NHS City and Hackney CCG Commissioning Intentions 2017/18 and 2018/19 1
Tonight is about hearing your thoughts 2
Planning The NHS planning timescale this year means that the contracts for the services planned for the next two years must be signed in December 2016. Our plans reflect both national and local priorities. Some of the local Issues we want to address: Cardiovascular mortality for under 75s • high for the least 20 years, but now declining Obesity rates still high • Smoking • High A&E attendances • Emergency admissions for over 75s still • high High levels of mental health need • One year survival rate for cancer is • improving, although overall mortality still 3 not good
Joint planning with City and Hackney We are working with London Borough of • Hackney and City of London Corporation to plan health, social care and public health services together. These arrangements will become more formalised from next April. By doing this we want to support our • providers to also work better together and join up services around the patients’ needs. Examples of this more joined up way of • working include: Developing a care model that enables • different professionals to look after the patient together, as a team. (quadrant based model) Setting up a single place to contact • services when in crisis (single point of 4 access)
Opportunities for Patient and Public Involvement(PPI) We want our services to reflect our local populations and their needs which is why local • residents and patients are involved in all our decisions. Our plans and ideas come from talking to patients and members of public, as well as • local GPs who form our membership. Our PPI structures were rated ‘outstanding’ by NHS England in 2015/16. • People can get involved in the CCG’s work through the following groups and • structures: 5
Where the CCG will spend its resources in 2017/18 Property Costs 0.5% Homerton NHS Foundation Trust 29.7% Running Costs 1.6% North East London Acute Trusts 8.5% Prescribing 7.5% Other Programme 7.5% Other London Acute Trusts 10.1% Homerton NHS Foundation Trust Primary Care 3.5% 29.7% London Ambulance Service 3.2% Continuing Care 6.6% Other Acute Trusts 1.1% Mental Health Services 12.9% Community Health Services 7.4% North East London Acute Trusts Community Health Services 7.4% 8.5% Mental Health Services 12.9% Continuing Care 6.6% Other London Acute Trusts Primary Care 3.5% 10.1% Other Acute Trusts 1.1% Prescribing 7.5% Other Programme 7.5% London Ambulance Service 3.2% Property Costs 0.5% Running Costs 1.6% Whilst the CCG is continuing to make investments in areas of local health economy needs, it continues to meet and exceed the National Mental Health Parity Of Esteem targets each year. £14m of non-recurrent funding has been made recurrent to facilitate this investment. 6
Pooled budgets CCG = Clinical Commissioning Group PH = Public Health 7 SC = Social Care
Long Term Conditions: You said… We did Our “Time to talk” scheme Peer support is You said.. (extended consultations for helpful people with multiple long term conditions) is a good idea We did We re-commissioned this We commissioned Hackney Council service and have expanded for Voluntary Services to run a grant it to include people with programme for local organisations to sickle cell disease as a offer peer support groups for people single condition with a range of long term conditions
Long Term Conditions Planned Work More people will have access to longer consultations and • reviews with their GP practice People will be supported to help themselves and manage • their condition through a range of different services including peer support and education We will find and treat more people with high blood pressure • People with Learning Disabilities will get enhanced support • from their GP and improved job opportunities
Primary Care Quality - You said… We did “Look at other “as we C&H patients ways of recognise that said… offering staff are under appointments pressure…” …” Commissioned We did As part of the same the GP contract some Confederation to practices are starting pilot on-line to try out group consultations - consultations for some practices people with certain have just started long term conditions offering these
Primary Care Quality Planned Work The NHS has an aspiration that all patients in the country • have access to weekend/evening routine GP appointments by 2020. City and Hackney CCG is considering how it can give • patients the opportunity to consult with their GP practice outside of standard practice opening times - which for most C&H practices is 8 am to 6.30, Monday to Friday.
Crisis Services (Urgent & Integrated Care) You said… We did Patients and carers find it You were difficult to know whether concerned that our to call 111, or our local We need more intention to keep You said out of hours service services for older people out of CHUHSE. Adding the people. hospital may not be Paradoc service as in some people’s another option to call best interest. would be asking people to make clinical judgments that GPs are best qualified to make. We did The GP contract Urgent care services will which supports continue to be managed Nursing Homes will in primary care with continue until January patients accessing GP’s 2019. The Frail Home We used this feedback telephone assessment in Visiting service will when revising service and out of hours. The have permanent specifications for our crisis sickest patients will be funding from 2017/18. services. visited at home or referred to hospital, with community teams supporting patients at home where it is safe to do so.
Crisis services Planned Work Simplifying access to urgent care services through a new integrated urgent care • service (111) and the development of a single point of coordination for crisis care services. Ensuring patients receive joined up health and social care through better integration • and coordination of multidisciplinary teams (quadrant working). Avoiding long hospital stays and ensuring patient choice through improved discharge • processes. Ensuring that patients approaching the end of life have the opportunity to express their • wishes about future plans, and be supported to die in the place of their choice.
Planned Care - You said… We did People who You were discharged communicate by Sign or after a procedure but You have no alternative can’t speak English said You Said couldn’t get your but to go to A & E with they were having dressings changed and Minor Eye Conditions problems with stitches removed at because you couldn’t accessing health your GP practice see anyone quickly services in the City of London and Hackney A new Post-Operative We did We are working with We will improve community Wound Care Service Islington CCG to and GP Practice started in April giving City commission a new service interpretation services by and Hackney patients for Minor Eye Conditions providing face-to-face access to dressing to provide care in 24/48 interpreting for those who changes at their local GP hours at a local Opticians- need it as well as greater practice, or one close by, 7 starting in early 2017 access to telephone and days a week. video interpreting
Planned Care Planned Work Develop a photography dermatology service so local GPs can send photos for • diagnosis directly to the consultant at the hospital. This will help some patients avoid a trip to the hospital and will enable the GP to start treatments more quickly Improve audiology services to provide better access to hearing tests in the • community Reduce cancer pathway delays - Aim to improve early diagnosis by achieving • 50% of patients diagnosed within 28 days by 2020. This will include supporting GPs to refer their patients straight to a diagnostic test so patients are diagnosed more quickly
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