Welcome to our final stakeholder bulletin as NHS Bromley Clinical Commissioning Group. On 1 April 2020, the new South East London CCG will be established covering the boroughs of Bexley, Bromley, Greenwich, Lambeth, Lewisham and Southwark. By coming together in this way, we will better fulfil our responsibilities, working with our partners across health and social care. Our aim is to get the best possible health outcomes for our residents by assessing their needs, deciding priorities and then buying services on their behalf from local providers such as hospitals, GPs, clinics, community health services etc.
As a fledgling CCG back in 2011, we set out our commitment to delivering high quality public and community involvement in our constitution, delivered through our governance and operating functions. Nine years on we have been recognised as one of the best performing CCGs in the country for public and community engagement, as the only CCG in London in 2018/19 to meet every single criteria in the national community involvement assurance process and included in NHS England’s Good Practice Inventory. Most importantly local people have shaped and informed tangible improvements to local services.
Being part of the new South East London CCG provides us with an excellent opportunity to build on our engagement with local people by learning from others and sharing good practice across a much wider area to ensure that the voices of patients and the public are at the core of our developments, planning and decision making. One Bromley, our local care partnership brings together statutory and voluntary organisations in Bromley to deliver proactive, joined up care. It is supported by the One Bromley Communications and Engagement Group which plans and delivers community and public engagement to help inform improved and integrated care across the borough. We look forward to continuing our work together to improve care for those in Bromley.
Finally, I would like to thank every single member of the public who has given up their time over the last nine years to work with us and share their views; to challenge us and provide such honest insights into what it is like to be on the receiving end of care in Bromley. You have helped us to make some remarkable improvements, and we look forward to continuing to work together in the new CCG and as part of One Bromley. To our patient advisory group members in particular; to members of patient participation groups, voluntary organisations, community groups and residents – we really couldn’t have done it without you.
Dr Angela Bhan, Bromley Managing Director
Dr Andrew Parson, Clinical Chair
Our Annual Engagement Report for 2019/20 is now available on the CCG website. The report illustrates how local people and stakeholders have helped to shape improved services for the wider population. Examples include new community based services, better support for families and young people with autism, improvements to outpatient care and improved primary care services.
The report acknowledges the huge contribution made by patient representatives, especially members of our Patient Advisory Group. We never underestimate or take for granted the time they give up to help us deliver better care for Bromley residents.
As part of the new South East London CCG there will be opportunities for Bromley residents to get involved in local services, as well as influencing those that are delivered across the whole of south east London - such as hospital services. More information will follow once the new CCG is established.
Members of our One Bromley patient network will continue as our first port of call for opinions and views on integrated health and care services in Bromley. If you are interested in joining the One Bromley Patient Network, please email firstname.lastname@example.org If you want to know more about One Bromley, please visit our website.
In our October stakeholder Bulletin we described the work we have been doing with Bromley Council to improve outcomes for young people with autism. We co-funded a 100 day challenge to identify and implement improvements that can be made.
We are delighted to announce a couple of improvements that have come from this work. The first is the production of a new ‘Do you know guide for families with children and teenagers who have social and communication difficulties including Autism’. The guide has been designed by parents, carers and other professionals to share helpful hints and tips. It includes details on training for parents, support groups, clubs and local information and advice. You can download the Guide here
Another improvement is a new service, delivered by Bromley Well which offers practical and emotional support to people over the age of 16 with Autism. Eddie Lynch, one of the Directors at Bromley Third Sector Enterprise* (BTSE) and Chief Executive at Bromley Mencap said, 'Through our consultation with young people it became clear that more support is needed around transition, housing, benefits, health, employment, life skills training and social and leisure activities. A survey of parents and carers through the Bromley Autism Partnership Group identified that information was poor and there is a lack of clarity around community services for young people with Autism. The new service will provide specialist one-to-one and group support to people with Autism aged 16+. Starting support at age 16 will ensure young people are supported through the transition to adulthood which can present challenges for people with Autism'. The support will include drop-ins and outreach sessions across the borough to ensure as many people as possible are able to benefit. There will be monthly workshops and peer support at Community House, South Street in central Bromley. For more information, please call Bromley Well on 0300 330 9039 or email email@example.com
Members of our patient advisory group and the Bromley Heart Support Group were closely involved in the commissioning of our cardiac rehabilitation and exercise referral programmes. The new service started in September and we took some of our patient representatives on a tour of the service so they could see first hand how it worked. We are pleased to hear that patients using the service have been extremely positive. Over 90% found the trainer, course content and setting of goals and objectives good or excellent. “You saved my life as I was so depressed and anxious from my diagnosis – I cannot thank the service enough. I have gone from no physical activity to around eight hours activity a week”.
If you are interested in the service, please speak to your GP to see if you meet the medical criteria.
The CCG is committed to providing information in a range of formats so that residents with different needs are able to access the services they need. This includes providing information in other other languages, large print and in easy read. A number of staff have been trained to produce more information in easy read formats for people with learning disabilities. Recent examples includes information on how to get involved in shaping local services, feeding back to people who informed the improvements to the NHS annual health check and information about blood testing services in the borough.
These materials are all available on the CCG website.
Children and young people with epilepsy will soon be able to have their follow-up hospital appointments in school through a virtual clinic. This new arrangement, developed in partnership with parents, aims to reduce disruption to a child’s education while making sure they still get the specialist support they need.
One Bromley is leading the way on implementing the ambitions set out in the NHS Long Term Plan to improve outpatient experience for patients and clinicians, as well as make services more efficient. By working together as an integrated local partnership, clinical pathways are being reviewed from referral to discharge to identify improvements and opportunities for change. There is a real appetite and shared commitment to solve challenges that have previously eluded individual organisations.
So far, work has focused on four clinical specialties – general paediatrics, rheumatology, haematology and cardiology. Many improvements have been made already, such as patients using community services; making some clinics virtual; providing specialist advice from hospital consultants to help avoid some outpatient referrals; and providing some outpatient clinics in community settings.
A new patient information leaflet about these improvements is being produced and will shortly be available to patients when they are being considered for a hospital referral.
Bromley health and care services are working together through One Bromley, to improve the safe discharge of patients who are medically fit to leave hospital. Initiatives such as the Transfer of Care Bureau, a single discharge referral form and Discharge to Assess have all contributed to Bromley being the best performing borough in London and second best in England in relation to hospital discharge.
The Transfer of Care Bureau, based at the Princess Royal University Hospital, is made up of health and social care staff working together to discharge patients quickly and safely to the most appropriate place as soon as they are medically fit to leave hospital. This can include discharge home with the right community support, discharge to a rehabilitation facility or to residential care. On average, 25 to 30 patients a day are discharged through these pathways. Once out of hospital a community assessment is undertaken to meet their long term needs.
The Passport is a single referral form which was developed across south east London and is used in Bromley. It provides much simpler documentation for staff to make referrals to the different integrated discharge pathways and stays with the patient even if they have to move to a different Discharge pathway. This avoids staff having to fill in lots of different paperwork, makes the discharge process much simpler and avoids delays.
Discharge to assess helps get people out of hospital who no longer need acute hospital care but who do need longer term care in some shape or form. Their longer term needs are rapidly assessed once out of hospital. In January this year, discharge to assess supported 105 patients to be discharged from the PRUH on the day they were medically fit. This saved on average five bed days per patient.
These arrangements are also helping to reduce the number of vulnerable and frail patients readmitted to hospital. Recent figures show that 93.5% are still at home three months after discharge.
In addition, a scheme to provide rapid access to therapies is also diverting patients out of the emergency department and back into the community for further therapy assessment or intervention where there is no acute medical need. Hospital therapists are proactively identifying around seven patients per week, saving on average three bed days for each. In addition, community therapists based across the wards are proactively pulling patients into community therapy pathways, flexing resources to meet the needs of patients to achieve early discharge. This proactive approach has resulted in the highest number of patients being transferred into community therapy pathways for over four years.
Last winter, Bromley was one of the best performers in London for vaccinating the over 65s. This is looking likely to be repeated again this year with over 70% in this age group and nearly 50% of under 65s in the at risk groups vaccinated so far. The Bromleag Care Practice, which provides primary care services to most care and nursing homes in Bromley, has vaccinated 81% of the residents they look after - a real feat in this very vulnerable group. These results have been achieved through a combination of GPs proactively reaching patients at risk and services working together with targeted publicity, all under the umbrella of One Bromley. We have even been asked to share our approach with other parts of London which can help to deliver better outcomes for more patients.
We have also run a campaign to increase staff uptake which in turn helps to protect patients and encourages them to have their jab. For the first time this year, front line staff in Bromley Council, local Fire and Police officers have been offered the flu jab at specially held vaccination sessions. The campaign features our staff from all parts of the Bromley health and care organisations explaining why they had their flu jab. This is a great example of partnership working and has attracted positive coverage from the local papers.
We are still in flu season, so if you haven’t had your jab yet, please do take it up. Speak to your GP or pharmacist to get more information.
The flu vaccine
Flu can affect anyone but if you have a long-term health condition or you are aged 65 or over, the effects of flu can make it worse even if the condition is well managed and you normally feel well.
Flu is a highly infectious illness with symptoms that come on very quickly. It is not the same as a cold; it is caused by a different group of viruses and the symptoms start more suddenly, are more severe and last longer. If you are in one of the at risk groups then your flu vaccine is free. Make an appointment with your GP or visit your local pharmacy as soon as possible.
A flu vaccine is available for free on the NHS for:
For more information about who should have the flu vaccine click here.
Every sustainability and transformation partnership (STP) in the country is required to respond on how it will deliver the ambitions set out in the NHS Long Term Plan. The response for south east London was developed with input from partners including staff, patients and the public. A number of our patient representatives joined the public meetings that were held in the summer of 2019 to inform this response.
The response sets out how we will deliver national and local priorities, complementary to other operational and strategic plans that we have across and within south east London. The full response is available to read here