Braintree District Council Health & Well Being 15 th July 2013 Mid Essex Clinical Commissioning Group Clare Steward Deputy Accountable Officer / Director of Strategy & Primary Care 1

What do we do?  MECCG is the successor organisation to the Primary Care Trust.  It serves the communities in Chelmsford, Braintree, Colne Valley, Witham and Maldon, South Woodham Ferrers and surrounding areas  It received its authorisation from the National Commissioning Board (NCB) with effect from 7 March.  From 1 April it will lead the local NHS and be responsible for planning and buying healthcare through: assessing local needs listening to patients and public working in partnership designing services and agreeing contracts managing quality and performance 2

MECCG health and social landscape 50 member GP practices three localities/ nine sub localities 48 dental practices 61 pharmacies 60 opticians. 3

Taking the lead with system partners; As an authorised CCG we now hope to deliver our vision of providing modern healthcare facilities that deliver appropriate, accessible and affordable services in the right place. The advantages of having GPs as commissioners are they are close to patients know the good and bad things about services know what needs changing. 4

Strategic objectives Transformation and integration Practice engagement Public confidence Improving quality and outcomes for all Meeting the financial challenge through responsible use of resources 5

2013/14 Budget Recurrent healthcare funding £990 per head of population (Essex Av. £1100) £372m healthcare budget £9.3m Running Costs £22.5m QIPP 6

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Examples of existing schemes  Rapid Assessment Unit for frail & older people – avoid hospital emergencies  Multiprofessional teams for end of life care at home  High Impact Team reviews with residential care and nursing homes to avoid hospital emergencies (Nurse, MH nurse, Pharmacy, Therapist)  Practices managing referrals working with central team of clinicians  Prescriptions for less expensive drugs

Examples of new schemes 2013/14  A&E streaming tool  Reduce unnecessary use of ambulance  Medical response vehicle  Review clinical policies, ensure they are adhered to  Single point of referral  Practice level multi-disciplinary team meetings (MDTs)  Improve physio self-care, reduce wasted appointments  Comply with national guidelines on drugs  Mental health rapid assessment to reduce admissions

Our intention is for this not to be about “cuts” Our priority is about improving Efficiency We have some difficult decisions to make in the future So what can we do better together?

11 Taking Forward Integrated Commissioning  System wide pathway commissioning approach to frailty launched in July  Lead Accountable provider  Year of care shadow tariff provides opportunities to all providers  Combined health & social care risk stratification tool

Proactive

13 Managing unplanned care  System wide plan to manage unplanned care  Will go to BDC for comment on 18 th July  System join up on patient education and winter planning  System wide planning event in September

Some of the areas of joint focus; Self management Health Improvement Right care first time Support and counselling Integration Personalisation Enhancing public involvement Supporting our carers Enhancing care in home settings Thinking differently to maintain system-wide sustainability 14

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How? CCGs need to meet the quality and productivity challenge, providing ways in which clinician-led commissioning can involve local people in shaping responsive, local patient centred care. This will involve working closely with partners and providers, including the local District authorities, with particular reference to efficiency, high quality and standard of care and value for money. 16

How you add value Identifying in partnership locality Health & Wellbeing priorities and working together to add value to outcomes Local knowledge – information triangulation Mapping needs and concerns Focus on the individual Enhancing commissioning plans & identifying joint commissioning opportunities Supporting care Connecting with patients, relatives, carers and community groups “No decision about us without us” 17

Shared values Patient/customer focused Sound appreciation of patients’/customers’ needs Cost effective, high quality services Local knowledge Credibility 18

19 So where now? Identify shared health & wellbeing priorities Identify & understand where the added value is Link this to the mid Essex integrated plan Plan how and when to deliver this partnership work and the governance structure in which to do this

Contact Details Clare Steward, Deputy Accountable Officer/Director of Strategy and Primary Care, Mid Essex CCG - Krishna Ramkhelawon, Consultant in Public Health, Essex County Council - Sian Brand, Deputy Director of Strategy, Mid Essex CCG – 20