Annual General Meeting 25 September 2018
Mike Maguire Chief Officer NHS West Lancashire CCG
NHS 5 Year Forward View Published in October 2014. It has a series of system expectations: • New systems of working both locally and nationally • Exploit the information and IT revolution • Accelerate Health Innovation Drive efficiencies and productivity
New NHS plan • A new NHS plan is beginning to be developed • With an extra £20.5bn for the NHS nationally over the next years • We want YOU to have YOUR say on how you feel this funding should be spent • Please visit the Healthier and Lancashire market stall to complete the survey, or visit this link: http://bit.ly/NHShaveyoursay
Whole System Working • First year of full co-commissioning of primary care alongside NHSE • Integrating community services with primary care • Developing closer working with VCFSE • Finding a sustainable solution for Southport and Ormskirk NHS Hospital Trust with Southport and Formby CCG along with ourselves • Financial stability of the whole system
The challenges facing our health and social care system – Quality of care A & E Access & wait times Readmissions • • Poor performance Access to a GP is a • Mental health growing challenge locally against 4 unplanned hour wait targets readmissions are • Number of worse than national programmes have average been introduced to • More awareness address this such as work required on Extended Access, other services extended hours at available to Walk-in centres, residents POD and promotion of self-care and use of pharmacy
The challenges facing our health and social care system – health and wellbeing Smoking Cancer Mental health Frail and elderly • • • • Higher rates of Main cause of A shortage of 80 Our population is premature deaths mental health beds getting older death due to smoke related illnesses, across Lancashire • • such as COPD Routinely missing and South Cumbria Elderly residents target of patients are living with • • Continued, greater seen within 62 days In Lancashire and multiple complex South Cumbria long-term health work around health risks of smoking there is double the conditions required average mental health referrals into services
Primary Care • Primary Care at Scale • Extended Access • Working in Neighbourhoods
A new era in technology • Orcha • Artificial Intelligence • Hospital of the Future • Better Points
Viran Medical Centre • Public engagement exercise open until Friday 28 September • Public and market engagement taken place since June 2017 • CCG commissioned H2A, an independent public and patient engagement consultancy to manage consultation process • Patient sub-group has been created to work with H2A and the CCG • Hilda and Helen from H2A are available today to take comments as part of engagement exercise • Final decision to be made after 8 October 2018
Looking ahead – 2018/19 • We will continue to work alongside our partners within the Healthier Lancashire and South Cumbria Framework and with the Cheshire and Merseyside Health and Care Partnership to address the challenges • We will continue to focus on a delivery of care outside of an acute setting and within the community that we started four years ago • We will continue to work with partners such as the VCFSE, Well Skelmersdale and West Lancs Borough Council, to help redress the health inequalities that our residents face in West Lancashire and focus more on health and wellbeing • We will focus more on supporting our care homes • We will aim to maintain our ‘good’ CQC rating and strive towards ‘outstanding’ • We want residents to share their views on the long-term financial plan for the NHS. Please see Lucy at the Healthier Lancashire and South Cumbria market stall for surveys or visit: http://bit.ly/NHShaveyoursay
Annual General Meeting (AGM) • Our annual report and accounts for 2017/18 are available online or upon request • The minutes of our last AGM are available to all attendees today
West Lancashire: • 112,000 population • 18 GP practices • Three neighbourhoods: Ormskirk & Aughton, Skelmersdale and Burscough and the Northern Parishes • £168m funding allocation • £1,500 per person
How we spend your money
Financial duties • Delivered our statutory duty to break-even on our revenue allocation • Managed within our cash limit • Operated within running cost allocation • Achieved our ‘Better Payment Practice Code’ • Clean audit report from External audit, including value for money opinion
Claire Heneghan Chief Nurse, NHS West Lancashire CCG
Transforming health and social care in West Lancashire
West Lancashire a picture of where we are at the moment • Our population is ageing • People are living longer with more complex illnesses and long-term conditions • The cost of drugs and new medical technology is rising • There are growing problems around mental health and wellbeing • Limited resources means we have to use our money wisely, ensuring the greatest benefit for our community as a whole • We need to ensure that the limited resources are invested fairly and equitably. We need to find the balance between health and social care
So what did we do? • The focus used to be on acute care within a hospital setting • Primary care and community services saw little investment • So we listened to our local population • These conversations lead to the development of the Building for the Future vision • Everything that we now do is centred around our neighbourhoods and our communities
So where do we need to focus? • We need to bring services out of hospital, with patients treated at home or in the community • We need to embrace technology • We need to focus on recruitment within primary care • We need to ensure that we offer value for money with ever increased financial pressures • We need to build safe, resilient, sustainable services
This is what we are doing to address these challenges
Dawn Threlfall Medicines Optimisation Project Support Manager NHS West Lancashire CCG
Prescribing Ordering Direct Service (POD)
Medicines waste programme • Successful waste reduction programme ‘Being A Hoarder Is Out of Order’ • Aimed at tackling issues of wasted medication thought to cost NHS £300m nationally and £600,000 per year in West Lancashire. • CCG saved more than expected of which, the medicines waste campaign played a key role and proceed right to do campaign
“Don’t Be a Waster” To celebrate anniversary of our medicines waste campaign we have relaunched our campaign with a fresh new look.
So what lessons did we learn? • Pharmacies ordering medication did contribute to wasted medicines • We still had pockets of vulnerable patients that pharmacies were ordering for that caused us concern • We set out to get our own systems in order but did not achieve this • Needed to trial new initiatives which is where our Prescribing Pod concept came from
Prescription Ordering Direct Service (POD) • This service is a new way in which patients can order prescriptions. • Started as proof of concept in Excel Primary Care. • Expanded across Skelmersdale Early 2018. • New POD opening in Burscough on the 1 October 2018 • Between the two POD’s will cover all practices apart from Beacon Primary Care, Viran, Parbold & Hall Green.
OUR VISION We will partner with our local stakeholders, providing a designated point of contact to support them with all medicines related issues. Working together, we will improve: SHARED COST TEAM CAPACITY ACCOUNTABILITY UTILISATION We will reduce the We will support the We will reduce the time required to implementation of a cost of medicines process strong, effective through appropriate prescriptions, neighbourhood, medicines use, the increasing the providing a reduction of capacity of the demonstrable medicine errors and practice workforce model to the reduction of to manage their highlighting the medicines waste. workload more benefits of cluster effectively . working.
WHAT DID WE DO TO ACHIEVE A PRESCRIBING CENTRE OF EXCELLENCE? 1. Set a clear vision 2. Planned to succeed – strong project management focus 3. Set measures that will provide benefits for patients, the workforce and the organisations 4. Pooled back office resources 5. Provided dedicated time and space 6. Professionals present to train and coach the workforce, embed change and realise savings 7. Opened phone line 8. Streamlined the workflow on emisweb
POSITIVE PATIENT OUTCOMES • Improved access to clinicians • Safer, more convenient prescribing • One place to discuss medicines issues • Care Navigation • Patient education both patients and Clinicians • Reduction in errors • Improved medication review and management of long term conditions • Identify red flags
Examples of positive patient outcomes
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