ESTATE PLANNING
n Promoting community engagement to promote good mental health and wellbeing.
Developing an estates masterplan for key population cohorts: these principles for models of care have clear implications for the health and care estate in Plymouth. By comparing the gap between the current estate and the future estate needed for mental health, we prioritised multidisciplinary team (MDT) clinics, pathways for urgent care (such as crisis care), and social spaces in non-clinical settings.
To address some of the key healthcare and wellbeing issues in Plymouth, The PSC focused on sub-localities, instead of looking at needs across the entire city.
the unique characteristics and needs of different neighbourhoods. For example, the city centre has a higher prevalence of complex needs, including alcohol and drug dependency, but a lower proportion of residents aged 65+ compared with other areas. The development of our estates Blueprint for the Plymouth City Centre demonstrates the four steps of the Blueprint approach in practice.
Identifying the needs of the local population: We began by assessing health and wellbeing in the City Centre, quickly developing a picture of a sub-locality with high deprivation and a high prevalence of long-term conditions. From this insight, we prioritised three particular population cohorts: n Children and young people: due to worse rates of family vulnerability, child poverty, educational outcomes, and childhood obesity compared with Plymouth as a whole.
n People with mental health needs and addiction: due to high prevalence of mental health needs, worse outcomes than the rest of Plymouth, and high rates of addiction, loneliness, and homelessness.
n The unplanned care cohort: due to particularly high demand for unplanned care.
Agreeing common principles for models of care: We then established common principles for models of care for each cohort based on system, organisational, and national plans. For example, within Mental Health and Addiction, we identified a range of principles, including: n A bio-psycho-social model with integrated working across primary care, acute service, community services, social care, and the voluntary sector, recognising that health is impacted by a range of factors.
n Options to access crisis care outside hospital Emergency Departments.
Blueprint – alignment with the
New Hospital Programme (NHP) new models of care aligned to the needs of the whole population, now and in the future.
n The NHP provides an opportunity for redevelopment of the acute estate to deliver transformation of health and care.
n While the NHP is about ‘hospitals’, the purpose of this major capital investment is not just to improve buildings, but also to support and enable the transformation of the healthcare sector.
n The NHP therefore requires providers to articulate a compelling case for change, with the identification of
78 Health Estate Journal January 2024
n New models of care in the acute setting cannot be developed in isolation – systems must consider how to develop coherent, integrated models of care across community and primary settings centred around population need. It is this thinking which underpinned the Blueprint approach developed by the PSC and the Plymouth LCP.
The PSC says that Plymouth has ‘a shortage of flexible spaces that enable seamless, efficient care and collaboration’, and ‘a lack of community infrastructure to offer services to people with chronic conditions and preventative services’.
Identifying projects, business cases and funding: Finally, we translated the vision for estates into three practical recommendations for estates investment: n An expanded wellbeing hub, enabling co-location of services in an accessible location.
n Extending primary care practices to accommodate specialist mental health input and social support.
n A new integrated health and wellbeing hub serving as the central hub of integrated primary, secondary, social, and voluntary care.
We followed the same process for Children and Young People, and Unplanned Care, identifying care principles, estates implications, and concrete priorities to pursue. The Blueprint programme has
transformed Plymouth LCP’s approach
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