NHS Croydon CCG Governing Body Tuesday 3 March 2020
Welcome to St Mary’s High School!
NHS Croydon CCG origins CCG concept laid out in 2012 by the Health and Social Care Act “Equity and Excellence: Liberating the NHS” Put commissioning into the hands of the GP
NHS Croydon CCG 2013-2020
Resilience and Resolve • Doing things differently, putting clinicians at the heart of decision making – pairing clinicians with managers • Focus on transformation • Re-designing pathways to ensure seamless transition between Croydon-based levels of care • QIPP / efficiency savings – over £100million saved through emphasis on quality improvements • Financial balance and surplus achieved 2018/19 • Our staff are central to this
Thanks to all our staff • Strength, resilience and leadership from our team • We’ve recognised many of our colleagues for living the CCG’s values
Thanks to all our staff • We hope to win big at the SWL “SAMs” awards later this month – half of the 16 nominated colleagues have been shortlisted: Nominee Award Category Aarti Joshi, Kamal Balakrishnan and team Innovation Development of the ‘blue button’ initiative Catherine Wallace Leadership Support & development of nurses and HCAs in general practice Daniel Dodd Partnership Working with LAS for alternative care pathways Daniele Serdoz & team Living independently for everyone initiative Quality improvement OOH team Croydon CCG Remote assessments to support hospital discharges to care homes Sudh Rai Sarah Blow's unsung hero Croydon Continuing Healthcare team Performance against national targets and delivery against QIPP Team of the year Joint Pharmacy Team Development of pharmacy team and QIPP
Our vision Longer healthier lives for all the people in Croydon
Our vision Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services
Innovation – services Personal Independence Huddles Integrated Coordinators Urgent Care FGM Telehealth
Innovation – technical and systems The Living Independently For Everyone (LIFE) Team Connecting • Mental health your Care • Primary Care Networks • Integrated Care Networks plus and Localities • Single IT system across Croydon GPs • Protected Learning Time
Our vision Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services
Working together – with partners One Croydon Alliance • Croydon Health and Care Plan Alignment with CHS • Joint Control total • Place-based leader and joint executives Health & Wellbeing Board Croydon Transformation Board Dementia Friends for Croydon NHS 70 SWL CCGs working together
Working together – with Croydon Council
Working together – patients and public engagement
Andrew Brown Chief Executive Officer Croydon BME Forum
Our vision Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services
Use resources wisely Quality, Innovation, Productivity and Prevention (QIPP) • Board made up of service managers, executive and GPs • Clinically-led • Focus on quality 13/14 14/15 15/16 16/17 17/18 18/19 Target £14m £11m £10.5m £18.4m £29.3m £27.6m Delivered £14m £11m £10.5m £14.5m £21.2m £26.7m
Use resources wisely Cost and Quality Oversight Board • The new QIPP • Brings together – Partners (CCG and CHS) – Functions (finance and quality) • The focus remains on clinically-led quality
Using Resources Wisely Medicines Optimisation Team – 2013 to now
Team Core Activities Financial Management Implementation of Best Practice •Implementation of NICE guidance. •Development of prescribing guidelines & GP prescribing resources e.g. Vitamin D guidelines and Patient leaflets •Input into service redesign: in relation to use of medicines in new care pathways, transformation plans e.g. new urgent care model •Delivery of Training events e.g. repeat prescribing processes •Medication Safety •Horizon scan for emerging drugs Reduction In Waste and Polypharmacy •Managed entry of new drugs & formulary development. • Facilitation of safe seamless care across the •Development of annual prescribing interface e.g. Hospital Discharge Referrals workplan and Prescribing Incentive process. Scheme (PIS). • Integrated Care Networks Pharmacist •Visits to all 57 GP practices to agree Service annual prescribing targets • Falls Prevention •Provision of hands on support and advice by Practice Support Pharmacists • Support to care Homes to each practice • Community Pharmacy Support e.g. •QIPP Domiciliary medication reviews
Using resources wisely
2013/14 – CQUIN with CHS to improve transfer of information post discharge 216 patients referred via this pathway from August 2013 to July 2014 Anonymised data analysed for six months before and after each referral 184 fewer A&E attendances (35% reduction) 155 fewer emergency admissions (35% reduction) 968 fewer emergency bed days (53% reduction) Cost avoidance of over £380,000
2017/18 – ICN Pharmacists Between April to December 2018 the team: • Managed 524 cases. • Identified 867 medication related problems equating to an average of 1.7 per patient. • Recommended 381 changes to medications to address clinical problems or waste resulting in a saving of £21,239. • Provided 685 episodes of patient or carer education. • Made 117 referrals to other professionals or services. • Using an adapted RiO scoring tool to estimate the likelihood that a medication related problem would have led to an admission had we not intervened, 65 admissions were avoided equating to an estimated saving of £205,786. 1. https://www.sps.nhs.uk/wp-content/uploads/2017/08/Croydon-explantory-doc.pdf
2018/19 – Self Care campaign Collaborative SWL approach to Engagement within the Local develop support material : System • Self Care Position Statement • CCG Chair letters to key stakeholders • Self Care Briefings for 36 conditions • Self Care Posters • Referral to Community Pharmacy Prescription Pads.
2019/2020 – Waste Campaign
Making the news….
Our vision Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services
Help people look after themselves Proactive and Preventative Care • Group consultations • NHS Parliamentary award • HSJ Value Award shortlist • Expert Patient Programme • Proactive support for people at risk of long term conditions
Help people look after themselves • Social Prescribing • Referral to local, non-clinical services to provide holistic support for people • Including exercise, social groups, debt advice and much more • Designed with residents to help people live healthier lives
Our vision Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services
High quality services Croydon Talking Therapies
High quality services Croydon Talking Therapies cont’d Dementia diagnosis Early Intervention in Psychosis
High quality services Cancer National 2019/20 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 Target YTD Cancer two weeks 93.0% 95.3% 95.6% 95.3% 96.7% 96.3% 96.9% 95.9% Breast symptoms two weeks 93.0% 95.5% 97.9% 95.3% 97.6% 98.5% 96.8% 97.8% First definitive treatment 31 days 96.0% 98.5% 98.1% 98.0% 97.7% 97.6% 97.6% 98.1% 62 days first treatment plus rare 85.0% 82.8% 77.0% 82.4% 84.4% 84.7% 83.2% 81.6% cancers First treatment 62 days, Screening 90.0% 95.3% 98.2% 92.4% 94.9% 89.3% 83.5% 92.7%
High quality services Learning disabilities • Croydon CCG is 22 out of 190 CCGs for the proportion of residents with an LD receiving an annual health check
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