Harrogate and Rural District Clinical Commissioning Group Patient and Public Involvement Group presentation
Welcome • Dr Alistair Ingram – GP and Clinical Chair of the CCG • Amanda Bloor, Locality Director for Harrogate and Rural District at NHS North Yorkshire and York
Agenda for this meeting Scene setting • The Health and Social Care Act 2012 • What is a Clinical Commissioning Group (CCG) • Harrogate and Rural District CCG (HaRD CCG) • Questions / Discussion Patient and Public Involvement • How we see this working locally • Discussion • Comments our proposed approach • Any other suggestions on how we could do it differently? • Feedback from discussions
Scene setting
Health and Social Care Act 2012 • Announced by the coalition Government in May 2011. • Received Royal Assent in April 2012. • NHS modernisation is essential for three main reasons:
Health and social care act (2) 1. Rising demand and treatment costs . Demand is growing rapidly as the population ages and long term conditions become more common; more sophisticated and expensive treatment options are becoming available. The cost of medicines is growing by over £600m per year. 2. Need for improvement. There are important areas where the NHS falls behind those of other major European countries. 3. State of the public finances. Whilst the Government has maintained the NHS budget, this is still among the tightest funding settlements it has ever faced. Simply doing the same things in the same way will no longer be affordable in future.
National Context • Until now, vast majority of health services people access were commissioned (selected and paid for) by Primary Care Trusts (PCTs) • The Health and Social Care Act heralds huge reforms to ensure decisions about health services are made as locally as possible, by clinically-led organisations • This means PCTs will be abolished by April 2013 and new Clinical Commissioning Groups (CCGs) will take responsibility for identifying and commissioning local health services
What is a CCG? • A Clinical Commissioning Group (CCG) is a group of local GP practices. • By “health services” we mean services typically provided by large hospital trusts, including community, mental health and voluntary services. • CCGs will ‘shadow’ the existing PCT until April 2013, after which time they will take full responsibility for commissioning the majority of your local health services
CCG Governing Body • Chair of Governing Body (a non-executive Chairman) • Clinical Chair • Accountable Officer • Chief Finance Officer • GP(s) acting on behalf of member practices (Board GPs have been aligned to groups of practices) • Lay member – lead role in overseeing key elements of governance • Lay member – lead role in championing patient and public engagement • Clinical member – registered nurse • Clinical member - doctor who is secondary care specialist
How do CCGs fit in the new NHS?
Harrogate and Rural District CCG HaRD is the emerging CCG for the residents of the Harrogate and Rural District.
HaRD CCG (2) • Represents 19 member GP practices • Aligns with the local authority boundary of the Harrogate Borough Council • Serves a resident population of around 160,000 Our main service providers are: • Harrogate District Foundation Trust (for hospital and community services) • Tees, Esk and Wear Valleys NHS Foundation Trust (for mental health)
HaRD CCG (3) • Is working towards full authorisation as a statutory NHS body • Is aiming for authorisation in the autumn of 2012. • Is until then a committee of NHS North Yorkshire and York’s Board • Is accountable for £179 million of the local NHS budget from April 2012 • Has six GPs on our Board (organisational structures currently being determined) • Is developing our longer term commissioning strategy • Has agreed our vision and values - an organisation with a culture of transparency and inclusivity.
HaRD CCG (4) Does Not: • Commission Primary Care – GP’s, Dentists, Optometrists, Pharmacists. These will be commissioned by NHS Commissioning Board. • Want this forum to be about complaints. There are mechanisms already in place for this.
Our Vision “We will secure high quality services, in the most appropriate setting, making maximum use of available resources. Through clinical leadership and collaborative working we will achieve the best possible health outcomes for all our local population.”
Our Values Aligned to the NHS Constitution: • Respect and dignity • Commitment to quality of care • Compassion • Improving lives • Working together for patients • Everyone counts
5 Strategic Priority Areas Five overarching strategic priorities for the local area, based on data from the Joint Strategic Needs Assessment (JSNA), Quality Outcomes Framework (QOF) registers, local population and Office for National Statistics data: 1. Urgent Care 2. Integrated care 3. Planned & effective care 4. Vulnerable people 5. Health and Well Being Strategy We have clinicians leading and influencing the work in each of these areas . . .
GP Board Portfolios • Alistair Ingram – Clinical Chair; leading on Health & Wellbeing Board and the North Yorkshire Review • Rob Penman – leading on Urgent Care and Prescribing • Chris Preece – leading on Integrated Care and Long term conditions • Rick Sweeney – leading on Vulnerable people, safeguarding • Sarah Hay – leading on Planned, safe & effective care • Gareth Roberts – leading on Planned, safe & effective care
Board Chris Preece Chris Preece Practice Dr Akester and Ptrs Dr Akester and Ptrs Alignment North House North House Dr Fletcher & Ptrs Dr Fletcher & Ptrs Dr Burton & Ptrs Dr Burton & Ptrs Rick Sweeney Sarah Hay Rick Sweeney Sarah Hay Dr Bannatyne & Dr Bannatyne & Partners East Parade Surgery Partners East Parade Surgery Stockwell Road The Spa Surgery Alistair Ingram Stockwell Road The Spa Surgery Alistair Ingram Eastgate Surgery Park Parade Surgery Link with H&WB Eastgate Surgery Park Parade Surgery Link with H&WB Beech House Surgery St. Luke’s Practice Beech House Surgery MPs St. Luke’s Practice MPs Councillors Councillors NYSR NYSR Gareth Roberts Rob Penman Gareth Roberts Rob Penman Nidderdale Group Leeds Road Surgery Nidderdale Group Leeds Road Surgery Dr Asaad &Partners Springbank Dr Asaad &Partners Springbank Dr Moss &Partners Church Lane Dr Moss &Partners Church Lane Kingswood Surgery Surgery Kingswood Surgery Surgery
Strategic Priorities 1. Long Term Conditions/Integrated Care A Long Term Condition is; “a condition that cannot be cured but can be managed through medication and/or therapy” Includes diabetes, asthma and coronary heart disease. Around 15 million people in England with at least one long term condition. We are participating in a Department of Health national development programme for LTCs. This identifies 3 key areas: 1. Risk profiling 2. Integrated team working 3. Self care/shared decision making Integrated Care; Losing barriers between aspects of Health and Social care.
Strategic Priorities 2. Urgent Care As part of this work we aim to review: • A&E utilisation • Ambulance services: urgent and patient transport • Out of hours services • Local pathways to be included in the new NHS 111 service • Primary care minor injuries enhanced services • Paediatric Clinical Assessment services
Strategic Priorities 3. Planned safe and effective care Areas of focus in planned care are: • Ensuring best practice pathways are utilised. • Using Commissioning for Quality and Innovation (CQUIN) to drive quality improvements • Reduce length of stay in hospital • Redesigning pathways in ophthalmology and urology • Deep Vein Thrombosis (DVT) prevention • Rates of referrals to secondary care
Strategic priorities 4. Vulnerable people • Improved care for people with dementia • Reducing inappropriate hospital admissions for Care Home residents
Strategic priorities 5. Health and Well Being Strategy This will link to Joint Strategic Needs Assessment (JSNA) Likely to target areas that impact on wider public health and longer term outcomes: • Smoking Brief intervention • Alcohol – responsible drinking • Children's’ services – healthy start • Healthy eating • Exercise/physical activity
Patient and Public Involvement “You have the right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services.” NHS Constitution
Proposal for a HaRD PPI Group • Open to representatives from each of our GP practices. • Regular meetings – quarterly? • Allows the CCG to engage in open discussions on commissioning strategy, service modernisation plans, redesigning of care pathways. • Enables a two-way dialogue directly between the CCG and patients.
Discussion -Tell us what you think of our proposal? - Any ideas on how we could do it differently? - What things do you think we need to consider? - Please fill in the feed back forms
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