Agenda item

Jacky Taylor, from Northamptonshire Healthcare Foundation Trust (NHFT), gave an overview of the community services offered by NHFT for older people, including;

·        Comprehensive district nursing service - most people using this service are house bound, some patients have needs that the district nurses specialise in. Most patients are elderly, and have long term chronic needs, but do provide services for people who are 18 years plus. District nurses provide information on self-management, and also work with other organisations such as Age Concern, Marie Curie and Macmillan nurses.

·        Specialist nurses - Give advice to patients on their illnesses and skill up general district nurses also.

·        Podiatry - only now available for people with complex foot conditions. Can no longer manage the ‘healthy foot’ (nail cutting etc.).

·        Physiotherapy service - 12 locations across county. Patients can self-refer, or be referred by their GP.

·        Wheel chair service – only provided for people who need a wheelchair for inside their home as well as outside.

·        Frail and elderly programme – multi disciplinary team. The elderly can receive short term high intensity care in own home without having to go to hospital. Bringing treatment to the elderly stops them from losing their self-managed capabilities. Accessed by GPS, district nurses and hospitals, for instance.

·        Older Peoples Mental Health Team – There are four inpatient units, two in Northampton and two in Kettering. Community nurses have satellite bases. CMHT can be contacted through GP or Crisis team.

RR asked whether preventative medicine is used, for instance it was felt that stopping the ‘Healthy Foot’ service meant that there is no focus on prevention, only on cases once they have become ‘complex’. JT said that preventative medicine and approaches are delivered to an extent by district nursing, through self-management and education on how to care for selves. Also, NHFT works closely with practise nurses and GPs.

Cuts to services are a result of budget pressures and an attempt to spend more wisely. Not an easy decision to make –with reference to Podiatry, the commissioners decided a service would be commissioned only for people with serious foot problems (all put out to public consultation).

MH felt that through personal experience, the service is not complete and things aren’t joined up. BN also raised concerns over what is ‘complex’, and what is classed as not. JT said that where someone does not qualify for the Podiatric service, private Podiatrists should be used. ACTION: JT to find out whether there is an approved list of private services. If so, this will be sent to AM for circulation.

AT raised an issue with Hospital Chiropody around records not being kept of patients. NGH is not JT’s remit. However, with reference to patient’s records, at NHFT every episode of care is counted as a new patient. If a condition is ongoing, this will be recorded as one episode of care. All records are computer based, and if a patient is seen again in the future, NHFT will have access to past admission data with patients permission for data sharing.

An explanation was given about the Clinical Commissioning Groups. JT explained that PCTs were split up, and in their place CCGs were formed. Many professionals sit on these groups. CCGs receive money, decide on the services to provide, and then buy services from the pot of money. Some commissioning for NHFT is also done through Northampton County Council around social services.