Health and care services in Liverpool are set to be transformed under far-reaching proposals which could save hundreds of lives every year.
Liverpool Mayor Joe Anderson and Dr Nadim Fazlani, chair of Liverpool Clinical Commissioning Group, jointly unveiled a series of proposed reforms to NHS and care services in the city at a Mayoral Health Summit at the city’s Town Hall.
The proposed change programme, called Healthy Liverpool, is being led by senior clinicians in the city. It is designed to ensure that people consistently receive the best quality care and that services are modelled in the right way to meet changing needs.
Dr Fazlani, who has been a practising GP for 25 years in Kensington, Liverpool, said: “We believe we should offer the best care to everyone, irrespective of where they live in Liverpool, to a consistently high standard.
“Issues such as an ageing population and opportunities such as advances in medical technology mean care services can and should be organised is a more effective way. A different approach will enable people to have the very best health and care.”
The proposed reforms will mean:
• improvements in primary care
• greater access to GPs
• more support for people to manage their own care
• better illness prevention
• some services moving from hospitals into the community
• changes to some hospital services to improve outcomes and quality
Mayor Anderson said: “Liverpool is fortunate in that it is served by genuinely world-leading hospitals, staffed by excellent clinicians. We want to protect and develop those assets so that they can continue their amazing work at the forefront of modern medicine.
“But we also want to ensure all parts of the health and care system are operating in the best way for the benefit of the communities they serve.”
The Healthy Liverpool reforms aim to demonstrably improve the health of people in Liverpool by 2018/19 so that:
• People in the city are living longer, with the gap between Liverpool and the rest of the country narrowing; with life years lost reduced by 24 %
• Quality of life for people with long-term conditions is improved, with at least 71% reporting a good quality of life
• The number of avoidable emergency admissions to hospital is reduced by 15%
• The experience of hospital patients is improved to the within the top ten areas in the country
• Out-of-hospital patient experience is improved to within the top five areas in the country
The Healthy Liverpool proposals published today have been led by Liverpool doctors and other clinicians, along with Liverpool City Council, NHS Trusts and other stakeholders. They are also a response to the findings of the 2013 Mayoral Health Commission, which made a series of recommendations on how health in Liverpool could be improved.
The launch of the Healthy Liverpool Prospectus for Change will be followed in the new year with a city-wide engagement campaign, which may lead to some elements of the proposals to be put to formal public consultation in the second half of 2015.
The Healthy Liverpool programme focuses on health and social care services being delivered across three ‘settings of care’:
Living Well – supporting people to self-care and equipping them with the knowledge and resources to take make healthier lifestyle choices;
Community Services – transforming services delivered in the community, with care delivered across 18 neighbourhoods by teams of GPs, community nurses, social care workers, and others, working with schools, and local community organisations to deliver integrated services to improve the health and wellbeing needs of each person, and far better access to more specialised community health services;
Hospital Services – ensuring that local hospitals are the best in the country, offering excellence seven days a week, and that the specialist services they offer are called upon appropriately.
Six areas have been identified where NHS leaders believe the biggest positive impact can be made. These areas of focus are cancer; mental health; children and young people; healthy ageing; long-term conditions and learning disabilities.
Underpinning the Healthy Liverpool vision is a strategy which will see a move for even more services delivered in and close to people’s homes and more effective joining up of health and social care services so that different parts of the health and care system – such as doctors and social workers – are working together seamlessly.
There will also be an increased focus on activity designed to prevent ill-health, including a bold ambition for Liverpool to become the most physically active city in the country by 2020.
A key challenge facing Liverpool – and which these reforms will address – is its ageing population which, in line with national trends, is expected to grow significantly.
By 2021, it is estimated that the number of people aged over 65 in Liverpool will increase by just over 9%, or 5,700 people. The number of people over 85 will increase by 23.6%, or 1,800 people. Many of these people will have complex long-term care needs.
Dr Fazlani said: “We believe the case to transform health and social care is overwhelming and tackling how we care for an ageing population is an important part of the case for change we are setting out in the Healthy Liverpool Prospectus.
“But there are other, equally important, issues we must address. For instance, lung cancer alone accounts for over 12% of the gap in life expectancy between Liverpool and the rest of England. And life expectancy within Liverpool itself varies considerably, even between neighbouring communities.
“The life expectancy gap between men living in Childwall and Kirkdale is more than 12 years.
“It is wrong that people in Liverpool have significantly poorer health than elsewhere in the UK and Europe and that life expectancy within the city is so varied. Our aim is to change that.”
Dr Fazlani said work to reshape some care was already underway. Joining up health and social care was already an emerging reality and work was taking place to deliver person-centred care in neighbourhoods and communities.
He added: “Improving primary and neighbourhood care will enable people to stay healthier and independent for longer and also reduce demand on hospitals.
“Our hospital services largely continue to operate in the same way as they did in the last century, despite the changing face of the population and technology. We believe some hospital services would benefit from a fresh approach to the way they are organised.
“If we reduced emergency admissions to hospitals by just 11% we would be able to afford an extra one and a half GPs in every practice in the city. This is the virtuous circle we are aiming to create.
“Quality of care has to be foremost, however. Without quality, we won’t achieve the outcomes we are aiming for. All the proposed reforms under consideration will therefore be underpinned by a rigorous approach to standards and quality.”