But what is clear to us is that these things are not enough to make sure the health and care provided in our county has a positive future. A mid-2018 review of how we work together to support older adults aged over 65 by the Care Quality Commission, the independent regulator of health and social care in England, told us improvements are needed in our care for older people in particular.
We know that we need to do things very differently in Northamptonshire, that we need to make sure we learn from what is working – and what is not. Together, with the input of our community and our staff, we need to think about how we can support the growing health and care needs in our county and keep a firm eye on the future so that we can make sure our services are sustainable.
To achieve this it is only right that we improve how we work together. If we fully commit to working in partnership we can make a collective difference. If we think about the needs of our community first – and less about our individual organisations, the people of Northamptonshire can be both empowered to manage their own health and wellbeing and also have access to the best possible care when they need it. We know we must change – so we have made a collective commitment to work together as Northamptonshire Health and Care Partnership (NHCP) to transform the future of care in our county.
This generation of Northamptonshire people is living for more years than previous ones. It is almost certain that the next few generations will live longer than ours. We estimate that the numbers of people over 65 in our county will grow from 122,000 in 2014 to 201,000 by 2034. These extra years of life are a considerable gain for those of us that get them so, through our Partnership work, we want to make sure they are as full of health and independence as possible. Indeed, our main purpose is to use our resources to increase the good health and independence of the whole population as much as we can. We want a positive future for our community so we can all choose well, stay well and live well.
Unfortunately, however, growing older for many people means spending too many of those extra years of life becoming increasingly ill with a range of diseases. This leads to too many people losing more of their independence earlier than they, and we, would want. Over the years, as they have evolved and developed, our health and social care services have not been set up in a way that can manage the changing needs and demands of such a large number of older, sicker people in a coordinated way.
Also, our current ways of working together are not as coordinated as we want them to be. So we know we need to change how we work and we want to make sure we are all working on the right priorities so the future for our county is a positive, sustainable one.
If we are to make a positive difference, we must be ambitious in changing how we do things. It is clear that our local challenges are significant and we must make ambitious strides to address them. We cannot do more of the same and so we are striving to do things differently.
Northamptonshire Health and Care Partnership (NHCP) consists of key health and care providers in the county.
While we all remain as separate organisations with our own local responsibilities for the services we provide, we are committed to working together towards a positive future for our community.
By working more closely in partnership we are being ambitious about doing things differently and clear on our local priorities; so together we can improve the quality of care and the health and wellbeing of our community.
Members of our Partnership include:
- Our general hospitals: Northampton General Hospital (NGH) and Kettering General Hospital (KGH). They have well-established expertise in delivering acute physical care for our community. Acute care is a where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery. In medical terms, care for acute health conditions is the opposite of chronic care, or longer-term care.
- Northamptonshire Healthcare NHS Foundation Trust (NHFT) provides many of our county’s community health services outside of hospital and closer to home, such as community nursing and health visiting. It also provides our mental health care and other specialty services such as specialist dentistry. Community services are intended to help people who need health care closer to their home and aims to support them to live well and with independence wherever possible in the community.
- Supporting our more day-to-day health needs we have doctors and other healthcare staff in GP practices across the county providing our primary care. Typically the GP practice, or doctors’ surgery, acts as the first contact and main point of on-going care for people locally, and coordinates other specialist care that people may need. Our GP practices are often part of GP federations, which locally include 3Sixty Care, GP Alliance, and PML. These GP federations also provide a range of other health services which support GP practices and provide care to the broader community. Practices nationally are also coming together to form much larger, single-partnership ‘Super-Practices’. Lakeside Healthcare Group in Northamptonshire is one of the country’s largest such super-practices.
- Northamptonshire County Council provides much of our local community services and social care. This includes adult social care, children and family services, education, libraries and public health services.
- In addition to Northamptonshire County Council, the district and borough councils in our county look after many of our government services at a local level, such as housing, waste management, museums and much more. Proposals are in place to reform the structure of local government in Northamptonshire by 2020. You can read more about these proposals.
- Our voluntary and community service providers deliver a wider range of services and local community support. They make a significant contribution to Northamptonshire’s development and our provision of care.
- East Midlands Ambulance Service provides emergency 999 care and telephone clinical assessment services for a population of 4.8 million people, including our county.
- Commissioning (the continual process of planning, agreeing, procuring, funding and then monitoring) of our health and social care services across Northamptonshire is undertaken by a range of organisations, including NHS Northamptonshire Clinical Commissioning Group (CCG), NHS England and Northamptonshire County Council.
In 2018 Northamptonshire celebrated the 70th anniversary of the NHS. Within a few weeks of the NHS being founded in 1948, our social care system was also set up to meet the needs of the time.
Historically our services were set up in very different ways and based on varying different priorities, and this has created differences in the way people receive support. These differences now mean our community is not getting the high quality and continuity of care we would all want to provide, and to receive.
Seventy years later, at a time when our population is growing older, it is crucial that our health and social care organisations work together with the voluntary and community sector to help older people to maintain their independence for longer
While some of our social care is free to access due to the way it’s funded, some of it is bought directly by services users from a wide range of different suppliers. Many people in our community get bits of their care from different parts of these different organisations. This makes things quite complicated for social care providers and, most importantly, for those receiving support.
Until very recently our health and care organisations were accountable only for the part of care that they provide to the patient or service user. Unfortunately this has meant that someone who needs care for a variety of conditions could be receiving services from five or six different organisations with very little coordination between them.
This is confusing and a wasteful use of resources, and the reality is that this situation leaves no one taking overall responsibility for the coordination of this fragmented care. As individual providers we all want to improve the quality of the services we provide and outcomes for our patients and service users. Underlying all we do is the desire to help those we care for stay well and live well – so we know it is time to change.
It is for these reasons we have committed to work together as Northamptonshire Health and Care Partnership – because together we can do more create positive lifetime of health, wellbeing and care in our community. If we work together and work differently, we can bring about the changes we would all want to see. We can help empower people to choose well, stay well and live well.
Whether for mental or physical ill health, nearly all of us need the NHS — whether that’s at the doctor’s surgery, an outpatient visit for physical care or perhaps a referral to mental health services – and many of us will need social care at some point.
A few of us may need to use a lot of NHS and social care services all the time throughout our lives. For example, children and young people who need regular care are often working with a number of different organisations, leaving parents facing a confusion of different organisations which they are expected to navigate between. We also know that even if you don’t use NHS, social care or voluntary community services very much, our care must still seem very uncoordinated.
We have agreed that we cannot keep creating an environment where people in our community experience their care in these fragmented and uncoordinated ways. We all know that providing health and care is challenging right now, and that is a reality throughout the country. Things are very difficult, and we have particular challenges locally that we must acknowledge and deal with – together.
Northamptonshire Health and Care Partnership is the STP for Northamptonshire. We have called it this because we want to be clear on our focus on working in partnership.
The aim of STPs is to make services more joined-up, to agree key priorities for local health and care, and to plan collectively to improve the health and wellbeing of local communities.
Read more about STPs.
As a Partnership, our shared vision for the future of Northamptonshire is for ‘a positive lifetime of health, wellbeing and care in our community’.
We all want everyone to be able to live the healthiest life they can – whoever they are and wherever they live in the county. When people become ill, they should get the care and support they need in the right place at the right time – either to help them get better or to make sure they can live independent lives for as long as possible.
Through having a shared vision we can all be sure to play our part as it guides our activity and helps us make decisions about what we do.
For us, this vision links our collective focus on:
- services which enable more positive, proactive care to prevent illness and promote healthier living – not just reactive care when people are already unwell
- delivering health and care that supports wellbeing and self- management of health, both for our staff and for those we care for
- shaping our services around community needs and localised care
- framing our clinical approach to providing care
We have agreed that our mission – our purpose – is ‘empowering positive futures.’ This is our daily aspiration; it is why we do what we do. We want to work together so that our community can be empowered to ‘choose well, stay well and live well.’
We know that we can only empower positive futures for those living in Northamptonshire if we make sure we collaborate more closely and work differently to how we have been.
It remains a reality that sometimes we will all need to have our own individual focuses as separate organisations. We have national, regional and local requirements for our own specialist areas and we must deliver to these targets and standards – but by working together as a Partnership we can keep a focus on aligning our services and experiences of care. We can all help each other and those in our community to have better experiences and a more positive future in which they are empowered and are central to all we do.
Traditionally each leader of each of our health and care organisations is responsible only for the services provided by their own organisation. For most of the care within each organisation this will continue: this remains our business as usual work.
However, if we are to provide the people of Northamptonshire with person-centred, coordinated care then we need to also work together on transformational activity to create pathways of care which are coordinated through organisations. This is the transformational difference.
We want people to be able to access health and care services seamlessly through our different organisations and receive coordinated, high-quality care. This will only happen if we all work together effectively with collective clarity on our focus, what we need to change, which changes will support the best outcomes for our community and which changes will help people improve and manage their own health and care and so empower them to choose, live and stay well.
So by transformation we mean those areas and services where if we work together differently, if we transform, we can bring about the changes that can create a more positive future for our community.
By sustainability we mean that we are focusing on providing services that meet local needs now and into the future. We are keeping our focus firmly on empowering positive futures through considering all forms of sustainability in all we do.
Our community quite rightly expects all of us to work together to provide a system of care that works seamlessly for the public. In mid-2018 the Care Quality Commission (CQC), the independent regulator of health and social care in England, reviewed the way in which services worked together in Northamptonshire – and found that there was much more we should be doing to work more collectively. Much of the CQC’s feedback held up a mirror to things we already knew we needed to address and which we were already taking steps towards doing.
We don’t underestimate the challenges we face or the impact of our older ways of working. We know our local demands and our financial situation is complex. We know our community needs are growing, and we know they expect and deserve more. We know we will need our community to help us by focusing on staying well and using our services wisely. It is for all these reasons we are focused on creating a positive future driven by our collective desire to improve the quality of care and outcomes for our community.
We also know that our plans are a work in progress. We want to engage more with our community, the people who live and work in Northamptonshire, including frontline health and care professionals, so we can get it right. We, as leaders in providing health and care for Northamptonshire, are committed to building our local engagement so we are all part of the journey.
Over the coming months our NHCP leadership group is committed to working together to create strong pathways of care that work across and between our organisations. It is a work in progress because we need to engage more with our community and our staff, but in summary we are focusing on:
Better health and wellbeing
We want to:
- empower positive futures for our community by creating the conditions for people to choose well, stay well and live well
- keep our focus on building a positive lifetime of health, wellbeing and care in our community
Better standards of care
We want to:
- improve access to our services so people get the right care and support in the right place, at the right time
- ensure our health and care services are joined up across all our organisations so the care people receive is seamless and easy to access
Better collaborative working
We want to:
- work together to deliver high-quality, joined-up health and social care that focuses on the needs of our communities first
- use our resources wisely so our health and care staff and volunteers aren’t too busy to look after their own wellbeing as well as those they care for
Better management of our resources
We want to:
- better meet people’s needs with the funding we have available
- improve, develop and create health and care services that are sustainable for years to come
Over recent years we think we have not been collectively clear enough on where we need to make changes to truly deliver transformed experiences of care. The Care Quality Commission (CQC), the independent regulator of health and social care in England, has fed this back to us and we accept that we need to make this change.
This is why we are focusing on being clear about our highest priorities, on where we can find ways to improve sustainability and, as a Partnership, give robust direction on ways to be effective. We believe we will achieve this initially by concentrating on a number of priorities that, one by one, will demonstrate how working together can empower positive futures for our community.
It is important to recognise that we can’t do everything, and we can’t do it alone. We will need the support of our staff and our communities to shape how these things are delivered and how they evolve. The leaders of our organisations are committed to making sure that we stop the experience of fragmentation that too many Northamptonshire residents, and staff, have at the moment.
Our hope is that by bringing a clear focus around our key priorities for transformation, together we can lay the best foundations to be sustainable and to help people to live well and stay well.
Together we can be better.
Our first four are:
- Urgent and emergency care
- Our hospitals working more closely together
- Care in your area
- How we plan, buy and monitor services
In some parts of the county we are already starting work on these.
By outlining these four priorities, this does not mean there aren’t other areas in which we are working together differently. We are very proud of the hard work of many of our colleagues who are truly transforming care in Northamptonshire, and they will continue to plan and deliver local improvements to cancer care, services for children and young people, maternity care, learning disability services, mental health services and health and wellbeing services.
However, as a Partnership we must be realistic in our daily focus and how we jointly spend our time. In the next few months and years we will progress to look at other areas of health and care until we have them all aligned across our organisations.
All of the Partnership organisations in Northamptonshire will continue to strive to provide the best possible health and social care for our community across all of our services. Sometimes this will be provided by our organisations individually and sometimes this will be through collaborative projects. But as a Partnership, we must focus on our transformation priorities – where we feel we can make the most difference by working together to truly deliver a positive lifetime of health, wellbeing and care in our community.