Area Agency Partnerships
Blackburn with Darwen is divided into five neighbourhoods, (North East, North West, South East, South West, Darwen and Rural). Each neighbourhood has an Area Agency Partnership, made up of representatives from across the public, private and voluntary sectors, focussing on the particular needs of each area. NHS Blackburn has identified a lead Director for each neighbourhood, together with a lead Associate Director who represents the PCT at the AAP meetings.
Borough Council
The formation of the Care Trust Plus in Blackburn with Darwen represents the most recent development in a long standing and fruitful partnership between the PCT and the local authority. Other examples include our joint initiative to deliver free leisure across the Borough, Re:Fresh, our development of the Joint Strategic Needs Assessment for Blackburn with Darwen and the creation of joint functions such as the Joint Intelligence Unit.
For full details of the council’s activities, visit www.blackburn.gov.uk
Care Quality Commission
The Care Quality Commission (CQC) is the independent regulator of all health and adult social care in England.
Their aim is to make sure better care is provided for everyone, whether that’s in hospital, in care homes, in people’s own homes, or elsewhere.
They regulate health and adult social care services, whether provided by the NHS, local authorities, private companies or voluntary organisations. And, they protect the rights of people detained under the Mental Health Act.
The Care Quality Commission’s vision is for people to receive high quality health and social care which:
- Supports people to live healthy and independent lives
- Helps people and their carers make informed choices about care; and
- Responds to individual needs.
Care Trust Plus
The Care Trust + was established on April 1st 2010 and means that the PCT and Council are responsible for planning and buying all health and social care services as well as other services that can improve health and well being. The money to fund health and social care services for adults and children is now together in one organisation. Many other things affect local health and well being – so a Care Trust + is able to consider the health effects of other services like housing and leisure and influence how they can be improved.
The Care Trust + involves local people in helping to decide, design and buy the best health and care services for local needs.
Children's Trust
Children’s Trusts are local partnerships which bring together the organisations responsible for services for children, young people and families in a shared commitment to improving children’s lives. It is local authorities – through their Directors of Children’s Services and Lead Members for Children’s Services – which lead Children’s Trusts, but they work closely with the other local agencies with a legal duty to be part of the Trust: strategic health authorities, primary care trusts (PCTs), police authorities, local probation boards, youth offending teams, Connexions partnerships, the Learning and SkillsCouncil for England and district councils.
Clinical Standards
NHS Blackburn with Darwen must ensure that impact assessed professional standards are in place in a way that assures patients receive evidence based care. Emphasis therefore has been placed on the development of robust, evidence based policies that are accessible to all staff at all times. To determine the effectiveness of the clinical standards in place Clinical audit is undertaken. Clinical Audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change and as such is fundamental to clinical governance and the quality agenda.
Commissioning For Quality
Our strategy as quality commissioners is to ensure that as system leaders, we drive improvements in services through our commissioning cycle.
The objectives of the “Commissioning for Quality Strategy” are: To improve the quality of care and performance across all commissioned services, to work actively with providers to design and redesign pathways of care which are in line with our triple aim and to improve the quality of commissioned services year on year through a robust commissioning cycle
We work within the following principles in order to drive improvement; establishing metrics and measures; measuring metrics and outcomes; Improving quality over time through challenging improvement targets and rewarding quality through “Advancing quality”, CQUIN and other contractual incentives.
We also undertake a range of activities to ensure that we have a timely knowledge of quality improvements and reduced performance across our service providers.
Communications and Engagement
Our detailed plans for Communications and Engagement are set out in our strategy, which was approved by the Board in March 2010. This can be accessed via the following link http://www.bwd.nhs.uk/trust-board/communications-and-enagagement-strategy/
We recognise that the formation of the Care Trust Plus provides us with a wide range of new opportunities and the Board has made a commitment to review the strategy in this context as an early priority.
Corporate Social Responsibility
Corporate Social Responsibility refers to our duties as a good corporate citizen, eg in using resources in a responsible way, in meeting our duties to local people, eg in valuing diversity, in safeguarding children and vulnerable adults, in being prepared to respond to emergencies as they arise.
See also Social Value
Diversity and Equality
We have developed a detailed statement of purpose with regard to Diversity and Equality and this can be accessed on this website via the following link http://www.bwd.nhs.uk/diversity-and-equality/
Financial Controls
We are proud of our track record for strong financial control and management, with the PCT having “balanced its books” in every year since its formation. We recognise that the NHS is entering a period of significant financial challenge and detailed plans and models have been developed across a range of funding scenarios. Underpinning all of our financial modelling is the key linkage between our strategic plan and the associated investment plans designed to support delivery.
Health Care Providers
We commission health services from a wide range of providers across the North West and beyond. Our main providers are Lancashire Care Foundation Trust, (the mental health trust for Lancashire), East Lancashire Hospitals Trust, (hospital/ secondary care services) and our own Provider Services Unit, (community services).
We also commission primary care services from GPs, Dentists, Pharmacists and Optometrists across Blackburn with Darwen.
Health Inequalities Programme
The Health Inequalities Programme is for NHS BwD and BwD BC to work in partnership with Voluntary and Community Services and the residents of BwD to address deprivation and reduce inequalities. Issues of deprivation included employment, health, disability, education, skills and training, barriers to housing and services and the living environment.
The programme will also involve implementing the recommendations for the National Support Team for Health Inequalities, who visited BwD in December 2008. The aim of the visit was to investigate how BwD are addressing health improvement and health inequalities in relation to:
- Cardiovascular disease secondary prevention
- Acute management of heart attack and stroke
- Cancer
- Tobacco control
- Frail elderly/seasonal excess deaths
- Infant Mortality
Healthy Community Partnership
The Healthy Communities Partnership is a key enabler for a vision to improve the health and well being of local people. The partnership consists of 7 teams across the Borough who work to support this vision, for example via their involvement and linkages to the Re:Fresh programme.
Improving Primary Care
Primary care is commonly described as community based health services that are usually the first, and only, point of contact that patients make with the health service. It covers services provided by family doctors (GP's), community and practice nurses, community therapists (such as physiotherapists and occupational therapists), community pharmacists, optometrists, dentists and midwives .
The drive is to modernise service delivery in primary care by developing more effective partnerships to ensure that patients have access to a wider range of safe health and social care services that are integrated and responsive to their needs, which help them to pursue healthy and independent lifestyles, are of a consistently high standard and which play a key role in the protection of vulnerable children and adults.
Improving Primary Care Services
Working closely with Independent Contractors and the Professional Committees, the tPCT seeks to continuously improve the quality and efficiency of the primary care services provided to our patients by the four independent contractor groups (Medical, Dental, Pharmaceutical and Optometry) working within the Borough.
Managing the Practitioner Lists in accordance with NHS Regulations and related legislation, we also work with our Practitioners and their Representative Committees to develop, support and manage the agreed service contracts and performance standards to ensure that the best possible level of primary healthcare is made available for patients within the current level of resources.
Innovation
Innovation is about doing things differently or doing different things to achieve large gains in performance. It is a myth that most innovations come from laboratories, policy makers or senior leaders. Most innovations, whether in the public sector or the private sector, come from staff working within those organisations. For the NHS, these innovators are the clinicians, managers and support staff that deliver healthcare.
Often, ‘innovation’ makes us think of technological developments. Whilst new technology, including medical devices and information technology, makes an important contribution to innovation in the NHS , a critical component, is service innovation and transformation . It involves designing the process our patients go through, the way we work and the way we redesign and develop our health services.
We will be exploring opportunities for innovation at every level in the organisation.
Please do not keep your ideas to yourself !
Integrated Strategic Needs Assessment
See Joint Strategic Needs Assessment section.
Investment
Our Strategic Plan sets out our vision and objectives, all of which is underpinned by detailed investment plans. These are subject to detailed scrutiny and challenge and incorporate plans for disinvestment, in services which are no longer required, effective or are felt to offer comparatively less value for money than other investment options. Our investment plans are sensitive to changes in the underlying financial outlook and have been modelled across a number of funding scenarios.
Joint Intelligence Unit
The main aim of the Joint Intelligence Unit (JIU) is to provide the fundamental evidence base to support working in partnership in Blackburn with Darwen. The core functions of the JIU are:
- Corporate research – consultation / engagement and intelligence
- Corporate opinion research
- Public health intelligence
- Research and intelligence for Adult Social Care
Additional key areas of work of the JIU include contributing to the Joint Strategic Needs Assessment and Health Equity Audits to ensure they drive the development of strategies and plans to improve the health and well being of local people and reduce health inequalities.
Joint Strategic Needs Assessment
Blackburn with Darwen’s JSNA is coordinated by the Joint Intelligence Unit and overseen by a Reference Group and Strategic Leadership Group.
The existing website was only intended as a short-term solution, and a new more flexible and easily updatable site is being commissioned.
Examples of good practice suggest that we should adopt a standard structure for each topic, arranged under five or six headings. These will include service delivery aspects, so commissioners will be integrally involved as producers, and not just users, of the JSNA. Alcohol has been chosen as the first topic on which to pilot this new approach.
Local Area Agreement
Local Area Agreements are an agreement between the Government and Local Strategic Partnerships which build on partnership working to address key issues within localities. They focus on a core set of locally developed priorities and outcomes. The Local Area Agreement for Blackburn with Darwen forms part of the wider Sustainable community strategy.
http://www.bwdlsp.org.uk/server.php?show=nav.1931
Local Involvement Network
Local Involvement Networks or LINks were set up by the Government in April 2008 to give local people a stronger voice in how their health and social care services are delivered. A LINk is an independent network of local people and groups, whose responsibility is to find out what people want from their health and social care services.
Blackburn with Darwen LINk helps councils, the local NHS and organisations who provide care services to listen and respond to a wide range of views so that people, groups and organisations can influence all health and social care services in the area.
For more information, visit Blackburn with Darwen LINk at http://www.blackburnwithdarwenlink.org.uk/
Local Strategic Partnership
Blackburn with Darwen's Strategic Partnership (LSP) is a Borough wide partnership body. It's made up of representatives from the Council, other public sector organisations (like the health and police services), business, and the voluntary, community and faith sectors.
The aim of the LSP is to 'bend' the mainstream funding provided by those different organisations and services and to present a co-ordinated approach. Its particular focus is to promote the achievement of the Local Area Agreement’s four key priorities for 2008-2011; namely:-
- Improving the local economy
- Building stronger, safer communities
- Improving educational achievement
- Improving health and well being.
It is also more widely responsible for promoting the Borough’s Sustainable Community Strategy.
Meeting Patient Needs
Meeting Patients Needs is the name given to an initiative which runs across Pennine Lancashire and is focussed upon the redesign of aspects of local health provision. Phase 1 of the programme was implemented during 2007 and related to the delivery of urgent and elective hospital care. Other elements of the programme consider areas such as the delivery and women’s and children’s services and the provision of care closer to home.
Mental Health Provision
A key element of our role as a commissioner is to secure effective mental health services for our population. Additionally we have the responsibility as lead commissioner for the Lancashire Care Foundation Trust, which means that we co-ordinate commissioning services from this organisation on behalf of all the PCTs in Lancashire.
NHS Constitution
The NHS Constitution was published on 21 January 2009.
The NHS Constitution brings together in one place what staff, patients and public can expect from the NHS.
As well as capturing the purpose, principles and values of the NHS, the Constitution brings together a number of rights, pledges and responsibilities for staff and patients alike. These rights and responsibilities are the result of extensive discussions and consultations with staff, patients and public and it reflects what matters to them.
http://www.dh.gov.uk/en/Healthcare/NHSConstitution/index.htm
Other NHS Commissioners
We work in collaboration with other NHS commissioners across a number of “footprints” as follows:
- Pennine Lancashire – working with NHS East Lancashire, for example in commissioning services from East Lancashire Hospitals Trust
- Lancashire – working with all Lancashire PCTs, for example in seeking opportunities for increased efficiency in our operations, collaboratively commissioning certain services, eg cancer services
- North West – for example, co-operating to commission specialist services via the North West Specialist Commissioning team
Overview and Scrutiny
The Health and Social Care Act 2001 provided the Overview and Scrutiny functions of unitary authorities and county councils statutory powers to call in witnesses from local NHS bodies, and make recommendations that NHS organisations must consider as part of their decision-making processes. Similarly the Health and Social Care Act 2001 places requirements on NHS organisations to consult with health overview and scrutiny committees when considering substantial developments or variations to services.
We regularly present to the Blackburn with Darwen Health and Social Care Overview and Scrutiny Committee and value the positive working relationship we have with the committee.
Partnerships
NHS Blackburn with Darwen is involved in a range of successful partnerships, both with groups and individuals, which we believe are key to the delivery of our vision to improve health and well being and reduce health inequalities. Our World Class Commissioning Assessment in 2008 scored us particularly highly on our development of community partnerships and our Care Trust Plus proposal represents the next stage of our partnership working with the Borough Council. We have ambitious plans to develop our wider community engagement processes and run regular community events to which all are welcome.
Contact the Director of Governance and Engagement for further information.
Patient Experience
Improving the patient experience is a fundamental and essential component of the quality agenda. Patient choice over treatment and care is a central feature of the NHS and the patients' experience of treatment and care is a major indicator of quality. NHS Blackburn with Darwen is committed to involving patients and the public in its work and our strategy aims to promote partnership between patients, carers, the public and the tPCT at every level.
NHS Blackburn with Darwen is also committed to working in partnership with other organisations to drive forward the quality agenda, improve the patient and/or individuals experience and to reduce health inequalities. The planning of services must therefore involve a multi agency approach ensuring that patients, service users, their families and carers are involved in decisions about their own health and social care, have the information available to enable them to make an informed choice and are able to have concerns acted upon in a timely manner.
Personalisation
The personalisation agenda is designed to give individuals more control over the way in which services to meet their needs are chosen and commissioned. The personalisation agenda has moved forward quickly in the field of social care and presents an early opportunity for the Care Trust Plus to further move forward with this agenda and to learn from existing good practice from both social care and health colleagues.
Prevention
It is estimated by the World Health Organisation that about only 30% of the health of a population is determined by the application of health care system budgets. The rest is determined by good education, housing environment, nutrition, transport systems etc. Prevention therefore starts by seeking to create healthy places to live – it also seeks to increase the investment of health care and other systems in disease prevention. Reducing health inequalities across Blackburn with Darwen is the number one priority for prevention and this requires action on the social and environmental determinants of health.
Providers
In addition to the Health Care Providers described above, the Care Trust Plus commissions services from a range of other organisations, in particular providers of social care. To support the effective strategic commissioning of social care services, the relevant teams from the Borough Council transferred to the Care Trust Plus in April 2010.
Quality
Improving the quality of care – in terms of safety, effectiveness and patient experience is a central motivation for everyone working in the NHS.
Central to improving quality of care is a reduction in variation of care from all providers. To achieve this we need to work within a set of principles so that we can ensure that we are achieving our goals. These are:
- Leadership
- Bring clarity to quality - Having guidelines and standards to
- measuring quality - metrics
- Publishing information on quality through Board reports and quality accounts
- Recognising and rewarding quality improvement
- Safeguarding essential levels of safety and quality
- Staying ahead through innovation
PCTs have an essential role as leaders of the NHS in creating the environment for cultural change.
Our Quality for commissioning strategy describes how we will ensure that as system leaders, we will drive improvements in services through our commissioning cycle.
Quality, Innovation, Prevention, Productivity
QIPP embraces all of the current concepts of quality in the context of making the best possible use of the available resources that we have across the NHS. The component parts of QIPP are:
Q - Quality
I - innovation
P - Prevention
P - Productivity
These are described in the matrix below
| Quality | |
|---|---|
| Safety | Safe systems No preventable harm No healthcare acquired infections |
| Effectiveness | The right thing for the right patient at the right time Adoption of NICE guidance Use of Better Care, Better Value metrics to reduce variation Learning from errors and near misses |
| Experience | Patients, users and carers central to everthing we do Compassionate, personalised care for all Informed and empowered patients as partners in care |
| Innovation | Invent or begin to apply new services, methods or processes Invest to save Accessibility to evidence based practice, research and development Systematic approach to the widespread adoption and diffusion of evidence based practice |
| Productivity | Care delivered in most clinically and cost effective setting Doing more with the same, doing the same with less and doing more with less Eliminating inefficiency and waste by design Encouraging the workforce to be the best possible through organisational development |
| Prevention | Supporting people to improve and maintain health Promoting self-care for people with long term conditions Tackling health inequalities, focusing resources where they are needed most |
In October 2009 QIPP was renamed the "Quality and productivity challenge"
Research and Development Programme
One of the main aims of the Research and Development Programme is to drive forward the health agenda in Blackburn with Darwen. World Class Commissioning decisions have to be made on sound knowledge, intelligence, innovation and best practice to improve commissioned services.
There are links between Research and Development and the Joint Intelligent Unit. Effective practice is promoted through the application of best knowledge, robust evidence and systematic evaluation, working with areas of need from the Joint Strategic Needs Assessment for all aspects of work that are concerned with the health and well being of Blackburn with Darwen.
Resource Reallocation
See section on investment above
re:fresh
Re:fresh is a unique, ground breaking partnership between the Council and the Care Trust Plus. Costing £6m over three years, it is an innovative plan to improve health and well being of residents by encouraging them to change their lifestyles and increase levels of physical activity. This is achieved through 2 key strands:
- Programme of free leisure
- Engaging and enabling
We believe we are the first in the country to offer a comprehensive programme of free leisure for all adults across a spectrum of activities combined with a community level awareness and support model toencourage, motivate and signpost individuals to making healthier lifestyle choices.
To find out more visit www.refreshbwd.com
Self Care
The actions people take for themselves, their children and their families to stay fit and maintain good physical and mental health;meet social and psychological needs;prevent illness or accidents;care for minor ailments and long term conditions; and maintain health and well-being after an acute illness or discharge from hospital” (Department of Health 2005)
Self care includes both self care and self management. Self care is about individuals taking responsibility for their own health. Self Management is about individuals making the most of their lives by coping with difficulties and making the most of what they have. It includes managing or minimising the way conditions limit individuals lives as well as what they can do to feel happy and fulfilled to make the most of their lives despite their condition.
Sexual Health
Self Care represents an important strand of our plans to improve the health and well being of local people and relates to building the capacity of individuals and groups.
Our web site has a section on self care which can be found at the following link http://www.bwd.nhs.uk/patient-services/self-care/
Our Dragon’s Apprentice scheme provides a good example of self care in action as local groups are invited to bid to a panel of “Dragons” for funding for their projects and schemes. Examples of the sorts of schemes funded via the Dragon’s Apprentice are a local football team for mental health service users, a local credit union. A video of the award winners talking about their experiences can be found on our website at http://www.bwd.nhs.uk/patient-services/self-care/dragons-apprentice/
Smoking Cessation
A wide range of services and support are available to those who want to stop smoking. These are described in detail and key contact details are provided on our web site via the following address http://www.bwd.nhs.uk/patient-services/nhs-stop-smoking-service/
Social Care Agenda
The Care Trust Plus development represents the most recent step in a long standing history of collaboration and co-operation between health and social care in Blackburn with Darwen. From April 2010, commissioning of health and social care has been joined together via the establishment of the Care Trust Plus.
Social Determinants of Health Programme
The Social Determinants of Health Programme will focus on the economic and social conditions under which people live, which determine the health of people living in Blackburn with Darwen. This will provide a basis for effective policy-making for improving population health related to the social determinants of health which include the impact of early life, the life course, the social gradient and health, unemployment and job insecurity, social cohesion poverty, social exclusion and housing.
Social Value Programme
The Social Value Programme is a national project to guide commissioners on ways of realising maximum social and public value from commissioning activity and investment. NHS Blackburn with Darwen will be working with NHS North West to develop a framework within which social value concepts can be embedded in commissioning and procurement and work more effectively with partners to deliver social value outcomes. A system will be developed to measuring social, environmental and economic value which will include:
- Income
- Employment
- Health
- Education
- Housing
- Environment
- Crime
Substance Misuse
Excessive alcohol drinking is a top priority both nationally and locally, being a major cause of mortality and morbidity with a strong link to deprivation and health inequalities. Key areas of development locally have focused on rising awareness, screening and early identification of those drinking at levels of increasing and higher risk and offering individualised interventions to reduce the risks, while improving treatment access and outcomes for those requiring treatment.
BwD residents requiring more information about their own alcohol consumption/risk levels can contact their GP Practice or can go to www.nhs.uk/units . In addition to this if anyone feels they need help for their alcohol use can contact Specialist services by calling 01254 226062 OR Inward House (Evolve) 01254 297050
Third Sector
The third sector, (sometimes referred to as the Voluntary, Community and Faith Sector), consists of a wide range of groups and organisations, many of which play a direct role in the health and well being agenda. A thriving third sector is important to the local community and the Care Trust Plus sees effective engagement and partnership with the third sector as being of particular importance.
The Council for Voluntary Services (CVS) acts as the umbrella organisation for local third sector groups and their website can be accessed via the following link http://www.bwdcvs.org.uk/
Transforming Community Services
Transforming Community Services (TCS) is a change programme for the delivery of primary health care services and new requirements in commissioning health care designed to promote high quality standards of care.
Each organisation is required to agree plans with regard to the future shape and model for community services for implementation by 31 March 2011. Regular updates on progress are presented to our Board. Board papers can be found at http://www.bwd.nhs.uk/trust-board/board-papers/
Transforming Pathways
A care pathway is a complex intervention for the decision making and organisation of care processes for a well-defined group of patients
- Defining characteristics of care pathways include: An explicit statement of the goals and key elements of care based on evidence, best practice, and patients’ expectations and their characteristics;
- Facilitation of communication among the team members and with patients and families;
- Coordination of the care process by coordinating the roles and sequencing the activities of the multidisciplinary care team, patients and their relatives;
- Documentation, monitoring, and evaluation of variances and outcomes; and
- Identification of the appropriate resources.
The aim of a care pathway is to enhance the quality of care across the continuum by improving risk-adjusted patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources.
The NHS Institute for Innovation and Improvement supports the NHS to transform healthcare for patients and the public by rapidly developing and spreading new ways of working, new technology and world class leadership.
Triple Aim
The Triple Aim methodology is an international learning initiative concerned with three critical goals or values that must be addressed simultaneously:
- Improve the health of the population
- Enhance the patient experience
- Reduce the per capita cost of care
The Triple Aim project has enthused stakeholders and communities because its clear aims and principles are easily embedded into our partnership working which is centred on improving health inequalities. It is not to be viewed as an add on or short term project but a methodology that should be applied to work programmes that are already a key strategic priority for the organisation and as a means of accelerating delivery.
World Class Commissioning
World class commissioning is a statement of intent, aimed at delivering outstanding performance in the way NHS Blackburn with Darwen commissions health and care services on behalf of the population it serves.
World class commissioning will have a direct impact on the health and well-being of the population, driving unprecedented improvements in patient outcomes, and ensuring that the NHS remains one of the most progressive and high-performing health systems in the world.
World class commissioning will deliver better health and well-being for all so that:
- People will live healthier and longer lives
- Health inequalities will be dramatically reduced.
It will deliver better care for all by ensuring:
- Services will be evidence-based and of the best quality
- People will have choice and control over the services that they use, so they become more personalised.
It will deliver better value for all in the way that:
- Investment decisions will be made in an informed and considered way, ensuring that improvements are delivered within available resources
- The PCT will work with others to optimise effective care.
