Transcript Presentation title on one or two lines

Patient reference groups
AAPs
Health networks
Commissioning process/update
Background – Why!
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Durham Dales and Easington (DDES) Clinical Commissioning Group (CCG)
developed a two year plan in April 2014 which is being refreshed in light of new
national guidance and local priorities.
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A revised list of commissioning intentions for 2015/16 was developed and shared
with locality clinical leads and member practices at the DDES wide meeting in
October 2014
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The executive were asked to review the draft list of commissioning intentions and to
provide feedback based on key questions, noting however, that DDES is in year 1 of
its 2 year plan and therefore this review process is primarily to ensure that there are
no gaps in the planned programme of work (rather than to add to the list of priorities).
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Following engagement with member practices, the CCG is now sharing with
governing body and our stakeholders what we feel should be our priorities to seek
their feedback.
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During this engagement process, we will be communicating to patients,
public and other stakeholders that their feedback, if related to our current
priorities, will be used, where relevant, to inform the refreshed plan. If the
feedback is related to new areas, we will review and consider the
feedback at this stage and then revisit it at future stages of the planning
cycle to go through a robust prioritisation.
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A pro forma has been developed to capture feedback from our members
We are currently sharing our early draft with patient representative
groups, area action partnerships and health networks at meetings
throughout November, December and January 2015.
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To engage the wider public, an open engagement event is being planned
for 14 January 2015.
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A patient focused information document has also been produced, which
will be used as a key communication document in engaging patients and
the public in the commissioning planning process.
Last year you said we did !
Following feedback:
WE DID
YOU SAID
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Bring hospital services into the community
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This is within the 2 year and 5year Commissioning Strategy
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To attach Mental Health to the practices
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Implement Integrated Primary Care Model for Mental Health
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To have joint health and social care assessments
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County Durham Joint Health and Wellbeing Strategy
reflected in the development of integrated services as part of
the Better Care Fund
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To put in place hub and spoke arrangements within a
federation
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A plan for life in development, regular federation contact
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To have outpatient specialities within practices
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Developing outpatient review programme at each specialty
review
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To not forget about offenders health
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Area Team are responsible for this service
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To have other forms of communication with my GP
practice
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Primary Care Strategy and DDES CCG funded incentive
scheme, via use of technology to increase access and
communication., Website, facebook page, twitter, GP
teamnet
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To integrate with Local Authority, Housing and Public
Health
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To have a set up like the old mini cottage hospitals
County Durham Joint Health and Wellbeing Strategy also
linked with the Better Care Fund and Health and Wellbeing
Board, ISIS integrated care, frail elderly and many more
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Funding currently would not support
Timescales (2014-2015)
Date
October 2014
Activity
Internally refresh the 2 year work plan based on updated information
October
Share with member practices and seek feedback by 7th November
November
Share draft work plan 2015/16 with executive and governing body to agree process and seek input
November 2014 – January 2015
Share with stakeholders what we feel should be our priorities and why, using the public document
developed. To include Area Action Partnerships (AAPs), Patient Reference Groups (PRGs) and
health networks. Engagement team leading on development and implementation of process; AAP
links, heads of service assisting on delivery of information and seeking feedback.
November/December
Share with providers
November /December
Share progress with member practices/executive
December
Review against new planning guidance
December/ January
Prioritise work plan using robust tool
January
Stakeholder event planned for 14th January 2015 to share work plans, discuss priority areas, and
invite feedback
January/February
Share with member practice / executive for sign off
January / February
Draft plan submission
February / March
Publish intentions
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The two year plan covers 12 work programme areas and incorporates a
number of projects.
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Further work was undertaken to identify the CCG’s top priorities for
2014/15 (all of which are anticipated to remain for 2015/16):
– Urgent care
– Primary care
– End of life
– Diabetes
– Frail Elderly
– Demand Management
– Mental Health and Learning Disabilities (added November 2014)
Commissioning Priorities for April 2014 to March 2016
What!
Priority Area
To further develop access to
health care services over 7
days a week
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To ensure community based
services are joined up and
working well with other
aspects of health and social
care
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To continue to improve
mental health and learning
disability services so that they
are given the same priority as
physical health
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In this priority area, DDES CCG aims to:
Work with General Practice to improve the availability of patient appointments across 7 days of
the week
Work with hospitals to ensure that services, including scans and testing, are available 7 days a
week and are maintained at a consistently high standard seven days of the week
Work more closely with local government to plan and buy services across health and social care
Continue to improve current community-based services, such as nursing and physiotherapy
Increase the community services that provide support for people in their home and in
community-based settings to allow people to leave hospital sooner or avoid hospitalisation
altogether
Provide care closer to home whenever appropriate
Keep people independent for as long as possible, avoiding residential and nursing homes where
appropriate
Improve GP diagnosis of people in the early stages of dementia
Review the patient care pathway in dementia treatment, improving patient experience and
health outcomes
Provide support for more people with learning disabilities to move from in-patient / institutional
settings into supportive community settings, whilst increasing available community support
services
Support patients to recover from episodes of poor mental health (including those in crisis) more
quickly, to return home from hospital more quickly and help to prevent further episodes
Priority Area
To ensure that commissioned
services are delivering the best
outcomes and value for money
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In this priority area, DDES CCG aims to:
Review services regularly to keep up with the changing needs of the local
population, to keep improving health care for all, and to ensure that public funds are
used appropriately
Implement clinical systems and GP referral pathways that are joined up with
hospitals and neighbouring CCGs, where relevant
Ensure prescribing of the most beneficial medicines to help patients stay as well as
possible
Understand why some patients are re-admitted to hospital soon after discharge in
order to identify potential areas of improvement
Review GP referrals to hospital to ensure appropriateness
To ensure the health system is set up 
to best manage busy periods (such
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as winter flu season)
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Improve ambulance performance, such as response times
Improve patient transport for non-emergency visits to hospitals or other medical
appointments
Review of urgent care services
Improve patients’ access to their own GP for urgent issues
Increase patients’ use of 111 for non-emergencies
Reduce unnecessary visits to hospital
Evaluate what and how services can be delivered closer to patients’ homes by health
care professionals with knowledge of their medical history
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Ensure GPs identify and support their patients who are at high risk of developing
cancer
Improve the diagnosis of cancer at an earlier stage in order to reduce the number of
cancer deaths in the under 75 age group
Look closely at cancer services and patient care pathway to identify any gaps
Work with the local authority to improve prevention services, improve people’s
experience of cancer services and improve outcomes for people with cancer
To improve cancer diagnosis and
treatment
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In this priority area, DDES CCG aims to:
Priority Area
To improve palliative care and end
of life services
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To review current services and
contracts and explore where new
contracts could results in
improvements for patients
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To redesign and develop patient
care pathways to improve patient
outcomes
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Ensure that GPs regularly develop and review plans with patients who may be
nearing their end of life
Improve services and options for people who are at the end of their life, providing
the best possible support, including the choice of dying at home
Review contracts coming to completion as well as those identified for potential
improvement; services such as weight management, wheelchair and other adaptive
equipment, continence, 111, Choose and Book
Review maternity services (as part of a region-wide review of how best to provide
maternity services) in order to continue to ensure that mothers and their babies
receive treatment that keep them as healthy as possible
Review patient care pathways for a number of conditions, including diabetes and
breathing problems (respiratory related conditions such as asthma and COPD),
stroke, cardiovascular disease, back pain
Identify when patients could benefit from healthcare provided in their home, GP
surgery or elsewhere in the community (rather than in hospital)
Priority Area
To work with local government to
improve public health and the other
aspects that impact on people’s
health
In this priority area, DDES CCG aims to:
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To further understand and put in
place what is needed to support
health services over the next 10
years
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To improve outcomes for children
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Work with local organisations and government to find ways to positively affect
people’s health and well-being
Continue to ensure that those who are eligible for personal health budgets are
offered the opportunity to use them, in order that they have more control over the
decisions about how to improve their health
Focus on identifying gaps in services for alcohol abuse
Understand the present and anticipated needs in workforce and take measures to
address these, working with Health Education North East
Support healthcare providers during transition periods such as services moving out
of hospitals and into the community
Ensure services for children address their mental health needs
Redesign and develop services for children with diabetes, emergency admissions,
breathing problems (respiratory), obesity
Aims of co-commissioning
The overall aim of primary care co-commissioning is to create a joined up,
clinically-led commissioning system which delivers seamless, integrated out-ofhospital services based around the needs of local populations.
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Improved provision of out-of hospital services for the benefit of patients and local
populations;
A more integrated healthcare system
More optimal decisions to be made about how primary care resources are
deployed;
A more collaborative approach to designing local solutions for workforce,
premises and IM&T challenges to develop a joined up system;
For this year, the scope of primary care co-commissioning is general practice
services. The commissioning of dental, community pharmacy and eye health
services is more complex than general practice with a different legal
framework. As such, our emerging thinking is that it is out of scope for joint and
delegated commissioning arrangements in 2015/16. However, we recognise
the ambition in some CCGs to take on a greater level of responsibility in these
areas and we will be looking into this for future years with full and proper
engagement of the relevant professional groups
Greater CCG
involvement in NHS
England decisionmaking
Joint decision-making
by NHS England and
CCGs
CCGs taking on
delegated
responsibilities from
NHS England
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