2017/18 NHS City & Hackney CCG Annual General Meeting Wednesday 5 September 2018 Tomlinson Centre
Annual General Meeting Panel Dr Mark Rickets Catherine McAdam David Maher Sunil Thakker Jane Milligan Chair PPI Lay member Managing Director Chief Finance Officer Accountable Officer
Running Order 7.30: Start of AGM Presentation 7.30 - 7.35: Opening from Mark Rickets & Jane Milligan 7.35 - 7.40: East London Health & Care Partnership: Update - Jane Milligan 7.40 - 7.45: Primary Care Update - Mark Rickets 7.45 - 7.50: Summary of CCG Annual Report & Achievements - Mark Rickets 7.50 - 7.55: Summary of Financial Position - Sunil Thakker 7.55 - 8.00: Co-Production Achievements & Further Work - Catherine Macadam 8.00 - 8.10: Questions and Answers with AGM Panel 8.10 - 9.00: Community Services Discussion and Close
Key Health Challenges in City & Hackney Socioeconomic Deprivation • Despite some improvements in recent years, Hackney remains the second most socio-economically deprived borough in London • Within Hackney, there is also inequality at electoral ward level
Life Course in City & Hackney All figures apply to Hackney and the City together Red indicates worse than the London average, amber similar, and green better. Grey indicates that the direction of the indicator isn’t clear
East London Health and Care Partnership ELHCP brings together 12 local NHS organisations (commissioners and providers) and 8 local councils to improve health and care services and outcomes; highlights include: Digital Technology - funding secured for ‘one London’ to be an exemplar of local health and care records to raise the bar around NHS and partners sharing data to deliver better care Workforce: • £400k for the international GP recruitment programme • Maternity recruitment & retention programme: launched in May and aimed at encouraging new talent
East London Health and Care Partnership ELHCP Highlights (Continued): Urgent & Emergency Care - August 2018: Successful roll-out of the new integrated urgent care 111 service Cancer – Measures being applied to increase the one year survival rate to 75% by 2020 across all cancers by 2020 Outpatients - Service transformation underway aimed at delivering 30% of services in the community for outpatients Engagement - An online citizen’s panel established to gather the views of patients and the wider community in shaping and driving decisions about health and care services
Challenges in City & Hackney Socio-economic Population growth • Socio-economic deprivation • Population growth deprivation Obesity Smoking Alcohol Mental Health Mental Health • Health inequalities Life expectancy • Socio-economic deprivation
City and Hackney CCG Headlines We achieved financial balance in 2017/18 as planned and are in a good position to achieve our aims in the next financial year All City and Hackney GP Practices rated by the Care Quality Commission (CQC) as “Good” or “Outstanding” East London Foundation Trust rated by the CQC as “Outstanding” Homerton Hospital rated by the CQC as “Good” overall, and “Outstanding” for A&E and Medical Care People in our area are spending less time in hospital Service delivery for 2017-18 and forward plans for Children and Young Persons mental health highly credited as among the best in London
Primary Care Achievements CCG has taken on responsibility Practices are making Investments to develop Patient with NHS England for making more appointments Participation Groups at practice decisions on what happens to • Five extended access bookable online; national and neighbourhood level and regular primary care. This includes hubs for all patients to money is being used to fund practice improvements • pm to 8pm Mon-Fri and 8am to developing improved GP premises use on top of what their pay for making and that patients say they want 8pm Sat and Sun and additional investment for own practice offers – changing appointments by practices serving populations for opening hours are 4pm phone at any time of the whom English is not their first to 8pm Mon-Fri and day and without having to language and consult via 8am to 8pm Sat and speak to a receptionist • Five extended access hubs for all Five extended access hubs for all interpreters Sun and offering more online patients to use on top of what patients to use on top of what consultations their own practice offers – their own practice offers – CCG money going to practices opening hours are 4pm to 8pm opening hours are to pay for training, support and 4pm to 8pm Monday - Friday Mon-Fri and 8am to 8pm Sat formal quality improvement and Sun and 8am to 8pm programmes Saturday and Sunday
Mental Health in Primary Care Achievements More comprehensive depression reviews : In 2017-18, GPs reviewed 3,564 patients on anti- depressants covering physical health, medication and whether they have the right support from psychological therapies and wellbeing interventions A best practice site : In 2018, City and Hackney primary care mental health services were selected by the Healthy London Partnership as a best practice learning site with findings to be shared across NHS
Primary Care Achievements City & Hackney CCG 83% Good
Integrated Commissioning Overarching Achievements Extended GP hours and launch of GP Hubs New school-based and vulnerable children’s health services Redesign of services to tackle childhood obesity Anticoagulation service to reach all GP registered patients New pilot to assess long-term care at home or community after discharge In urgent and emergency care, the joint procurement with NEL partners of the new 111 service
Unplanned Care Achievements Neighbourhoods model agreed as strategic priority for all City and Hackney New Homerton Hospital ambulatory service Seven day hospital and social care discharge New ‘discharge to assess’ model Improved care planning processes Health information exchange Working with partners across the East London Health and Care Partnership on services where a cross borough approach is beneficial In urgent and emergency care, the jointly procured new 111 service
Mental Health Unplanned Care We have expanded open door mental health crisis services, so that more people can get immediate help without needing to go through professionals first. Newly developed services at ELFT include: 24/7 Crisis line supported by a 24/7 urgent assessment team (launched in October 2017 ahead of national target) C risis Café for hot drinks and crisis support SUN project offering crisis planning and group support
Mental Health Unplanned Care City of London Street Triage Since being launched, Street Triage has reduced the number of people sectioned under the mental health act by the City of London Police by 46% Police surveys also show an improvement in working relationships with the NHS, substance misuse and homeless services Street Triage workers also provide important support to the police during suicide attempts which are particularly prevalent on the City of London's bridges
Planned Care Achievements New expanded anticoagulation service in the community 70% of blood taking services now provided in the community cutting down on patients’ trips to hospital Joint budgets and closer working with local government to improve the quality of care packages provided Work done to redesign Learning Disability Services to improve opportunities and outcomes for our residents
Mental Health Planned Care More people with anxiety and depression are recovering after receiving psychological therapy. City and Hackney now has the second highest recovery rate in London (out of 32 CCGs) and third highest number of people accessing treatment . City and Hackney also achieved its Quality Premium for its high BME recovery rate and older adult access rate Low Intensity therapy can now be accessed directly on-line, backed up by professional support, with or without a GP referral Waiting times for psychological therapies have improved – in 2017/18, over 90% of patients started treatment within six weeks of referral
Children, Young People and Maternity Achievements Midwifery performance at Homerton Hospital rated as “Good” Highest score in England for caring about the emotional health of our new mums and their families New services to women with moderate to severe mental health needs and help for them to raise healthy families Improved, re-designed children's health services, including: Audiology, School Based Health Services, the Family Nurse Partnership and Obesity early prevention services Provision of Special Educational Needs and Disability credited as being “Good” from joint OFSTED and CQC inspections
Mental Health Children and Young People Schools: the Children and Young People’s transformation pilot programme saw mental health clinicians in at least 50% of City and Hackney schools during the year, helping teachers identify young people vulnerable to mental health issues in order to put in place early support. We aim to extend this to all schools Access: City and Hackney’s mental health services saw more children and young people than any other borough in 2017-18
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