We know that our health and care system can do more for our residents. Where possible, we want to do more to prevent people becoming unwell, but when they do, we want to ensure that they are looked after by highly skilled health and social care professionals in the right place, at the right time.

A case for change was produced in December 2018 which highlighted the current problems our health and care system is facing. The main findings from this case for change were:

Demographics – The number of people in Central Lancashire is growing and the population is ageing. Our local hospitals are not set up in the best way for the future to deal with these changing needs.

Lack of alternatives – Local people do not have enough options for their care. This can result in increased use of urgent and emergency care services provided by our local hospitals.

Flow – Too many people wait too long for their care and too many experience delays when they are in hospital.

Workforce – Across our health and care system, including our local hospitals, we do not have the workforce that we need in critical areas.

Effective use of resources – As a health system, we are not making best use of the resources we have.

This Model of Care addresses these issues directly by providing a vision for the future:

“Our vision is that the people of Greater Preston, Chorley and South Ribble are enabled to lead healthy independent lives, and when required, their health and care services, are safe and effective, accessible, responsive and co-ordinated.”

Our Model of Care sets out a clear, clinically-led vision to address how we will improve our hospital services to ensure patients receive the best possible experience and clinical outcomes. It demonstrates an opportunity to deliver more joined up care.​

As a result of this model of care local people can expect the following:

• Services will be delivered closer to home where this is both safe and practical 
• The benefits of new technologies, research, learning and ways of working in the NHS
• Continued access to cost-effective care as taxpayers in line with the standards set out in the NHS Constitution
• Support to make the right choices about the best places to receive care and advice, leading to people living better, more independent lives
• Continued support to make practical choices and lifestyle decisions which will help patients use NHS services in a sustainable way
• To have healthcare services commissioned in ways which are absolutely focussed on reducing health inequalities and improving care outcomes. 

The Model of Care describes a vision for our local hospital services in the future. It also outlines how our health and care system (including GP services, community services, social care services) will work together to help provide more high quality care within local communities.

The combination of clinical leadership and patient engagement has led to the development of seven main ideas for future hospital services being outlined in the model of care:

Creating a single point of access and urgent care hub: Clinicians will be able to refer patients into a range of community services and access advice from experienced clinicians working in urgent care at the hospital, all through a single phone number. This will mean patients will receive care in the most appropriate  location.

More responsive urgent care services: By combining the skills of our existing workforce, we can provide an urgent care service (including ambulatory care) that that does more for our patients. It will be more efficient and equipped to treat more people, this will help improve flow and reduce demand on emergency care, meaning patients do not have to wait as long for care.

Delivering better emergency care: Emergency care provided across central Lancashire will be seamless. Clear and effective communication with the wider system will ensure that patients are directed or taken to the most appropriate service, first time, eliminating the need for a transfer. Patients who present with life threatening illnesses and major trauma will receive clinical priority of those patients who are not as in need of emergency care. This means patients will have better access to specialised care when they need it most.

Optimising the efficiency of critical care: Emergency departments are required to have a full critical care unit located on site. This is because they must be able to care for any patient that presents to them, including those with the most serious illnesses and injuries. This will result in a more efficient critical care workforce.

Separating planned and emergency surgery: By separating planned and emergency surgery, the risk of operations being cancelled will reduce whilst allowing emergency surgery to be more specialised for patients when they need it most.

Modernising outpatient services: We plan to improve the referral procedures for outpatients by providing more training and feedback for all referrers. We will also provide more outpatient care within local communities to reduce the need for travel to hospital; this may include the use of technology for patients who are comfortable using it. This will mean patients have to travel to hospital less and waiting times for outpatient appointments will reduce.

Improved discharge planning: The 10 steps of discharge planning will be used to ensure patients have an effective plan that will mean their hospital stay is no longer than is clinically needed.

Significant work has been undertaken to design the proposed model of care based on the feedback of clinicians, patients and the public as well as the wider workforce. By considering all of the feedback received together, the principles outlined below have been developed to underpin the model of care.

We have used numerous methods to engage with the public such as open public meetings, workshops, focus groups and digital methods including social media, emails and surveys.

The experiences, insights and feedback gathered from the engagement activities has helped develop this Model of Care. The following image highlights some of the key recurring themes which emerged from the engagement:

Alongside the views of the public, we have listened to the input and ideas of the people who deliver this essential care across Central Lancashire.

Seven engagement events were held with a range of professionals from across the health system.

A number of additional detailed discussions took place with staff which informed the proposed Model of Care including the key themes, the benefits it must achieve, future clinical pathways and how to make change happen.

The development of the Model of Care has been led by senior clinicians from within our local hospitals, GP practices and other services.  They have ensured that the Model of Care is linked to the relevant clinical standards, is evidence based, has considered best practice, and includes feedback from the public and others.