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St Helens Clinical Commissioning Group Annual General Meeting Thursday 25 th September 2014.

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Presentation on theme: "St Helens Clinical Commissioning Group Annual General Meeting Thursday 25 th September 2014."— Presentation transcript:

1 St Helens Clinical Commissioning Group Annual General Meeting Thursday 25 th September 2014

2 Welcome William Guest Chair

3 Agenda Welcome and Introduction Our Values Working WELL Together An overview of St Helens CCG’s Engagement Strategy Public Health Annual Report 13/14 Annual Report Key Highlights Annual accounts / Financial Overview Integrated Commissioning Plan Summary

4 Our Values Making a difference – right care, right place, right time Dr Stephen Cox Clinical Accountable Officer

5 Efficient and Effective Respectful and Caring Leadership and Ambition Innovation and Creativity Collaborative and Inclusive Honest and Transparent St Helens CCG has six Core Values

6 Developing our Values – themes from review Needs to be Jargon free and avoid too much ‘NHS speak’ Avoid clichés and unrealistic statements that will set unrealistic expectations Reflect our role as commissioners and some of our responsibilities as guardians of public money Make sense to staff and partners

7 St Helens CCG has six Core Values

8 Behaviours underpinning our values

9 Working WELL Together Mary Radcliffe Patient Group Member & St Helens CCG Health Forum member

10 An overview of St Helens CCG’s Engagement Strategy William Guest Chair

11 Why do we engage & involve the public? The law states as a Clinical Commissioning Group we have a legal duty to engage & involve the public (patients, carers & families) in; i) The commissioning of health and care services under the amended Health & Social Care Act (NHS Act 2006) ii) The engagement and involvement of individuals in their own health and care. iii) The Equality Act 2010 legally protects people from discrimination in the work place and in wider society

12 NHS IQ Local Authority Health & Wellbeing Board GP Members St Helens Voluntary Sector St Helens NHS Hospitals & Fairfield Clinical Colleagues (Consultants) 2013/2014 has seen improved stakeholder relationships…

13 Patients/Public – in commissioning services & procurement panels Twitter – 2,500 followers Facebook Working Well Together Event (150 attended) The Big Health Day Mental Health Strategy Event Patient & Public Health Forum CCG Public Membership Scheme – from 56 – 210 actively involved members of the public Community Group Visits – BME, LD, Homeless Patient Stories “our house of care ” Improved Patient Family Carer experiences 2013/2014 has seen Improved public Engagement…

14 Patients on every commissioning panel 500 actively involved members of the St Helens public Families & Carers actively involved and engaged An effective patient group in every GP surgery St Helens joint public engagement Strategy Effective Communications ‘real time” communications Co-commissioned Services Individuals making decisions about their own health & care needs Patient Family Carer

15 Working WELL Together… Follow us on twitter @sthelensccg Look us up on facebook Have you looked us up on the internet… Join our membership Look us up on Google + Telephone us 01744 627596 St Helens Chamber, Salisbury St, St Helens, Merseyside WA10 1YF

16 Public Health Annual Report 2014 Better Health Together Liz Gaulton – Director of Public Health September 2014

17 Background The public health annual report is the independent review by the Director of Public Health This is the first report since the implementation of the health and social care act 2012. PHARs (and their equivalents) have been carried out in St.Helens since 1873. The idea for this year was to reflect the reports when public health was last in the local authority.

18 Borough Overview St.Helens’ population is 176,221. It has recently stayed largely static in number but is predicted to increase in next 10-20 years By 2020 the population aged 65 years and over is projected to be 37,500, over 5000 more than in 2012. This will increase pressure on services relating to old age, such as social care Within the borough there are areas within most deprived 1% nationally, as well as the 7% least deprived. This suggests a wide variation in factors affecting health and quality of life

19 Health in St. Helens

20 Formation of NHS - 1948 Compulsory training for midwives - 1902 Infant Mortality in St Helens 1880 to 2012

21 Life Expectancy Life expectancy in St.Helens is increasing, and the gap between male and female LE has reduced. However, Still wide variations by wards Source: ONS 2014; *St.Helens Public Heath Intelligence from Primary Care Mortality Database

22 Joint Working To Improve Health Across the Council Declaration on Tobacco Control. The Parks for Life project. 2013/14 Winter Warm Campaign Working with providers Work with St Helens CCG on Smoke Free Homes Project. Encouraging uptake of flu immunisation in St.Helens. Alcohol Liaison Service at Whiston Hospital. Breastfeeding support service. Working with local organisations ‘ Other Ways of Telling’ project Projects to improve child health Working with the public ‘Conversations About Alcohol’ focus groups. Public Health web pages and Council's First magazine Working regionally projects undertaken on a larger footprint, such as with CHAMPs and PHE. E.g. Food Active (CHAMPs) “Get going this summer” (PHE)

23 Summary Picture of improving health, but still wide inequalities and further to go. 2013/14 was a year of transition but have achieved a great deal. Wide range of positive projects undertaken and examples of good joint working. Need to continue building on good relationships to work more effectively together going forward. Range of recommendations in report to improve health and reduce inequalities.

24 St Helens CCG Annual Report 13/14 Key Highlights Dr Stephen Cox Clinical Accountable Officer

25 Key patient rights and performance targets met eg: 18 weeks referral 4 hours AED wait NHS Constitution

26 Patients Local Authority Our local hospitals Community & Mental Health Providers 3 rd Sector NHS England Strengthened Partnerships

27 Resulting in: High quality hospital care Better access for vulnerable/frail elderly (Care Homes Scheme, Eldercare, AVS, IASH) Improved Continuing Healthcare System Better Services for children with vulnerability or special needs Managing winter pressures

28 Better Care Fund Developing Primary Care Services, e.g. Comprehensive Geriatric Assessment Re-design of Community Services Urgent Care Services Care Closer to Home Forward Together

29 Explanation of the CCG’s Accounts Paul Brickwood, Chief Finance Officer

30 Financial duties & targets met

31 How much did the CCG get to spend?

32 Where did the money get spent?

33 Integrated Commissioning Plan Sarah Johnson Deputy Accountable Officer

34 CCG What is an Integrated Commissioning Plan? NHS England Local Authority Health & Wellbeing Board Integrated Commissioning Plan

35 Key Principals of the Strategy Community Resilience Integration (services & vision) Out of Hospital redesign System Sustainability Quality & Safety Access

36 Why, what and how? Why: What: How:

37 Key Deliverables: 8.54% NEL Reduction in 2014/15 from 2013/14 Baseline Impact of NEL reduction in 14/15 due to re-coding of CHOBS/GPAU at STHK Incremental reduction in Outpatients attributable to Primary Care schemes & Services e.g. ECG Telemedicine Outpatient First Attends reduction of 1.5% in 14/15 and reducing by a similar amount in 15/16 and 16/17 Minimal growth expected for Planned Electives CCG will work with Primary Care to reduce GP referrals over the next 5 years using Referral Management Schemes Assumed 0.36% population growth each year CCG Activity 2014/152015/162016/172017/182018/19 Elective Ordinary Admissions5,279 5,2845,2895,294 Elective DayCase Admissions21,01521,03821,06621,09421,122 Non-elective Admissions21,69320,98120,26819,55618,843 Total Written Referrals (GP and Other)66,62466,69566,78466,87366,963 All First Outpatient Attendances57,45656,34055,03254,92754,734 GP Sourced First Outpatient Attendances34,08732,94531,60731,47231,248 All Subsequent Follow Up Attendances180,278179,196177,770177,548177,280

38 Why: What: How: To develop a robust action plan of communications, engagement and consultation in relation to the CCG 5 year Strategy and gather views, and consult with local people around key messages. In line with Transforming Participation in Health and Care – to engage and consult local people/patients in the development of local services from strategy to concept. To further develop CCG membership and encourage participation in all areas of commissioning. To ensure seldom heard groups have a say in the development of the strategy and thus in key commissioning areas. Key aims of the engagement plan

39 Better Care Fund Developing Primary Care Services, e.g. Comprehensive Geriatric Assessment Re-design of Community Services & support for voluntary sector Co-ordination of intermediate care service Urgent Care Services – Frailty pathway/Unit Care Closer to Home – Mental Health Forward Together

40 6 Characteristics of high quality health & social care systems Citizen inclusion and empowerment Wider primary care, provided at scale A modern model of integrated care Access to the highest quality urgent and emergency care A step-change in the productivity of elective care Specialised services concentrated in centres of excellence 2014/2015 PPG in all member practices. Early mobilisation of HealthWatch Services commissioned for one population. 37 individual general practice contracts requiring commissioner support for development. No workforce planning or succession assumptions. Wide variation in quality of services and accessibility. Direct commissioning is fragmented with unclear strategies 2014/15. Integrated Health & Social care Commissioning team. Fully approved overarching Section 75 with a pooled budget of £30m+ for CHC/FNC BCF assumptions developed and mobilised. Nurse led Walk –in-Centre based in a private building in the town centre with limited paediatric capability and diagnostics. Difficult to access routine primary care services OOH. StHK A&E department that consistently see’s global growth in NEL care year on year. Higher than average admission and re-admission rates. Functioning Urgent Care Collaborative – non decision making both locally and on a wider Merseyside footprint Higher than planned elective care episodes with growing backlog of patients on RTT pathways. GP Tutor engaged to support primary care referral education sessions. Wide variety of choice open to our population with key risks of over performance within the private sector. Planned Clinical Hubs based around localities with consultant led community referral clinics and electronic/telephone advise for GPs Inequity in access to specialised services exists despite there being a high number of Trusts within the Merseyside region. Services are fragmented with unclear intentions and strategies for 2014.15. 2018/2019 Borough based listening events. Highly proactive and flexible HealthWatch informing commissioning. Services commissioned to meet the needs of a locality model. Developed ‘App’ technology to support self-care and choice. Information sharing across organisations and sectors for the benefit of improved patient outcomes. Individual practices running on a locality basis with a collaborative approach to extended access, back office functions and specialist clinics based within a locality clinical hub – fully supported by specialist consultants from the Hospital. High achieving practices in terms of the CCG commissioned GP Quality Contract and holistic approach to managing core contracts with the CCG acting as a co- commissioner of primary care services Fully integrated health and social care services with borough based commissioning. High quality care for all. Fully developed links to education and shared Children’s services. A single integrated access point for all. A specialist Frailty Unit based in our Community Hospital will support our over 75s along with a Primary and secondary care shared ‘Comprehensive Geriatric Assessment’ The full mobilisation of the St Helens IAP that will see first line access to ‘step up and step down community beds. Increased capacity of therapy and social services based around the locality model of working. A fully operational Urgent Care centre within St Helens Hospital that will see all minor illness and injury within first class estates with supporting suite of diagnostics. A fully operational executive level Urgent Care Board with delegated decision making across the health economy to aid system sustainability. The CCG fully supports the reconfiguration agenda across Cheshire and Merseyside. We will see the formation of 2 ‘Super DGH’ with concentrated elective care in excellent facilities. It is also anticipated that the CCG will co-commission concentrated specialised services within Merseyside in a stand alone trust configuration model. St Helens CCG would also wish to explore the vertical integration of community and secondary care services. The reconfiguration of a single specialist centre of excellence for Merseyside with ‘spoke’ clinics delivered at an appropriate level according to population need. 40

41 Summary Dr Stephen Cox Clinical Accountable Officer

42 Questions for our Governing Body?

43 Thank you for joining us

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