Page 94 - HA Convention 2015

Special Topics

ST4.3 Improving Quality of Life of Long-term Patients 16:15 Theatre 1

Monday, 18 May A Future Ready Aged Care System
Ong B
Ministry of Health, Singapore

Singapore’s population, like Hong Kong, will be ageing rapidly in the next one to two decades. This is due to falling fertility
and increasing longevity. As a society, we will continue to invest heavily in health promotion and preventive health services,
while transforming care delivery to be more integrated and patient centric. With this in mind, primary care is being remodelled
as the core in our healthcare delivery system. We have reorganised our healthcare delivery into regional health systems
(RHS) to facilitate care integration at all levels, including care delivered within the community. We are enhancing services and
capacity in the area of long-term care, and working to better enable our seniors to receive quality and affordable care they
require while ageing as healthily as possible. These steps are the foundation for our vision of a sustainable and future ready
aged care system to support ageing in place for our seniors.

ST4.4 Improving Quality of Life of Long-term Patients 16:15 Theatre 1

Improving Quality of Life of the Long-term Patient — from the Community PerspectiveHOSPITAL AUTHORITY CONVENTION 2015
Sayer C
Camden Clinical Commissioning Group, National Health Service, UK

In the United Kingdom, the Health and Social Care Act 2012 created new statutory organisations — Clinical Commissioning
Groups (CCGs), led by clinicians and responsible for commissioning community services and most hospital services.
Camden CCG covers a population of 250,000 with 38 general practitioner practices, two large acute hospitals (University
College London Hospital and Royal Free, London) and two community trusts providing mental health services and
community nursing respectively. As with other inner London boroughs there are areas of great deprivation with huge health
inequalities including a life expectancy gap of 11.6 years for men between the poorest and wealthiest parts of Camden and
the second highest serious mental health burden in the UK. One in seven people in Camden live with a long-term disease.

The CCG recognised that for all patients with long-term health and mental health problems the challenges were:
(1) Identifying the outcomes that were important to patients;
(2) Lack of focus on prevention or addressing the wider determinants of health;
(3) Failure both to identify disease and to manage it well in the community; and
(4) Fragmented and poorly co-ordinated services resulting in ineffective and inefficient services.

The CCG set out to:
(1) Define with patients the outcomes important to them and to use these as systems measures of success;
(2) To use these outcomes to work with providers across health and social care to re-design services integrated across the

health system and delivered closer to home; and
(3) To measure and evaluate the impact of these service re-designs.

The impact has been:
(1) To increase prevalence figures across all long-term conditions;
(2) To improve both health outcomes and the outcomes patients defined as important e.g. remaining at home;
(3) To shift work out of hospitals into the community; and
(4) To improve significantly how well people with long-term conditions feel supported.

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