Care navigators help you find your way around the health system

All sixteen Portsmouth GP practices are introducing a new scheme which should help patients see the most appropriate healthcare professional faster.

Around 230 practice staff across the city, including a number of receptionists, have received external training to become care navigators.

They won’t offer you clinical advice – but will help signpost you to the most appropriate health service for your needs, as the GP isn’t always the best person to see or the route for getting the most appropriate care faster.

Dr Linda Collie, a Copnor GP who is the clinical lead for NHS Portsmouth Clinical Commissioning Group, which has paid for the staff training, said: “We know that it’s not always easy trying to navigate local health services to find out who is best placed to help you for a particular health problem or concern.

“Care navigators have access to a directory of information about services to point patients to the most appropriate source of help, advice and support.

“On many occasions, a GP might not be the most suitable person for the patient to speak to or see. Patients can often be seen much quicker by a nurse or physiotherapist for example. In some places, a GP practice may not even be the right place for an enquiry.

“The next time that you make an appointment at your practice, you may be asked some questions about the reason for your appointment.

“Don’t be offended by this – it’s simply so that the care navigator can ensure that you see the person best suited to help you. We want you to see the right person, first.

“You don’t have to do this. The care navigator is not being nosy, and will respect both your privacy and your right to say ‘no.’

“But the care navigators will play an important role in not only help you to access faster healthcare, but also ensuring that GPs can dedicate most of their time to those patients who most need their help.”

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Further integration of NHS Portsmouth Clinical Commissioning Group and Portsmouth City Council

Plans have been developed which propose new ways for the city’s council and NHS to work more closely together in future.

The plans set out options for further integration of the leadership of Portsmouth City Council and NHS Portsmouth Clinical Commissioning Group (CCG). This marks a continuation of a process of closer partnership which has involved senior joint appointments, and resulted in a range of positive changes such as targeted early health and social care support for children and families, a shared clinical record available to frontline NHS and social care staff, and integrated domiciliary care teams to help people return home after a hospital stay.

There are three key recommendations:

  • More decision-making to the Health and Care Portsmouth joint commissioning committee
  • Integrating the council and CCG approach to finance, including the creation of a joint role
  • Proposing future arrangements for the CCG’s accountable officer role.

In terms of the third point, the recommended course of action is that the CCG’s accountable officer functions are incorporated into the function of the Portsmouth City Council Chief Executive. The CCG will continue with its strong clinical leadership model, including clinical leadership for Health and Care Portsmouth and having a clinical chair for its governing board.

A paper containing these recommendations was considered by Portsmouth City Council’s cabinet on 9 July, and will go to the CCG’s Governing Board on 17 July. It will then be considered by the city’s Health and Wellbeing Board. If agreed by all three bodies, approval would then be sought from NHS England with regards the proposed changes to delivery of the CCG’s accountable officer role functions.

Dr Linda Collie, the CCG’s clinical leader and current accountable officer, said: “For many years now, our ambition has been to bring health and social care together, because we feel that would bring valuable, tangible benefits to people living in our city. Ultimately, our total focus must be on meeting the needs of people using services in Portsmouth, and the changes we have been making, and are now proposing, are designed to do just that.

“The CCG has always maintained a strong clinical voice at the heart of the decision-making process, and we believe these recommendations will continue that and enhance our effectiveness.”

David Williams, Chief Executive of Portsmouth City Council, said: “A huge amount has already been achieved through our integrated working with the NHS, and these recommendations are a natural progression in Portsmouth’s journey to truly integrated health and social care. We now have much closer working between the council and the CCG, and have positive relationships with the voluntary, community and social enterprise sector. These proposals mark an important next step on that journey.

“Increasingly, NHS and council teams are working together under the Health and Care Portsmouth banner, and it feels right that we should now try to make sure that the leadership arrangements reflect that progress and Portsmouth has a clearer voice within the wider health system.”

Cllr Matthew Winnington, the council’s Cabinet Member for Health, Wellbeing and Social Care said: “This paper is a statement of intent – it sets out a clear vision for how the council and the CCG can continue to work together to deliver joined up services.

“Local authorities play a unique role in the lives of our residents. Bringing together the council and the CCG means we can work together to tackle those wider issues that impact the health and wellbeing of people in Portsmouth – things like improved air quality, housing and economic development. I’m excited to be delivering on our mission to make sure we’re providing the right services for the people in our city so they are supported to live full, healthy and independent lives.”

FAQs

Why is the proposal being made?

The proposals are a natural development of work between the council and the CCG over a number of years.  They stem from requests made by both the council’s Cabinet and the CCG’s governing board to get broader and deeper integration between the two organisations. There are a number of factors involved: there are pressures on the health and social care system as a whole, and key documents (the NHS Long Term Plan and the Hampshire and Isle of Wight Strategic Transformation Plan) have set out how the NHS, local authorities and the voluntary, community and social enterprise sector can and should work together to address those pressures.

The proposals are about making sure there are structures and attitudes in place – in terms of resources, decision-making and people – to make sure the city can fulfil its desire to provide joined-up care for people in Portsmouth, delivered in the right place and at the right time.

Local authorities are uniquely placed to engage with residents on a number of factors that contribute to people’s overall health and well-being – like education, housing, leisure and transport. Bringing the council and CCG closer together means that resources, knowledge and expertise can be better combined for the benefit of the people of Portsmouth.  Together, the council and the CCG will work with the wider health and care system to influence the delivery of better, more cost effective services across the Hampshire and Isle of Wight area.

What has happened so far?

The two organisations have worked together for a number of years as part of the Health and Care Portsmouth programme, and already share a number of statutory posts – including in Adult Social Care, Children, Families and Education; and in Public Health. There are also shared commissioning functions and teams.

By sharing knowledge, expertise and resources we have been able to achieve much, including:

  • Health visitors and children’s social workers have been co-located since 2016; in addition a diverse range of health and social care professionals has been brought together to deliver a Targeted Early Help and Prevention service for children and families.
  • Adult community health, social care and therapies have been co-located to deliver multiagency care and co-ordination.
  • From June 2018 the CCG has commissioned an Integrated Primary Care Service incorporating the provision of three interconnected services: Out of Hours (OOHs), the AVS, and GP Enhanced Access. This will ensure safe, effective delivery of primary medical care services 24 hours a day, 7 days a week, and improve access to primary care.
  • A specific Blueprint for Adult Social Care in Portsmouth has been launched, with a cross-organisation programme board to ensure its delivery.
  • A joint health and care domiciliary care service specifically to enable people to return home as quickly and safely as possible after a hospital stay.
  • A collaborative approach has been taken to include the voluntary sector as an equal partner in the provision of health and care to Portsmouth residents. Through the signposting service, an easy access route for GPs has been available to access non-medical support from the voluntary sector for their patients.
  • A single clinical record across health and care providers in the city to improve communication between health and social care professionals. All GP practices within the city, Solent NHS Trust, and Adult Social Care use ‘TPP SystmOne’ as their primary clinical system – better for patients, and for the clinical staff.
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All systems go for new Lighthouse Group Practice in Portsmouth

Two GP practices in Portsmouth have now officially merged to form a new partnership.

Southsea Medical Centre and The Devonshire Practice officially joined together on 1 July 2019 to form the new Lighthouse Group Practice.

The move has been planned for months and was announced last May. It has been approved by NHS Portsmouth Clinical Commissioning Group, which is responsible for planning primary care services city-wide.

The two former practices have a combined registered of more than 13,500 patients. Both sites, which are 1.5 miles apart, will remain open.

Managing Partner Andrew Clarke said: “We strongly believe that by becoming a single practice, and pooling our clinical skills and staffing resources, that we will be able to offer improved high-quality services and good access to those services.

“It will also help us to offer our patients much more robust cover during times of staff holiday leave or sickness, and patients can be seen at whichever site is more convenient to them.

“We are also offering extended access hours with our healthcare assistant (7.30-8am Monday to Thursday; a nurse prescriber clinic (Tuesday 6.30pm-8.30pm) and a GP and nurse prescriber (Thursday6.30pm -8pm).

The new combined practice plans to provide:

improved same day access for its patients, especially patients who were registered at Devonshire, where appointment times have been adversely affected by staff sickness in recent months
an in-house pharmacist who will ensure that repeat prescribing processes are safer, better managed and provide an improved service to patients
modern facilities fit for the future
Improvements to the patients’ GP-led telephone triage system across both sites
a dedicated long-term conditions nursing team to work across both practices
a more attractive workplace for future staff, helping GP and other staff recruitment and staff retention – especially as it plans to become an NHS ‘training practice.’
Further enhancements to existing administrative systems to help GPs manage their paperwork – freeing up more of their time for appointments.

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First Contact Physio – telephone triage service now available in all GP surgeries in Portsmouth

A new physiotherapy triage service means direct access to care for Portsmouth residents.

People with muscle and joint-related pains can now get direct access to a new service available across the city. Following a successful trial, the First Contact Physio service is now available in all GP surgeries in Portsmouth; this puts patients directly in touch with a physiotherapist, without the need to see another clinical professional.

The new triage service is being delivered by Solent NHS Trust as part of Health and Care Portsmouth, and is running in surgeries across the city Monday to Friday 8am to 12pm.

Musculoskeletal (MSK) symptoms are one of the most common reasons for repeat consultations with 1 in 5 people contacting their GP with a problem.

With over 200,000 people living in the city, First Contact Physio will benefit many people as well as freeing up GP appointments for those who need them most. When they contact their surgery, patients with symptoms like back or neck pain, or a hip, knee or shoulder complaint, may be offered a same-day telephone appointment with a specialist physiotherapist. The consultation will provide an opportunity for patients to gain advice or treatment to speed up recovery.

Theresa Costello, Musculoskeletal Physiotherapist at Solent NHS Trust, said: “We are very pleased to be rolling out this service. Many of the patients we help just need support and guidance, from the right clinician, on what they can do to help alleviate or manage their symptoms. This can be done quickly and effectively through our telephone triage consultation without any further appointments being required. For patients that have required further assessment, it has been fantastic to be able to offer  them early access to the physiotherapy service. This has enabled patients to have an assessment, receive a diagnosis and start appropriate treatment far sooner. We are the only service in the locality that is managing on-the-day demand for MSK conditions from primary care with the telephone triage model.”

Muscle and joint related symptoms are often a common reason for both urgent and repeat GP consultations; however, the majority of these do not need to be assessed by a GP. Last year, the service helped to free up 2,940 urgent primary care appointments across Portsmouth. The feedback that has been receiving from both patients and primary care teams has been resoundingly positive.

One service user said: “I think this is an excellent service, the person I spoke to was very professional. They took the time to explain my symptoms and gave me exercises to help my condition.”

Another patient added: “I was very surprised at how quick it was. The physiotherapist was able to arrange an appointment for me and the person I saw was fantastic. They helped me so much that I haven’t had to go back.”

Dr John Thornton, from Kirklands Surgery in Portsmouth, said: “It is a highly efficient system that gets patients help in a timely fashion from experts in their field and as a bonus frees us up as GPs to help those who need our other skills.”

Dr Linda Collie, GP and Chief Clinical Officer at Portsmouth Clinical Commissioning Group said: “We know we need to change how health services operate in the city and this is one of the ways we are trying to improve out of hospital care for our residents.

“The physio triage service makes great sense for our patients. Doctors like me are not specialists in this area so it would be much more useful for our patients to see a physiotherapist directly to ensure they get the care they need more efficiently. This will free up our time to see those who need us most whilst ensuring all patients get the appropriate care and support.”

Patients also have the option to self refer to physio via the Solent NHS Trust website at: www.solent.nhs.uk/msk

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Getting Carers connected during Carers Week 2019

Carers Week, established by Carers UK 25 years ago, is an annual awareness campaign which takes place to celebrate and recognise the vital contribution made by the UK’s 6.5 million carers.
Carers Week 2019 are calling on individuals, services and organisations to do their part in Getting Carers Connected – helping them get the practical, financial and emotional support they need to care for a loved one.
Portsmouth Carers Centre is encouraging carers to swap their knowledge with other carers, share information on the services which made a difference to them and their loved ones. There are some brilliant services out there, but smaller ones are not always commonly known or sometimes get overlooked. Many carers access smaller services provided by small local organisation or local church other carers are not aware of but would benefit from.

Portsmouth Carers Centre aims for carers to get connected with new services and with other carers. From the 1st of June 2019, staff from the centre will be collecting information on services used by carers and add them to the knowledge board at the base on Orchard Road. Carers will have sticky notes available to write on and put on the board when they pop in to the centre; those who are not able to visit personally, can call, send an email or FB message and the information will be added for them.
So what are they looking for?
It may be a service, a group, an activity, a charity or an organisation that carers have attended in the past or present, which they enjoyed or helped them in some way. It could be someone from a pastoral service, church session, community centre or a group, home shopping service, a mobile hairdresser or a mobile chiropodist just to name a few!

All carers and carers friends are invited to come in and have a chat at Carers drop in at HIVE, Central Library 10AM-12PM on Wednesday 5th June.  Click here to find out more.

The main Carers Information Swap Day at Portsmouth Carers Centre will take place 10AM-2PM on Wednesday 12th June.  Click here to find out more. 

For those who are able join, it will be great opportunity to chat and swap information while having coffee and a cake, discuss the findings with other carers, Carers Centre staff, Community Connectors and Social Prescribing team. Everyone is welcome to attend.

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Better support for people in city care homes

Portsmouth’s Enhanced Care Home Team is providing better support for people living in Portsmouth care homes.

The multi-agency scheme pilot is expanding to cover more homes and improve the health outcomes for scores of vulnerable, older people – easing pressure on the local NHS.

Whereas previously if a care home resident fell poorly, a GP or nurse could be called out to see them, there is now far more emphasis put on pro-active care, involving a fully integrated approach which includes a core team of a GP, pharmacist, community nurses and care home staff, with a supporting team on standby when needed such as mental health nurses and a occupational therapist.

The service benefits include:

  • improved continuity of care,
  • improved patient safety through better clinical outcomes,
  • increased satisfaction of residents and their carers with the service,
  • reduction in urgent care usage,
  • a reduction in wasted/overprescribed medicines,
  • better trained care home staff.

The initiative, funded by the Portsmouth MCP (Multispeciality Care Provider) and BCF (Better Care Fund) to help health and social care organisations to provide new models of care, is a joint project involving NHS Portsmouth Clinical Commissioning Group (CCG), Solent NHS Trust, the Portsmouth Primary Care Alliance and Portsmouth City Council.

Pictured left to right, top row, are – Pam Macpherson (pharmacist technician), Quadri Olaniyan (pharmacist care home), Maria Rodrigues (deputy manager, Oak Grange), Morwenna Fenner (pharmacist technician); mid row – Carmen Palimaru (nurse, Solent NHS Trust); front row left to right – Charisma Williams (Home Manager, Oak Grange), Camilla Evans (GP) and Samantha Reilly (pharmacist).

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“Positive Minds” – a new type of support for mental and emotional wellbeing in Portsmouth

A new way of supporting people’s mental and emotional wellbeing will soon be up and running in Portsmouth.

Positive Minds logo

During Mental Health Awareness Week 2019, the city’s NHS has confirmed that the new service will be called ‘Positive Minds’ – that was the preferred choice of almost 300 people who responded to a survey asking for their views on the name of the new service, how it might work, and the range of services it would offer.

Positive Minds is a partnership between Portsmouth CCG, Solent NHS Trust and Solent Mind, the local mental health charity. The service is set to open in a central location in the city in the autumn. The facility will offer a mix of booked and drop-in slots, combining both mental health professionals and ‘peer supporters’ – people with personal experience of living through periods of mental and emotional difficulties.

It is intended to look and feel very different to traditional NHS services whilst providing a welcoming and supportive atmosphere. This will give people somewhere they feel able to turn to when they face periods of distress in their lives which might feel overwhelming.

The service is part of the wider “Health and Care Portsmouth” programme. This involves key NHS and social care services and organisations working much more closely together, to give city residents better, more joined up support than has been the case in the past.

Dr Nick Moore, a Portsmouth GP and the mental health clinical lead for NHS Portsmouth Clinical Commissioning Group said: “When we face distress in our lives, we need a place to turn. There are huge amounts of people who live through difficult times, and who might pay a price for that in terms of their mental and emotional health. Positive Minds is a new type of health care service that can offer people a safe environment which will provide support before they reach a crisis point.

“We know that a one-size-fits-all model doesn’t work. Positive Minds can offer professional help and support, where you are safe, heard, and able to take the first steps towards a more hopeful future. It’s also a place where you can meet others who have similar experiences and understand how you feel.

“The local NHS, the city council, and the voluntary, community and social enterprise sector are all signed up to working together to give people that flexible, open service. There is work underway to improve other mental health services as well, but Positive Minds will be a fantastic new option for people, when it opens later this year.”

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Solent NHS Trust has announced the winner of its inaugural Nurse of the Year Award.

Vanessa Bull, a Learning Disability Nurse, was presented with the award at Solent NHS Trust’s Celebrating Nursing conference today, Friday 10 May 2019.

Vanessa Bull and Sue Harriman

The award gave patients and Solent colleagues the opportunity to recognise those who really make a difference and is part of Solent NHS Trust’s celebration of International Nurses Day 2019 on Sunday 12 May.

Vanessa works within the Jigsaw team based at Southampton Civic Offices, which supports disabled children and young people as well as their families.

She is described by her colleagues as someone who always goes the extra mile and is truly passionate about getting the best outcomes for the children that she works with.

The panel of patients, volunteers and staff, selected Vanessa for her high standards, superb care that she provides to patients and her humble and impressive attitude.

On receiving the award, Vanessa said: “It was very unexpected, but it was lovely to win the award. All the nominees were amazing and everyone does such a fantastic job so it makes the award extra special.”

Solent NHS Trust Chief Nurse Jackie Ardley said: “We are very fortunate to have some incredible people working within Solent. The panel read through many fantastic nominations and it was such a difficult decision to choose a winner.

“It is with great pleasure that I congratulate the winner – Vanessa Bull – for her phenomenal work, particularly over the last 12 months. Vanessa clearly demonstrated the Solent values and shows outstanding innovation, compassion, as well as excellence.

“The conference was such a wonderful event and it was a pleasure to be able to recognise everyone’s hard work and dedication across the day. All our nurses have been pivotal in helping us achieve an ‘outstanding’ rating at providing caring services in our recent Care Quality Commission report. Together we can continue to learn and keep even more people safe and well at, or close to, home.

“We had 11 nurses shortlisted for the award, and just to be shortlisted is such a great achievement. All the nominees should be incredibly proud of themselves.”

All nurses, both registered and non-registered and working in Solent services, were eligible for a nomination.

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New senior appointment to help integration drive

Suzannah Rosenberg has been appointed to the role of Solent NHS Trust’s Deputy Chief Operating Officer in the Portsmouth and South East Care Group.

Suzannah will devote approximately four days a week to her new job, but will also continue to play a senior role at NHS Portsmouth CCG for the remaining day a week, where she is currently Director of Quality and Commissioning.

When the vacancy arose, both Solent and the CCG were very keen to make a joint appointment if possible, to reflect the way that city organisations are increasingly working closely together to deliver the Health and Care Portsmouth agenda.

Suzannah’s new title will be Deputy Chief Operating Officer and Director of Transition, and she will formally begin work in this role in July. She will also continue to lead on mental health commissioning for the city, and as senior responsible officer for the Integrated Care Partnership Mental Health Programme.

Suzannah said: “I have worked closely with Solent in my role at the CCG, and I believe that this new joint role offers a perfect opportunity for me to progress the work to improve and integrate services in the city. I hope that the joint nature of the role will enable me to play a part in delivering the result that we all want to see, which is integrated, person-centred services which provide the best possible support for those who rely on them.”

Sarah Austin, Solent Chief Operating Officer and Commercial Director, said: “This is an exciting and innovative approach that further removes borders between organisations and functions and will support the approach we would wish to see increasingly in the Integrated Care Partnership. I know everyone will welcome and support Suzannah in her new role.”

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A new service for Portsmouth – what you told us

We are planning a new service for Portsmouth, which is intended to offer a different way of supporting people’s emotional and mental health.

The service will offer both booked and ‘drop-in’ slots, with both professionals and peer supporters. We wanted to check in with city residents whether we were on the right track, and what you thought of a couple of possible names.

Almost 300 people responded to our survey, and a quick summary of the headline findings can be seen here.

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