LLR System Expectations

1. Safety first approach

We will adopt a safety-first approach to markedly reduce the infection hazard for patients and staff

  • We will make sure that every service applies the latest Infection, Prevention and Control guidance
  • We will ensure that every provider of services has appropriate cohorting arrangements in place for patients and staff
  • We will have the right Personal Protective Equipment to maintain safety for our staff and patients
  • As we transform our models of care we will ensure we adapt our safeguarding arrangements
  • We will provide health and well-being support to all our staff

2. Equitable care for all

We will pursue high-quality, equitable care for all focusing on health inequalities, community development and the impact of COVID-19 on our BAME community and staff

  • We will ensure that physical and mental health have parity
  • We will direct resources to where there is greatest need based on population health data by April 2021
  • We will develop Place and Locality Based Plans that will contribute to closing the health inequalities gap and support community resilience by January 2021
  • We will work with our academic and research partners to focus on the risk factors for COVID-19 and develop appropriate interventions by October 2020
  • We will work with our BAME staff to manage the enhanced risks that this group has from infection of COVID-19

3. Involve our patients and public

We will transform our public and patient involvement and seek to co-produce strategies which improve the health and wellbeing of local people

  • We will develop and implement a new approach and dialogue with our public to ensure advice and care is accessible when needed from the right setting by January 2021
  • We will develop innovative ways of engaging with our population and we will always involve patients in shaping our transformational programmes
  • We will develop a compact with local people which sets what they can expect from their NHS and what we would ask them to do in return by the end of December 2020

4. Have a virtual by default approach

Remote consultations at the front-end of all care pathways in all health and care settings especially before escalations of care 

  • We will ensure that prior to an escalation of care every patient is reviewed remotely by a relevant clinician seeking specialist opinion when appropriate to ensure that the patient is seen in the right setting by 30th September 2020
  • We will adopt a primary care ‘total triage’ approach for patients that need a consultation and this will be done remotely unless there is a clinical reason not to do so by the end of August 2020
  • We will ensure that all referrals to UHL for elective services will be done via a fully completed PRISM form by December 2020
  • We will ensure that all relevant specialities will have advice and guidance in place including a telephone/video option by the end of December 2020
  • We will conduct 70% of outpatient appointments and follow-ups virtually either by telephone or video consultation by the end of December 2020
  • We will ensure there is an alternative for those that cannot access the virtual option

5. Arrange Care in Local Settings

There will be a decisive shift away from hospitals to care in local settings based around Primary Care Networks

  • We will produce ‘Place Based Plan’s for the three ‘places’ (Leicestershire, Leicester City and Rutland)  and the seven ‘localities’ across Leicestershire (North West Leicestershire; Charnwood; Hinckley & Bosworth; Oadby & Wigston; Harborough; Melton; and Blaby) by January 2021
  • We will provide a two hour community based response from a  multi-disciplinary team to keep people at home and avoid admissions by November 2020
  • We will discharge patients from hospital to the right setting on the day they are deemed medically fit by November 2020
  • We will manage our actual and virtual bed base as one resource across Leicester, Leicestershire and Rutland with all discharges co-ordinated through a central service by November 2020
  • We will develop community based integrated multi- disciplinary teams including appropriate specialist support that will work as one team around the patient by November 2020
  • We will work with out of county providers to make sure that pathways are clear and understood by patients and clinicians

6. Provide excellent care

We develop standardised end-to end LLR pathways/clinical networks, tackling unwarranted variation, quality improvement, through a population health management approach

  • We will develop and implement standardised pathways for major conditions that improve outcomes, reduce health inequalities and reduce unwarranted variation by April 2021
  • We will use population health management approaches to risk stratify and segment our population and use this information to support transformation and commissioning of care
  • We will provide Primary Care Networks with data to identify unwarranted variation by August 2020
  • We will encourage all clinicians to work at the top of their licence by December 2020
  • We will deliver NHS performance requirements across all services by April 2022

7. Enhanced care in the community

Working with local government and the third sector we will provide enhanced care in the community

  • We will use population health management approaches to identify those at risk patients and use our multi-disciplinary integrated teams to support them by November 2020
  • We will ensure all patients that need a care plan have one, which is regularly reviewed and can be accessed by all those caring for the patient by November 2020
  • We will provide an enhanced offer to Care Homes by December 2020
  • We will work with communities to harness the volunteer and third sector to support local people by April 2021#

8. Have an enabling culture

We will put in enabling mechanisms to create a culture where our workforce thrive and are nurtured and there is simplified decision-making and governance structures

  • We will review and implement a new simplified system wide governance structure that enables transformation to be undertaken rapidly by July 2020
  • We will develop a single system wide Programme Management Office to support system efficiency and transformation by July 2020
  • We will establish clinical networks that enable specialists, general practice, primary care networks and other professionals to work together across the system by July 2020
  • We will develop clinical and managerial opportunities for secondment, rotation and shadowing by April 2021 that supports our underrepresented groups
  • We will ensure all staff involved in transformation are trained and competent in applying the quality improvement methodology adopted by the system
  • We will embed a culture of learning from best practice and research

9. Drive technology, innovation and sustainability

Technology, innovation, financial and environmental sustainability will underpin all our services

  • We will work with our partners to increase IT literacy skills in our population
  • We will ensure that multi-disciplinary team meetings are supported by the right technology which enables clinicians and services to review individual patients’ needs together by October 2020
  • We will undertake an assessment of remote patient monitoring technology and AI to enable improved productivity and support to patients by October 2020
  • We will deliver interoperability between NerveCentre and Systm1 by July 2020
  • We will use technology to support flexible, mobile and home based working to reduce our office footprint, environmental impact and running cost by the end of December 2020
  • We will develop a clear, deliverable plan by October 2020 to restore the system’s finances

10. Work as one system with a system workforce

We will take collaborative working to a new level by dissolving boundaries between services providers.

  • We will explore and implement volunteer models that support our population and services by April 2021
  • We will develop integrated workforce models that enable our pathway approach to be delivered and do not duplicate resources by April 2021
  • We will use our experience from the COVID-19 emergency to develop mutual aid protocols and arrangements across our providers by October 2020
  • We will explore opportunities for shared service teams for our back office functions by April 2021
  • We will become an Integrated Care System by the end of March 2021