New NHS & Challenges in engaging commissioners and GPs

Dr Sachin Gupta GP, Welwyn Garden City RCGP GP Champion for Carers, East of England Macmillan GP

The new NHS

• White Paper 2010 - Puts patient and public first - Improve patient care - Allow GP’s to commission care - Involves local authority - Improves patient choice - Integrate health and social care

Health and Social Bill

• • • • • Aims Give patients more choice Give clinicians more control Give organizations greater freedom from central control and political interference Promote competition to improve patient care Scrutiny by local authority through ‘Health and Well Being Board’

Clinical Commissioning Groups CCGs

• • • Composition – GPs, other health care professionals, Finance Officer, CEO/Accountable officer etc. PCTs abolished CCGs began work on 1 st April 2013

Health & Well Being Board

• • • Includes Local authority, representative from local authorities, councilors, public health consultant, CCG GPs, health watch etc.

Work in partnership with clinical commissioning groups Take public health responsibilities

What will changes mean for the NHS

• • • • • • • Giving responsibility for commissioning healthcare to GPs and their team Creation of independent NHS Commissioning Board to allocate resources and oversee CCGs Abolition of PCTs Transfer of public health responsibilities to local authorities Greater freedom for providers of healthcare Promote competition and patient choice Makes NHS more accountable to patient & public

Who directs funding

Jeremy Hunt, Secretary of State Input Input

DH Public Health England

• 4 regional “hubs” (in line with CB regions), and local units to fit with NHSCB local area

NHS Commissioning Board

4 SHA clusters (2012): becoming 4 NHS CB regions 50 PCT clusters (2012): becoming 27 NHS CB local area teams Chief Exec, Sir David Nicholson

Monitoring

Clinical Senates (Herts in EoE senate)

Clinical Commissioning Groups (CCGs)

Herts Valleys CCG E&N Herts CCG

Hertfordshire County Council

Responsible for Public Health National Health Watch Local Health Watch to evolve from LINk Health and Wellbeing Board

Commissioning services from…

Specialised services GPs, Dentists, Optoms, Pharmacists NHS Trusts All to be FTs Produced by The Communications Team, NHS Hertfordshire

Monitor CQC Regulation

Independent sector

Hertfordshire Integrated Commissioning Support

• Providing services for HVCCG and ENHCCG

Challenging in engaging CCGs

• • • • • • CCGs are new, finding their feet Adapting to the ‘new NHS’ Developing local and regional priorities Financial constrains Lack of awareness Lack of business cases

Challenges in engaging GPs

• • • Increase in workload- secondary care to primary care shift, QoF, CQC, increase in patient demands & expectations, low morale Performance management & financial constrains Lack of awareness - Who are carers - Issues faced by carers - Benefits of supporting carers - What can they do

Suggestions to engage CCGs & GPs

• Multi level engagement - Individual GP Practices - Locality level engagement - CCG - Health & Wellbeing Board - Other primary health care professionals – matrons, DNs Pharmacists etc - Other stake holders- public health councilors, local authority etc.

Continued…

Arrange presentation slots in - Practice meetings - Locality meetings - Practice managers meetings - CCG meetings- most CCG have one open meeting a month when anyone can attend and raise issues.

- Identity enthusiasts and build relationships - Work in partnership with other stakeholders

Highlight win win situation

Benefits of identifying carers - Keep carers health & prevents illness - Reduces referral to secondary care - Reduces placement in nursing and residential home -If not supported then ‘two patients in place of one’ - May reduce GP consultations and workload Opportunity to make a difference

Continued

- Share examples of good practice and outcomes - Use business cases to support you (eg Hertfordshire Business case for carer friendly projects) - Do not give up