Transcript Document
1 Putting Patients First Involving Voluntary Organisations in healthcare Thursday 18th April 2013 Who’s who... Speakers: Dr Bhaskar Bora Chairman & Clinical Lead Facilitator: Julie Van Ruyckevelt Participation & Insight Communications, Engagement and Public Affairs KMCS Welcome and introductions The plan for the session: Introduction to the CCG... Who we are; what we do; how we do it Getting to know each other... Finding out about local voluntary organisations Checking what we would like from each other Exploring how we can work together to make a difference to people’s experiences of care Dartford, Gravesham and Swanley Clinical Commissioning Group Update Dr Bhaskar Bora Setting the scene A Clinical Commissioning Group - a collection of GP member practices who have agreed to come together under one ‘umbrella’ organization – the CCG Its purpose is to collectively commission and be responsible for the delivery of healthcare to patients within a defined geographical area that is (preferably) coterminous with a local authority. DGS CCG comprises 34 practices (107 GPs) covering Dartford, Gravesham & Swanley. It serves a population of 249,000 making it the 2nd largest CCG in Kent & 3rd largest in Kent & Medway. The CCG The CCG is run on a day to day basis by a ‘Governing Body’ made up of elected GPs & appointed leaders. In addition, we have a small team of commissioners and managers. We are also buying in, and sharing some corporate functions to be more efficient and to maximise what we spend on front line care Who are we? The Governing Body Board Member Portfolio of responsibility Dr Bhaskar Bora Chair & Clinical Lead. Also accountable for Clinical Quality, Safety, Information Systems and Medicines Management Dr David Woodhead, Accountable Officer Accountable lead for the CCG – interest in non-elective care, Contracts and finance Dr Liz Lunt, Deputy Clinical AO Lead for mental health & community care Patricia Davies – Deputy AO Operational lead for the organization Bill Jones Chief Financial Officer Dr Bali Chalapathy Locality lead & lead for T&O, Neurology, planned care Dr Chirag Patel Locality lead & lead for planned care & education Dr David Short Locality Lead & Lead for safeguarding and children Mike Gilbert Company Secretary Su Xavier Public Health Consultant Geoff Wheat Chief Nurse Dr Mike Beckett Secondary Care Consultant (A&E at WMUH) Jacqueline Ardy Lay Member – Registered Nurse Rosemary Bolton Ashley West Lay Member – Public & Patient Engagement Lay Member - Governance The Team Commissioning and Support Staff: Karen Barkway, Gerry Clark, Zoe McMahon, Anne Gibbins, Chris Singleton, Bev Dennis, Kate Hamlin-Hawes, Sunday Adeniyi Jabeen Egan (lead Pharmacist) supported by the DGS medicines management team Nursing & Quality Team – Shared across North Kent Finance and Back Office Team – Shared across North Kent From our Support ‘bought in’ Services who include: Amy Igweonu, Sumona Chatterjee, Wendy Lakin Authorisation to become a Statutory Body Required to submit evidence to meet 119 criteria across 6 domains: 1. Clinical Focus and Added Value 2. Engagement with patients/communities 3. Clear and Credible Plan 4. Capacity and Capability 5. Collaborative Arrangements 6. Leadership Capacity and Capability What we are responsible for Commissioning of healthcare for patients in DGS (about 70% of the total budget) This includes the main categories as follows across both the independent sector and NHS providers: Acute hospital care Mental health & LD services (with some exclusions) Community Care (community nursing, therapy, pharmacy) Maternity services, children and young people Ambulance services What we are NOT responsible for There are a number of services which will be (due to their complexity, more far reaching impact beyond the local geography, or to avoid a conflict of interest) commissioned directly by the NCB. These include: Specialist services – e.g. specialist cancer care, trauma, renal services, HIV, neurosurgical care, forensic care, prison health, etc. Primary care – GP contracts and salaries, dental and pharmacy contracts & performance. Health Visiting The New NHS Structure The Local Landscape The Local Health Care Landscape - effective 1st April 2013 Kent-wide Health and Wellbeing Board and Local Health and Wellbeing Board aligned to CCG Public Health Social Services Collaborate Opinion Comment Patient Participation Group Patient Reference Groups Voice of the practice populus Member Practices NCB and (local) Area Team Assurance Mandate to operate Engage Voluntary Sector Healthwatch (National and Local) CCG Clinical Governing Body Commission Services Su p Wider Stakeholders po rt Re so ur Services Providers (including hospitals community nursing, ambulance, Mental Health) ce Kent Commissioning Support Service The Commissioning and Engagement Cycle www.institute.nhs.uk J F M A M J J A S O N D Our Commissioning Priorities for 2013/2014 The Budget 2013-14 Forecast Budget allocation £285,000,000 Budget pressures: 80% is consumed by Acute Care Demographic growth (+1.8m) Pay and Prices + 20% Continuing (nursing) Care + 20% High Cost Drugs Key Commissioning Priorities Children and Maternity Integrated Commissioning Long Term Conditions Mental Health Planned Care Urgent Care Prescribing Unscheduled care and Long Term Conditions Integrated health and social care teams, single point of access for patients and clinicians, reducing duplication between health and social care, streamlining care to patients. Pathways to redirect patients to the most appropriate service - development of specific pathways of care - supporting the implementation of 111 locally. Model of care in A&E - ensure patients are reviewed and treated by the most appropriate clinical team for their needs. Increase the diagnosis of dementia and support for patients via case management of patients an integrated team, and ensure ‘dementia friendly hospitals’ Planned care Consultant and GP co-ordination Discharge Planning – ensuring patients are discharged with minimal delay Improved Urology pathways – timely, appropriate investigation Local Provision of Nerve Conduction Studies Paediatric Orthopaedic pathways Use of Teledermatology Service Repatriation of elective activity at King’s, Guy’s and South London for non-specialist care to local providers Children’s and maternity care Extend the Community Children's Nursing Service to DGS area Increase in numbers of HVs A new multi-agency intensive support service for disabled children with severe challenging behaviour. Post abuse and sexually harmful behaviour services Invest in the Medical advisors role in relation to adoption medicals Mental health services Development of talking therapies in primary care - reduce waiting times Primary care mental health workers - shared care with primary care - support to patients in recovery Payment by Results (PbR) implementation - pathway redesign - working closely with secondary care Improve outcomes and the experience of care of service users Reduction in waiting times for CAMHS Medicine Optimisation Shared Care Guidelines on use of Melatonin Fentanyl Patches Review of Esomeprazole Prescribing Review Vitamin D prescribing Nice guideline implementation eg anticoagulation Inequalities What we’ve achieved already Reducing CVD across all localities = real reductions in standardised mortality = reduction in admissions = increase in quality and length of life through targeted treatment, = better use of resource = wider economic benefits to the tax payer. 5 year trend in hospital admissions rates for DGS Mortality rates from CVD 2007-2011 Directly age standardised mortality rate from Cardiovascular disease trend 2007-2011 Directly age standardised emergency admission rates CCGs 2007-2011 Directly age standardised emergency admission rates cardiovascular disease DGS CCG trend 2007-2011 Directly age standardised mortality rate CHD, DGS trend 2007-2011 Challenges Target resource Delivering high quality care Local care Working with voluntary organisations – the engagement landscape How will we work together to make a difference to people’s experiences of care? PPG Chairs Group