On Sept 12th Prof Nick Bosanquet gave a lecture at Blackpool Teaching Hospitals NHS Foundation Trust and then toured the hospital at the invitation of the Chairman Ian Johnson. His lecture was on the theme of “Blackpool Paths to Success.”
Hospitals are facing insolvency worldwide as the era of rising hospital admissions ends. UK Hospitals now face the same outlook as those in Sweden where admissions rose by 1 % in the last 10 years compared to 38% in the UK.They also face a 4% a year reduction in tariffs. In effect they are going to be paid less for treating the same number of patients. So how can they redesign services in order to improve outcomes?
Blackpool starts with some positives. It is now an integrated Trust covering community services as well as hospital services. It now has a Clinical Trials Unit which has raised the numbers of patients in trials from less than 1000 to 3700. Blackpool should now take the lead in developing a coherent strategy for the health economy with its new players in Clinical Commissioning Groups, and Health and Wellbeing Board s,
The new strategy can be based on a four stage model of healthcare:
Screening and early Detection.
Active treatment usually on a day basis.
Care programmes and risk management.
The model can be used to develop care pathways in key disease areas. The aim would e to raise Blackpool to best national and international practice. For example one year survival for patients with lung cancer is 18.3 % in Blackpool and Fylde compared to 33.4% in Liverpool. 75% of mortality is now in cancers, heart disease and respiratory disease
There are now clear international standards for process and outcomes. For cancer the US ambulatory cancer centres have set the standard with 10 days from referral to treatment. In heart disease we have a local success in the UK though the National Service Framework with a 40 % reduction in mortality over the last 15 years: and for COPD Finland has set the standard with a 36 per centre reduction in hospital admissions. All these successes were made possible by redesigning services so as to provide more coherent support and better communication with patients.
Partnership with pharmaceutical companies in community based trials is one key move to access the investment and the expertise to design these pathways, Prof Bosanquet mentioned the experience of Salford with the GSK sponsored trial on COPD.
There was considerable interest in the proposal for an agreed strategy across the health economy and in early 2013 Nick has been invited to return to Blackpool to work with the new partners in developing this.