Welcome
Housekeeping • Please turn your mobile phones off or put them on silent. • No fire alarm is planned today. If you hear the alarm, please make your way outside. • Toilets are available at the back of the main room
Aim of today • To update you on the development of Enfield CCG • To inform you about our key plans and priorities over the coming year • To build relationships with our key stakeholders and our local population • To give you the opportunity to get more involved in Enfield CCG
Today’s agenda We will start with some presentations: • About Enfield CCG • Our Commissioning Strategy and QIPP plans • Update on Healthwatch Enfield Then we will have an opportunity for you to ask questions. We will break for some food and refreshments at 6pm. At 6:30pm we will ask you to take part in some workshops on our key strategic plans.
Listening to you Your feedback is important to us today. We want to work closely with our stakeholders and our local population in developing our plans for the future. We would like you to get more involved in the CCG. You can: • Attend a Governing Body Meeting • Join your GP practice’s Patient Participation Group • Sign up to our mailing list • Volunteer to help us improve services for local patients • Visit our website www.enfieldccg.nhs.uk for more information We will ask you to fill in a feedback form about today’s event and we will make a report available in a few weeks time summarising everything we have discussed.
About Enfield CCG Presentation by Dr Alpesh Patel and Liz Wise
About CCGs • Clinical Commissioning Groups (CCGs) were created as part of the changes set out in the Health and Social Care Act 2012. • CCGs are led by GPs and are intended to improve clinical leadership in commissioning. • Every GP practice is now a member of a CCG and have signed up to a local constitution. • All CCGs have recently been through a vigorous authorisation process led by the NHS Commissioning Board which tested their ability to: - commission services - manage the funding - improve quality, reduce inequality and deliver improved outcomes for our patients within the available resources • During the authorisation process, we were working in shadow form with our PCT cluster NHS North Central London. PCTs closed on 31 March 2013. • We have been authorised and on 1 April 2013, Enfield CCG became the new statutory body responsible for planning and commissioning health services for patients in Enfield
Vision, mission and goals Our Vision • We are committed to commissioning services that improve the health and wellbeing of residents of Enfield borough through the securing of sustainable whole system care Our Mission • Local clinicians working with local people for a healthier future. Our Strategic Goals • Enable the people of Enfield to live longer fuller lives by tackling the significant health inequalities that exist between communities • Provide children with the best start in life • Ensure the right care in the right place, first time • Deliver the greatest value for money for every NHS pound spent • Commission care in a way which delivers integration between health, primary, community and secondary care and social care services “ Local clinicians working with local people for a healthier future ”
Enfield CCG’s locality approach • Population 2012: 312,000 (source: ONS) • Ethnically diverse: 154 languages spoken in Enfield schools • Coterminous with Enfield Council • 54 GP practices • 3 main local providers: Barnet, Enfield and Haringey Mental Health Trust Barnet and Chase Farm Hospitals North Middlesex University Hospital
Governing Body sub committees: chairs and membership
Understanding our challenges • Scope and complexity of clinical service and organisational change across all three main providers • Long history of an unsustainable system and scale of financial recovery • Pace of leadership and organisational development of the CCG
Quality and safety: putting patients at the heart of everything we do We will strive to improve the quality within our commissioned services through highly effective clinical leadership
Maintaining quality during strategic changes • Scope and complexity of clinical service change across all three main local providers • Barnet Enfield Haringey Clinical Strategy • Clinically supported • Secretary of State approved: A&E, Maternity and Planned Care changes, enabled by: • Primary Care development strategy and • Integrated Care Programme • FT related organisational change : • North Middlesex University Hospitals • Barnet and Enfield Mental Health Trust, including Enfield Community Health Services • Barnet and Chase Farm Hospitals with Royal Free Hospital NHS FT
How we are making a difference What motivates us to lead clinical change for member practices and patients? • Connecting practices together in new and different ways through primary care development networks signposting earlier opportunities to improve health and reduce outcome inequalities • Getting the books back in balance through sustainable, clinically-led re-design and re-shaping the provider landscape to work more productively, by integrating high quality care with and for patients • Seeing patients increasingly as partners in their own care with their practices by involving them more in lifestyle, self care, treatment and re- design decisions
Sustaining two way accountability Working in Partnership – clinically led change Member Practices involved in decision making re: structure and governance arrangements and the Involvement of Member Practices planning and development of services. Locality Leads holding Locality Group meetings bi-monthly. Consulting – locality and clinical networks Gaining views of the practices and patients , e.g. through Locality Group meetings, Protected Learning events (PLTs), Informing – named representatives Keeping all Member Practices up to date on proposed or planned changes e.g. through Locality Leads, Protected Learning Time,, CCG Newsletter, CCG Website, Patient Participation Groups, Clinical Network Leads.
Our Health Challenges Dr Shahed Ahmad, Joint Director of Public Health
Our health challenges THE CHALLENGE •Very high levels of poverty and child poverty •High rate of childhood obesity •Large gap in life expectancy •Life expectancy for women in Upper Edmonton the worst in North Central London •Blood pressure control still below national average THE GOOD NEWS •Best improvement in Year 6 childhood obesity rates in London •Improvement in blood pressure control •Best improvement in life expectancy in North Central London
Children living in poverty in north central London Child poverty - August 2007 30000 27050 24485 25000 20000 18555 17120 15600 15000 10000 5000 0 Camden Islington Barnet Haringey Enfield
Enfield has amongst the highest rates of childhood obesity in the country Obesity by local authority Obesity in children aged 10-11 • Reception 4 th worst nationally 14.4% years • Year 6 – 5 th worst nationally 25.1% Position in England Least deprived (38) Worst 10% (72) Worst 25% (37) Worst 50% (34)
Our health needs Life expectancy: female
Our health needs Life expectancy: male
Causes of the life expectancy gap in Enfield
Causes of Life Expectancy Gap in Enfield
Approaches to tackling health inequalities: systematic and sustainable ������������������������������� Short Term - Treatment of already existing conditions or risk reduction in people already at high risk of developing the major causes of morbidity � Medium Term - Lifestyle approaches. � Long Term - Addressing Wider Determinants of Health. � ���� ���� ���� ����
Approaches to tackling health inequalities: commissioning for best outcomes
Health and Wellbeing strategy priorities Health and wellbeing strategy Moving to Public Health Excellence Strengthening A healthy start Narrowing the Healthy Healthy places partnerships for every \child gap lifestyles and capacity •Healthy Enfield •Smoking •Healthy Parks •Childhood obesity •Cardiovascular •Health is everybody’s •Physical Activity •Temporary •Immunisation diseases business •Healthy eating accommodation •Infant Mortality •Cancers •Health in every policy •Obesity •Teenage Pregnancy •HIV •Making every •Alcohol •Screening contact count •Healthy Ageing
Improvement in controlling blood pressure and cholesterol levels CHD 6 National Ranking for Enfield CHD 8 National Ranking for Enfield 2008/09 149th 2008/09 141st 2009/10 134th 2009/10 128th 20010/11 110th 20010/11 121st (1st being the best and 152nd the worst) Source: Informational Centre
Largest Percentage improvement in AAACM for males in NCL cluster 2008-2010 14% 12% 10% 8% 6% 4% 2% 0% Barnet Islington Camden Haringey Enfield
Commissioning Plan 2013 – 2016 Richard Quinton Director of Finance and Commissioning
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