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Getting personal

Getting personal
20 October 2015

Pooled resources and long-term objectives designed with local people in mind is at the heart of this primary and acute care system vanguard

Pooled resources and long-term objectives designed with local people in mind is at the heart of this primary and acute care system vanguard

NHS North East Hampshire and Farnham Clinical Commissioning Group (NEHF CCG) works with its 24 GP member practices to plan and buy services for their 220,195 registered patients. It straddles the border between Hampshire and Surrey, giving it an insight into health and care issues across the wider region. The area covers a rural and urban geography with the population coming from a range of socio-economic backgrounds and some people living in the most deprived communities in the country.
Our area benefits from diverse communities and cultures, with a rapidly-growing Nepali community and a large traveller community. We are proud of our military connection, which is a prominent feature of our locality and that makes up an important part of our identity.
The goal of our vanguard programme is to empower people to take control of their own health as much as possible and to ensure that when people do need treatment, that high-quality services are provided for them.

The North East Hampshire and Farnham vanguard scheme is a system-wide partnership with partners including:

  • NHS NEHF CCG, primary care in the area working at scale.
  • Frimley Health Foundation Trust (acute hospital).
  • Surrey and Borders Partnership NHS Foundation Trust (mental health).
  • Southern Health NHS Foundation Trust (community services).
  • North Hampshire Urgent Care (urgent out-of-hours primary care).
  • Virgin Care (community services).
  • South East Coast Ambulance Service NHS Foundation Trust.
  • Surrey and Hampshire County Councils (social care) and the voluntary sector.
  • Primary care and other services are organised around five smaller localities in our area.

Integration bid background
When submissions were invited for vanguard sites in January 2015, partners in North East Hampshire and Farnham were already working on integrating some health and social care services. Introducing new models of integrated health and social care had previously been identified as one of NEHF CCG’s six key improvement programmes in its Five Year Strategic Plan.1
Our system partnership is committed to working together to join up care services, help local people avoid hospital when they don’t need to be there, meet the expectations of local people and make best use of declining public sector resources. Our system is fortunate to have many strong partners, with inspirational leaders who are not afraid to make difficult choices in partnership with local people.
System partners have been working together to create understanding, honest and trusting relationships over the last couple of years to make sure that we have the best chance of success when integrating services and facing challenging decisions.
Frimley Park Hospital is the first hospital in the country to be rated as outstanding by the Care Quality Commission (CQC).2 This is a resource that our community is proud of alongside other excellent services including primary care services that performs consistently well for the population.

The bid
The bid was made under the primary and acute care systems (PACS) category of the new models of care, although NHS England themselves acknowledge in The Forward View into Action: Planning for 2015/163 that “the characteristics described… are not set in stone. They are intended as an early guide”. Our vanguard, for example, includes a major acute hospital trust but it is not led by that acute trust.
We were confident that we had a good package to present but without being certain of exactly what the national team were looking for, it made for a very interesting experience for our team at the presentation event in London. Each team was rigorously observing and monitoring all of the others and trying to weigh up the relative merits of their own schemes.
We believe we were selected because while our plan is ambitious, it is also realistic, and firmly rooted in the solid collaborative work we and our partners already do day-in and day-out across our area. We highlighted our plans to support people and to bring services together around the individual and to move away from the acute setting and into a community or domestic environment. We explained how important the public and patient voice is to us and how we have been engaging and seeking to involve our local population in our work, to tap into the enormous resource that is the local community.
With the national resources and expertise we can accelerate the process. As a result of our successful submission we stepped up all of our integration activities. When the new models of care team came to visit our community at the end of April, they urged us to move faster still and to be even bigger and bolder so that we make the most of the strong partnerships and track record of our system.

Our population
Services will be designed around the individual, ensuring that a person only has to tell their story once. Individuals will be supported by a named individual to help and guide them to create a complete picture of their health and wellbeing and that both their current and future needs are met, putting the person in control. A holistic approach, involving a range of preventative support including social prescribing, means that no stone is left unturned in the search for ways to improve people’s lives.
Our ambition is that people will be supported to be happy, healthy, at home and we collectively make best use of public resources (see Table 1).

Our vanguard aims to create transformational system change to improve the experience of local people in two fundamental ways (Figure 1):

  • Strengthening our relationship with our community so that we design all services with our communities and
  • help people to look after themselves and each other.
  • Giving our workforce the best chance of providing joined up care by making sure that funding and organisational boundaries don’t get in their way.
  • Key milestones include:
  • Multidisciplinary teams in each of our five localities have been established since July 2015.
  • Formation of a new GP federation to help delivery of primary care at scale. Social prescribing pilot launched to signpost patients to appropriate voluntary and third sector services.

We want our population to be stronger, both physically and mentally, and better equipped to support itself.
The health and care needs of the population will be met within its own communities. When people do come into contact with health and care professionals they should have a personal and rewarding experience, one that they remember for all the right reasons.

Dr Andy Whitfield, chair and clinical lead for NHS North East Hampshire and Farnham Clinical Commissioning Group.

1 NHS North East Hampshire and Farnham Clinical Commissioning Group. Strategies. (accessed 4 September).
2 Care Quality Commission. Frimley Park Hospital NHS Foundation Trust awarded first outstanding rating by chief inspector of hospitals. (accessed 4 September).
3 NHS. The Forward View into Action: Planning for 2015/16. 2015. (accessed 4 September).

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