DHU Health Care

A Message from Lord Pickles and Lord Blunkett, followed by DHU Health Care's best practice article

The ability to listen and learn from one another has always been vital in parliament, in business and in most aspects of daily life. But at this particular moment in time, as national and global events continue to reiterate, it is uncommonly crucial that we forge new channels of communication and reinforce existing ones. The following article from DHU Health Care is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

Blunkett signature Rt Hon The Lord David Blunkett
Pickles signature Rt Hon The Lord Eric Pickles

dhuhealthcare.com/

15DHU HEALTH CARE |
BEST PRACTICE REPRESENTATIVE 2019
William Tucker, Lord Lieutenant
of Derbyshire, with CEO Stephen
Bateman at the opening of
DHU’s new HQ in 2018
DHU’s Johnson Building HQ,
Derby
DHU Health Care provide a range of services, including
out-of-hours, NHS 111 and integrated urgent care across
the East Midlands and Milton Keynes. Originally operating
in Derbyshire, they have expanded into Northamptonshire,
Nottinghamshire, Leicester, Leicestershire & Rutland, Lincolnshire
and Milton Keynes. Formed by the merging of two GP co-
operatives in 2006, they have been at the forefront of innovation
within the sector and were chosen to pilot the NHS 111 service.
CEO Stephen Bateman explains their rapid expansion and how
they collaborate with other local health and social care providers.
Although we had been operating since 1989, our current form was established
with the merging of two GP co-operatives in 2006. Both of these organisations
were providing out-of-hours care across Derbyshire, which we now provide as a
collective. We have grown and developed from this point, setting up additional
services and expanding across the East Midlands.
In 2010, we were chosen as a pilot organisation for NHS 111 in Derbyshire, and we
started providing community nursing services a year later. After the collapse of NHS
Direct, we picked up the majority of the NHS 111 contracts in the East Midlands
area and have been delivering these since 2013.
We have also looked to diversify our skillsets: we began delivering A&E streaming
services to Chesterfield Royal Hospital, subsequently extending this to the Royal
Derby Teaching Hospital. We also instigated a home visiting service and extended
hours clinical hubs in Erewash as part of the Prime Minister’s Challenge Fund and
the NHS England New Models of Care Vanguard programme.
FACTS ABOUT
DHU HEALTH CARE
»CEO: Stephen Bateman
»Founded in 1989
»Based in Derby, delivering
services across the East
Midlands and Milton Keynes
»Services: Out-of-hours medical
services, NHS 111, community
nursing, urgent care centres,
clinical advice and assessment
services, A&E primary care
streaming services, GP practices
and home visiting
»No. of employees: 1,290 and
400 sessional GPs
»No. of users: 2.5 million patient
contacts per annum, covering a
population of 5.5 million
DHU Health Care
THE PARLIAMENTARY REVIEW
Highlighting best practice
16 | DHU HEALTH CARE
These urgent care services use a mixed
clinical workforce of advanced nurse
practitioners and healthcare assistants.
Our growth continued, and in 2016,
we regained the East Midlands NHS
111 contract, including Lincolnshire,
and also took on the Leicester,
Leicestershire and Rutland out-of-hours
provision.
In LLR, we have also begun to offer
integrated urgent care provision
and 24-hour home visiting services.
To support this, we have been
collaborating with local GP Federations
in Leicestershire and have established
two joint partnerships alongside urgent
care hubs.
More recently, we have expanded into
Northamptonshire and extended our
urgent care offer into Milton Keynes.
Both of these contracts are due to
commence on April 1, 2019, and we
are working to prepare for these.
As a community interest company,
we do not report to shareholders and
so we are able to place our patients
at our heart. Although our heritage is
in Derbyshire, our success has led to
expansion and significant growth: in
2014/15 our turnover was £23 million,
rising to £52 million in 2017/18.
Our current forecast for 2018/19 is
£63 million, growing to £75 million
by2020.
Working to promote innovation
We work closely with the NHS to design
policy, and we are at the forefront of
integrated urgent care regulation.
Our work with the NHS means that we
have become a testbed for innovation,
specifically for the NHS 111 service. We
have also conducted pilots with clinical
pharmacists and were one of the first
NHS 111 providers to incorporate
dental nurses. We are also continually
developing our clinical assessment
services to ensure that patients can
receive clinical intervention as soon
aspossible.
Our findings have been included in the
new 2017 NHS guidelines concerning
integrated urgent care, and we were
involved in producing and reviewing
these. Our collaborative partnership
approach across the East Midlands
means that we are involved with
leadership throughout the area.
We have also developed strong
relationships with healthcare services
and sector leaders. We are the only
non-government body to be part of
the sustainability and transformation
partnerships board for Derbyshire, and
we are seen as a partner rather than
an independent provider.
We also have strong links with the East
Midlands Ambulance Service to ensure
that we provide the most effective
support for patients.
Mobilising contracts on time is critical
for securing staff jobs and safeguarding
services. When it is appropriate, we
partner with GP Federations. This
allows us to combine our significant
experience with their local knowledge
of the patient population, providing
a boost to our care provision. We are
seen as a major player in the field of
integrated urgent care but feel that
collaboration is the true way forward.
We strive to be financially aware at
all times. Although the quality of our
DHU Health Care
Flu Campaign Team
colleagues
As a
community
interest
company, we
do not report
to
shareholders
and so we are
able to place
our patients at
our heart
17DHU HEALTH CARE |
BEST PRACTICE REPRESENTATIVE 2019
service, and the care and compassion
we show to our patients, is our primary
motivation, it is essential that we remain
financially savvy. We always endeavour
to provide clear assurances to the local
community about the benefit of our
services to engender local support.
Adapting to changing NHS
management
One of the primary challenges we
face is the changing management of
the NHS on both local and national
levels. As we provide our service over
six sustainability and transformation
partnership areas, it is essential that we
are aligned to each NHS plan.
Our status as a growing company
brings challenges, both in terms of
recruitment and the pressure exerted
on our back office. To reduce the
impact of this, we have implemented
a divisional structure. We ensure that
local management teams are both
operationally and clinically focused in
that area.
As the length of our contracts changes,
we must adapt. Previously we had
shorter term, rolling contracts, but we
have now moved to longer contracts,
often lasting five years. While this
is challenging, it also presents an
opportunity, requiring strong business
processes and reporting to multiple
commissioners.
To help ease this process, we are
introducing ISO quality management
systems across our organisation to
continually improve our performance.
We are also developing a mixed clinical
workforce, including GPs, advanced
nurse practitioners, community nurses,
general nurses, clinical pharmacists and
emergency care practitioners.
Recruitment and retention of staff
is difficult in the health sector, and
there are not enough resources in
certain staff groups to deliver services
across the country. To combat this,
we are working in partnership with
Health Education England and local
universities on the development of
advanced nurse practitioner training
and clinical development opportunities.
We are working closely with our
NHS Commissioners in the design of
services using workforce development
modelling, which will support the
changes required to meet future needs
of our patients.
By maintaining our close relationships
with Clinical Commissioning Groups
and local NHS and social care providers,
we are sure that we will be able to
continue our growth. As our provision
expands, pressure will increase on our
services, but we are confident that we
will be able to meet these challenges
and remain at the forefront of the
sector for years tocome.
Our work with
the NHS
means we
have become
a testbed for
innovation,
specifically for
the NHS 111
Service
Magnetta Archer-Dyer,
Nurse Advisor for DHU
111 with managers and
clinical colleagues at the
Loughborough Urgent
Care Centre

dhuhealthcare.com/

This article was sponsored by DHU Health Care. The Parliamentary Review is wholly funded by the representatives who write for it. The publication in which this article originally appeared contained the following foreword from Rt Hon Kwasi Kwarteng.

Rt Hon Kwasi Kwarteng's Foreword For The Parliamentary Review

By Rt Hon Kwasi Kwarteng

This year’s Parliamentary Review reflects on a tumultuous and extraordinary year, globally and nationally. As well as being an MP, I am a keen student of history, and I am conscious that 2020 would mark the end of an era. It will be remembered as the year in which we concluded Brexit negotiations and finally left the European Union. Above all, it will be remembered as the year of Covid-19.

In our fight against the pandemic, I am delighted that our vaccination programme is beginning to turn the tide – and I pay tribute to the British businesses, scientists and all those who have helped us to achieve this. But the virus has dealt enormous damage, and we now have a duty to rebuild our economy.

We must ensure that businesses are protected. We have made more than £350 billion available to that end, with grants, business rates relief and our furlough scheme supporting more than 11 million people and jobs in every corner of the country, maintaining livelihoods while easing the pressure on employers. The next step is to work with business to build back better and greener, putting the net zero carbon challenge at the heart of our recovery. This is a complex undertaking, but one which I hope will be recognised as a once in a lifetime opportunity.

Through the prime minister’s ten point plan for a green industrial revolution, we can level up every region of the UK, supporting 250,000 green jobs while we accelerate our progress towards net zero carbon emissions.

With our commitment to raise R&D spending to 2.4% of GDP and the creation of the Advanced Research & Invention Agency, we are empowering our fantastic researchers to take on groundbreaking research, delivering funding with flexibility and speed. With this approach, innovators will be able to work with our traditional industrial heartlands to explore new technologies, and design and manufacture the products on which the future will be built – ready for export around the globe.

And I believe trade will flourish. We are a leading nation in the fight against climate change. As the host of COP26 this year, we have an incredible opportunity to market our low-carbon products and expertise. Our departure from the EU gives us the chance to be a champion of truly global free trade; we have already signed trade deals with more than 60 countries around the world.

As we turn the page and leave 2020 behind, I am excited about the new chapter which Britain is now writing for itself, and for the opportunities which lie ahead of us.
Rt Hon Kwasi Kwarteng
Secretary of State for Business, Energy and Industrial Strategy