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Norfolk and Waveney STP Executive Briefing Notes May 2019

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Community Action Norfolk are sharing this from the Norfolk and Waveney STP Executive, please contact them directly with any queries. 

Norfolk and Waveney STP Executive briefing note

Here’s an update summarising the key issues discussed by the Norfolk and Waveney STP Executive at their meeting on 17 May 2019.

Improving cancer care

  • Improving cancer care and our cancer performance are priorities for our partnership. If deaths from all forms of cancer are grouped together, cancer deaths account for 25% of all deaths in females and 30% of all deaths in males. Across Norfolk and Waveney about 3,200 people die from cancer every year.
  • Dr Linda Hunter, STP Cancer Clinical Lead, explained that we are working to remove variation, streamline care to speed-up diagnosis/treatment and improve supportive care for people affected by cancer. We are:
  1. Implementing new pathways which meet best practice across Norfolk and Waveney for lung, prostate, colorectal and breast cancer
  2. Developing three outreach community cancer nursing services (in King’s Lynn, Norwich and Great Yarmouth)
  3. Establishing a GP guidance pathway for people presenting with vague symptoms
  4. Enhancing cancer prevention and awareness.
  • The Executive also discussed our cancer performance. In Spring 2018 the Norfolk and Norwich University Hospital’s (NNUH) cancer performance fell below the national targets. This followed a 30% increase in referrals, pathway changes, which made care better but were more resource intensive, as well as increased patient knowledge and expectations.
  • Matt Keeling, Cancer Manager at the NNUH, explained that to improve performance the NNUH is using a new pathway modelling tool to look at the five most challenged pathways. The NNUH are also developing a way of predicting when they are likely to see increases in referrals and work is going on to do this with lots of partners involved.

A&E performance at the NNUH

  • Mark Burgis, Winter Room Director, introduced the item by noting the good progress that has been made recently to reduce ambulance handover delays at the NNUH and to reduce the number of 111 calls resulting in a 999 dispatch.
  • Chris Cobb, Chief Operating Officer for the NNUH, outlined the workforce, flow and process, and demand and capacity factors influencing current performance at the NNUH. The Trust believes that the long-term solutions to the challenges it faces will be found by working in partnership with the rest of the system.
  • The Executive discussed opportunities for us to use technology better to improve care and A&E performance, particularly the use of telemedicine in chronic care, which could prevent those requiring urgent care from getting worse to the point they need emergency care. People could monitor their own health using technology, then medical professionals could use this data to identify people who need to be seen because their health has deteriorated. The Executive agreed to scope how we could use technology like this to improve care for neurology patients.
  • The A&E Delivery Board is going to be looking at the top three or four pathways we could change which would help improve A&E performance. It is also looking at the walk in centre and trying to understand why fewer people are using it.

Digital Strategy approved

  • The STP Executive approved The Norfolk and Waveney STP Digital Strategy, which outlines our ambition to deliver care in new and innovative ways for our patients and citizens. This is important for our partnership because according to the latest NHS Improvement figures, Norfolk and Waveney is the least digitally-mature STP in the country.
  • Our strategy is made up of five objectives which set out the goals of the strategy: 
  • Our strategy also sets out five priority partner projects for 2019:
  1. Joint Electronic Patient Record solution for our three acute hospitals and acute services integration
  2. Primary care integration and GP Online / GP Connect (which allows clinicians within IC24 services to view patient records from participating GP Practices)
  3. Norfolk and Waveney Integrated Care Record
  4. Creating an STP Digital Team so that we have the people with the right skills to implement our strategy
  5. STP Workstream Delivery Support.

Managing the finances and performance of our health and care system

  • Key to our success as a partnership will be to work much more closely together to manage our finances and performance. This is why we now produce reports that look at the finances and performance of our health and care ‘system’.
  • Here are the key points from our May finance report:
  1. Our local NHS organisations made over £100m of efficiency savings in the 2018/19 financial year.
  2. Despite this, because of the pressures facing our health and care services, last year our CCGs and NHS trusts had a combined deficit of £97.6m.
  3. We are planning that our NHS organisations will deliver a combined deficit of £16.4m in this financial year, which would represent a very significant improvement in terms of our financial performance.
  4. To achieve this we will need to continue our work to create more integrated ways of working and all organisations will need to live within their means. 
  • As mentioned last time, we are developing a performance framework for our partnership to help to address our performance issues together, supportively and effectively. We discussed a draft of the report at our meeting and are looking at how we can continue to refine and develop it.
  • As a partnership we have agreed we will focus on a small number of significant indicators, including referral to treatment waiting times, cancer, emergency care and out of area placements.
  • To find out more read the system finance and performance reports, published with the papers for the May meetings of the CCG governing bodies and provider boards.