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Frequently asked questions (FAQs)

Below are some frequently asked questions. If you cannot find the answer you are looking for you can contact us. Questions asked by organisations and groups can also be seen by clicking on the relevant link below. 

 

 


What is Better care together all about?

Better care together is about ensuring that health and social care services in Leicester, Leicestershire and Rutland are capable of meeting the future needs of the local population. There are significant opportunities to improve the quality of care for people by providing more support and care for them in the community, closer to home. At the same time, services face increased and more complex demands because of the ageing population.

There are also financial pressures, with the local NHS funding gap predicted to reach almost £400m in five years’ time (2018/19). All of this means that big changes are needed to the way health and social care are delivered. NHS organisations and local authorities have formed a partnership to plan and deliver such changes, under the Better care together banner. 

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Why can’t extra funding put things right? 

The NHS and local authorities across the country are facing tightening budgets and extra demands on them – simply there isn’t extra funding available. 

The greater focus on care away from hospital is about change across the whole system to meet the needs of an ageing population, so we need a joint approach. NHS and social care services can work together more closely for the benefit of local people. In fact, there are real opportunities to improve patient outcomes and experience through better prevention of ill-health, early intervention and community-based support. So while there are financial pressures, this isn’t just about money. 

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Who has contributed to this plan? 

The plan has had input from a wide range of organisations and individuals. These include doctors and other professionals, voluntary organisations, patients and members of the public. They will continue to be involved in the work of Better Care Together. 

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Is it true that Better care together is receiving national support? 

Leicester, Leicestershire and Rutland is one of 11 health and social care economies deemed to be ‘challenged’. NHS England, the NHS Trust Development Authority and Monitor have funded support for these areas, to help with the development of 5-year plans.  

Why is there little mention of social care? Isn’t that a big part of looking after more people outside hospital? 

There are big opportunities to provide more effective support by getting health and social care professionals to work together more closely – particularly with frail, older people and those with long term conditions. Work is already underway to address this. Under a separate government scheme called the Better Care Fund, local health and social care budgets are being pooled to promote this integrated working. This new approach will start next year. It is part of the wider Better care together plans.  

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How can you solve Leicester’s health problems and Rutland’s at the same time?

Leicester, Leicestershire and Rutland is a diverse area with a wide range of differing challenges. By involving organisations and professionals across these communities, we can ensure that wherever possible, services are being tailored to meet local needs.   

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How will a £400m funding gap be closed without damaging services and losing staff? 

It is possible to make NHS budgets go further by working differently and providing care which is more efficient, prevents ill health and reduces the number of hospital admissions.

However, the scale of the financial challenge does mean that some difficult decisions will need to be made along the way.

As the thinking about best practice evolves, many health and social care staff will work differently in future to deliver services in new ways. For example – fewer hospital beds would be expected to lead to a smaller workforce. This creates opportunities to reduce reliance on locums and agency staff. There will also be a need to recruit to new community-based services – so in fact, the overall long term impact on jobs is not yet clear. That depends on work to be done in the coming months. Staff and the wider public will be heavily involved and consulted about any changes.

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Will there be cuts? 

There will be changes in services over time, which may mean that they are delivered differently. However, it is important to understand that providing a different service is not a “cut”. The changes will be designed to ensure that the needs of local people are being met. Services won’t be changed unless doctors and other professionals are satisfied that those needs can be met in other ways which are often better for patients.

It is a fact that the changes also need to close the big financial gap in health and social care budgets, so finding ways of working more efficiently is an important element of Better Care Together. The scale of the financial challenge does mean that some difficult decisions will need to be made along the way. It is not possible at this comparatively early stage to say what those might be, but the public will be heavily involved and consulted.

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Are you closing Leicester General Hospital? 

No. Leicester’s hospitals will probably become smaller and more specialised overall, to support the drive to deliver much more non-urgent care in the community. It stands to reason that if more patients are cared for at home, less space is needed in hospitals. This does create an opportunity to do what the hospitals’ clinicians have been pressing for – to consolidate all acute services onto two sites, potentially the Royal and Glenfield. However, while the direction of travel indicates that its role may change, this does NOT mean that the General Hospital site would close. It is expected to continue to provide a significant amount of healthcare, including the Diabetes Centre of Excellence, community beds, rehabilitation, psychological therapies and outpatient clinics. In any event, this is a long term plan. There is a lot more planning, talking and listening to do before any final decisions are made.

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Will staff be expected to move their location? 

Yes, some people may. The services are nothing without the staff and so if a service moves the expectation is that staff would move to. Most staff contracts reflect the fact that services move around frequently and hence people are expected to have to work at different sites during their career. Clearly, this will require lots of detailed planning to look at things like travel and access before anything happens and staff will have plenty of opportunity to contribute to those plans. 

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Won’t reducing the number of beds make things worse? 

The increasing pressure on services because of rising demand is one of the reasons why the NHS needs to think differently about how care is delivered. The strength of Better care together is that the plan is long-term and covers the entire system. This means that the right support services can be put in place in the community, to stop people ending up in hospital when they don’t really need to be there. For example – a lot of people with chronic conditions or recovering from surgery can be cared for at home by specialist nurses – with the amount of support tailored to their needs. Putting more of these services in place will significantly reduce the number of beds required in our acute hospitals.

It is adopting this “big picture” approach that will enable NHS and social care organisations to meet the needs of local people AND remain financially viable. All the planning around this is based on assuming a sensible occupancy rate - how full the beds are. This will be an improvement on the current position, where our hospitals are much too full to run smoothly.

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What's the difference between BCT and BCF?

Social care is a big part of Better care together (BCT), and all three councils responsible for social care in (Leicester, Leicestershire and Rutland) LLR are partners in BCT.

The Better Care Fund (BCF) is a government funded scheme which supports the transformation and integration of health and social care services. BCF has a focus on social care and out of hospital services, whereas BCT is a locally led programme which looks at the whole of health and social care in LLR.

Many of the changes which are being implemented for frail and older people, in particular dementia services, are being funded by BCF, but they still fall under the BCT umbrella of change. 

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I still can’t get to see my GP when I want to, how will that be sorted? 

Better care together is looking for opportunities to improve all aspects of health and social care, including that from GPs. Indeed, GPs themselves are actively involved in the work we are doing. It is recognised that the success of Better care together depends on providing the right service in primary care (GPs, pharmacists and other community services which are a first port of call for people). That is why a primary care strategy is being developed, mapping out the future shape of these services. The new national policy of a named GP for every person aged over 75 will also make it easier for frail older people to access the services they need. However, bearing in mind that there isn’t an endless supply of additional doctors or unlimited budgets, it would not be right to suggest that it is possible to create a system which can always guarantee immediate access to a GP. 

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What are the criteria for the decisions being made? 

The following criteria will inform all Better care together decision making:

QUALITY: Maintaining or improving safety, outcomes and patient experience

ACCESS: Issues affecting a person's ability to reach the right service (e.g. transport, waiting times)

VALUE FOR MONEY: Delivering real savings (without compromising quality of care)

ACHIEVABILITY: Assessing whether a proposal can be done within the designated

SCALEABILITY: Proposals which are workable across Leicester, Leicestershire and Rutland

LEVEL: Impact according to the part of the service involved (e.g. whole system change or a single department or care pathway)

ROI TIMELINE: How long it takes for any investment to lead to savings

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When will changes begin?

Some changes have already started and further changes will happen gradually over the coming months and years (remember BCT is a five year programme ending in 2019). At the present time we are unable to say when each and every change will occur as a large number of them are subject to formal public consultation.

We will have a better idea about when different things will happen once we have completed the public consultation and have analysed the results. 

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