Transcript SOUTH NORFOLK CLINICAL COMMISSIONING GROUP

SOUTH NORFOLK CLINICAL COMMISSIONING
GROUP
Stakeholder Event
20th November 2013
Dr Jon Bryson, Chair - South Norfolk CCG
Ann Donkin, Chief Officer
Development of
South Norfolk CCG
– Geographic coverage
– History of the organisation
– Financial context
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to
improve the health and well-being of the whole and diverse population of South Norfolk
Practices and Localities
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Deprivation
MSOA E02005517 (Breckland
most deprived)
MSOA E02005606 (South
Norfolk most deprived)
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Organisation
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Phase 1 – shadow CCG formed in July 2012 bringing together two constituencies: Mid
Norfolk and South Norfolk
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Phase 2 – Go through ‘Authorisation’ process – now complete
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Phase 3 – building capacity in the CCG ‘office’
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Phase 4 – engaging member practices, stakeholders and patients in delivery
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Directly employed staff:
– 10 in November 2012
– 15 of 25 in June 2013
– Optimum number 35?
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Commissioning Support Unit
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Capability in Localities & Practices
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Provider landscape
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CCG interfaces with more than one acute care delivery system
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Norwich & Norwich University Hospitals NHS Foundation Trust governance risk rating
AMBER-GREEN and financial risk rating 3
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West Suffolk Hospital NHS Foundation Trust governance risk rating GREEN and financial
risk rating 3
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Near monopoly providers for mental health care, community services and ambulance
services
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Services generally highly regarded by patients – positive Inpatient and GP Surveys
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Current areas of performance concern include:
– under performance against key targets e.g. Accident & Emergency 4 hour wait, 18ww
RTT at Norfolk & Norwich
– main contract signed late: October 2012
– poor ambulance response and turnaround times
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Financial Context
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Stable CCG financial position but pressures in Continuing Health Care
and Prescribing
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Legacy issues inherited from NHS Norfolk – use of non recurrent
resources
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Quality, Innovation, Productivity and Prevention (QIPP) challenge in
context of low/no growth in resources - £5 million rising to £18 million
in 2015-16
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QIPP challenge to date met by largely transactional measures
•
CCG has no areas where it is an outlier on spend or outcome (SPOT
analysis), spend per head and hospital utilisation rates are below
national averages but variation at specialty level e.g. Gastro,
Ophthalmology, Cardiology & Urology
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Governance & delivery
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve the
health and well-being of the whole and diverse population of South Norfolk
Governance and Structure
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve the
health and well-being of the whole and diverse population of South Norfolk
Governance and Structure
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve the
health and well-being of the whole and diverse population of South Norfolk
Strategic Vision
Frail older people
Planned care & tackling
variation
Emergency & urgent care
• Integrating health and social care and
integrated pathways of care
• Case management
• Redesigning elective care pathways
• Reviewing thresholds for surgical
intervention
• Prescribing practice
• Reforming the urgent care system
• Avoiding unnecessary hospital
admission
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Commissioning Intentions
2014/15
South Norfolk CCG’s commissioning intentions fall into two categories:
• Contract negotiation - focusing on improving patient experience
and the quality and safety of services
• Commissioning for Quality, Innovation, Productivity and
Prevention (QIPP) – reviews, developments and improvements of
clinical workstream priorities
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Commissioning Intentions
2014/15
Contract Negotiations:
• Compliance with best practice pathways for Stroke Care
• Compliance with Norfolk prescribing formulary
• A focus on A&E attendance to admission ratio and consultant-toconsultant referral limits with hospitals
• Clinical threshold controls for equipment and elective
procedures
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Commissioning Intentions
2014/15
South Norfolk CCG’s 2014/15 QIPP Programme:
Emergency and Urgent Care priorities:
• ‘Domino’ project (involving all partner organisations in Norfolk):
• Urgent same day and next day clinics
• Access to assessment services and diagnostic testing to
reduce the need for admission
• Reduction of length of stay in hospital
Planned Care priorities:
• Reviewing orthopaedic pathways and related physiotherapy
services
• Community services for glaucoma, rheumatology and
dermatology
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Commissioning Intentions
2014/15
South Norfolk CCG’s 2014/15 QIPP Programme:
Out of Hospital Care priorities:
• Changes to continuing healthcare contracts and regular
assessment of patients to ensure high quality care
• Greater involvement in community settings of Consultants for
Frail and Elderly Medicine
• Re-procurement of patient transport services
• Continued development of integrated care teams and reablement
services
• Implementation of the community bed review
• Development of community nursing and therapy services
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Commissioning Intentions
2014/15
South Norfolk CCG’s 2014/15 QIPP Programme:
Mental Health and Learning Disabilities priorities:
• Engage closely with Norfolk & Suffolk Foundation Trust’s Radical
Redesign
• Support the planning of the re-procurement of the IAPT service
• Development of Dementia pathways for roll-out in 14/15
Women and Children priorities:
• Children’s urgent and emergency telephone services for GPs
• Extension of the Early Pregnancy Assessment Service to
weekends
• Review of the pathway for Children with Long Term Conditions
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Commissioning Intentions
2014/15
South Norfolk CCG’s 2014/15 QIPP Programme:
Primary Care priorities:
• Improve the clinical management of patients in care homes and
at the end of life
• Development of Diabetes care out of hospital settings
• Work with the NHS England Area Team to develop a Primary Care
Strategy
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve
the health and well-being of the whole and diverse population of South Norfolk
Summary
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Population which enjoys relatively good health compared with the rest
of England
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Generally highly regarded primary and secondary care provision
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Fairly stable financial environment
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Good relationships between clinicians across primary and secondary
care
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An engaged and active membership across key stakeholder groups
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve the
health and well-being of the whole and diverse population of South Norfolk
Healthy South Norfolk
To deliver the highest quality integrated healthcare which is appropriate, effective, efficient and sustainable, in order to improve the
health and well-being of the whole and diverse population of South Norfolk