North West London Hospitals NHS Trust & Brent Teaching Primary Care Trust

Transforming healthcare delivery locally

Overview

North West London Hospitals NHS Trust are working in partnership with Brent Teaching Primary Care Trust, to build on and extend the Hospital at Night model within the acute setting and develop nurse-led care in the community through the Brent "Ward in the Community" model. All planned to support the delivery of activity differently - ensuring reduction in the workload of training doctors and equivalent grades to meet junior doctor hour's targets.

Organisational background

North West London Hospitals NHS Trust incorporates Northwick Park & St Mark's Hospitals in Harrow, Central Middlesex Hospital in Park Royal and outreach services based close to local communities in Wembley, Willesden, Edgware, Stanmore and Harlesden. The hospitals are located in the London Borough of Brent and service the Brent and Harrow population of 500,000 plus patients referred from throughout the UK and abroad. The trust has over 4,000 employees.

Brent tPCT aims to deliver a better and more responsive health service and improve the health of local people putting the patient at the centre and involve local people, users and carers in reviewing and designing services to meet their needs.

Challenges

This project will provide a framework for multi-disciplinary team working, explores inter-professional relations, and establish the skill mix needed to ensure delivery of an effective and efficient service in primary and secondary care. The project will refocus traditional teams for the benefit of the patients and the staff.

This project proposes the engagement of a multi faceted team including the trust's "Change for Better" programme along with engagement of the medical and clinical teams in both the trust and Brent tPCT and the foster collaborative partnership working throughout Brent health community.

The project will need to take into account a number of work areas currently underway at local level which may well have a significant impact upon final outcomes and recommendations. These include vital links between POPP (Partnerships for Older People Project), BECaD (Brent Emergency Care and Diagnostic Centre) and NWLH generally, and coordinating more effectively general practice teams, specialist and community nursing teams, intermediate and rehabilitation care services within PCT, care co-ordination service, social services and voluntary sector.

Objectives of the pilot

• Significant contribution to WTD compliance
• Enhance coordination of cluster nursing teams to improve efficiency and effectiveness and to accommodate the new community matron role
• Coordinate local services more effectively:
• Acute
• General Practice Teams
• Specialist and Community Nursing teams
• Intermediate and Rehabilitation Care services within Brent tPCT
• Care Co-ordination service
• Social Services
• WTD co-ordinator
• Redefine provision medical cover
• Foster sharing and learning between teams
• Address training and education needs
• Through learning sets and networks improve communication across and within teams
• Improve discharge between hospitals and community nursing
• Set up development programmes for all skill-mix within the district nursing workforce
• Develop referral protocols within existing pathways
• Develop health care assistant role working across health and social care needs
• Improved patient services and co-ordination of care
• Improve working relationships between stakeholders
• Through evaluation apply learning into the services
• Share and disseminate learning from the project sector wide

Delivering compliance

This pilot will deliver:

• A multidisciplinary half day seminar
• Modelled options for delivering excess of hours
• New roles, ways of working and models of care
• A significant contribution towards WTD compliance

Pilot duration: September 2007 to September 2008