Annual General Meeting 2014/15 Dr Tim Spicer 14 July 2015
Welcome This is our second 2014/15 was our The patient is at Annual General second year as a the centre of all Meeting fully authorised we do CCG We aim is to We continue to commission the work as part of an highest quality established care for the Collaborative of population CCGs in NWL
Introduction to the CCG We commission We have 31 Primary care is hospital care, member practices changing, urgent care, and a population providing more community & of around 200,000 services closer to mental health patients services We are aiming to Hospital care is invest more in changing, mental health to focussing more on achieve specialist care commitments of parity of esteem
Agenda for today Annual General Meeting 4.15 Arrival, tea and coffee 4.30 Introduction and scene setting Dr Tim Spicer 4.35 Some local achievements Patient and public engagement Trish Longdon Changing face of primary care Dr Tony Willis Changing mental health services Dr James Cavanagh 5.05 Working in collaboration across Clare Parker North West London 5.15 Quality and Safeguarding Jonathan Webster 5.25 Annual Accounts 2014/15 David Tomlinson and 2015/16 budget 5.35 2015/16 priorities Janet Cree 5.45 Questions Dr Tim Spicer 6.00 Close
Patient and public engagement Trish Longdon Governing Body Lay Member
I am actively sharing the patient voice at CCG committees I worked with other patients and organisations across NWL to shape the future of wheelchair services I shared my experiences as a new mother to help develop mental health services I am now able to book Sharing and change my GP appointments online Success I can now follow the CCG on Twitter I shared my experience of inadequate changing facilities at the hospital for my child with complex needs, now they I can now choose the nurses and have Changing Places carers that help me everyday with facilities my long term condition
What can the CCG improve on? Patient People Participation being Groups at GPs prepared to share their experiences Improving links with groups in the community
Quotes from CIS Video It’s incredibly good for one’s outlook on life I know I’m going to get better now They couldn’t be any nicer and they take good care of Now I’ve got you confidence After they came it’s all changed. It’s a big relief I can’t tell you It’s the most what it meant to wonderful, be back at home wonderful service
Out of Hospital Services Commissioning quality services closer to home Dr Tony Willis 14 th July 2015
Collaborative-wide Primary Care Contracts Contracts with GP federation to deliver a range of services aimed at improving care • Proactive • Local • Quality based • Patient experience • Evidence based
Out of hospital services (17 in total) • Ambulatory BP monitoring • Mental health • Anticoagulation • High risk medication • Care planning • Phlebotomy • End of life care • Ring pessary • Diabetes • Spirometry • ECG • Wound care • Homeless
Focus on diabetes 3 contracts to improve diabetes care • High risk of diabetes • Level 1 (key care processes, care planning, reducing hypoglycaemia risk) • Injectable initiation
Local issues • Wide variation in quality / • No unified diabetes model of 1 ° care delivery guidance for clinicians • Diabetes care in silos • Low levels of pre-diabetes intervention • Low uptake and completion of structured education • High levels of prescribing expenditure • Little patient involvement in decisions about own care
Care planning 1 st visit Information gathering Between Information sharing visits Agenda setting shared decision making 2 nd visit Agenda and shared goals and actions (care plans) Goal follow up
Invitation letter
Common elements • Common GP clinical system (SystmOne) • Network based contracts (min population 30k) • No exception reporting • Patient empowerment • NHSE and Diabetes UK representation • Named diabetes lead GP and nurse for each practice • Diabetes education programme for clinicians • Diabetes care dashboard • Encouragement to focus on patient goals
Example of guideline page
Dashboard • CCG, network, practice, patient • Aim to reduce variation • Peer review • Discussion at MDGs • Target learning • Patient experience a factor
London Strategic Clinical Network – Models of care
Changing mental health services James Cavanagh GP Governing Body Member and interim Vice Chair
Mental Health • H&F CCG supports the national ambition of achieving parity of esteem between mental and physical health by 2020 through the following programmes: Shifting Settings of Care: people receiving their care closer to their homes, and in a less-intensive environment. Urgent care: Developing a single point of access of all referrals to secondary care. Memory services: delivering a service which is GP-led and support people with dementia and their carers after their diagnosis. Perinatal: supporting mothers and fathers with mental illness through their pregnancy and post natally. Delivering on national wait times eg IAPT, Early Intervention Psychosis.
Back on Track- IAPT service A talking therapies service for those with common mental illness (anxiety and depression). 16% of those with common mental illness have accessed this service (15% nationally). 50% of those who enter treatment recover. Low wait times for treatment. Wide range of therapeutic modalities; groups; CBT: 1:1 and couple counselling. Supporting and educating those with a long term condition on how to manage their condition, eg diabetes. For 15/16: Digital solution for those who wish to access online support. Locating in job centre to support those getting back to work
Working in collaboration across NW London Clare Parker Accountable Officer
Collaborative working with neighbouring North West London CCGs • Collaborative with Central London, Hounslow, West London and Ealing CCGs • Shaping a Healthier Future with 7 CCGs in NW London
Our vision of care Improved hospitals delivering better care Promoting 7 days a Wellbeing week, more and services improving available Multi- mental closer disciplinary health for Better out of to home Care North hospital co- West services, People are ordinated London greater empowered around access to to manage the GPs at their own patient, convenient wellbeing led by times and and health the GP locations 7 days a week
Primary care transformation • Network-based services • Online services and convenient appointments • Common IT network • Out of hospital services • Primary care joint co-commissioning
Whole Systems • 9 Early Adopters, unique models of care • Co-produced Integrated Care Toolkit • Information & Data Sharing • Facilitating expert input and sharing best practice • Next steps : Launch & Sustain, Change Academy, Pooled budgets, Evaluate
Mental health • Mental Health & Wellbeing transformation • NWL Crisis Concordat • Acute psychiatric liaison services • Primary Care Plus • Dementia strategy and framework
Acute reconfiguration • A&E from Hammersmith and Central Middlesex Hospitals • NW London Urgent Care Centres 24/7 • Ealing Hospital maternity, neonatal & paediatric transition • Implementation Business Case development • 7 day services • Engagement and communications
Quality and safeguarding Mary Mullix Deputy Director of Quality, Nursing and Patient Safety
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