NHS Calderdale CCG Annual General Meeting 10 September 2015

Welcome and Introductions David Longstaff, Deputy Chair

Housekeeping

Who we are 26 GP practices in Calderdale (our member practices) Governing Body – includes Chief Officer, Chief Finance Officer, 7 GPs, 2 lay members, secondary care specialist, registered nurse. Staff - CCG supported by approx. 55 staff (some shared with Greater Huddersfield CCG and North Kirklees CCG) Commissioning Support – e.g. Human Resources, Business Intelligence, Communications and Engagement (Yorkshire and Humber Commissioning Support in 2014/15)

To commission high quality health services on behalf of approx. 217,000 people: To ensure that healthcare is available for anyone who needs it; To help people to maintain a healthy lifestyle; To reduce health inequalities locally; To ensure high quality services and keep people safe; To maintain financial balance and best use of resources. Our Role

Annual Report 2014/15 Dr Steven Cleasby Assistant Clinical Chair

So what did this mean in practice in 2014/15? Making a difference  Care Closer to Home  Hospital Services programme Delivery of Quality, Innovation, Productivity and Prevention Targets Continuous quality improvement and safeguarding Public and community engagement Maintaining financial balance

Quest for Quality in Care Homes Community Based Respiratory Service Palliative care and end of life services Integrated learning disability service Staying Well Programme Food for Life Partnership Community Children’s Clinic (C3) Mental health - Crisis Resolution Team, Child and Adolescent Mental Health General Practice Schemes – extra appointments, check ups for the over 75s. Making a difference

Quest for Quality in Care Homes 24 Care Homes  Telecare  Telehealth  Integrated social and clinical approach to support care planning 24 Care Homes  Telecare  Telehealth  Integrated social and clinical approach to support care planning  26% reduction in hospital stays  16% reduction in hospital bed days  Emergency hospital admissions reduced by 25%  Reduction in cost of hospital stays of £456,166  Care home staff feel more supported and empowered  58% reduction in GP visits to Quest for Quality care homes  26% reduction in hospital stays  16% reduction in hospital bed days  Emergency hospital admissions reduced by 25%  Reduction in cost of hospital stays of £456,166  Care home staff feel more supported and empowered  58% reduction in GP visits to Quest for Quality care homes

We are beginning to see change for the better in a number of aspects of health and wellbeing: Quest for Quality in Care Homes Community Based Respiratory Service – Andrew’s Story Making a difference

Andrew’s Story 7 Day Service; Multi-disciplinary Teams 7 Day Service; Multi-disciplinary Teams Nurse-led community clinics; daily specialist clinics Nurse-led community clinics; daily specialist clinics Post discharge home visits and regular contact with the patient to monitor their condition.

We are beginning to see change for the better in a number of aspects of health and wellbeing: Quest for Quality in Care Homes Community Based Respiratory Service – Andrew’s Story Integrated learning disability service Making a difference

Services for people with learning disabilities LEAD THE WAY

We are beginning to see change for the better in a number of aspects of health and wellbeing: Quest for Quality in Care Homes Community Based Respiratory Service – Andrew’s Story Palliative care and end of life services Integrated learning disability service Staying Well Programme Food for Life Partnership Making a difference

Food For Life Partnership Over 60% of Calderdale schools in the programme; Work in schools and communities on positive food culture: school meals, cooking, growing, farm visits; engaging parents, staff and the community. 15 bronze, 2 silver and 1 gold award (Ravenscliffe High School); Their Catering Manager - BBC Cook of the Year (Radio 4, Food and Farming Awards); Focus now on hospitals, early years and care homes (Quest for Quality).

Clinical leadership CCG is a clinically-led membership organisation 7 GPs on the Governing Body (elected by membership); Clinical Leads for each of the priority areas; Practice Leads’ meetings; Commissioning locality groups.

Working in partnership

Looking ahead

Continuing to develop enhanced and integrated community services (CC2H, Vanguard and Better Care Fund Programme); Continue to work with partners on future model of hospital services; Develop Primary Care Strategy and Focus on Mental Health services – mental health innovation hub. Our priorities for 2015/16

Annual Accounts 2014/15 Julie Lawreniuk, Chief Finance Officer

Our financial position

Delivering our financial duties Financial DutyAchieved? Performance in 2014/15 Achieve operational financial balance Surplus of £7,570k delivered Maintained capital expenditure within Capital Resources Capital resource limit fully utilised Manage cash within the CCG's Cash Limit Cash balance: £14k

Our provider footprint Acute Community / primary care Mental health Continuing healthcare Local authority and third sector Calderdale/Hudds FT – 88.9% Bradford Teaching Hospitals FT – 2.7% Independent (Spire/BMI/Yorkshire Clinic) – 3.2% Leeds Teaching Hospitals Trust – 3.7% Other NHS Trusts – 0.8% Other NHS FTs - 0.6%

What do we spend? £268 million NHS providers £184.4m Non-NHS providers £42.8m Running costs £5.0m Primary Care £1.4m Prescribing £34.0m Other commissioning £1.2m

Who do we spend it with? Type of Provider % By Value NHS81.0% Independent sector – continuing healthcare / funded nursing care / mental health / learning disabilities 8.3% Local authority3.9% Independent sector – primary care (including GP Practices) 2.9% Independent sector - elective & diagnostics2.0% Not for profit1.9%

Penny Woodhead Head of Quality and Advisor to the Governing Body Patient and Public Engagement Annual Statement of Involvement 2014/15

Overview – Why it’s important NHS Constitution Summary of engagement and consultation activities Meeting statutory duties - Sections 242 and 244 The CCG Strategy for patient and public engagement and experience Supporting Calderdale CCG vision and values

Engagement Mechanisms Calderdale Health Forum Health Connections Calderdale CCG Website Relationship matrix Patient Advice and Liaison Service (PALS) Healthwatch Service Redesign Activities

Partnership Spotlight: Engagement Champions Calderdale has a thriving community asset based approach to engagement which has resulted in training 90 community champions. They deliver engagement activity across the district reaching grass roots communities. NHS Calderdale CCG also has relationship matrix which helps us to reach groups which represent our most diverse communities. GP Practice Patient Reference Groups continue to be actively engaged through a Bi Monthly Health Forum.

Meaningful engagement  We are getting better at engaging the public in not only the design and development of services but also in the development of specifications and evaluation of ‘bids’.  The CCG is using engagement as a standard approach to decision making and we have a process in place to ensure this happens.  The support we receive from the public in our commissioning arrangements is vital to ensure we get our services right.  We use engagement to support our equality duties by ensuring we talk to the right people about the right things and consider the views of all protected groups.

What have we done? Some of the projects we have undertaken over this period:  Wheelchair services procurement  Providers Strategic Outline Case engagement  CCG Commissioning Intentions engagement  Child Development Services  Musculoskeletal (MSK) services  Diabetes services  Autistic Spectrum Condition (ASC)  Care Closer to Home stakeholder event  Supported self-care engagement  Patient Transport services  Care Closer to Home stakeholder event – Upper Calder Valley

Care Closer to Home An event to engage with staff and key stakeholders took place at Todmorden Town Hall on 4 th March Who did we engage with and what did we ask?  Local Councillors and MPs  Healthwatch  GP Practice Patient Reference Groups  The Third Sector  Clinicians and staff from a number of local health and social care organisations. The purpose of the event was to share ideas on care closer to home and listen to stakeholders’ ideas and suggestions for the local area. We asked:  People to tell us a story about a time when care was at its best  How people would like Care Closer to Home to be in the Upper Calder Valley  People to tell us what the preferred future looks like.

Case study: Care Closer to Home; Common themes  Services closer to home, delivered by the right staff in the right setting.  Transport networks including parking.  Supported self-care and prevention.  All sectors want to play a key role in developing and delivering services.  Staff want to work holistically and seamlessly together.  Participants wanted to see a single point of access.  Stakeholders want to continue being involved.  Good communication and information throughout the system.  The model to reflect the diverse population: ‘one size does not fit all’. What did we do? Using the findings to develop a model and specification for Care Closer to Home for the Upper Calder Valley.

Calderdale, Greater Huddersfield and North Kirklees CCGs wanted to improve and develop wheelchair services provided to their populations.  Engagement took place on wheelchair services in December  Service specifications were developed from the views collected from the engagement process.  The specification was then shared with service users and carers for further comments. This led to a procurement process. What did we do: We asked those people who had participated in the engagement and development of the specification to be part of the procurement process. Two service users were recruited as lay representatives as part of the team that would evaluate the potential providers of local wheelchair services. Case study: Wheelchair services procurement

What did the lay representatives help us do: The lay representatives worked with managers to evaluate the following criteria from the bidders:  Service Delivery;  Service Quality and Patient Experience; and  Performance Monitoring. The lay representatives were also involved in the Evaluation and Consensus meeting which was instrumental in choosing the successful bidder. This was agreed by the CCG’s Governing Body. What was the outcome: The procurement led to Opcare being selected as the preferred provider of Wheelchair Services. In addition Opcare are establishing a Wheelchair Service User Group and continue to involve service users and carers.

We’ve engaged Calderdale Health Forum members over the past year on a number of service areas and strategies, such as Care Closer to Home, including single point of access, and the future NHS implications of the Five Year Forward View and supported self-care: Supported self-care What we asked: 30 forum members were asked to give their views on supported self-care at one of the regular forum meetings. Members discussed the following questions:  Who can support people to self-care?  What can the CCG do to support people to self-care? Calderdale Health Forum

What they told us that we needed to consider:  Consistent care and support across Calderdale.  Support and training for family and carers  Building on what is already there.  Forums of support for self-care.  Up to date and accessible information about what is available and contact details.  The individual support we give at different levels and at different times. What we did:  We used the information provided to further develop and inform our plans for Care Closer to Home. Calderdale Health Forum

Engagement Projects planned for 2015 – 16 now underway:  Primary Care Strategy  Right Time, Right Care, Right Place – hospital services transformation  Care Closer to Home  Ophthalmology  Autistic spectrum condition (ASC)  Maternity and Paediatric services If you would like more information on how to get involved, please visit the ‘Get Involved’ section at

Any questions?