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Statement by the President of the Committee for Health and Social Care

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Wednesday 27 November 2019

General Update


Since my last statement to the Assembly in July we have seen continued progress in pursuing the objectives of the Partnership of Purpose - an essential and collaborative approach that will allow islanders fair access to solutions that meet their health and care needs by placing the user at the centre and making every contact count.

The Partnership of Purpose is more than just a theoretical concept. It is a substantial and complex long-term programme to reshape the Bailiwick's approach to health and care and meet the challenges of growing demand, growing medical advances and growing expectations. We are already seeing the benefits of embedding the values of the Partnership of Purpose across not only Health and Social Care but also the private and third sectors with some significant and tangible outcomes emerging from collaborative thinking and working.

Here are a few examples;

Firstly, following a review of The Acute and Community Pain Service, steps have been taken to develop a more collaborative, integrated, person-centred approach. Psychologists and physiotherapists are working with doctors and nurses to develop this new way of working. Working with the creative industries we are now exploring how virtual reality, alongside other technology, can be used to support better patient outcomes by individuals managing their pain.

Secondly, an agreement on improved data sharing across health care providers through collaboration with the primary care sector is in its early stages but is progressing well and will make a considerable difference in being able to provide a more joined up service.

And thirdly, the setting of a fixed tariff for certain sexual health services means individuals can go to Choices, their GP or the Orchard centre, wherever they feel most comfortable, for the same cost.

Sir, while we are still at the relatively early stage of a 10-year programme to transform HSC, the Partnership of Purpose is already more than an ideology - it is becoming part of the conversation, it is being referenced by third party stakeholders and is helping to inform decisions and service developments. Real change is happening and a wide-ranging portfolio of programmes and projects are, in different ways, bringing the transformation to life.

Here are a few examples of projects that have already improved outcomes for islanders. Not only are real benefits being felt by patients, the transformational way people are being cared for means better value in the long run.

We've supported the launch of a pilot project for familial hypercholesterolaemia led by Queen's Road Medical Practice and Wessex Genetics. This is now live and will lead to long-term savings in cardiovascular care and the avoidance of early deaths.

There is a steady and increasing requirement for access to clinical genetics services and we are also looking to establish a visiting service comprising a consultant geneticist and a genetic counsellor. This model is a much more cost effective way of meeting the increase in demand than sending service users to the UK for consultations and is easier for Islanders.

We've introduced a new diagnostic service in cardiology, using CT scans to create 3D imaging. This has resulted in less patient travel off-island and reduced the need for invasive follow up. Also, by re-evaluating eligibility criteria, we've reduced pressure on the Individual Funding Request panel for expensive care designed for patients who cannot tolerate open heart surgery.

We have recently opened two new scanners in Radiology; a SPECT-CT scanner- the only one in the Crown Dependencies- and a CT scanner. Together they will provide us with 10 years of Nuclear Medicine and CT scanning with improved clinical functionality and, importantly, resilience.

We've initiated a series of guidance documents for GPs to streamline and clarify referrals to secondary care, which will result in an overall reduction in waiting list numbers and times. We've also clarified and updated the purpose, frequency and need for more than 700 tests currently processed in the hospital labs which we anticipate will lead to savings through the reduction of over-testing.

We've introduced free screening for cervical cancer which looks like it willincrease take up to over 90%.

We've developed and published a Joint Strategic Needs Assessment for the over-50s providing an unprecedented understanding of the needs of this sector of the population;

We've signed up to the prevention concordat for mental health and conducted an evidence-based gap analysis of mental health services that has fed through to our budget submission

We've opened the autism hub and created an Autism Outreach service that will change the lives of those in our community and mean we are bringing home those who to date have had to live far apart from their families.

We've developed a policy framework for the use of medicinal cannabis and produced guidance notes.

As promised, we've demonstrated our commitment to adopting a permissive approach towards funding, and I was delighted to announce earlier this month that we have been able to secure access to Orkambi and Symkevi for people living with Cystic Fibrosis in the Bailiwick.

We have also begun piloting new ways of working in Alderney primary care.

Sir, these initiatives are underpinned by the values of the Partnership of Purpose, people-centred and making use of cross-sector working, making every contact count.

The work continues and there are a number of other areas where further developments will be made before the end of this year.

In respiratory services, we will have made thecapital funding case for palliative ventilation equipment for degenerative neuromuscular conditions which will save hospital readmissions; ended lease arrangements for some medical equipment saving £100K per annum in the next seven years; developed a clinical protocol to support end-of-life arrangements for respiratory patients and embedded arrangements to support multi-disciplinary working.

In Specialist Nursing provision we will have appointed specialist nurses to cover patient cohorts in Chronic Pain, Chronic Respiratory conditions, Palliative respiratory conditions, Urinary tract cancers and Bowel cancers.

In acute care, we will have conducted NHS Improvement audits in hospital wards to facilitate efficient discharge from care and multidisciplinary teamwork.

Finally, in respect of the overall model of care, in the next few months we will be announcing plans to formalise arrangements around the Partnership of Purpose itself,establishing a mechanism to accredit those public, private and third sector bodies working with us to realise the Partnership's values.

I said earlier in my statement that the Partnership of Purpose has become part of the conversation. Well, this conversation extends beyond the Bailiwick's shores to our colleagues in Jersey. Published last month, the Jersey Care Model closely reflects the Partnership of Purpose in its ambition, areas of focus and driving principles. Indeed, it even references the need to create a Partnership of Purpose and I look forward to meeting with my Jersey counterpart next week to discuss common opportunities.

I am grateful to all those involved in collaborating on the projects I've outlined today, especially those delivering front-line services. Successful transformation is being brought to life by our committed and professional staff. Just last month, the urology and emergency departments won three awards at the Nursing Times Awards for their innovative, patient-centred practice.

I said at the beginning of this statement that the health and care transformation programme is substantial and complex. However, we have a firm grasp of the nettle and continue to see progress. Some of the 2017 resolutions have proved slower and more challenging to deliver than expected while in other areas we are more advanced than we anticipated. We are well on track to ensure that we have set firm foundations for the new model of care by the end of this term and so ensure that any future Committee can hit the ground running.

Sir, the Committee is dependent on the members of this Assembly to continue to support this essential programme of work. It will be achieved by cross-committee cooperation to truly deliver collaborative solutions to the Bailiwick's health and care needs. Recognising that people's health is determined primarily by a range of social, economic and environmental factors, the forthcoming publication of the latest Wellbeing Survey will provide a wealth of information which all Committees can use to inform policy development and service delivery. Whether through the Integrated Transport Strategy, Justice Policy, transforming education programme or other initiatives collectively we can create an environment for health which supports a sustainable health and care system for our existing population and those generations to come.



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