Innovators given green light to transform Havering’s emergency care and health system

Alan Steward and Dr Ed Diggines talking about the vanguard project. Picture: Sandra Rowse

Alan Steward and Dr Ed Diggines talking about the vanguard project. Picture: Sandra Rowse - Credit: Archant

Listening to Alan Steward and Dr Ed Diggines speak, it’s clear they are excited – and very proud – about Havering being chosen for one of eight “vanguard” projects across the country.

The pair are part of the Barking and Dagenham, Havering and Redbridge (BHR) System Resilience Group (SRG), which has been announced as the only area in London where the pilot scheme is being rolled out – aimed at transforming the whole emergency care system.

Unlike previous reforms, which have been largely top down, each vanguard has been chosen to design, test and perfect innovative ways to improve our healthcare system.

“It’s all about trust,” says Dr Diggines, Healthbridge GP Federation lead.

“There used to be this culture of working collaboratively, but the systems have become more and more complex.

“People feel they are just being carried through different parts of the system. It’s about bringing those relationships together.

“It’s a human business. It’s about the patient having a relationship with a clinician that they trust.”

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Dr Diggines was part of the team which put together the vanguard bid, based around streamlining access to healthcare into three access points – click, call or come in.

As a result of the success of the bid, the SRG – which includes representatives of commissioning groups (CCGs), local authorities, GP federations, out-of-hours provider PELC, London Ambulance Service, patients’ watchdog Healthwatch and the North East London Pharmaceutical Committee (LPC) – will receive part of a £200million fund and expert support to allow them to implement changes quickly.

“We have three CCGs, three local authorities, community providers – it gets really complicated,” said Mr Steward, chief operation officer at Havering CCG (clinical commissioning group).

The boroughs together have a population of 750,000, which would make it as the third biggest city in the UK behind London as a whole and Birmingham.

The SRG proposals include putting in place a “getting you home” plan within 24 hours of a patient entering hospital, working with the community treatment team and intensive rehabilitation services which provide “intermediate care” at home.

While the two-year vanguard project officially started on Tuesday, Mr Steward and Dr Diggines said there would be a full launch in early October to involve patients in designing services.

The pair admitted there were challenges for healthcare providers here, with BHRUT (Barking, Havering and Redbridge University Hospitals Trust) – which runs Queen’s and King George Hospitals – still in special measures, and the strain of the growing population on GP services in Havering being widely reported.

But they insisted projects in the boroughs had provided “momentum”, such as the formation of GP Federations like Havering Health and Healthbridge, providing evening and weekend appointments at “hub” surgeries, and BHRUT teaming up with the Virginia Mason Institute in America, one of the best regarded hospitals in the world.

Dr Diggines said: “People were quite open to say you’re a challenged area, do you think you’re the right place because you’ve been struggling so much? But it’s a lot to do with momentum.”

And Mr Steward said: “I think part of it was about the progress being made over the past 12 to 18 months. It’s not just about the hospital, but you can see it’s up by about 20 per cent in terms of hitting that four-hour target.”

He said over the past year, the number of Dtoc patients (delayed transfers of care) had gone down by 61 per cent, including patients being unable to leave hospital because the support is not available elsewhere.