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25.07.18

ICS Wave 2: Cumbria

Source: NHE July/August 2018

Cumbria’s healthcare system has come a long way since being recognised as one of the most challenged health economies in England, writes Stephen Eames, leader of the North Cumbria Health and Care System and chief executive of North Cumbria University NHS Hospitals Trust and Cumbria Partnership NHS FT.

When you think of Cumbria and the Lake District, you think of fresh air, mountains and a healthy outdoor lifestyle. The reality is all that… and a lot more.

Alongside the lakes and fells, we have towns made up of some of the most deprived wards in England. Some of those areas have very high rates of childhood obesity and cardiovascular disease, with many living with multiple long-term conditions. Tackling some of those health inequalities has to be at the heart of our plans.

On top of that, our system has faced its own poor health – challenging finances, difficulties recruiting specialist staff, and national scrutiny in the form of the Success Regime.

Our transformation from one of the “most challenged” health economies in England to being held up as an example of one of the “most improving” has been remarkable, and is a credit to how hard our staff have worked. Our focus now is on integrating our services and putting the patient at the heart of everything we do.

We are committed to involving our community to work together to shape service change. We know the health inequalities faced by our communities, and the pressures on our services, cannot be fixed by the NHS alone – we simply don’t have all the answers.

We are committed to involving our third-sector organisations in our transformation. We’re funding a health partnership officer hosted by Cumbria CVS to ensure we build those relationships into our developing integrated care communities on the ground. We also want to ensure we have that valuable experience and expertise influencing how our new integrated care system develops.

So what are we doing that is different?

Our relationships with our social care colleagues have never been stronger, and we work closely with Cumbria County Council. Prevention and population health is central to our vision and our public health team is leading from the front.

We’re doing our best to tear down the artificial boundaries between organisations to allow staff from social care, community services and primary care to work together in their local area, developing rapid response hubs to support the most vulnerable, ensuring they get the care they need at home and avoid unnecessary admissions to hospital.

Our eight integrated care communities are developing with professionals from different organisations wearing one team shirt – they are all on the side of the patient.

Our Home First teams are assessing patients who come into our emergency departments to ensure those elderly frail patients who would do better at home with the right support can avoid admission to an acute hospital, which might mean they lose both muscle strength and confidence.

Our Reach Out team assesses every acute patient at risk of developing delirium every day. They monitor patients, support those with dementia during their hospital stay, and help our busy nurses and healthcare assistants provide the right care. We are pleased that length of stay for those patients is being reduced.

We have a long way to go, and no doubt we won’t get it all right first time, but we now have the confidence of the wider health system as there are plans for a new £30m cancer centre and a £30m investment in West Cumberland Hospital.

What sets North Cumbria apart is our drive to do better, our willingness to learn, and our commitment to do better for all of us – our patients, our staff, and our community.

 

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