Local Operating Plan

Local Operating Plan 2010-11

What is the Local Operating Plan?

Download the full plan. [Adobe Acrobat PDF - 218.18 KB]

The LOP explains how in this year we will deliver on a range of priorities. These priorities are set in several ways:

• Our own five Strategic Plan, covering 2009-14
• The Department of Health’s Operating Framework, which sets out some key principles for the NHS for 2010-11.
• Other issues, such as national targets, regional policies and local partnerships.

Our priorities

Our vision is to improve the health and well being of people in Nottinghamshire. Our five-year Strategic Plan sets out how we will achieve this. It is underpinned by three main goals:

1. Reduce inequalities by closing the gap in life expectancy between our most and least deprived areas.
2. Improve quality so that local services are in the top 25% for safety, effectiveness and patient experience.
3. Improve productivity so that local services are in the top 25% for efficiency and value for money.

If we achieve these goals, we estimate we will save 430,000 years of life. 

The NHS Operating Framework sets out additional key principles. These include more services closer to home, improved cleanliness, easy access to services, and patient satisfaction.

We are fully signed up to the national QIPP programme, which is designed to deal with growing financial pressures while continuing to enhance services:

Transformation

A key theme for 2010-11 is the need to transform services to develop better care pathways and make the local NHS more efficient. This involves the development of community and other services as alternatives to hospital care, which are cheaper and offer a better patient experience.

Our community services are currently provided by Nottinghamshire Community Health, an autonomous organisation hosted by NHS Nottinghamshire County. These services are due to be devolved to other organisations by April 2011, under the national policy Transforming Community Services.

Our plans

Planning by NHS Nottinghamshire County is divided into eight areas of healthcare. The following sections highlight some of key things we intend to do in 2010-11.

Long term conditions

People with long term conditions account for 80% of all GP consultations, and make up a significant proportion of hospitals’ workload. We will focus on helping these patients to stay well and out of hospital. Priorities for 2010-11 include:

• New care pathways for heart failure and respiratory disease
• New regular health checks to identify people with heart disease
• New services and care for people with diabetes
• “Information prescriptions” to help people live with their conditions

Staying healthy

This programme covers a wide range of activities focussed on preventing ill health and reducing health inequalities. This will reduce the long term burden on health and social care. Priorities for 2010-11 include:

• Sexual health: more Chlamydia screening and contraceptive services

• Smoking: increasing the quitting rate and promoting smoke-free environments
• Cancer: cervical cancer vaccines
• Obesity: new county-wide weight management programme for children
• Alcohol: new care pathway, treatment services and campaigns

Maternity and newborn

The aim is to shift from doctor-led to midwife-led delivery where it is safe and appropriate. This will improve patient experience and reduce costs. Priorities for 2010-11 include:

·         New care pathway following extensive public engagement

·         Reduced Caesarian Section rates

·         More screening for Down’s syndrome

Children and young people

As with adults, the aim is to provide high-quality care for children close to home, to reduce the need for hospital treatment.  Priorities for 2010-11 include:

• More community children’s nurses
• Enhanced mental health services for children and adolescents

Mental health and learning disability

The aim is to have a single pathway providing equal access for all, including people with a learning disability. Work in this area needs to support partnership working and joint commissioning with Nottinghamshire County Council. Priorities for 2010-11 include:

• Development and monitoring of new psychological therapies service
• New community-based services for people with dementia
• Resettlement of people with learning disabilities into community settings

Acute care

People need access to the right care, in the right place, at the right time. This means providing alternative services to those traditionally provided only in hospitals. But we also recognise that in some cases, highly-equipped centres of excellence are the best option for patients. Priorities for 2010-11 include:

• Stroke: a review of acute stroke care and support services to allow early discharge from hospital
• Falls: a new service to identify and support those at risk from broken bones
• Cancer: more radiotherapy machines
• A & E: work to keep people out of A & E if they can be treated more appropriately elsewhere

Planned care

Patients should only be referred to hospital when they really need to be there. GPs will be crucial in ensuring this happens, freeing up valuable NHS resources.  Priorities for 2010-11 include:

• Clinical pathways to reduce referrals to hospitals
• More clearly defined thresholds for surgical intervention
• New models of care as an alternative to hospital

End of life care

We want to increase the choices available to people about the care they receive in the final stages of illness. In doing so, more people will have the chance to die at home, if they wish. Priorities for 2010-11 include:

• New care pathways for those at the end of life
• More support for those caring for the terminally ill
• A centre to co-ordinate care for those at the end of life

Wider issues

Some elements of what we do affect some or all aspects of healthcare. Among these, priorities for 2010-11 include:

• A range of short breaks for carers looking after those who are ill or disabled
• Increasing access to primary care – more GP surgeries offering extended opening hours, more NHS dentistry
• Wider access to screening for breast and bowel cancer
• The elimination of mixed-sex accommodation in hospitals
• Close monitoring of ambulance response times

Finance

We have planned for a 5.7% increase in our financial allocation for 2010-11. Nevertheless, significant financial pressures are anticipated, with efficiencies required in 2010-11 and beyond.

A priority for this year will be to introduce schemes to deliver the required savings in future years. To this end, projected spending includes allocating 2% of our total budget (around £20m) to fund service transformation.

We have also taken into account the need to reduce our management costs by at least 30% by 2014, as outlined in the NHS Operating Framework. This reduction is underway in 2010-11.