Andrew Bennet: So what we’ve tried to do in our Vanguard was to develop new care models
that would join up services around communities in Morecambe Bay.
Morecambe Bay is a very dispersed area, we have some small towns but we also have the
Lake District and large travelling distances in between and there are differences between
the communities.
Dr Marwan Bukhari: We have a deprived area in Morecambe and in Barrow and the Trust spans
more than 50 miles from one side to the other with four hospitals involved and quite a lot
of care that needs quite a lot of different thinking regarding delivery.
AB: Three years on, what we are able to say now in Morecambe Bay, are a whole series of
really positive stories about how our new care model has developed.
Dr Andy Maddox: We have been working very hard to form an Integrated Care Community.
Integrated Care Community basically means that we are not working in isolation as a
Healthcare deliverer anymore.
We're starting to work with other organisations like our acute trust, our community provider,
our social services, our police force, our fire brigade, our third-sector voluntary agency
and of course our patients.
Trying to provide care for our patient population in a very different, much more proactive,
rather than reactive way.
Val Baxter: Once a month we had a multidisciplinary meeting, where we invited people from the
ICC to offer ideas and support and how to improve things for that particular family.
MB: Overall, there have been challenges with the approach.
There's a sense that you're beginning to lose control.
In other words, control is being passed more to Primary Care and to the patient, and you
have to be able to trust the patient and your Primary Care colleagues to recognise when
there's a problem, when you're the expert.
AB: We’ve also used technology to re-establish better communication between GPs and hospital
consultants.
That means that in many cases we can create a flow of information between the GP and the
consultant so that patients don’t need to go for a hospital appointment.
That saves time and travel and resources.
Dr William Lumb: So we’ve pushed quite hard on real-time sharing so that within the hospital
they can see the GP record and they can see extensive parts of the GP record.
We pushed on Community Services been able to see the GP record and vice versa and that's
been quite important.
MB: There's actually much closer interaction between us and Primary Care.
So that wall has actually been broken down.
Primary Care and us talk to each other all the time and they are very much part of what
might be called a virtual MDT.
AB: In terms of women and children's services, professionals there have found ways in which
by providing the right advice to people at an earlier stage, children don't need to come
into hospital.
VB: Some of the things we did was provide education for the parents and the child about
their condition or just general advice and support.
For example, directing families to what to do when the child has a temperature or simple
things like constipation, so we set up some groups to provide that.
AB: The work that we have done locally on a strategy and the connection to the Vanguard
programme was build those new care models but make them as tailored as we can to the
needs of their communities.
WL: We’ve seen the results already: the Morecambe Bay Vanguard is performing very
well for non-elective admissions.
So those emergency admissions, we’ve cut those and I think we're still significant
ahead of the pack in performance terms.
MB: The advice I would give is first of all trust your GPs, make sure that the education
infrastructure is there, not just for the patients but for the GPs, and make sure there's
enough publicity about using that approach.
Dr Andy Knox: We’ve seen some phenomenal conversations develop here in Morecambe Bay.
The community are really galvanised, people are hugely engaging in the conversations and
what happens is, you never know the potential of just bringing people together to talk and
to find each other, to encounter someone who’s completely different to them and then see
what sparks out of that and becomes a movement for change.
AB: I think it takes an awful lot of effective partnership so a sense of a common purpose
or a commitment to a common plan, I think that makes it much more likely that you will
succeed and I think in Morecambe Bay, we’ve had a sense that we can only take the system
as a whole forward if we were prepared to work together.
I think that would be the story of better care together.
It’s the together bit in Better Care Together.