Review of community services across the Norfolk and Waveney Integrated Care System

June 2023 update

Last month saw the first update for staff, partners and stakeholders across the Norfolk and Waveney Integrated Care System (ICS), outlining the start of a Norfolk and Waveney wide review of Community Services.

Community services cover a wide range of services and provide care for people from birth to the end of their life. Community health teams play a vital role in supporting people with complex health and care needs to live independently in their own home for as long as possible. Services also include health promotion services, such as school health services and health visiting services.

Many services involve partnership working across health and social care teams, made up of a wide variety of professionals including community nurses, allied health professionals, district nurses, mental health nurses, therapists and social care workers.

Community services are mainly delivered in people’s homes (this includes care homes) but also in community hospitals, clinics and schools.

With the above in mind, this important review will help ensure more joined-up health and care and improved support for people of all ages.

Over the last month, Tricordant, working with organisations across our ICS has completed their initial work on scoping and positioning the review. This has laid the foundations for developing a future vision for community health provision and included more than 25 interviews with senior Executive Officers, Place Board Chairs and a range of Directors, including sessions with all five Place Boards.

Whilst the original focus of the Review was focused on community health provision, following initial feedback, the Review will broaden its scope to consider how we integrate the work of our community providers with social care, primary care, council services, public health and voluntary, community and social enterprise (VCSE) sector groups.

From this early scoping work, we know that improvement needs to be within a consistent strategic framework but locally delivered as determined by our Place-based partnerships and teams.

To recap, our collective vision is to help the people of Norfolk and Waveney to live longer, healthier, and happier lives. We have agreed four system priorities:

Driving integration to deliver people-centred care that is joined-up and consistent. This means a shift in focus and investment to community-based support so that people stay healthier for longer in their own homes and communities.

Prioritising prevention to support people to be healthy, independent, and resilient throughout their lives. Community services can ensure that signs of developing conditions and ill-health are proactively addressed.

Breaking the cycle of inequality across defined social groups. Community services would work alongside councils and VCSE organisations to improve the determinants of health and target risk factors such as smoking and obesity.

Enabling resilient communities by releasing and supporting communities who have the knowledge, assets, and abilities to help residents flourish. Community services are well placed to work in partnership to facilitate this change.

Next steps

We need to make sure that together, with our residents, staff and communities, we develop a shared vision for community services in Norfolk and Waveney.

From June to early August, we will be engaging key stakeholders across the system to develop this shared vision alongside a co-designed strategic outcomes framework.

We will hold two events for staff, organisations, and system partners. These two sessions to start the process of designing what community services should look like will take place on Wednesday 5 July, 1:30-4:00pm and Tuesday 11 July, 10am until 12:30pm. You can book your place and find out more details online.

In parallel with these two workshops, a series of online events for our residents and communities will be scheduled. Crucially, this will ensure that our residents and communities have an opportunity to have their say at this very early stage in the process.

Five events will take place, one held for each of our ‘places’ across Norfolk and Waveney. Our residents, staff will be more than welcome to join an event of their choice, it does not have to be the event which is linked to the place in which they work or live.

Dates of these online events will be announced very soon and will take place throughout July and into August. People unable to join these events will also be able to share their views via an online survey that will run concurrently. This will be open for a period of eight weeks.

We want to hear from as many of our residents as possible, including people using community services, carers and others with an interest in such services to sign up for one of our online workshops or indeed take part in the short survey.

In addition, we will use the views of hundreds of people we have heard from earlier this year. More than 700 people fed into a recent Joint Forward Plan engagement exercise which featured many comments and suggestions about how we can improve services in the community for our residents, staff and communities, ultimately, making best use of resources to help people stay well and remain healthier for longer.

Our developing Insight Bank and Community Voices project will also be used, pulling qualitative feedback and conversations where our staff, people and communities have shared their thoughts and views linked to this review.

If you have any questions, please submit these to nwicb.communications@nhs.net and these will be added to an anonymised frequently asked questions document which will also be available and updated regularly online.

May 2023 update

Prior to the formation of NHS Norfolk and Waveney, community services have been historically commissioned by five different Clinical Commissioning Groups, each having their own need and prioritisation for people and communities at place level. This led to differences in how services were provided across Norfolk and Waveney.

We now have an important opportunity to look at the way community services are commissioned and delivered across Norfolk and Waveney, to look closely at how we can improve how and where care is provided.

To do this, a review of community services has now begun.

Health and care services provided locally play a crucial role in delivering our Integrated Care Strategy, providing care close to people’s homes that is joined up, prioritises the prevention of ill-health, addresses inequalities and helps build resilient communities. Our ultimate aim is to move services, where possible, closer to where people live and allow them to stay in their own homes whilst receiving treatment, wherever possible.

More than 700 members of staff, people and communities recently shared what they wanted to see as priorities for health and care services. Their feedback has led to an emerging Joint Forward Plan for Norfolk and Waveney which will be published next month. As part of this engagement exercise, a recurring theme was an ask for more joined up health and care, as well as improved support for people of all ages.

This review is an important first step to the transformation of services and provides an opportunity for us to address some of our historic challenges to ensure that people receive timely care and the support they need, in the most appropriate setting, helping them live independent lives for as long as is possible. It also provides an opportunity to deliver on some of the commitments made in the Norfolk and Waveney clinical strategy, in terms of moving health and care pathways into the community and the Fuller Stocktake, recommending integrated community teams supporting general practice.

The review will cover community services provision for people at all stages in their lives, recognising that a high proportion of our population are older; by 2036, one in three people will be over 65 years of age.

The project is led by NHS Norfolk and Waveney and supported by an independent organisation, Tricordant, who will oversee the scoping and conduct of the review as well as the development of an outcomes framework, which will describe what we all want community services to achieve in the years ahead.

The review will initially require support and contributions from all partner organisations, including staff, stakeholders, and our voluntary, community and social enterprise (VCSE) sector to develop plans for community healthcare that successfully achieve our shared ambitions.

The current estimation is that scoping of the exercise and engagement with organisations, stakeholders, VCSE sector and partners will take place in the Summer followed by the production of a report in Autumn to inform the wider transformation of community services across Norfolk and Waveney. At this point, this is when we will engage fully with our people and communities of Norfolk and Waveney, building on their comments and feedback to date and seeking views on initial ideas to improve and strengthen community health and care of the future.

We will keep everyone informed at regular intervals. We want to work closely with our staff and partners from across the health and care sector, local authority, as well as our vital VCSE partners to ensure an inclusive process that maximises its chance to achieve a step change in community services across Norfolk and Waveney.

Further information and updates will be available on the Norfolk and Waveney ICS website.