Live Well

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We commission a range of services which fall under our Live Well priority:

999

The 999 services provide 24 hours, 365 day a year to patients who require urgent medical treatment and transport to the most appropriate Acute Hospital to meet their medical needs.

We ensure our providers allocate the most appropriate resource to the patient’s needs:

  • Hear and Treat: Incidents with no face-to-face response and advice/signposting is have given.
  • See and Treat: An ambulance has arrived on seen, following an assessment and / or treatment, the patient is not required to be conveyed to an Acute hospital
  • See, Treat and Convey: an ambulance has arrived on seen, following and assessment and / or treatment the patient requires further medical attention and is conveyed to the most appropriate hospital.

To support an improved flow of patients across Bedfordshire, Luton and Milton Keynes, we work proactively with our providers to identify and establish alternative care pathways to reduce avoidable hospital conveyance, which support minimal hand over delays at the receiving Acute Trust, to include direct access to handover category 3 & 4 patient to community services.

Adult Mental Health and Learning Disabilities

We commission services for our local communities with mental health and learning disability needs.

Our mental health, Learning Disabilities and well-being services cover four main areas:

  • Improving access to psychological therapies
  • Adult mental health services and specialist learning disability services (including memory assessment, early intervention Psychosis, mental health crisis and  eating disorders services).
  • Recovery services
  • Child and adolescent mental health services

Ambulance, A&E and Urgent Care

The commissioning of ambulance services is an essential part of the urgent and emergency care pathway. We work closely with our provider organisations, East of England Ambulance Service (EEAST) and South-Central Ambulance Service (SCAS) to ensure the successful delivery of the 999 service.

The two Ambulance Services we commission in Bedfordshire, Luton and Milton Keynes are:

  • East of East of England Ambulance service (EEAST) operates across the East of England, which includes Bedfordshire and the Acute hospital within the county is Bedfordshire Hospitals Foundation Trusts.
  • South-Central Ambulance Service (SCAS) operates across the South-Central area, which includes Buckinghamshire and the Acute hospital within the county is Milton Keynes University Trust

We ensure they have clear plans to meet national performance, clinical and quality standards, transformational and financial objectives and should performance improvement plans be required we will work collaboratively with the providers.

Ambulance Handover Delays

At times of pressure in the emergency care system, there is a potential for delays in the transfer of care from one provider to another. This can result in significant delays in the overall system, and potentially lead to serious situations.

Ambulance handover delays are a known risk to patients as this could potentially result in an adverse effect on the patient’s condition and outcome and can have a significant impact on services.

We work with the ambulance services and Acute Trusts daily, to eliminate handover delays of over 15minutes. We are committed to ensuring that patient care remains seamless and that patients conveyed to hospital are handed over in a professional and timely manner and allow the crews to return into the community to respond to their next urgent call. 

Emergency Department Performance

Around 1,000 patients attend the Accident and Emergency department across Bedfordshire, Luton and Milton Keynes daily due to acute illness or injuries, which required immediate or urgent medical attentions.

To ensure patients are seen as quickly and safely as possible there are number of performance measures that are in place and monitored throughout, 24 hours, 365 days of the year, these include

  • Total Time in the Emergency Department
  • Time to initial assessment
  • Time to treatment
  • Re-attendance
  • Left without being seen

There are new proposed standards that have been developed Nationally and these are being field tested across England and Bedfordshire Hospitals Trusts are part of this programme.

Cancer

The Bedfordshire, Luton and Milton Keynes cancer programme aims to commission effective, high quality cancer services at a local level whilst also working strategically with system and regional partners.

  • To improve and maintain the national cancer waiting time standards
  • To continue to work with the East of England Cancer Alliance to implement the Cancer Transformation Programme
  • To manage the recovery and restoration of cancer services due to Covid-19

Our vision is to:

  • Have Cancer care available in all of our system
  • Improve Cancer care with earlier diagnosis
  • Provide excellent support during and post treatment
  • For patients to be able to access services to support them
  • For there to be a great patient experience

Community Urgent Eye Services (CUES)

We commission the Community Urgent Eyecare Service (CUES) which provides urgent assessment, and treatment for sudden onset eye problems such as flashes, floaters, vision loss or minor eye injuries, for residents of Bedford, Luton and Milton Keynes. The service is for all adults and children registered with a GP in Bedfordshire, Luton and Milton Keynes.

Non-Emergency Patient Transport

The service plays an important role for those patients who require transport and have a medical condition that requires the skills/support of service, to safely transport them to their outpatient appointments which include renal dialysis appointments.  Similarly, to support the Acute Trusts in discharging people to the most appropriate place to meet their needs, transport may be identified as the appropriate resource and is a critical component in maintaining flow.

Primary Care

We undertake commissioning and monitoring of our 96 GP practice contracts, our 111 service and 23 Primary Care Networks (PCNs).   Primary Care Networks were introduced in 2019 to support GP practices working together in PCN groupings, with each PCN typically serving a population of 30,000-50,000 patients.  Working together brings economies of scale and fundamentally allows a wider range of services to be offered. 

Networks are in the latter stages of development; they are seen as the foundation of all Integrated Health and Care Systems and are working collaboratively with our health and social care partners and local communities to support the design, delivery and integration of health and social care services to meet the needs of our population.

More information on our GP practices, PCNs and Health and Care Partnership can be found here https://blmkhealthandcarepartnership.org/primary-care/

The Integrated Care Board is also preparing to take on commissioning responsibility for the wider range of primary care services from April 2023; this will include community pharmacy, dental and optometry (eye) services.  This change will enable the Integrated Care Board to further integrate these key services into the Bedfordshire, Luton and Milton Keynes Integrated Health and Care System.  We will publish more information on the plans for these services once the preparation plans are agreed with NHS England.

Rehabilitation Services

Rehabilitation focuses on the impact that a health condition, developmental difficulty or disability has on a patient’s life. It involves working in partnership with patients and those important to them so they can maximise their potential and independence, and have choice and control over their lives. It helps to ensure people are included in their communities, employment and education, rather than being isolated. Effective rehabilitation delivers better outcomes and improved quality of life and has the potential to reduce health inequalities.

We commission:

  • Intermediate services from our community teams. This includes therapy-led assessments and delivery to help people recover at home or in bedded units
  • Cardio rehabilitation delivered by hospital trusts and within community services
  • Community physical and occupational therapy with council partners
  • Neuro-rehabilitation
  • Pulmonary rehabilitation delivered by hospital trusts and community services
  • Specialist stroke