NHS Herefordshire, the leader for health in the county, is delivering on expectations in terms of improving health care. In the Vital Signs 2008-09 assessment – produced by the national Care Quality Commission – the primary care trust is performing against the expectations set for it in 24 out of a possible 37 areas and is performing ahead of expectations in 7 areas.
The commission measures the difference between the expected performance of primary care trusts and what they have actually achieved. The commission found that NHS Herefordshire is performing better than expected in several areas, including access to a GP, proportion of patients seen for clinical care within target, numbers of infants being breastfed and how well the trust plans and purchases comprehensive mental health services for children and young people.
NHS Herefordshire has already put in place plans to address six areas where it is performing less well than expected, including its plans for prevention and treatment of stroke, screening for Chlamydia and proportion of carers receiving a ‘carer’s break’
The Vital Signs assessment paid particular attention to services for disabled children, which were identified by the government as priority for all trusts.
NHS Herefordshire and Herefordshire Council have joined up their services for children and young people’s health - providing coordinated and comprehensive long-term care for children with disabilities and life limiting conditions, as well as supporting parents.
Herefordshire Council has improved engagement and consultation with carers as part of the ongoing development of The Carers Hub, which has been contracted to work with carers of adults and children, and with other agencies, to make sure that support is available and accessible. Having listened to the needs of carers, a ‘short breaks’ services was set up in October 2008 last year, and support has also been provided in terms of dedicated social workers for carers and new information packs for carers.
Respite care is also available at Acorns Children’s Hospice when referred, and is co-ordinated by the lead health worker involved with the child, young person or family.
Special equipment for children and young people to use at home or school is now provided through a new integrated service between the council and the primary care trust. Equipment such as a standing frame or seating support is often designed specifically for particularly children after an assessment by paediatric physiotherapists. The service has consistently achieved its target of delivering equipment within seven days of agreement to provide.
NHS Herefordshire has also invested significantly in planned preventative maintenance of both powered and non-powered wheelchairs to ensure that children using powered chairs have these available at all times and are safe.
Where medical care is needed to reduce the severity of a disease or slow its progress, in the event of conditions that are incurable, there a network has been set up to engage with parents and carers to ensure their needs are understood. A group of ‘life limited’ young people involved with the Acorns Children’s Hospice have worked with the primary care trust to help ensure that services are provided effectively and in the right way.
The trust is working to make nursing available 24 hours, and a range of additional services are made available, on a case by case basis, to support the needs of children approaching the end of their lives, and there are close links with the out of hours GP service to support effective medical help and treatment.