Newsletter - Issue Two - April 2004

What’s Happening

Welcome to the second issue of the Treatment Centre newsletter. Since the first issue a lot has happened; in particular the planning decision notice has been received, the clinical specification drafted and communication plan developed.

Planning/Building

The decision notice for planning approval has recently been received. Work to clear the site of hedgerows and trees will commence in April.

The internal layouts of the Treatment Centre have been revised to incorporate an endoscopy suite. Also the number of beds has increased to 34, provision made for a larger Physiotherapy room and a more spacious reception area is planned.

Clinical

The Treatment Centre activity has been revised to include 3000 upper/lower g.i. endoscopies and the Centre will include an endoscopy suite on the ground floor. The cataract procedures have been reduced by 1500 and orthopaedics increased by 966. These changes have increased the total number of procedures from 10,000 to 11,351 per year all within the same financial envelope. 

A sub-group is being established to include local secondary care clinicians, to develop selection criteria for endoscopies and referral protocols to acute Trusts when endoscopy findings warrant this action.

Agreement has been reached pertaining to the Clinical Service Specification. Patient care pathways have been agreed for six major procedure groups representing the bulk of all procedures.

The Clinical Group is reviewing access to NHS transport for those patients who have a medical need for transport to the Treatment Centre. Attention is also being given to providing ‘road shows’ to inform the Treatment Centre NHS user communities.

The Treatment Centre will be working to very high quality standards, aiming to deliver quality of care that will be at least as good as the best currently provided by the NHS.

The Quality Assurance and Clinical Governance protocols for the Treatment Centre will be provided and applied by the New York Presbyterian healthcare system.

Key to the success of the Treatment Centre will be the delivery of short lengths of stay per inpatient procedures on average (e.g. 5 day stays for hip and knee replacements). This will involve novel approaches to patient care within the facility in particular by improved pain management and intensive physiotherapy. However some patients will still have longer stays to meet their particular needs

Over time more innovative techniques will be introduced such as the minimally invasive total hip replacement which can reduce lengths of stay down to 1 – 2 days.

The impact on community hospital beds will be less than anticipated. Detailed analysis shows that a maximum of 1 – 2 patients per PCT will require a community hospital/nursing home bed per week.

Contractual

Contracts are due to be signed on the 30 April 2004. At the time of writing there remain a few outstanding issues to resolve within the contract and the 19 supporting schedules.

Plans to provide the infrastructure to support the contract monitoring and management have been developed and involve a Contracts Management Board to oversee the services being provided by OR International as well as using a Referral Management Centre to monitor demand and inform GP practices of capacity and choice available. The development of interface services will help manage demand and ensure resources are used effectively.

The process of paying for the Treatment Centre services is quite complex and involves the attainment of key performance indicators.

Therefore a local Contracts Management Unit is being developed to manage this process.

Timescales

The following provides an indication of the timescale for the completion of the project

• Construction Orders placed 31 March
• Contracts signed 30 April
• Designs complete 2 April
• On site infrastructure work commences 5 April
• On site construction work commences 14 June
• Facility commissioned 29 Nov
• Treatment Centre doors open 17 Jan

Communications

It is planned to hold a series of local meetings/seminars in each of the five PCT’s soon after contract signing to inform and update all local health care professionals. A communication plan has been developed and is being implemented. Positive meetings have been held with the management of the two Somerset Trusts and the Bath Trust. Clinical Directors have been invited to clinical group meetings.

Presentations have been made to the following organisations/people:

• In January to Sir Nigel Crisp and the University of the 3rd Age
• In February to Dorset & Somerset chairs and Chief Executives.
• In March to the Dorset & Somerset Modernisation Group and to the Independent Reconfiguration Panel (provision of information on the Treatment Centre programme).

Each PCT will communicate with their primary care clinicians. Website is currently under construction.

For further information please contact Philip Eke, Project Director at Mendip PCT on 01749 836520