Welcome to the latest Joined Up Care Derbyshire Update. Joined Up Care Derbyshire brings together partner organisations and sets out ambitions and priorities for the future of the county’s health and care. The updates follow each Joined Up Care Derbyshire Board to provide you with details on all the latest developments. This is a summary of some of the key discussions at the April board meeting.

Strategy for Primary Care

Primary Care remains at the heart of the local health and care system.  The local GP vision, the CCG priorities and the national strategy for the sector continue to support this, build on existing success and to support practices to remain sustainable, to work at scale and in partnership and to continue to innovate in the provision of integrated care.  A local primary care strategy is in development and this will be co-produced with primary care and other colleagues during the summer.

Primary Care Networks (PCNs) are being established to help practices work at scale and deliver an ambitious vision.  Our local approach is that as much of the implementation is determined by PCNs to ensure they are locally owned.  There are 14 proposed PCNs for Derby and Derbyshire and these largely reflect the geography of places and practices.  We must confirm our final list of PCNs during May.

A transfer of resources from hospital-based care to primary and community care is required to deliver the agreed Derbyshire model.  This will require some very detailed analysis, understanding and agreement about what this resource is needed for and how it can be released from secondary care in a meaningful way to support place-based services, tailored to local need.

Digital Developments

In 2015 all health economies were required to create a joint Local Digital Roadmap (LDR) including all NHS and social care partners.  The focus in Derbyshire has been on ‘converge and connect’ strategy, supporting standardisation of information on common systems to support joined up care. There has been a significant amount of progress across the county, lots of which isn’t immediately visible but has made a significant difference to patients and clinical services. 

Developments have included:

  • Shared records across community, mental health and social care to improve timeliness of care
  • Supporting clinicians to transfer electronic readings from automated diagnostics and incorporate into patient records (eg BP monitoring)
  • Interoperability between services, particularly to support out of hours, end of life and infection control, including future support for patients to access own records
  • Migration of mental health system to TPP SystmOne, as used in 80% of GP practices
  • Safely sharing patient data across GP extended access hubs, supporting 108,200 additional and flexible GP appointments 
  • 100 mobile laptops to enable GPs to working in patient homes
  • GP practice improvements, including patient display systems, security systems and equipment for consulting rooms to support practice expansions
  • Wifi installed in care homes
System Finances

At month 11, the NHS element of the Derbyshire system is reporting an overspend of £13m, but it is expected that as month 12 information is validated that the NHS will achieve their final plans, including related sustainability funds from NHS England and NHS Improvement.  The JUCD Board reflected that this a significant achievement for the system, considering the extent of the challenge we faced at the start of the financial year, and expressed their thanks to everyone involved for delivering this.

We begin 2019/20 with a £136.6m system deficit.  It remains a challenging position, but the recovery plans to address the challenge are increasingly detailing transformation approaches which see parallel improvements to the quality and experience of care, whilst also providing financial savings. 

A System Savings Planning Group has been established, including invitations to local authority colleagues, to ensure that our change programmes are properly coordinated across the system and to understand how we can share learning from previous work. We are also looking towards a system approach to how we engage with the new, joint health regulator, further evidencing that the system is increasingly working as a single unit in how it plans and is held accountable for change.