Agenda item

Members were provided with an update on the Proactive Management of Integrated Services for the Elderly (ProMISE) Programme by Paul White, Associate Director of Development & ProMISE Programme Director from the CCG.

He explained the rationale behind the ProMISE programme was to create a pro-active system, a transition from a reactive approach. This would mean Case Management would be at the heart of the programme and patients who appeared to be struggling would be offered a detailed home based assessment allowing early intervention to reduce the need for secondary care.  The programme would be running a pilot scheme in December 2014. Such intervention may help to reduce the numbers of falls and fractures which contributed to a number of unplanned hospital admissions.

For diabetes, an upskilling of primary care staff, nurses and GPs, was required, with the intention that each diabetes patient would have a care plan.

End of life services would enable patients to die in a preferred place with support offered to those patients who wished to die at home.  In addition “Falls” clinics would be established.

The Board was informed that a new programme, FLO, was being introduced, at present 30 GP practices had enrolled.  The aim was allow cost and very simple Healthcare system provided via the patients own mobile phone or landline.  Primarily an automated SMS (text) messaging based system used by clinicians to send reminders, health tips and advice to patients; and collect, monitor and track patient’s health readings taken by the patients using self monitoring equipment such as blood pressure machines.  Patients can text back their readings to FLO and messages are free even if the patient has no credit on their phone.

Another development, Patient Liaison Officers, provided an enhanced service for signposting, identifying carers and non-clinical co-ordinating.

For UTI (Urinary Tract Infections) simple training would be offered to spot the signs of UTI.  Already 5 patients had been identified early avoiding hospital admission. The training costs were minimal, only requiring 3 hours of a matron’s time and a web based programme may also be considered.

The Chairman was impressed with the on going work and pleased to see a move towards a more pro-active approach and community based initiatives. Although this did make savings that could be used elsewhere it provided cost avoidance in reducing the dependence on secondary care. Councillor Evans sought greater clarification and Mr White explained that the aim was to reduce demand so that capacity could be reduced which would lead to a reduction in expenditure.

The Board recognised the importance of communicating the programme to residents.  It was noted that a communication working group was working on raising the profile of the programme.  A report from Bromley’s communication team would be submitted to a future meeting.

Members questioned whether any legacy work was being considered for 2016 onwards.  In response Mr White explained that the programme was about enabling and establishing a pro-active approach to reduce the dependence on secondary care and freeing up money to invest in other areas.

The Board then enquired about screening for example screening patient with diabetes for heart disease.  In response it was told that this was ongoing through the health checks programme. It was also included in the work around case management and care packages and self managing lifestyle and obesity. The intention of ProMISE was to provide and non-recurring fund to reduce reliance on the acute sector.

RESOLVED that

The report is noted

1. The Board supports the release of funds, specific to the programme related activities 2013/14 – subject to the ratification of the Executive of the Local Authority.

2. The Board supports the planned expenditure 2014/15 and 2015/16, recognising that whilst there may ne subsequent revisions to the breakdown or the investments these will not result in a  material change to the overall expenditure plan. – Subject to ratification by the Executive of the Local Authority.

3. It is noted that further progress reports will be submitted to the Board at regular intervals.