Paignton & Brixham Locality Development

Paignton Brixham Locality Estates Bishops Place Surgery Corner Place Surgery Withycombe Lodge Surgery Pembroke House Surgery Paignton Community Hospital

Cherry Brook Medical Centre Mayfield Medical Practice Paignton Brixham Locality Estates Cherry Brook Medical Centre Grosvenor Surgery Mayfield Medical Practice Old Farm Surgery

Paignton Brixham Locality Estates Brixham Hospital Compass House Medical Centre Greenswood Medical Centre St Lukes Medical Centre

Brixham Draft in development Point of Access Practice Population: 20,922 Population Over 65: 6,788 Population Over 80: 1,784 Point of Access BRIXHAM GPS TSDHCT Employed Workforce Total Registered 35.06 wte Total Non Registered 22.96 wte Total = 58.02 wte Compass House Medical Centres St. Luke’s Medical Centre & Greenswood Surgery Customer Service Centre Public Brixham Community Hospital Brixham Health & Social Care Team St Kilda Midvale Clinic Paignton Health & Social Care Team (detail elsewhere – includes Physio and OT at Paignton Hospital) KEY Torbay and Southern Devon Health and Care Trust Employed Community Nursing Therapies Adult Social Care Administration & other staff Of Community Nursing and Therapies staffing, utilisation is split between the following: Intermediate Care: 0.85 wte Band 6 Nurse 2.28 wte Band 6 OT 1.5 wte Band 6 Physio 1.0 wte Band 4 1.47 wte Band 3 St Kilda: 1.0 wte Band 5 nurse 0.84 wte Band 6 OT 0.85 wte Band 6 Physio 1.0 wte Band 4 AP 0.8 wte Band 3 admin 0.8 wte Band 3 TI Ward: 0.6 wte Band 6 Physio 0.35 wte Band 6 OT 1.0 wte Band 5 OT 0.81 wte Band 4 OT AP 1.0 wte Band 3 Physio TI (NB wte already accounted for in staff group) Community Nurse Zone Lead - 1.0 wte Band 7 Community Nurse Team Leaders - 2.54wte Band 6 IC Nurse - 0.85 wte x Band 6 IC Nurse (St Kilda) - 1.0 wte x Band 5 Community Nurses - 7.74 wte Band 5 Assistant Practitioners - 0.53 wte Band 4 Healthcare Assistants - 1.65 wte Band 3 Phlebotomist - 0.6 wte Band 2 Community Matron - 1.0 wte Band 7 Community Matron HCA - 0.6 wte Band 3 Total Registered 14.13 wte Total Non Registered 3.38 wte Grand Total = 17.51 wte OT Lead - 0.6 wte Band 7 Physiotherapy Lead - 0.5 wte Band 7 Occupational Therapist - 4.83 wte Band 6 Occupational Therapist - 1.0 wte Band 5 (rotational) Physiotherapist - 3.9 wte Band 6 Physiotherapist - 1.0 wte vacancy; 1.6 wte mat leave Equipment Officer - 0.8 wte Band 5 Assistant Practitioners - 2.81 wte Band 4 Therapy Assistant - 0.8 wte Band 3 SWIC - 0.67 wte Band 3 Technical Instructors - 0.8 wte Band 3 Total Registered 13.43 wte Total Non Registered 5.88 wte Grand Tot = 19.31 wte Social Work Lead 1.0 wte x Band 7 Social Workers 1.0 wte Band 7 5.5 wte Band 6 Community Care Workers 0.8 wte Band 5 HSCC 4.3 wte Band 5 Hospital Discharge 0.8 wte Band 7 (vacancy) Total Registered 7.5 wte Total Non Registered 6.7 wte Grand Total 14.2 wte Manager - Brixham Office & Manager Midvale Clinic 1.0 wte Band 4 Zone Admin 1.4 wte Band 3 St Kilda admin 0.8 wte Band 3 Midvale Reception 1.0 wte Band 3 1.0 wte band 2 Midvale Cleaners 0.8 Band 2 Total Registered 0 wte Total Non Registered 6.0 Grand total = 6.0 Zone Manager 0.5 wte Band 8b Deputy Zone Manager 0.5 wte Band 8a Total 1 wte Non-Registered Brixham Community Hospital Draft in development

Paignton Draft in development Point of Access Practice Population: 51,269 Population Over 65: 13,205 Population over 80: 3,737 Point of Access PAIGNTON GPs Paignton Medical Partnership Bishop’s Place Surgery Grosvenor Road Surgery Corner Place Surgery Mayfield Medical Centre & Cherrybrook Surgery Old Farm Surgery Pembroke House Surgery Withycombe Lodge Surgery Customer Service Centre Public Paignton TSDHCT Employed Workforce Total Registered 54.03 wte Total Non Registered 33.43 wte Total = 87.46 wte Community Nursing Therapies Adult Social Care Intermediate Care KEY Torbay and Southern Devon Health and Care Trust Employed Zone Manager 0.5 wte x Band 8b Deputy Zone Manager 0.5 wte x Band 8a Office Manager / PA 1.0 wte x Band 4 Lead Community Nurse 1.0 wte x Band 7 Community Matrons 2.0 wte x Band 7 Community Nurse Team Leaders 5.05 wte x Band 6 Community Nurses 12.9 wte x Band 5 Assistant Practitioners 2.2 wte x Band 4 Healthcare Assistants 4.18 wte x Band 3 Phlebotomists 1.8 wte x Band 2 Admin 0.91 wte x Band 3 Total Registered 20.95 wte Total Non-Registered 9.09 wte Grand Total 30.04 wte Lead Occupational Therapist 1.0 wte x Band 7 Occupational Therapists 3.81 wte x Band 6 3.0 wte x Band 5 OT Technical Instructor 1.0 wte x Band 3 Lead Physiotherapist Physiotherapist 2.5 wte x Band 6 Physio Technical Instructor Admin Coverdale Ward Physiotherapist 1.0 wte x Band 6 Physio Technical Instructor 0.8 wte x Band 3 Occupational Therapists 1.0 wte x Band 6 1.0 wte x Band 5 Total Registered 14.31 wte Total Non-Registered 4.8 wte Grand Total 19.11 wte Lead Social Worker 1.0 wte x Band 7 Senior Practitioners 2.0 wte x Band 7 Social Workers 6.84 wte x Band 6 Community Care Worker 5.45 wte x Band 5 Review Officer 0.53 wte x Band 4 Carers Assessor 0.4 wte x Band 4 Admin 1.0 wte x Band 3 0.35 wte x Band 2 Total Registered 9.84 wte Total Non-Registered 7.73 wte Grand Total 17.57 wte Occupational Therapists 1.0 wte x Band 7 3.83 wte x Band 6 1.0 wte x Band 4 Physiotherapist 2.5 wte x Band 6 Community Nurses 0.8 wte x Band 6 2.0 wte x Band 5 Community MH Nurse Community Care Worker 0.8 wte x Band 5 Assistant Practitioner Support Worker Intermediate Care 3.6 wte x Band 3 Physio Technical Instructor 0.41 wte x Band 3 Admin 1.0 wte x Band 3 Total Registered 8.93 wte Total Non-Registered 9.81 wte Grand Total 18.74 wte Total Non-Registered - 2.0 wte Draft in development Paignton Community Hospital Torbay Acute Hospital

Activity Summary Directly Age Standardised Rate (DSR) per 100,000 registered population 2013/14- 2014/15 (annual average) Activity   Paignton and Brixham Locality South Devon and Torbay Count of registered patients DSR per 100,000 A&E 19,485 26,658 24,032 MIU 6,790 9,349 12,883 Elective 20,207 12,678 11,101 Non-Elective 17,376 11,519 10,300 Outpatient - all activity 97,666 121,456 107,547 Outpatient - single patients 50,379 32,566 29,403 Source: SUS activity data

Outpatient Activity Heat Maps

Outpatient Activity Heat Maps

Totality of Health Service Use: Paignton & Brixham GP Consultations: 506,380 Community Therapy and Nursing Services: 125,433 Secondary Care Outpatient Appointments: 106,614 Radiology events: 27,618 Represents the totality (as far as we can quantify it) of health services used by Dartmouth. Need to map this against social care and mental health usage. Model of care impacts upon utilisation of each of those service areas with exception of radiology, A&E and elective care. The numbers are activity and not people specific (limited by data). GP Practice. 87% of registered population had at least 1 interaction with practice in year. 7% have 3 or more LTC and 43% have at least 1 A&E and MIU Attendances: 23,482 Intermediate Care: 12, 300 Elective Acute Care: 11,335 Non Elective Acute Care: 6,624 Figures relate to activity not people and is based on available NHS data Community Hospital Admissions: 1,154

Paignton Community Hospital Utilisation Total Admissions 723 Of which, patients registered within the locality 380 Of which, patients registered outside locality 343 Average LoS (days) 13 Total bed days 9,293 Beds 28 Brixham Community Hospital Utilisation Total Admissions 431 Of which, patients registered within the locality 287 Of which, patients registered outside locality 144 Average LoS (days) 14 Total bed days 6,111 Beds 20

Paignton and Brixham Locality Community Hospital Utilisation Total Admissions 1,154 Of which, patients registered within the locality 667 Of which, patients registered outside locality 487 Average LoS (days) 13.5 Total bed days 15,404 Total Bed Stock 48

Overall Financial Position As a CCG above our target resource allocation by £28m (c8%) We need to reduce our spending to move closer to what the DH says we should be spending on our population Timescale and by how much is unclear Can expect a reduced or nil level of growth Will have to deliver efficiencies across the system to remain within the funding available & still treat the health needs of an ageing population. Shortfall in budget against contract £5million this year and £15 million 20126/17 Target (£000) Allocation (£000) DFT (%) 2015/16 351,130 379,182 28,052 7.99

Community Hospital Costs No of beds Bed Days Bed day Cost £ No of Admissions Avg. cost per Admission ASHBURTON HOSPITAL 10 3388 £306.56 176 £5,901 BOVEY TRACEY HOSPITAL 9 3088 £326.22 235 £4,287 BRIXHAM HOSPITAL 20 6253 £261.81 431 £3,798 DARTMOUTH HOSPITAL 16 4391 £331.58 387 £3,762 DAWLISH HOSPITAL 18 5278 £362.28 440 £4,346 NEWTON ABBOT HOSPITAL 7768 £342.61 595 £4,473 PAIGNTON HOSPITAL 28 9462 £263.70 719 £3,470 TEIGNMOUTH HOSPITAL 12 4476 £267.80 261 £4,593 TOTNES HOSPITAL 6016 £285.04 364 £4,711 178 59,041 4064 Avg Bed Day Cost £297.90 Avg cost per admission £4,328

MIU Costs Hospital Attendances Cost Per Attendance Ashburton MIU 268 £541.99 Brixham MIU 3081 £93.56 Dartmouth MIU 3340 £64.73 Dawlish MIU 3851 £71.94 Newton Abbot MIU 16453 £51.22 Paignton MIU 3274 £71.45 Teignmouth MIU 3492 £57.74 Totnes MIU 5665 £85.78 50,244 £69.77 Avg. MIU Attendance Cost

Community Nursing Costs Locality Activity Avg Cost Coastal 32,322 £32 Moor to Sea 32,632 £38 Newton Abbot 34,813 £34 Paignton/Brixham 49,283 Torquay 43,228 Average cost £35