Caring, Learning and Growing Scarborough & Ryedale Community Services One Year On….. Who We Are and What We Do Caring, Learning and Growing

Caring, Learning and Growing Our Mission Our Mission Our Values Our Strategic Goals We are a multi-specialty health and social care teaching provider committed to ‘ Caring, Learning and Growing’ Caring, Learning and Growing

Caring, Learning and Growing Our Values Our Mission Our Values Our Strategic Goals CARING LEARNING GROWING for people while ensuring they are always at the heart of everything we do and using proven research as a basis for delivering safe, effective, integrated care our reputation for being a provider of high quality services and a great place to work Caring, Learning and Growing

Caring, Learning and Growing About Us We employ 2,700 staff – operating across three care groups: Mental Health Specialist Services Primary Care, Community, Children’s & Learning Disability Services We deliver our services from more than 70 sites - across Hull, the East Riding and North Yorkshire Our annual budget in 2019/20 is £130m Scarborough and Ryedale Community Team – aprox 200 staff Caring, Learning and Growing

Management Team for Community Services Lynn Parkinson Chief Operating Officer Professional Accountability Managerial Accountability Julia Harrison-Mizon Primary Care, Community, Learning Disabilities and Children's Services Care Group Director Dr Sergio Raise Associate Medical Director Nia Abbott Assistant Director Children’s Services Trish Bailey Clinical Care Director Maggie Bean Primary Care Matron Helen Cammish Assistant Director Community Services Ian Tweddell Service Manager Malton IPU Sarah Locker Hub Manager Scarborough North Rishi Sookraj Hub Manager Scarborough South & Ryedale Natalie Belt Service Manager Gillian Black Community Services Projects Lead Carol Wilson Community Services Locality Matron Jeanette Hyam Community Services Locality Matron

Service Development from 2018… Journey start 2018 May - Commenced Community Service Provision S&R / TUPE of >200 staff December – Increased community service provision (including; Cardiac Rehab, Home Oxygen Service, Diabetes Education, Continence services) Spring 2019 April - Phase 2 services; NHS Continuing Healthcare (CHC) including Funded Nursing Care (FNC) and Fast Track, Primary/Community Frailty May – Integrated Community Hub Rapid Response service (replacing ‘Rapids’ and ‘CRT’) Autumn 2019 October - Elderly Medicine Service to commence Caring, Learning and Growing

Scarborough North Hub Structure Sarah Locker Hub Manager Scarborough North Roxanne Woolcott Team Leader Rachel Laud Clinical Lead Lynne Symonds Team Leader Specialist Services Continence (Including Product Service) Heart Failure Cardiac (Including Cardiac Rehab) Respiratory (Including Pulmonary Rehab) Home Oxygen Continuing Health Care (Including CHC /FNC / Fast Track) Frailty Scarborough North Community Nursing Scarborough North Community Therapy MSK Out Patient Service Health Care Support staff Caring, Learning and Growing

Scarborough South and Ryedale Hub Structure Rishi Sookraj Hub Manager Scarborough South & Ryedale Alison Gibson Clinical Lead Ryedale Catherine Ingham Team Leader Ryedale Emma Babbage Team Leader Scarborough South Dawn Richardson Clinical Lead Scarborough South Ryedale Community Nursing and Therapy Hub Team Scarborough South Community and Therapy Hub Team Specialist Services TVN Dietetics SLT Stroke services Diabetes (Including patient Structured Education classes) Health Care Support staff Health Care Support staff Caring, Learning and Growing

Caring, Learning and Growing What’s different? Achievements Hubs developed/operationalised – Scarborough North (Tennyson Ave), Scarborough South (Eastfield Practice) & Ryedale (Malton Hospital) Caring, Learning and Growing

Metrics – Community Services 11 months on 16,500 new referrals received – av. 1,500 new referrals per month 220,000 Face to face contacts – av. 20,000 FTFC per month CAS taken 35,700 calls = 3,245 calls per month (5.7% abandoned) Current (as of 31.3.19) Supporting 6,104 unique patients = ↑32% (from May 2018) Caring, Learning and Growing

Metrics – Malton In-patient unit 20 bed unit + 4 day case chairs Bed Occupancy 83.38% (86% 2017/18) Av. length of stay 12.5 days (18.56 2017/18) Safe staffing levels achieved against validated tool Caring, Learning and Growing

Challenges along the way….. Staffing levels – vacancies, sickness Low rates of stat & mand training (at TUPE transfer) Skill & knowledge gaps in core and specialist competencies (at TUPE transfer) Equipment – basics were absent/obsolete Introduction of IT – laptops and phones & data collection Silo/task driven working – cultural change Waiting lists Venues for community clinics HTFT, Primary care and NYCC integration Pilot 24hr community service (Friday 8am – Sunday 10pm) Introduction of 7 day working for therapy staff Caring, Learning and Growing

What's different now? Achievements Single Point of Access for patients, carers, families, professionals – ‘CAS’ 24/7 using call-centre technology Extended working day for core team & overnight service All staff use single electronic patient record on SystmOne Clinics delivered within GP practices, community base including Sports Centres, Community spaces….. Development of generic job descriptions / core competencies Recruitment to specialist posts incl. respiratory, SLT, dietetics and cardiac/heart failure Caring, Learning and Growing

What's different now? Achievements Pilot 24hr community service (Friday 8am – Sunday 10pm) Staff have appropriate, maintained equipment Support to patients in home environment- OPAT IV pilot Reduced waiting times for specialist services Safety culture – developed and enhanced 78% of staff have had an annual appraisal & objectives set Improved statutory and mandatory training compliance Recording of all referrals, clinical and non-clinical contacts Performance reports to CCG monthly – improving data quality Development of Hub safety huddles - extend to GP practices Caring, Learning and Growing

Integration North Yorkshire County Council Weekly MDT NYCC and HTFT staff Daily phone call (DTOC for community & Malton IPU) NYCC support to Malton IPU MDT Agreement (in conjunction with CCG) x3 ‘Discharge to Assess’ (D2A) pathways Initial discussion regarding ‘Trusted Assessor’ Caring, Learning and Growing

Caring, Learning and Growing Next Steps Caring, Learning and Growing

Caring, Learning and Growing Better communication with system partners Further integration with primary care and NYCC MDTs 7 day therapy service (from 1st May) Further Health Care Assistant training and competency assessment New specialist roles in recruitment – i.e. pharmacists Further development of rapid response to compliment implementation of new pathways with YAS Development of coordinator roles within Hubs to support effective triage - planned and unplanned care Community Frailty & Elderly Medicine Clinics SystmOne into Care Homes Caring, Learning and Growing

Partnership working and Integration Caring, Learning and Growing