Annual General Meeting 2016 Dr Neville Purssell, Chair
Annual General Meeting Wednesday July 13 2016 Time Topic Presenter 18:30 Open forum with CCG & partner organisations 19:00 Introductions & Scene Setting Dr Neville Purssell, Chair 19:05 Overview and achievements in 2015/16 Dr Neville Purssell, Chair (i) Mental Health (ii) Homelessness (iii) MSK 19:25 Working in Collaboration across North West Clare Parker, Chief Officer London 19:40 Quality & Safeguarding Jonathan Webster, Director of Quality and Patient Safety 19:50 Annual accounts & 2016/17 Budget Deputy Chief Financial Officer: Helen Troalen 20:00 Priorities 2016/17 Jules Martin, Managing Director 20:25 Question and Answer Session 20:55 Last thoughts and Close of Meeting 21:00 Close
Central London CCG? We have 35 Patients and 2015/16 was member The patient is at This is our third GPs at the our third year practices and a the centre of all Annual General heart of as a fully population of we do Meeting everything we authorised around do CCG 200,000 GB consists of We commission GPs, practice CCG Council of The CCG Chair hospital care, staff, lay Members and is elected by urgent care, members, a Governing the Governing community & secondary care Body Body members mental health consultant and services CCG officers 3
Part of a larger system Central London CCG Tri-borough CWHHE CCGs Collaborative North West London CCGs Collaboration Whole London Five year forward view 4
Overview & Achievements 2015/16 Year of achievement and challenge • Vision: personalised, localised, integrated and specialised care for local people This means • Making it easier to book weekday, evening, and weekend GP appointments • Providing better staffed specialist hospital units 24/7 • Focus on mental health services • Coordinating your care better across the NHS • Moving more healthcare services closer to your home Year ahead promises to be one of challenge and opportunity • Increasing demand for mental and physical health problems • Pressures on financial position • Important CCG focuses on clear transformational plans that are achievable
Mental health and wellbeing Clinical lead: Dr Paul O’Reilly Delivery Manager: Robert Holman
Mental health in Central London National context Local context • Mental health affects all of us • Population increasing • Significant social costs of mental ill • Ageing population health • High incidence of mental ill health • Lower life expectancy for people with • High homeless population serious mental illness • Historically under-funded
NWL priorities PERSONALISED LOCALISED INTEGRATED CENTRALISED I know how to My care is now I’m not treated ‘in I have a positive I can manage I can access lead a healthy more convenient parts’, but as a My mental experience which I can access my health and excellent and physical have positive lifestyle and can because the whole person in a helps me feel support near support relationships, health needs to where I manage my own services closer to coordinated way. confident in the secure housing, are met quickly when live or work. financial care. my home are more quality of care together. I am in crisis. security, etc accessible. provided to me. I feel in control over my care because I know I will be Whoever I see, I am (in hospital) no My needs are decisions are I am provided with a knows me and my longer than I need to I get the right I don’t have met in the involved in taken with me wider range of high preferences, and I be, and am able to support to help to tell my least restrictive planning me recovery and consider my quality care within no longer have to receive effective care setting – in the story to lots my care from a crisis lifestyle and my community for community repeat my details sooner rather than of different and live and where people. individual all of my health and each time. later. independently. support. possible. choices wellbeing needs .
Successes • Developed high quality, responsive services for people in crisis • Diagnosing dementia early, to support people to live well • Improved access to evidence based therapies for people experiencing psychosis for the first time • Improving access to psychological therapies which help people with anxiety and depression to recovery • Commissioned partnership to manage Primary Care Mental Health services
Successes • Developing better mental healthcare for women during and after pregnancy. • Rolling out innovative suicide awareness training • Joint leadership across West London & Central London.
Challenges • Need to ensure our investment in mental healthcare delivers good outcomes for patients and value for money for the taxpayer • Are we doing all we can to treat mental and physical health in an integrated way? • How do we reduce reliance on hospital care and specialist (secondary) care? • How do we promote resilience within the population?
Intermediate Care Network for Homeless Health Partnership Clinical lead: Dr Paul O’Reilly Delivery Manager: Sophia Malik
Background 25% of all rough sleepers in England and Wales are in Westminster, accounting for 50% of rough sleepers in London. Homeless People: • Access A&E 7x more than the general population. • Tend to have more co-morbidities than the general population. • 1 in 5 rough sleepers who had contact with hospitals had 3 or more diseases • Are 40x less likely to be registered with a GP • Are likely to die much younger than the general population. • Are over 9x more likely to commit suicide than the general population 13
Our Response Following on from various Department of Health pilots, in October 2015 Central London CCG launched the Integrated Care Network (ICN) for Homeless Health. Hostel Beds GP Integrated Care Leadership Care Network Coordination and street outreach Homeless Health Team Redesign 14
The GP Perspective 15
Patient Case Study • Elderly street homeless woman • Critical lung issues • ICN stay meant she was able to engage with health service • Resulting in health improvements and in accommodation 16
Impact Wellbeing measured with EQ5D (a measurement Health Outcome assessed tool) at start and end of by clinician during patient’s patient’s term with the final week with the service service
Impact Even in these early days the results are extremely promising. 18
Community MSK Service Clinical lead: Sheila Neogi Clinical partners: Nick McGrath and Neil Cook Senior Delivery Manager: Will Reynolds
Service Model • Clinical triage of all referrals • Community-based multi-disciplinary team: Orthopaedics, Rheumatology and Pain clinics • Non-Surgical Rehabilitation Sports and Exercise Consultant and specialist GP clinics • Ultrasound Guided Injections on-site in the community • Condition management class rehabilitation programmes 20
Innovation • Innovative patient self-referral approach: web-portal and telephone (demonstrated at our Planned Care stall!) • Consultant-led primary care education • Developing patient empowerment, health-literacy and self- management • Pioneering e-consultation with Primary Care • Acute Rheumatology and Pain Consultant joint clinics now provided in the community 21
Sites • New purpose-built clinical space is being developed at a hub site in the North - due to open in August ’16! • Delivery from SWC in the South continues as well as across a range of GP premises across the locality • Local leisure centre site for non-medical setting of rehabilitation class programmes Convenient, friendly and welcoming local services! 22
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Patient Satisfaction Patient numbers 1,200/month, 20% surveyed
Working in Collaboration across North West London Chief Officer: Clare Parker
Shaping a Healthier Future overview Two distinct parts to these plans: local service improvements, which includes primary care transformation and whole systems integration to better coordinate health and social care; and changes to our hospitals. Our plan was to: • make progress in local services as quickly as possible to improve care for patients and take pressure off hospital services, especially A&E • at the same time, there were a number of key hospital changes that needed to take place on safety grounds • we would then move to secure the capital funding needed to modernise our hospital and primary care facilities, through the ImBC. Local services will be in place before changes to hospital services are made. 27
Local service improvements: NW London-wide • NWL GP practices offer extended opening weekday hours (8am-8pm) and weekend access to over a million people in NW London • Investment in new technology at 80 GP practices means they now offer online, email, video or telephone consultations to over half a million patients • Eleven primary care hubs are already providing access to primary care and social care services in one place • A single discharge agreement in place across NWL to get patients home quickly and safely reducing stays by up to three days • Nearly two-thirds (250 of 389) of NWL GP practices have signed up to an information sharing agreement 28
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