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Trafford’s Local Care Alliance (LCA) – Find Out More About What’s Been Happening to Improve Health & Social Care Services and Have Your Say

Trafford Local Care Alliance (LCA) and Care Complex

Trafford’s LCA is an integral part of our new operating model for commissioning in Trafford. It is an alliance of provider organisations, community health, social care, primary care including general practice, mental health and VCS sector organisations which are committed to working in partnership, delivering a place-based approach to strategic commissioning and outcome focused models of care in Trafford, so that we can deliver better health and social care outcomes for the people of Trafford. High quality sustainable integrated community health and care services are at the heart of a vision for a new transformed model of health and care in the borough.

A key objective of the LCA is to support a shift in care from hospital to the community and reinvesting some of the resulting savings in more affordable and sustainable alternatives. The LCA will operate within national aims, regional ambitions and the Trafford context, delivering the right outcomes for the people of Trafford.

The LCA’s Memorandum of Understanding now extends beyond our founding partners (Trafford Council, Trafford CCG, Pennine Care, Manchester Foundation Trust, Greater Manchester Mental Health Trust and Thrive Trafford) to primary care with Trafford Primary Health and Local Medical Council in an advisory capacity. Mastercall, our out-of-hours provider, also joined the alliance in September.

Sara Radcliffe Corporate Director of Commissioning for the CCG and the Council, continues to Chair our System Board on an interim basis while we appoint an independent Chair, bringing us into line with other LCAs in Greater Manchester. We expect an appointment to be made by December 2018.

The work programme for the LCA has gathered significant pace and maturity over the past few months. Commissioner and provider leads are now working collaboratively on a new offer contributing to system resilience for winter 2018 and that this work is now moving to implementation, if not already in place. Collectively we have agreed four themes to deliver benefits across the system which will impact on our performance over winter.

Theme 1 – Urgent Care Streaming at the Front Door

This theme will aim to support the Trust in the achievement of the 95% four hour target whilst also helping to support the flow of non-elective patients into the hospital. We recognise that we have a disproportionate number of patients attending ED inappropriately who could be managed in alternative settings. This theme aims to tackle that issue and to place Trafford, Manchester and MFT in a position where they are able to comfortably manage patients appropriately where they most frequently attend. We have agreed to explore a model to introduce streaming of patients from the front door of Wythenshawe Emergency Department (ED).

Theme 2 – Risk Stratification
This theme will focus on identifying patients at risk of hospital admission and coordinate their care closer to home, supporting them to stay at home longer. Our agreed focus for the winter period is to deliver a targeted, GP led programme of smoking cessation which will initially be for risk stratified patients in general practice with a diagnosis of COPD and a high rate of admissions, and also patients coming out of hospital with smoking cessation medication. Smoking cessation will see quick benefits for the person, potentially reducing their admissions by half.

Theme 3 – Continued and further improvement of the position around Delayed Transfers of Care (DTOC)
This theme will aim to continue and further improve the position of delayed transfers of care at Wythenshawe Hospital, which remains the outlier in terms of not achieving the 3.3% target compared to other acute sites – no more than 17 Trafford residents delayed per night in an acute bed.

Theme 4 – Trafford Enhanced Care Home Team (TECHT) Expansion
This theme will consider the expansion of the existing TECHT service to be available in all care homes, expanding on a stepped approach based on admissions data to indicate where TECHT can have the most impact.
Flu and pneumonia vaccine pathways within nursing and care homes will be proactively managed and reported to ensure that all residents receive the vaccines. This will also include vaccination programmes for staff and care home residents.
Anticipatory care planning will be rolled out for all care home residents to reduce the number of residents who are dying within a hospital setting rather than their preferred place of death.
Our next steps will be to review expected outcomes and how they will be measured. We are also planning a system wide vision workshop for November to start to explore what the alliance means for Trafford going forward.
We continue to explore dependencies and synergies within the wider System Resilience Plan for Trafford, ensuring the LCA is co-owned and co-designed with commissioners and providers in order to deliver on our system-wide objectives.

Kelly Stephenson is working as the programme lead for both the Local Care Alliance and the Care Complex, so please contact Kelly if you have any questions on either programme of work: kelly.stephenson1@nhs.net
If you are working or volunteering within a local VCSE organisation and would like to ‘Have Your Say’ and input from a VCSE perspective into the next LCA please email Dan Shelston at Thrive Trafford on dan@pulseregeneration.co.uk