Coast can we begin to address some of these challenges together by making the best use of our joint resources.
Our vision
Our partnership working across the Fylde Coast is supported by a clear vision: a Healthier Fylde Coast: Improving health and care together.
By working more closely together we will deliver three key aims:
- We will have healthy communities across the whole of the Fylde Coast.
- We will have safe, high quality services with better outcomes and experiences of care for our patients.
- We will have health and care services which are fit for the future, delivered by a skilled, motivated and resilient workforce.
Big changes are needed if we want to improve the health and wellbeing of people living on the Fylde Coast.
These changes are not limited to just the health service – we need to encourage changes in attitudes and behaviours of local people so they can better take care of themselves.
We need to look at the bigger picture and work better and smarter together – not only for the benefit of patients and their families, but for our staff too.
Our key areas of focus
Thinking about the NHS Long Term Plan, the local challenges we are facing and what you have told us is important, has helped us shape our key areas of focus over the next five years.
Population health
We will do more to prevent people getting ill, reduce health inequalities (the differences in people’s health) and improve the health and wellbeing of our communities.
Primary and community care
We will further strengthen primary care and provide more care within your local communities.
Quality
We will improve the quality of care and clinical outcomes.
National standards
We will deliver improvements in mental health care, cancer care, urgent and emergency care and planned care.
We will do all of this through:
Our resources
We will make the best use of our people and our assets to provide more efficient services and improve our financial position.
Partnerships
We will work more closely with our partners at all levels.
Our plan
- We will have healthy communities across the whole of the Fylde Coast.
- We will have safe, high quality services with better outcomes and experiences of care for our patients.
- We will have health and care services which are fit for the future, delivered by a skilled, motivated and resilient workforce.
Prevent illness and improve health and wellbeing
- Help people to access services that promote a healthy lifestyle and encourage everyone to live well for longer.
- Encourage and support people to take care of their own health and wellbeing, and that of their family and friends.
- Increase the number of people who access screening and immunisation services, particularly those linked to cancers and childhood diseases.
- Look at the needs of our different populations and plan our services in a way to meet those needs.
- Give children a great start by supporting them and their families through the first 1,000 days of life.
GP service fit for the future and care in the community
- Support further development of our primary care networks. This will help GP practices to work better together to meet the needs of their communities.
- Further develop our neighbourhood care teams – teams of different health professionals – to provide more support in the community. Particularly for people with long term physical and mental health conditions.
- Support families with maternity services, before and after they have their baby, making sure that there is continuity of care across hospital and community settings.
- Provide better support for people who are elderly or frail – making sure they spend as little time away from home as possible and helping them to return to their normal lifestyle where possible.
Better quality of care and better health after care
- Reduce the number of deaths that could have been prevented.
- Reduce the number of patient harms that could have been avoided.
- Make sure people experience the highest quality of care in the last 1,000 days of their life.
- Make sure people receive a standardised and consistent experience of care, particularly for high risk or complex conditions.
- Improve the quality of care, particularly in a hospital setting, to address the concerns of regulators.
- Offer a more personalised approach to care.
Improve care
Urgent and emergency care:
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Provide a more joined up approach to urgent and emergency care to simplify access and make it easier for people to make the right choices about where to go for treatment.
- Make sure people are only admitted to hospital if necessary, and wherever possible are treated and helped to return home on the same day.
- Make sure people spend as little time away from home as possible if they do need to be treated in hospital for a period of time.
- Provide better support for people who are elderly or frail when they need to access urgent and emergency care.
Mental health:
- Enhance the support for children and young people, making sure they can move into adult mental health services smoothly.
- Provide better support in local communities for people with both ‘low level’ and ‘severe’ mental ill health.
- Provide better support for people in mental health crisis, especially those who seek the help of our emergency services.
- Work with hospital teams to make sure people who need to spend time in hospital with ill mental health can return home as soon as possible.
Cancer care:
- Increase the number of people accessing cancer screening services, particularly for bowel, breast, cervical and lung cancers.
- Increase the number of cancers that are detected in the early stages.
- Work with our partners across Lancashire and South Cumbria to improve access to treatment and improve people’s health following their treatment.
Planned care:
- Improve the process for referring people from primary care to hospitals to –make it easier for them to see a specialist and receive a diagnosis.
- Redesign our model of outpatient services by making better use of technology and using our community teams so people only go to hospital if needed.
- Make sure people are only admitted to hospital if necessary, and wherever possible are treated and helped to return home on the same day.
- Work with our partners across Lancashire and South Cumbria to make sure our planned care services are safe and fit for purpose, and improve people’s health following their treatment.
- Work with our partners across Lancashire and South Cumbria to improve our critical care services, particularly for children
Make the best use of our people
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Value our staff by increasing our focus on their wellbeing and developing compassionate leaders.
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Develop new and enhanced roles to attract staff to the Fylde Coast and encourage them to stay here.
- Increase our use of digital technology to offer increased quality and continuity of care.
- Make sure we make the best use of our buildings to support the way we want to deliver care.
- Use the “Fylde Coast pound” (our collective pot of money) responsibly to provide best value for our residents
Work better with out partners
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Make sure we involve people when reviewing and redesigning our services.
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Make sure we involve our wider partners, particularly the voluntary, community and faith sectors, in considering how best to support people with their health and wellbeing.
- Further strengthen working relationships between primary, community and hospital services to support continuity of care and an improved patient experience.
- Work with partners across Lancashire and South Cumbria to provide safe and sustainable hospital services.
Population health
We will do more to prevent people getting ill, reduce health inequalities (the differences in people’s health) and improve the health and wellbeing of our communities.
Our priorities
We will:
- Help people to access services that promote a healthy lifestyle and encourage everyone to live well for longer.
- Encourage and support people to take care of their own health and wellbeing, and that of their family and friends.
- Increase the number of people who access screening and immunisation services, particularly those linked to cancers and childhood diseases.
- Look at the needs of our different populations and plan our services in a way to meet those needs.
- Give children a great start by supporting them and their families through the first 1,000 days of life.
Why is this an area of focus?
Preventing avoidable illnesses and helping people to live heathy lifestyles are key themes in the NHS Long Term Plan.
On the Fylde Coast we know:
- People living in Blackpool are dying earlier than people living in other parts of the Fylde Coast. More than half of early deaths could potentially be avoided.
- There are high numbers of people diagnosed with diseases caused by unhealthy lifestyles, including the impact of smoking, alcohol consumption and unhealthy eating.
- We have an ageing population. By 2041, the over 65s will make up around a third of the population. So it’s more important than ever to make sure people stay healthier for longer and don’t feel lonely or isolated.
- Getting the best start in life is really important as it will impact on a child’s health and wellbeing, setting them up for a positive future.
How will we know if we’re making a difference?
We’d like to see positive changes an increase in the number of people who:
- Are vaccinated against diseases, including childhood vaccinations and flu vaccines for vulnerable people.
- Are screened for bowel, breast, cervical and lung cancer.
- Have access to alcohol care teams.
- Quit smoking.
- Are supported by the NHS Diabetes Prevention Programme.
- Are living longer, healthier lives. And we’d like to see a reduction in the number of people who:
- Need to access emergency services at the hospital.
- Need to have overnight stays in hospital.
- Experience stillbirths or new born babies dying.
In Fleetwood, health, local authority and voluntary sector partners have joined initiatives together which have contributed to a significant reduction in the number of residents attending Blackpool’s A and E, down 11.5 per cent in a year.
There has also been a reduction of 9.4 per cent in the number of people being admitted to hospital in an emergency.
Successful initiatives spearheaded by local residents wanting to make a difference include the Men’s Shed to improve mental health in the male population and the Harmony and Health Singers, which has helped combat loneliness and improved the health of hundreds of older people.
More information on what is going on in Fleetwood (opens in a new window)
We can learn from this and support other communities with similar schemes across the Fylde Coast.
You've told you you would like to see:
- More action to prevent ill health through early detection and better access to screening programmes.
- More help to manage your own health conditions and for us to promote and support an increase in self-care.
- Services working more closely together to provide healthy and safe spaces for you to live, work and spend your free time.
- More action to reduce the differences in people’s health across the Fylde Coast.
Primary and community
We will further strengthen primary care and provide more care within your local communities.
Our priorities
We will:
- Support further development of our primary care networks. This will help GP practices to work better together to meet the needs of their communities.
- Further develop our neighbourhood care teams – teams of different health professionals – to provide more support in the community, particularly for people with long term physical and mental health conditions.
- Support families with maternity services, before and after they have their baby, making sure that there is continuity of care across hospital and community settings.
- Provide better support for people who are elderly or frail, making sure they spend as little time away from home as possible and helping them to return to their normal lifestyle where possible.
Why is this an area of focus?
Transforming the way people are cared for out of hospital and within their local communities is a key theme in the NHS Long Term Plan.]
On the Fylde Coast we know:
- A large number of people have long term physical and mental health conditions. We need to work more quickly to increase the care that is provided in the community instead of in hospital.
- More and more people are using health and care services, so it’s important for us to work with all of our partners to plan and deliver things in a different way that better meets their needs.
- By 2041, the over 65s will make up around a third of the population. While we need to focus on encouraging people to stay healthy, we also need to support people and their families with the challenges associated with ageing. This could include managing multiple diseases and treating mental ill health.
How will we know if we’re making a difference?
We’d like to see an increase in the number of people who:
- Access non-clinical services to support them with their overall wellbeing.
- Have their needs met by primary care or community based care instead of going to the hospital.
- Have a good experience of care, with continuity provided by their neighbourhood care team.
- Are able to return to their own home, and their normal lifestyle, after a stay in hospital. And we’d like to see a reduction in the number of people who:
- Need to access emergency services at the hospital.
- Need to stay in hospital for a lengthy period of time.
One example of how we can do this in our neighbourhoods is around diabetes:
- There are more than 22,000 people with diabetes on Fylde Coast.
- 90% have Type 2 and around 2,000 are managed in hospital.
- But most of the care associated with diabetes can be delivered in the community.
- By working together we’re trialling a community based diabetes service and hope to use this model for other clinical conditions.
You’ve told us you would like to see:
- More care in your community instead of having to go to hospital unnecessarily and spend time away from home.
- Better care for the elderly, supporting them to live independently and spend less time in hospital.
- More activities within communities to help people live healthier lives. Including better support for children, young people and families, and for people with complex needs, such as alcohol and substance misuse.
- More options to contact health and care professionals by phone or other digital solutions.
Quality
We will improve the quality of care and clinical outcomes.
Our priorities
We will:
- Reduce the number of deaths that could have been prevented.
- Reduce the number of patient harms that could have been avoided.
- Make sure people experience the highest quality of care in the last 1,000 days of their life.
- Make sure people receive a standardised and consistent experience of care, particularly for high risk or complex conditions.
- Improve the quality of care, particularly in a hospital setting, to address the concerns of regulators.
- Offer a more personalised approach to care.
Why is this an area of focus?
The NHS Long Term Plan says we need improve the quality of care we give to people, with a particular focus on people experiencing much better health following treatment and care for major health conditions.
On the Fylde Coast we know:
- There are a number of deaths that could be prevented, particularly when patients experience serious illnesses (such as respiratory diseases) or sudden conditions (such as a stroke).
- There are too many cases of ‘avoidable harm’, for example people who are staying in hospital who experience pressure ulcers.
- There needs to be a greater focus on planning for the end of people’s lives, and recognising when it is important to start having conversations about this.
- Many people spend a significant amount of time in hospital as they approach the end of their lives, which in many cases is not what they or their family want to happen.
- The Care Quality Commission has identified the need for an improvement in the quality of care in hospital.
How will we know if we’re making a difference?
We’d like to see positive changes in:
- Deaths which could have been prevented, particularly for high risk and complex conditions.
- Avoidable harms to patients, such as pressure ulcers.
- Patients’ experience of care.
- The amount of time spent in hospital in the last 1,000 days of life.
- People accessing personal health budgets.
- The Care Quality Commission’s rating of local services.
In 2014, the hospital’s sepsis mortality rate was the third worst in the country with between 30 to 35 per cenr of sepsis patients dying from the disease.
Following a year of intensive quality improvement work, the death rate from the disease was halved through innovative changes to treatment methods.
A multi-professional group, made up of clinical and non-clinical staff from a number of different care organisations on the Fylde Coast, worked together and traced the journey of a sepsis patient and recognised the need to put more emphasis on treatment in the first hour of hospital attendance.
This was done via the introduction of equipment and tools to support sepsis care, building up the skills and education of staff and raising awareness with the public on the condition.
As a result, the number of sepsis deaths have been cut in half to around 15 per cent, putting the hospital in the top 30 per cent of best performing hospitals nationally.
By using this approach across other conditions, we can improve clinical outcomes and patient experience.
You've told us you would like to see:
- High quality, safe services.
- Better coordinated care that feels more personalised.
- More options and choice about the way in which you access and receive care.
- Patients always treated with dignity and respect.
National standards
We will deliver improvements in mental health care, cancer care, urgent and emergency care, and planned care.
Our priorities for mental health
We will:
- Enhance the support for children and young people, making sure they can move into adult mental health services smoothly.
- Provide better support in local communities for people with both ‘low level’ and ‘severe’ mental ill health.
- Provide better support for people in mental health crisis, especially those who seek the help of our emergency services.
- Work with hospital teams to make sure people who need to spend time in hospital with ill mental health can return home as soon as possible.
Our priorities for cancer care
We will:
- Increase the number of people accessing cancer screening services, particularly for bowel, breast, cervical and lung cancers.
- Increase the number of cancers that are detected in the early stages.
- Work with our partners across Lancashire and South Cumbria to improve access to treatment and improve people’s health following their treatment.
Our priorities for urgent and emergency care
We will:
- Provide a more joined up approach to urgent and emergency care to simplify access and make it easier for people to make the right choices about where to go for treatment.
- Make sure people are only admitted to hospital if necessary, and wherever possible are treated and helped to return home on the same day.
- Make sure people spend as little time away from home as possible if they do need to be treated in hospital for a period of time.
- Provide better support for people who are elderly or frail when they need to access urgent and emergency care.
Our priorities for planned care
We will:
- Improve the process for referring people from primary care to hospitals to –make it easier for them to see a specialist and receive a diagnosis.
- Redesign our model of outpatient services by making better use of technology and using our community teams so people only go to hospital if needed.
- Make sure people are only admitted to hospital if necessary, and wherever possible are treated and helped to return home on the same day.
- Work with our partners across Lancashire and South Cumbria to make sure our planned care services are safe and fit for purpose, and improve people’s health following their treatment.
- Work with our partners across Lancashire and South Cumbria to improve our critical care services, particularly for children.
Why is this an area of focus?
The NHS Long Term Plan says we should be providing better care for major health conditions. This includes making sure people with cancer get better results after their treatment and significantly improving mental health services. It also says we need to shorten the waiting times for pre-arranged appointments and find ways to reduce the pressure on emergency hospital services.
On the Fylde Coast we know:
- There are significant levels of depression, severe mental illness, suicide and self-harm, with 10.4 per cent of the population reporting a long-term mental health problem.
- The number of people who have cancer locally is higher than the average across England.
- There are high levels of alcohol consumption, high rates of smoking and high levels of obesity, all of which contribute to cancer development.
- Waiting times are too long, for planned care and emergency care, and for both mental and physical health conditions.
- More and more people are using urgent and emergency care services, so it’s important for us to work with all of our partners to plan and deliver things in a different way that better meets their needs.
How will we know if we’re making a difference?
We’d like to see an increase in the number of people who:
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Access ‘low level’ mental health services, particularly children and young people.
- Are screened for bowel, breast, cervical and lung cancer.
- Have cancer diagnosed in the early stages.
- Are able to return home on the same day of their treatment in hospital.
- Are able to access services in the community rather than attending the hospital. And we’d like to see a reduction in the number of people who:
- Wait longer than the national standards for their treatment, across planned and unplanned care.
- Attempt suicide or self-harm.
- Need to access emergency services at the hospital.
- Need to stay in hospital for a lengthy period of time.
You’ve told us you would like to see:
- Shorter waiting times, particularly for mental health services.
- Better access to cancer screening programmes.
- A single point of access for urgent and emergency care services.
- Fewer people with chronic conditions making unplanned visits to hospital.
Our resources
We will make the best use of our people and our assets to provide more efficient services and improve our financial position.
Our priorities
We will:
- Value our staff by increasing our focus on their wellbeing and developing compassionate leaders.
- Develop new and enhanced roles to attract staff to the Fylde Coast and encourage them to stay here.
- Increase our use of digital technology to offer increased quality and continuity of care.
- Make sure we make the best use of our buildings to support the way we want to deliver care.
- Use the “Fylde Coast pound” (our collective pot of money) responsibly to provide best value for our residents.
Why is this an area of focus?
The NHS Long Term Plan talks about the significance of the NHS workforce in delivering ambitious changes, with an emphasis on recruiting and retaining staff. It also says we need to be better at looking after the health and wellbeing of the workforce.
The use of digital solutions to support different models of care and improve efficiency is also a key theme. The financial challenges facing the NHS are well known.
The NHS Long Term Plan stresses that there is a lot of work to do to make sure money is invested in the right places to get better value for patients.
On the Fylde Coast we know:
- It is sometimes difficult to attract staff to live and work on the Fylde Coast, particularly in some clinical professions.
- The workforce is ageing and we need to ‘grow our own’ staff of the future.
- Individuals work very hard, often in difficult and challenging circumstances, and they need to be supported.
- There is not enough use of digital solutions within some of our services.
- In the past, we have mainly made decisions in our own individual organisations about where to invest money.
How will we know if we’re making a difference?
We’d like to see positive changes in:
- The number of people choosing to work on the Fylde Coast.
- The rating from the Care Quality Commission relating to “well led” services.
- People accessing the NHS app and using online consultations.
- The amount of information that can be accessed digitally rather than on paper.
- The way we use our buildings to improve patient and staff experience.
- The financial position on the Fylde Coast.
And we’d like to see a reduction in:
- People being absent from work due to sickness.
With thousands of people working for Blackpool Teaching Hospitals NHS Foundation Trust, not all of them with access to emails, keeping in touch has always been tricky.
However, the creation of a staff app has enabled hospital chiefs to get important messages to staff via their mobile phones to keep them up to speed on all the latest developments in the Trust.
You've told you you would like to see:
- Staff feeling valued for their knowledge, experience and contribution to the patient experience.
- More opportunities for staff development.
- More joined up digital systems that allow information to be shared across providers so people don’t have to tell their story multiple times.
- Organisations working together more to share resources and make better use of money.
Partnerships
We will work more closely with our partners at three levels – primary care networks working in neighbourhoods, the Fylde Coast Integrated Care Partnership, and the Lancashire and South Cumbria Integrated Care System.
Our priorities
We will:
- Make sure we involve people when reviewing and redesigning our services.
- Make sure we involve our wider partners, particularly the voluntary, community and faith sectors, in considering how best to support people with their health and wellbeing.
- Further strengthen working relationships between primary, community and hospital services to support continuity of care and an improved patient experience.
- Work with partners across Lancashire and South Cumbria to provide safe and sustainable hospital services.
Why is this an area of focus?
The NHS Long Term Plan describes how integrated care systems will continue to develop and that by April 2021 these systems will be in place across the whole of England.
It also talks about the need for greater collaboration across the NHS, and between the NHS and its partners who provide health, care and wellbeing services.
On the Fylde Coast we know:
- In the recent past, engagement with residents has been strong, there are good examples of how services have been shaped based upon what we’ve learned. We need to continue with this approach.
- The voluntary, community and faith sectors have a very strong presence on the Fylde Coast, and are supporting many individuals and communities with their health and wellbeing. We need to continue to build on this.
- Some of the challenges we are facing will need to be addressed by working in partnership on a bigger footprint. We need to do this to make sure people are in better health after their treatment and get good value for money.
How will we know if we’re making a difference?
We’d like to see positive changes in:
- The number of people we engage with across all of our communities.
- Partners being part of our neighbourhood care teams, and helping us to focus on the wellbeing of our residents.
- Clinicians from primary, community and hospital services working together to design services based upon the needs of our residents.
You’ve told us you would like to see:
- Organisations working better together to share resources and make better use of money.
- Services working together to improve health and wellbeing in local communities.
- Better communication between organisations and services.
- More joined up working and coordination between services.
How we will deliver this?
By enabling and supporting staff to do their job well.
We want to create a healthier Fylde Coast and work together as partners to improve health and social care.
We want to ensure the system provides high quality, compassionate care and supports its staff. Everyone who works within the Fylde Coast system plays a part in achieving this.
Here on the Fylde Coast we are committed to working together with our health and care partners to develop an integrated health and care workforce with the capacity and capability to provide safe and sustainable care, ensuring we invest in the development and wellbeing of our people. We aim to fulfil the Long Term Plan’s ambition of making the NHS the best place to work.
We know demand for health and care services is growing. To meet that demand and deliver the vision set out in this strategy, we will need more people working in the NHS over the next 10 years across most areas and in some new ones yet to be fully defined.
But more of the same will not be enough to deliver this strategy. We need different people in different professions working in different ways.
We also need to address the cultural changes that are necessary to build a workforce that benefits a world-class 21st-century healthcare system.
We need to promote positive cultures, build a pipeline of compassionate and engaging leaders and make the NHS a responsive, inclusive and modern employer if we are to attract and retain the people we need to deliver this plan.
The Fylde Coast ICP values and behavioural framework has been developed to ensure we have a set of core behaviours that helps us deliver our vision and priorities.
Be courageous:
- People speaking up and escalating concerns appropriately, either about unsafe practice or inappropriate behaviour.
- Being open to challenges from others on your own behaviour and welcoming feedback from others
Be accountable:
- Taking responsibility for your own work, tasks and actions.
- Keep promises you make, following them through.
Be compassionate
- Be friendly and welcoming, introduce yourself by saying ‘Hello, my name is’.
- Care is provided with compassion or empathy and it passes the ‘Me Test’.
Be collaborative:
- Being a team player and supporting colleagues to ensure goals are met.
- Resolving issues within the team in a constructive and timely manner.
The framework applies to us all and is part of everyone’s role. The framework sets really clear standards of behaviour and equips staff with a point of reference for their own behaviour and the behaviour they can expect from colleagues, irrespective of what part of the system they work in.
Our ambitious plans to address these concerns include:
- Making the NHS the best place to work
We will improve the experience of our people and we will do this by developing a new offer with our staff setting out explicitly the support they can expect from the NHS as a modern employer.
Interventions will include promoting equality, inclusion and widening participation; tackling bullying and harassment; providing great education and training; improving mental and physical health and wellbeing; engaging with staff like never before and enabling flexible working.
- Changing the workforce operating model
We will work with our partners in the Lancashire and South Cumbria ICS to ensure we have coordinated approaches to initiatives such as action to reduce temporary staffing spend including the establishment of techenabled collaborative staff banks; implementing regional approaches to succession planning and talent management and overseeing the employment implications of the development of primary care networks and ensuring these networks have appropriate leadership and management.
- Holistic approach to workforce transformation and workforce growth
We will aim to increase supply and improve retention via a number of initiatives including international recruitment and the ‘Return to Practice’ scheme. We will continue to fund continuous professional development via the apprenticeship levy. We will use recognised workforce planning tools to develop new ways of working. We will also look to increase placement capacity for students from all disciplines.
- Delivering 21st century care
We will look to develop new roles and to build a more adaptable workforce including multidisciplinary healthcare teams and expanding undergraduate medical placements.
- Improving the leadership culture
We will develop system leaders via the Healthier Fylde Coast 100 System Leaders programme, develop compassionate and inclusive leaders via the implementation of the values and behavioural framework and implement systemwide processes for managing and supporting talent.
How we will deliver this
By working more closely together across our system we will be in a stronger position to tackle some of our biggest health needs and challenges with the way in which we provide services and deliver high quality care.
The Lancashire and South Cumbria Integrated Care System (ICS)
The Lancashire and South Cumbria Integrated Care System is a partnership of NHS organisations, local councils, voluntary, community and faith sector organisations, public sector and local communities, made up of five Integrated Care Partnerships:
- Morecambe Bay.
- Fylde Coast.
- Central Lancashire.
- Pennine Lancashire.
- West Lancashire.
The Healthier Lancashire and South Cumbria ICS is the name which has been given to the regional partnership. The aims of the ICS are to:
- Join up health and care services;
- Listen to the priorities of local people; and
- Tackle some of the biggest challenges we are all facing.
By working in partnership across the ICS we have a greater opportunity to integrate how we plan, design and provide services collectively to reduce variation and provide a consistent approach to delivering health and care services which empowers communities to live and age well.
Partners across the ICS have agreed eight key strategic priority areas over the next five years which have been developed based on the needs of local communities and the ambitions outlined within the NHS Long Term Plan. Each priority is underpinned by specific work programmes to deliver each priority.
The eight strategic priority areas are:
- Primary and community based care.
- Acute and specialised services.
- Mental health.
- Prevention and population health.
- Urgent and emergency care.
- Workforce development.
- Commissioning development.
- Digital innovation.
The Fylde Coast Integrated Care Partnership
As already described within this document, the Fylde Coast Integrated Care Partnership is working together to improve the health and care of the Fylde Coast population, in addition to contributing to the work at Lancashire and South Cumbria level to ensure the needs of local communities are taken into consideration when planning and making decisions.
Primary care networks and neighbourhoods
Primary care networks are groups of GP practices working together to make sure their services meet the needs of local people. They are a key part of the NHS Long Term Plan.
Across the Fylde Coast our primary care networks work closely with other health and care services within our ‘neighbourhoods’ to provide more personalised and joined up care.
You will hear us talk about neighbourhoods often. They will become the bedrock of health and care services in the future.
We have eight neighbourhoods on the Fylde Coast which cover populations of typically between 30,000 and 50,000. In total we have 36 GP practices working within the neighbourhoods.
Through neighbourhoods you will see more joint working and we will aim to provide as much support as we can in a community setting.
Aligning our priorities
How do we know our Fylde Coast priorities align with those of the Lancashire and South Cumbria Integrated Care System (ICS) and the national expectations outlined in the NHS Long Term Plan?
It is important for us to be aware of how our locally determined priorities fit with the priorities of the Lancashire and South Cumbria ICS and NHS Long Term Plan . The diagram below demonstrates how the priorities at Fylde Coast, ICS and a national level are linked.
Next steps
This strategy outlines our overarching plans for the next five years. It describes many of the challenges we face and how we aim to tackle these with our partners.
This strategy will inform the development of more detailed operational plans over the next few years. These plans – which will contain measurable targets and financial information – will be continually updated as part of our annual planning process.
We would like to thank everyone who has taken the time to give us their views and share their experiences about local health services. This feedback has very much helped to inform this strategy.
As we develop our more detailed plans we will continue to seek the views of our staff, partners, patients and members of the public. So we thank you in advance for your contribution.
There are a number of ways for people to get involved in helping to shape health and care services across the Fylde Coast.
More information is available on our website (opens in a new window)